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Permit • A 4 CITY OF TIGARD MASTER PERMIT PERMIT #: MST2000 -00067 -- 1 DEVELOPMENT SERVICES DATE ISSUED: 03/20/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 0911 Z1 SITE ADDRESS: 11815 SW WILDWOOD ST IGINIAl. PARCEL: 2S110BA -05300 SUBDIVISION: SHADOW HILLS ZONING: R -2 BLOCK: LOT: 012 - JURISDICTION: TIG REMARKS: Remodel master bedroom from 2 small bedrooms, reconfigure bathroom and add 225 sq ft new second story deck. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 15,000.00 OCCUPANCY GRP: R3 BDRM: BATH: 1 TOTAL: sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: - TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: • FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS: 1 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: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: > 600 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: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: _ _ TOTAL FEES: $ 459.99 SIBLEY, BARBARA D OWNER This permit is subject to the regulations contained in SIBL Tigard Municipal Code, State of OR. Specialty Codes and 11815 BARBARA WILDWOOD D ST 1181 OR DW all other applicable laws. All work will be done in 5 SW accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rea #: forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. . REQUIRED INSPECTIONS Underfloor insulation Electrical Rough In Electrical Final • PLM /Underfloor Framing lnsp Mechanical Final Mechanical Insp Gas Line lnsp Plumb Final Plumb Top Out Gas Fireplace Final inspection Electrical Service Insulation Insp Building Final Issued B 1 Permittee Signature : e I � ' II Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day CITY " TIGARD Residential Building Permit Application Plan Check # 3 10 13125 SW HALL BLVD. Additions or Alterations Rec'd By Date Rec'd 3 .... 00 TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. - 7 -00 V 503 - 639 -4171 II ' Date to DST 3 1 3 - 0 0 F 503 - 684 -7297 1 / rmit # �lr 7 Print or Type C Iled i7 od - Incomplete or illegible applications will not be accepte A 0 •g.' li, Name of Project Name Job SfP ven '.'y-5 Architect Mailing Address Address Site Address 9 7zzi/ r 7 c /0 5LD Ern? Wood 0/.5- SW W /LOWOOD ST T /6ARAo City/State _ _ / n Zip Phone Name Name T 13 Al f o % �f 2Z 3 2,V6 ��F3/e,9 Si C3G E y �J Owner Mailing Address // 8/5 SLJ W/L.OWo°b ST Mailing Address City /State Zip Phone Engineer T /GARS 9 "IVY City /State Zip Phone General Name • Contractor 7 Describe work New 0 Addition Alteration, . Repair 0 Mailing Address to be done: Prior to permit Additional Description of Work: 5 ,,.0" .bearee''''s , Re.ce •-rly°st issuance, a copy City /State Zip Phone Rew...bd.e(: Mu.,Teer ;re... Z b,T>^ ,-) Jerk- of all licenses G ° i- are required if Oregon Const. Cont. Board Exp. Date PROJECT t� expired in COT Lic.# VALUATION $ /.5 660 -- database _ _ Mechanical Name NEW CONSTRUCTION ONLY'. Sub- T/30 .Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address Indicate the restricted energy installation by the electrical Prior to permit issuance, a copy City /State Zip Phone subcontractor in the following areas of all licenses Restricted Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms expired in COT Lic.# Installations Vacuum Irrigation database System System Plumbing Name (check all that Other: Sub- T D apply) Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO (check one) (check one) Has the Subdivision Plat recorded? N/A YES NO Prior to permit City /State Zip Phone . issuance, a copy — ------ of all licenses are Oregon Const. Cont. Board Exp. Date ', required if Lic # expired in COT / I`h arby acknowledge that I have read this application, that the i database Plumbing Lic. # Exp. Date information given is correct, that I am the owner or authorized agent' ; / of the owner, and that plans submitted are in compliance with \ Oregon State laws. Name i Signature of Owner /Agent - Date ' Co ) Electrical 7-E D % .- _ ,a,, . k _ � . ��� 2 Z �ontact Person Name Phone # H °.y.E Mailing g Address \ l cr6er r0. 56I,, w14t635- -1 603 i /g/V Contractor (1)G Soinr sor wK 63c-1-01 0 ■ City /State Zip Phone �e - t( 3 -4 - I- __ , Prior to permit issuance, a copy FOR OFFICE USE ONLY: of all licenses are Oregon Const. Cont. Board Exp. Date required if Lic.# Plat #: , /� 4 &e, Ij0�2 d _65 Q expired in COT oN I 7 �U'r! database Electrical Lic. # Exp. Date Setba . ks: Z Solar: Electrical Supervisor Lic. # Exp. Date Engiwring Approval: Planning Approval: TIF: y/ -- / / O. 66 Q i:\dsts \forms\sfaddalt.doc 9/8/99 Permit #: H vT 4P40O -' 0 F / .\ Address: /1 ` / 560 4)4 p Goo01 5p - : t� . ; > �•�_, 11 o ' .. 4 .7.0.: ! LMfir :IZ -" ' Issued by: � Date: 3 .2 a - I: g9 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 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. ri A 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 0. roe 3B. 