Permit CITY OF TIGARD MASTER PERMIT
/ DEVELOPMENT SERVICES PERMIT # : MST98 -0017
l- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/0/98
PARCEL: 29105DD -01700
SITE ADDRESS...:14775 SW SUNRISE LN
SUBDIVISION ZONING: R -7
BLOCK LOT • JURISDICTION: URB
Remarks: Kitchen addition PATH I 494 5Q FT
BUILDING
REISSUE: STORIES • 1 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS -- REQUIRED
CLASS OF WORK.:ADD HEIGHT • 12 FIRST • 494 sf GARAGE • 0 sf LEFT • 57 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD : 40 SECOND...: 0 sf FRONT • 0 PARKIN SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT • 69
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL : 494 sf VALUE..$: 26439 REAR • 99
PLUMBING
SINKS • 1 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAIN: 1 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 1 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN (100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS : 0 CLOTHES DRYERS: 0
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
ELECTRICAL
— RESIDENTIAL UNIT— -- SERVICE /FEEDER— —TEMP SRVC /FEEDERS — — BRANCH CIRCUITS— -- MISCELLANEOUS— — ADD'L INSPECTIONS -
1'.s'. SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 1 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 688 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HM /SVC /FDR: 0 681 - 1'•'.' amp.: 0 601 +amps- 1'' v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR)=225 A.: ) V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: .. BOILER • HVAC • LANDSCAPE /IRRI6: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: ::
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL # SYSTEMS: 8
Owner: Contractor: — TOTAL FEES:$ 407.01
STEVEN NELSON OWNER This permit is subject to the regulations contained in the
14775 SW SUNRISE LN Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97224 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone #: 579 -5087 Phone #: not started within 1 :' days of issuance, or if the work is
Reg #..: suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-801-0010 through OAR 952-081 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
RE(H)IRED INSPECTIONS
Erosion Control Electrical Rough Insulation Insp Building Final
Footing Insp Framing Insp Gyp Board Insp
Foundation Insp Low Voltage Rain drain Insp
Plumb Top Out Gas Line Insp Electrical Final
Electrical Servi 0 Gas Fireplace Plumb Final
Issued By: • Permittee Signature:
++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + +++ + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
•
r4 Plan Check #/ _' % p
CITY OF TIGARD Residential Building Permit Application Rec'd By C- 0
13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd - ,, '►
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 1 'Z 7 3 - 1 ,
V 503 - 639 -4171 Date to DST '
F 503 -684 -7297 Permit # MIS - 1
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Project nn Name
l�`
Job - VG l � rt
/ 001 cr t;71■1 Ilk D K 1.1 t ( O '?rta7Vt Vey /G,'J..c
Address Site Address Architect Mailing Addres
Name ,, / City /State Zip Phone
S'�VfA G. / v i4t4 Name l,Rrp OK -19 al-1 �7 0
Owner Mailing Address Name
tieZ75-- `( SW TR4 € LAi Engineer Mailing Address
C t O OR , ZV Phone - 431:9 -� g
/ � � - / City /State Zip Phone
General Name S7 y So Q 7
Contractor gY t Describe work New 0 Addition Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit Additional Description of Work:
issuance, a copy City /State Zip Phone /IWO E345efrie 7r - S''4 -t/ts„
of all licenses PROJECT OZ 6' / 3
are required if Oregon Const. Cont. Board Exp. Date
expired in COT Lic.# VALUATION
database
Mechanical -Name NEW CONSTRUCTION ONLY:
Sub-
/o f Sq. Ft. Hou // Sq. Ft. Garage
Contractor Mailing Addr- s 7 / y
Prior to permit Corner Lot IYES NO Flag Lot YES NO
issuance, a copy City /State is Phone (check one) (check one)
of all licenses Restricted Audio /Stereo Burglar
are required if Oreg eConst. Cont. Board w - 'ate Energy System Alarm in expdataba eOT Installation Garage Door HVAC
Plumbing Name W r Opener - Systems
Sub- (check all that Other:
Contractor Mailing Address apply) ,
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
sf. Prior to permit City /State
issuance, a copy Zip Phone Has the Subdivision Plat recorded? N/A YES NO
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# Reissue of MST #: Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
Name ��� agent of the owner, and that plans submitted are in compliance
�, with Orego State laws.
Electrical Sigictf of Or/ gent . Date
Sub- Mailing Address
Contractor Contact Person Name Phone #
City /State Zip Phone
' Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat #: &Of - 'A �� ` Map/TL #:
of all licenses are Oregon Const. Cont. Board Exp. Date 1 `/5) - ' G L 'Q. - 1 60J) - l70
required if Lic.#
expired in COT �t Ck - f 1 Zont; • _ Solpi
database Electrical Lic. # Exp. Date 1
Engin ring Approval: Planp9 I,
Approval: TIF: `
I:SFREM.DOC (DST) 4/97
f
n
Permit #: I n r ISTq CC — 00 ( 7
O F
: ��, Address: (�� v'
C OW lit r l 5-2 L
�=...•' Issued by:6 MAILUVIAA-A. Date:
1 g
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill 'n the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
O P 1. I own, reside in, or will reside in the completed structure.
0 01 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
ag Aid
before or upon completion.
❑ 3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
IC 3B. I will be my own general contractor.
f
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Prop y Owners bout Construction Responsibilities on the reverse side of this form.
CT /7/6 h
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
Note: This Inj rmation Notice to Property Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not _registcted with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled to he an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax lay As an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091.
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources
at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation Insurance for your employees. If you fail to obtain workers' compensation insurance, you may
be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information,
call the Workers' Ccmpensa_i0 Dn ision at the Department of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1- 800 - 829 -1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052,
503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop- own.pm4
1 /94
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST Qo' 1
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested c 5722 2 /OO AM PM BLD
Location ) ( 4 - 7 - 1S SLtin1C', Suite MEC
Contact Person Ph S) q'S D PLM
Contractor Ph SW, 29 SWR
iiLDIN Tenant/Owner ELC
Refining Wall ELR
Footing Access:
Foundation 2 FPS
Ftg Drain /v / — / � 41// SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear Framing •- — ' vi LS� i..��;� �► = 1 _ -
Insulation
Drywall Nailing C3
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
cafz PART FAIL
LUMBIN
PosT&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
- PART FAIL
Po =
(Rough In
Gas Line
Smoke Dampers
4 . P : T FAIL -
LECTRIC
Service
Rough In
UG /Slab
Low Voltage
�larm
S ` PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ . ] Unable to inspect - no access
ADA ��
O t he oach /Sidewalk
Date a / 6 / O Inspector / d PIA E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.