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Permit
, z, f pp! CITY OF TIGA MASTER PERMIT PERMIT #: MST2006 -00330 COMMUNITY DEVELOPMENT DATE ISSUED: 12/15/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 110BD - 00400 SITE ADDRESS: 11750 SW WILDWOOD ST ZONING: R - SUBDIVISION: SHADOW HILLS LOT: 002 JURISDICTION: TIG Project Description: Detached garage BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK. ADU HEIGHT: FIRST: sf BASEMENT sf LEFT: SMOKE DETECTORS. TYPE OF USE SF FLOOR LOAD: SECOND: sf GARAGE. SO sf FRONT. PARKING SPACES • TYPE OF CONST DWELLING UNITS: THIRD. sf RIGHT: VALUEA A OCCUPANCY GRP: BDRM: BATH: TOTAL: p sf REAR: PLUMBING SINKS. WATER CLOSETS. WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS. LAVATORIES. DISHWASHERS FLOOR DRAINS: SEWER LINES. SF RAIN DRAINS CATCH BASINS. TUB /SHOWERS: GARBAGE DISP WATER HEATERS: WATER LINES BCKFLW PREVNTR• GREASE TRAPS. OTHER FIXTURES. MECHANICAL FUEL TYPES FURN < 100K. BOIL/CMP < 3HP• VENT FANS. CLOTHES DRYER. FURN > =100K: UNIT HEATERS HOODS. OTHER UNITS: MAX INP• btu FLOOR FURNANCES• VENTS: WOODSTOVES• GAS OUTLETS ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 0 • 200 amp: 0 - 200 amp: W /SVC OR FDR• PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp. 201 • 400 amp: 1st W/O SVC /FDR. SIGN/OUT LIN LT. PER HOUR: LIMITED ENERGY 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR. SIGNAL/PANEL. IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601vamps•1000v. MINOR LABEL: . 1000+ amp/volt . PLAN REVIEW SECTION Reconnect only >=4 RES UNITS: SVC /FDR> =225 A.. > 600 V NOMINAL: CLS AREAISPC OCC. ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO. VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM. INTERCOM/PAGING: OUTDOOR LNDSC LT. BURGLAR ALARM OTH: BOILER: ' HVAC• LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER. CLOCK: INSTRUMENTATION. MEDICAL: OTHR: HVAC• DATA/TELE COMM' NURSE CALLS: TOTAL 0 SYSTEMS: This permit Is subject to the regulations contained in the Tigard Owner: Contractor: • Municipal Code, State of OR Specialty Codes and all other applicable BARRY CARLEY MT VIEW CONTRACTING laws All work will be done in accordance with approved plans This 11750 SW W ILDWOOD ST. 13350 SE BLUFF RD permit will expire if work is not started within 180 days of issuance, or TIGARD, OR 97224 SANDY, OR 97055 if the work is 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 - 001 -0010 through 952 -001 -0080 You may obtain copies of these rules or direct Phone: 503 620 - 2478 Contact #: PRI 503 310 - 4404 questions to OUNC by calling 503 246 6699 or 1 800 332 2344 FAX 503 - 668 - 6731 Reg #: LIC 155554 TOTAL FEES: $ 403.51 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 / " Issued•By : -- e ,A.,Le. , .�� ..x' Permittee Signature : za.,,, Call 503.639.4175 by 7:00 a.m. for an inspection that business day. • This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit ApplicatRECEIVED FOR OFFICE USE ONLY City of Tigard Received I '. 13125 SW Hall Blvd., Tigard, OR 97 C 1 h Review 1006 Date/B _ 15 • ' :. j + � t:o � '0O 330 Phone: 503.639.4171 Fax 503.598.1960 ` Date/B Other Permit: T t G A RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By Juns ® See Attached Checklist for Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method 1 Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El I - and 2 -family dwelling 0 Commercial/industrial Valuation: $ a I 0 00 ID Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors Job site address: 1 17.5 ©.sw u3. (S w r c ,, e 1 S .f- New dwelling area: square feet City /State/ZIP: . ( rc-cl j Q 9 . . BALI Garage /carport area: square feet Suite/bldg. /apt. no.: oject name: 8,- t N Cctf (e y Covered porch area: square feet Cross street /directions to job site: J Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. C O r. 5i-6't.c C 1r c x 5 C1 CI 10 / Valuation: $ Existing building area: square feet New building area: 5-0 ( square feet ❑ PROPERTY OWNER 0 TENANT Number of stories: Name: a'rr C A vc ley n Type of construction, Address: 1 ( t 0^ S :�J , \, J t I S (tit 0(4. �( 54 Occupancy groups: 1 City /State/ZIP: '. c,. -c- 0 C\ 7- 1, ,Y Existing: Phone: (541:-.5 ) ( ! ‘ CO - -' Fax: ( .: 675 -05 c/3 New: - ' _.. ❑ • APPLICANT - - ' ❑ CONTACT PERSON.. ., . NOTICE . - , • . Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR Business name: M "C , O t 't_ al C .:ter, j- BUILDING PERMIT FEES* Address: ( 33 70 5 L G/K I � (Please refer to fee schedule) 5 / A Structural plan review fee (or deposit): City /State/ZIP: S '& ACt 0 f4 v 1 5 r7 FLS plan review fee (if applicable): Phone: ( 5 '3 i YO y Fax: ( 5 c%3) b V �:J 3I CCB Iic.: 1 565 f) 9 r'rr.."''' Total fees due upon application: Amount received: \Authorized signature: This permit application expires if a permit is not obtained 1 � within 180 days after it has been accepted as complete. Print name: ' I S ?C. CAA Date. * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building \Pennits\BUP- RES- PennnApp doc 03/21 /06 440- 4613T(I1 /02/COM/WEB) Building Permit Application FOR ()rr1C1 USE oMN Cl of Ti and Received Permit No `J g Date/B . n . Ali rZktfi INI • q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateB . o , s„.1.1 Other Permit. Inspection Line: 503.639.4175 Date Ready/By: turfs 10 See Attached Checklist for T1 CA It l) Internet: www.tigard- or.gov Notified/Method Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ID Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: J f 7 5 Q Sw uut• 1,0 w c, ' 1 New dwelling area: square feet City /State/ZIP: , 1' c. J C) R. 93- ),Ati Garage /carport area: '_square feet Suite/bldg. /apt. no.: Project name: B°kC r, y Cct' (Q,v Covered porch area: square feet Cross street/directions to job site: ` Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map/parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. C. O ,n st c t� C I 1 tA.y‘ 0 ,- r-1-6, C ,,v, e 51A d p / Valuation: $ C17 Existing Existing building area. square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: 3 eve.Ni CiNC ley Type of construction: . Address: I I - d S,, W t (O wag) SA- Occupancy groups: City / State/ZIP: j' 4,-rcl U 9 10 Existing: 3 Phone: (5.o ) 6 f7 Pi f Fax: (5 0 3) 675 - 0,5 y3 New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the • Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City / State/ZIP: apply: Phone: ( ) I Fax: : ( ) . E -mail: CONTRACTOR Business name: PVT r Vt‘e- 1 C o ed .+" BUILDING PERMIT FEES* (Please refer to fee schedule) Address: 13 5 (J 5 j ��K Structural plan review fee (or deposit): City /State/ZIP: Sc�,Aay D LAN CA ' 0 55 Phone: ('rj•O3) 'S 10 r( YOY Fax: ($ v) 661 6 ,3! FLS plan review fee (if applicable): CCB lic.: SG 5 5 y �� Total fees due upon application: 1 � Amount received: Authorized signature: This permit application expires if a permit is not obtained (1 within 180 days after it has been accepted as complete. T Print name: v A s ?L C. Date: • Fee methodology set by Tri- County Building Industry Service Board. I\ Building \Permits\BUP- RES- PamitAppdoc 03 /21/06 440- 4613T(li /02/COM/WEB) y One- and Two - Family Dwelling ., Building Permit Application Checklist ,t 1-0R 011.1C1 l SE <)NIa City of Tigard Received Permit No.: 114 n 13125 SW Hall Blvd., Tigard, OR 97223 Dates • 0 Phone: 503.639.4171 Fax: 503.598.1960 Assoaated permits 24- Hour Inspection Line: 503.639.4175 ❑ Electncal 0 Plumbing ❑Mechanical I ` IGA Itl7 Internet: www.tigard- or.gov 0 Other - 1 - 11E FOLLOWING; I'T'EMS ARE REQUIRED FOR PLAN REVIEW W Ye No N/A I Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ • 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity _ ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. Q ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- 0 ❑ ❑ protection, etc. 10 _ 3 omplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ but ding codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 • Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ ' and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings . and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ • systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore on and shall be shown to be :..licable to the I o'ect under review. JUIRISI)IC I IONAL SPECIFICS 23�T to plans are required for Item 11 above. Site plans must be 8 -1/2" x II" or 11" x 17". • • • 2 ,, o sets each are requiredfor Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ! ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. ' Site plan to include tree protection measures as required by conditions of approval.. ❑ ❑ ❑ O A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions; ❑ 0 ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings .. 4. on a lot of record approved prior to September 9, 1995. . r : I:\ Buildmg\Permits\BUP- RES- PamttApp doc 0321/06 ;' 44 5 ao-6 c2- eo Plumbing Permit Application Building Fi xtures • FOR OFFICE liSE ONLY City of Tigard Received Y Permit Na: a 13125 SW Hall Blvd., Tigard, OR 97223 plan Review o • Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit No.: r I G n 1; I) Inspection Line: 503.639.4175 Date Ready/By Jam. 65 See Page 2 for Internet: www.tigard - or.gov Notified/Method Supplemental Information TYPE OF WORK - FEE* SCHEDULE ' ' ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 It for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION ,�� Site utilities Job site address: I l ?SO S I /. L L , ' Catch basin or area drain 16.60 City /State/ZIP: '09 S ,N 57221 Drywell, leach line, or trench drain 16.60 /�� f .-/y drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: /3 i Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve ' 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 • f..Q r/`-7j %/4)Gr Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: -� C2 (f Expansion tank 16.60 Address: / / /� li ' (�, /; j � Fixture /sewer cap 16.60 City / State/ZIP: /; 4 .17Z ?? W/! Floor drain/floor sink /hub 16.60 Phone: ( Spy) G2_0_ I Fax ( ) . SYJ 2 Garbage disposal 16.60 ❑ APPLICANT u CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60 Tub /shower/shower pan 16.60 E-mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: ho h , r gU /_ Water heater 16.60 Address: // o l am) f j G' uoa,( , Other: City/State/ZIP : � / !�� G��2! -9' Subtotal �� / / Minimum permit fee: $72.50 ( Phone: 0 ) Z Y �S Fax: (�3) G. ?.S =OS' 3 Residential backflow minimum permit fee: $36.25 CCB Lic.: r Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8 % permit fee) Authorized signature: TOTAL PERMIT FEE Print name: I Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. • I \ Building\Peimits\PLMF- PermitApp doc 04/06/06 4404616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard • Page 2:- Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: " Permit Fee: . Footing drain - 1 a 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 - 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service -1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fixture or Item . Qty. Fee (ea) Total additional $100.00 or fraction thereof to and • including $10,000.00. Commercial Back Flow Prevention Device 46.40 ' $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backfiow Prevention Device each additional $100.00 or fraction thereof; to (minimum permit fee $36.25) 27.55 and including $25;000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 , $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Plumbing,Installations Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ My new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: • Replace engineer. Previous Capped Added Existing ❑ Any new exterior plumbing site utilities. Baptistry/Font - ❑ Medical gas and vacuum systems for health care facilities. Bath - Tub /Shower ❑ Any multipurpose fire sprinkler system. , - Jacuzzi/Whirlpool ❑ Any complex structure as defined in OAR918 780 - 0040. Car Wash - Each Stall , • - Drive Thru Submit 2 sets of plans with any of the above: Cuspidor/Water Aspirator Dishwasher - Commercial ra t m • I or•Riser Diagram - Domestic g Drinking Fountain ❑ Isometric or riser diagram is required for.new buildings • Eye Wash • that meet the'qualifications above. Floor Drain /sink : 2" -3" -4 " Car Wash Drain Comments regarding fixture work: Garbage - Domestic " Disposal - Commercial " - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall - Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an • - Bradley increase of sewer'EDUs, a sewer permit will be issued and ' -Commercial fees assessed for the sewer increase must be paid before the - Service plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor • Water Closet - Toilet Urinal Other Fixtures: • i \Building\Perrnits\PLM- PermitApp doc 09/12/06 r . r r, �r Permit #: V\ ,1 OO(0'M330 *® Address: I V S� ) l .pu)Ol� �I 0 p1 `l� � n Issued 171g Date: Ill t5 J 0-(= o ®� 0_ %,\ 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 - in= the°appropriate blanks and initial boxes 1 and-2-,-and either box 3A or 3B: - :- - - . _ - 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale 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 3 13. I will be my own general contractor. 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 i' : 'emation is correct and that I have read and do understand the Information - Notice to Property Owners a I out Cons - uction Responsibilities on the reverse side of this for . • i' i..alligi (z as G 6 (Signat e of permit applic (Date) (White copy to iss ing agency permit file, pink co. to applicant) Information Notice to Property Owners • About Construction Respounsibiiities • Note.; This Information Notice to Property Owners about Construction Re,sponsibzlrties 1 " \was"developed by the Construction Contrac'tdrs Board `in accordance with ORS 79I.O55(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an ex structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered 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 be an employer and the people you hire will be employees. As the employer, you must complywith the following: Oregon's withholding tax law:' As an employer, you must withhold income taxes from employee wages at thetime 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 Department 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 ifoneofyour employees is injured on the job. For more information, call the Workers' Compensation Division at the Department ofCohsumer 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 RESPONSI'=ILITIESAND 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, f ire. 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 ofrough -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-ow n.pm4 1 /94 Dec.13. 2006 2:41PM CLEAN WATER SERVICES 503 6814439 No.6169 P. 1_ e lL, tic)/ cuud 15...:D 5036boo .2 1 rNes rum 171 L . t 3 I 11' \I DEC 0 S 2006 U , — B y — ` — ` CWS File Number OG- 00366'41 I CleanWat:r Services Our eommilmenl is clear. Sensitive Area Pre - Screening Slte Assessment Jurisdiction , //20 F T(4� S Date _ . / Tax Map & Tax Lot . / O _ Owner 1 , r , r V • -. - Applicant _us 1. ` Ai . 1.0. VIM, t Site Address 1 j` >Fompan ,, , . A • 4 n, _ Address 6 . ♦ C .. r ' � . Proposed Activity r ML " , • City State Zip ■ K I A S Phone - rte.�fi�T Ar_ Z/D�-�/ '" 1 Fax (aA _ le log-• 7) ... By submitting this form the Owner, or Owner's authorized agent or representative, acknowledges and agrees that employees of Clean Water Services have authority to enter the project site at all reasonable times for the purpose of inspecting project site conditions and gathering information related to the project site. Ottlelal IMO only below this line Metal use only below WO line official use only below nib line Y N NA \ Y N NA ❑ F M n Se sit ve re omposite Map S I nf structure maps Map 4.