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 information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ?fatlitIf■ta) ,...dadeejf / /&V (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) ]Info ration Notice to Property Owners Abut Construction Respo �sib6Dft s Note: This Information 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. EMPL*YER RESPONSDl OLlTDI S 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 comply with the following: Oregon's withholding tax flaw: 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' Compensation Division 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 RfESPONSD TES AND AREAS OF COI(lCEItiN: 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 owri general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate nines so they tan perform the required inspections. - If you have'additional questions, write or call the Constructidn CantracteSrs 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 • r''`''ITY'OF TIGARD.BUILDING INSPECTION DIVISION ttOv_Gv. i , r - 244tiour Inspection Line: 639 -4175 • Business Line: 63 . p 639-4171 / SI , BUP Date Requested ! --.1 A , �`� PM BLD Location 1/ 1 h 5 ' Wl / w 14/ s f ' Suite MEC Contact Person jil/Y7 Ph ,54/ - G 2 ZL PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam - Ext Sheath /Shear Int Sheath /Shear Framing - Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ — _ _ Final PASS PART FAIL - Post & Beam Under Slab - . Top Out 54.,.�.- Water Servi ��' Sanitary Sew Rain Drains F PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final , PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage . Fire Alarm Final PASS 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 _ Approach /Sidewalk Date 9/) a I n spect or \ " v`' C / Other EXt�1 Final ~ - ' ' _ PASS P r , FAIL DO NOT REMOVE this inspection record from the job site.. - CITY OF TIGARD BUILDING INSPECTION DIVISION /Z MST AU'UUU�o 24- Hour,h speetion Line: 639 -4175 Business Line: 639 -4171 ■ • BUP - Date Requested "7 3 AM PM BLD Location /J8 5 $ - t"/ Suite • MEC - Contact Person - Ph .54/ — b Z Z PLM - Contractor l/ PP / h L SWR BUILDING Tenant/Owner P/1G� C4, (rZ /w aAI,Gw(, ELC Retaining Wall - 7"— / L- ELR • Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: • Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ Final • PASS PART FAIL _ CPLUMBIJ Post & Beam Under Slab • Top Out Water Service • Sanitary Sewer _ Rain Drains ART FAIL NICAL Post & Beam - Rough In Gas Line • - Smoke Dampers — Final ' PASS PART FAIL • Service • Rough In - - UG /Slab • Low Voltage Fire Alarm • . • . Ina PART FAIL BackfilUGrading 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 r inspection RE: V Unable to inspect - no access ADA Approach /Sidewalk Date 3 l3 Inspector o Other Ext Final PASS PART • FAIL • DO NOT REMOVE this inspection record from the job site ' CITY OF TIGARD BUILDING INSPECTION DIVISION MST WOO doo -- 7: 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested g --- oZ9 AM PM BLD Location I) q / 8 604:1-06,(/0-,¢," Suite MEC Contact Person MA .c.;-6-(2-01. Ph 3 i - O. - 2 - ( PLM Contractor Ph SWR BUILDING Tenant/ ELC Retaining Wall ELR Footing Access: - Foundation FPS Ftg Drain Crawl Drain Inspection Notes: S Slab v2° i SIT Post & Beam Ext Sheath /Shear i ())12 men Sheath /Shear r �? Framing . Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: - C/0 Fi -_ — PART FAIL C7 - P iC) LUMBING Post Beam _ Under Slab Top Out • Water Service • Sanitary Sewer Rain Drains • Final PASS PART FAIL MECHANICAL Post & Beam - Rough In - Gas Line Sn•.e P ampers P • PART FAIL • ELECTRICAL Service Rough In UG /Slab • Low Voltage Fire Alarm Final - PASS 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 Approach /Sidewalk Date 8 - 9 — " / Inspector - EXt Other P Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • CITY OF TIGARD BUILDING INSPECTION DIVISION M Gov -004167 24 -Hour Inspection Line: 639 -4175 .Business Line: 639 -4171 ' • BUP -- Z--00 D 6' 3 ' / O Date Regquested AM PM BLD Location l 1 0 / 5 / a///406V Suite MEC Contact Person 41 Ph 3 I ( D z 7 -r° PLM Contractor Ph SWR 41UILDINO Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain • Crawl Drain Inspection Notes: QQ , / SGN Slab 2 "util rJ SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear, Framing ul�io Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Fina A PART FAIL BING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 Approach /Sidewalk Other Date 7-12. - U Inspector Ext Final • PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST woo-0°6607 24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171 BUP Date Requested 5 3 00 AM PM BLD Location ( I / S k)/) L Suite MEC Contact Person la / / IL Ph (Q q `7 '" 1(.Q qd p PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall E LR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _ Final ART FAIL PLUMB Post & -earn U lab op 0 Water Service • Sanitary Sewer Rain Drains Fi ff.ASW PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 Approach /Sidewalk V other Date S / 3) 6 Inspector �" U Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION I , sT.�D — GGG 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP • Date Requested ,,7 y�Q�/ AM BLD Location /1 f"J / zAJ 4 i/ u1cc /2 57 Suite MEC Contact Person Ph PLM Contractor Ph 3 Lf G 2-1 ,6 SWR BUILDING Tenant/Owner ELC • •ng Wall • ELR Footing Access: Foundation FPS Ftg Drain SGN • Crawl Drain Inspection Notes: Slab SIT Post & Beam ' Ext Sheath /Shear Int S ath /Shear rmin. InsuTation Drywall Nailing Firewall - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof _ - Misc: _ F• PAS PART FAIL BI NG Post & Beam - Under Slab Top Out - Water Service Sanitary Sewer - Rain Drains Final PASS PART FAIL • MECHANICAL Post & Beam - Rough In Gas Line Smoke Dampers Final P ASS PART FAIL Service - ough In Low Voltage Fire Alarm F'.- 1 - ART FAIL S Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspectiori 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 Approach /Sidewalk Date /� ?/ 2 Inspector 7 Ext Other Final PASS PART FAIL DO NOT- REMOVE this inspection re cord from the job site.