(il? CI I ' "1 [ a s y ❑ f L ocally adopted studies or maps Other specify , ❑ 0 Specify Based on a review of the above information and the requirements of Clean Water Services Design and Construction Standards Resolution and Order No. 044: ❑ Sensitive area potentially exist on site or within 200' of the, site. THE APPLICANT MUST PERFORM A SITE CERTIPICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER. If Sensitive Areas exist on the site or within 200 feet on adjacent properties, a Natural - Resources Assessment Report may also be required. IN Sensitive areas do not appear to exist on site or within 200' of the site. This pre - screening site assessment does NOT eliminate the need to evaluate and protect water quality sensitive areas if they are subsequently discovered. This document will serve as your Service Provider letter as required by Resolution and Order 04-9, Section 3.02.1. All required permits and approvals must be obtained and completed under applicable Iomal, state, and federal law. ❑ The proposed activity does not meet the definition or development NO SITE ASSESSMENT ORISERVICE PROVIDER LETTERS REQUIRED. Reviewer Comments: Reviewed By: Date: /4// /06' Post -Ite Fax Note 7671 Figg/ EMFM Official use only To _____ %M Returned to Applicant Co./Dept. r H co. Mail ` Fax A_ Counter _ Phone a Phone + 0 • • G8/ !t0 Dire /,1. _ �3' . t, Fax p 0 , / Fax # ' �� _ ■ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00330 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1512006 _ Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 2/13/2007 TIME: 7 :02AM PAGE: 42 • SITE ADDRESS: 11750 SW WLDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage OWNER: CARLEY, BARRY • PHONE #: 503-620-2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503- 310 -4404 Inspection Request Scheduled For: Date: 2113/2007 Pour Time: f; Code # Inspection Description Confirm # - Contact # Message 399 Plumbing final 0433055 -01 503- 310 -4404 N Corrections /Comments /Instructions: • • • • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS • FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED Inspector: �WI� Date: t 12" © Phone #: (503) t6y7 CITY OF TIGARD - - BUILDING DIVISION PE MIT # MST2006 00330 13125 SW Hall Blvd., Tigard, OR 97223 �w DATE °SUED: 12/15/2006 Phone: (503) 639 -4171 i • Inspection Requests (24 Hrs.): (503) 639 -4175 „ � L1 � ... INSPECTION WORKSHEET FOR DATE: 3/2/2007 TIME: 7:00APVI PAGE: 4 11 SITE ADDRESS: 11750 SW WILDWOOD ST CL SS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage f OWNER: CARLEY, BARRY PHONE #: 503- 6;20 2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 03-310-4404 Inspection Request Scheduled For: Date: 3/212007 Pour Time: Code # Inspection Description Confirm #' Contact # if Message • 299 Final inspection ' 044265 -01 503 -310 -4404 `y _ Corrections /Comments /Instructions: '5 412 Gb-1.4 ‘.-. -T t . . t 1 , - l • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ) ,M ./ Inspector: Date: —� v 7 Phone #: (503) 718- __ZI),Z CITY OF TIGARD r- . .BUILDING DIVISION PERMIT #: MST2000.00330 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1512005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7 :03AM PAGE: 30 SITE ADDRESS: 11750 SW WILDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: • 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage OWNER: CARLEY, BARRY PHONE #: 503 - 620 -2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #:. 503 310 - 4404 Inspection Request Scheduled For: Date: 1/11/20Q7 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 042002 -01 503. 310 -440. N Corrections /Comments / Instructions: • • • • 8 II ' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: CI_ /t/ Date: I 11 loq Phone #: (503) 718 - Zh yy • CITY OF TIGARD + BUILDING DIVISION PERMIT #: MST2006 -00330 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/15/2006 • A ' Phone: (503) 639 -4171 1 • Inspection Requests (24 Hrs.): (503) 639 -4175 `'I I.. , INSPECTION WORKSHEET FOR DATE: 2/28/2007 TIME: 7 :02AM PAGE: •13 • SITE ADDRESS: 11750 SW WILDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 ' TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage ' OWNER: CARLEY, BARRY / PHONE #: 503 - 620.2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503 Inspection Request Scheduled For: Date: 2/W2007 /2007 Pour Time: Code # Inspection Description Confirm # ' Contact # ' Message 299 Final inspection 044093 -01 503 - 310 -4404 N Corrections /Comments/ Instructions: ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL CCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 2 — 2.- -d 7 Phone #: (503) 718- — Z4 -4- ----- • I CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00330 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/15/2006 I Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ' L INSPECTION WORKSHEET FOR DATE: 2/20/2007 TIME: 7 :09AM PAGE: 81 . SITE ADDRESS: 11750 SW WILDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: . PROJECT NAME: CARLEY DESCRIPTION: Detached garage OWNER: CARLEY, BARRY PHONE #: 503 - 6202478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503 310 - 4404 Inspection Request Scheduled For: Date: 2/20/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 239 Final inspection 043557 -01 503 - 310.4404 N Corrections /Comments /Instructions: " • • I 1 • • [I] PASS E] PARTIAL APPROVAL ' ' , ❑ CANCEL /NO I ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i i Inspector: ' Date: � —O Phone #: (503) 718- 24i 11 1 CITY OF TIGARD . BUILDING DIVISION F PERMIT #: MST2006-00330 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/15/2006 Phone: (503) 639 -4171 1 mc�ga� I � l Inspection Requests (24 Hrs.): (503) 639 -4175 ' ^_ .. . INSPECTION WORKSHEET FOR DATE: 1/8/2007 . TIME: 7 :00AM PAGE: 12 SITE ADDRESS: CLASS OF WORK: 11750 SW WILDWOOQ ST SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage OWNER: CARLEY, BARRY PHONE #: 503 - 620 - 2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503.310 - 4404 Inspection Request Scheduled For: Date: 1/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 041897 -02 503-310-4404 N Corrections /Comments /Instructions: - - - - 4 4 ' r 1 S oV - -t ri' - ,/ 47 _. - , 4,7 -III ..- ._ .,141lio. ) I Z- . 2 fl P7,r. =� O " pr DO Ll� 4-' .. az- _ = " o&! 1 ©1 dF • rg0 v S of -r, Rik) s . • 4 dot .IgLI / ltrd • • I I L PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS l ikrAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . Inspector: Giii- ' Date: 18/ 7 Phone #: (503) 718- 2-61(g CITY OF TIGARD BUILDING DIVISION PERMIT #: MMsT200E-00330 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/15/2006 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 W "- INSPECTION WORKSHEET FOR DATE: 1/8/2007 TIME: 7;00A1y1 PAGE: 13 SITE ADDRESS: 11750 SW WILDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY DESCRIPTION: Detached garage OWNER: CARLEY, BARRY PHONE #: 503- 620 -2478 • CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503-310-4404 Inspection Request Scheduled For: Date: 1/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 041897 -01 503310 -4404 N Corrections /Comments /Instructions: • • • Fj. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: eith f Date: J A 7 Phone #: (503) 718- zC( CITY OF TIGARD r.• -_ BUILDING DIVISION PERMIT #: IvIST2006.00330 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/15/2006 Phone: (503) 639 -4171 tea' $ICI Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12/22/2006 TIME: 7:00AM PAGE: 8 SITE ADDRESS: 11750 SW WI LDWOOD ST CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 002 TYPE OF USE: PROJECT NAME: CARLEY . DESCRIPTION: Detached garage OWNER: CARLEY, BARRY PHONE #: 503 - 620-2478 CONTRACTOR: MT VIEW CONTRACTING PHONE #: 503 - 310 Inspection Request Scheduled For: Date: 12/22/2006 Pour Time: 9 :00 Code # Inspection Description Confirm # Contact # Message 205 Footing 041482 -01 50- 3104404 N Corrections /Comments /Instructions: 0:1 A 11/P (9 Fe4D-- i(C4V tee'_/ Alpy gr. • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • C ' LL FOR INSPE TION ❑ ADDITIO AL F ES ASSESSED Inspector: 401 Date: Phone #: (503) 718 -21*