InitiallyGood ADDRESS:
i\records\microFlm\targets\building.doc
�l�.�P��lon Noxrc�g
City of Tigard Building repurtment ( 1(r
13125 an Ball Blued. Tiger:', Oregon 47213
Inspection Line (Aec--O-Phone)t 639-+175 Business Phor.e: 639-4171
Inspections__ [ V � ( C`•+_/� G�� �_�-- __
Footing Plbg. Underelao Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINALc
Post/Beam Strut-t, Ban. Sewer Framing Bldg.
Post/Beam Neck. Rain Drain Insulation
PI-bg. Underfloor Ratef Line /� Gyp. Rd.
Date Requested._ ' Z' ?O /a`�'► Time: ANPN
/ > > , o
Addresss—��.t'�S A I �l L L Permit is
I S 6 /(
Builders_
TRE FOLLONINGa CORRECTIONS ARR MWIREDr r �7
�l '
Ineps dors —_ -- Dates ' 21/ h C-f
AP NBD DISAPPROVED APPROVED StTRJECT TO ABOVL
�j C Call For Re.lnnp.
INSgPCIION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Orego:: 97223
Inspection Line (Rec-U-Phonon„: 639-4175 Busln?en Phonn: 539-4; 11
Inspection: c ' n =
Footing Ptbg. Underslab Mach. Rough-in Appr/8•iwlk
Pound. Dlbg. Top Ont Gas Line INAL h
Post;llean Struct. stn. Sewer. Framing ldq• ` �-f�,
Poet/beam Mach. Rain Drain Insulation -Plumb.
Plbg. UnderfJoor Nater Line I/Gyp. ed. h
Date Requested: Z�� _Timat AM pK
Address:
OPermit ft��/ �L
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: -- _ Date
--APPROVED IMAPPROVED APPROVED SfJWRcT TO ASM
e—, ---
Call For Reinnp.
INSPECTION NOTICE
CltV of Tigard Nulldtnq Department.
131-2S BW Ball Blvd. Tigard, Oregon 772^.3
Innpection Line (Roc-O-Phone)s 0,39-4175 Business Phone: 639-4171
Inspect.iun^
Footing Ping. Underelab Hach. Rough-ine Appr/Sdwlk
Found. Plbq. Top Out Cas Line jiM jyp
Post/Beam 3truct. Sart. Sourer Framing Al
Post/Beam Mach. Rain DraitI 1 I:isulation .ply,
PlbV Underfloor Mater Line pyp, 8d• _Meoh. \
Date Requested: 7- a -C11�_ _Time: AN
Address:
Builder: a� /,� �n /1 —A ',•,�v(�k
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�l
.",,LA_ cam. w1�_
cj
V_v%A, - c�- h�
2
Inepectorr_ L"_4(- y
APPROVFD `Y DISAPPROVED -- APPROVRD SUBJECT TO AgM
V Cal l For Reinsp.
1
INS Ka LOA RT-1cI
City of Tigard Building Department
13125 SN Nall Blvd. Tigard, Oregon 97223
Inspection Lire (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspectl.on:__
Foot 1.rig Plbg. Underalab Merh. Rough-in Appr/Bdwlk
Found. Plbg,. Top Out Gas Line P?M11L
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain insulation -Plumb.
P.lbg. Underfloor yy Water Line Gyp. Bd. -Meoh.
Date Requestedr 17
/-7 L Timet A�M
Address: T�(�\ " I1 Perm-it it
Builder:_�7
THE FOLLOWING CORRECTIONS ARE REQUIREUr
Inspector.: f� �` �— --- Date: /
APPROVED DISAPPROVED APPROVRD SUBJECT TO ABOVE
—Call Fnr Reinsp.
_� I
INSPECTION NOTICE
City of Tigard Buildiny Dept.-tment
13125 Sq Ball Blvd. Tigard, Oregon 97223
Inaractton Line (Rec-O-Phone): 639-4175 Businesa Phone: 63c,-4171
l.rspection.- ___
Fo..ting 1bg. Cnderelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Post/beam Struct. San. Sewer. Framing -Bldg.
Poet/Beam Meeh. Rain Drain Insulation -Plumb.
Plbq. Underrloor Watery Lino Gyp. Bd. -Me ch.
Data Requestedt__ //—7 _Time+: _ PH
a. �oa� ` /_ RLI Permit 4V
.)LI.OWINr, CORkECTIONS ARE REQUIRED:
Inspectors-
Date: t{
AP��WOVSD DISAPPROVED _Z �PPROVRD SUBJECT TO ABOVR
__—Call For Reinep.
��P=CTION KOTICE
City c.f Tigard Building Department
13125 BO Ball. Jlvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
lootin7 Plbg. Underelab Mach. ftugh-in Appr/Sdwlk
Found. Plbg. Top Out Cas Lina FINAL:
Post/Beam Struct. San. Sewer Fr:ueing -9ldg
Post/Beam Mach. Rain Drain Insulation -Plumb.
Pll:y. Underfloor Vater Lina GYP. ed. -Mach.
Dite Requasted: a Timet AN PM
Address:._G o Permit 1:
Buildor:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_----► ---- Deter_
APPROVED DISAPPROVED APPRovan SUBJECT To ABM
Call For :Reinnp.
INSPECTTCN NOTICE
city of Tigard Building Dc �artwnnt
13125 SW Ball Blvd. Tigard, 0-egon 97223
Inspection Line (Rec-,O••Phcne): 639-4175 Business Phone: 639--4171
Inspections - -- —--- --
Footing Plbg. Underulah Hech. Rough-in Appr/Sdwlk
Found. Plbg. Top 'wut Gas Llne FINALS
r—•
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain � -Plumb.
Plbg. Underfloor Nater Line ;yp. Bd. -Hoch.
Date Rncpiearte,.is ( Times AAM PM
Address: I�U �S �� c��W� _ Permit `tM'T /2_-0�
Pullder: uq - /S1 (�
TEE FOLLOVII40 CORRECTIONS ARE REQUIREDs
Inapector �. _�� Date:
_APPROVED DISAPPROVED APPROVED SUBJECT TO AFOVR
Call For Reinep.
N�. SPECTION NOTICE
city of Tigard Building Departaent
' 125 SW Ball Blvd_ Tigard, -regon 97223
Innpec+' . :.ine (Rrac-O-?hone: 634-4175 Business Phone: 639-4171
]nepectior,:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out. Gas Line FINALS
Poet/Beam Struct. San. Sewer (^ ng -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. 6d. -=Nech.
(J - � - ,�
Dale Reguestod: Time: AN PN
Address, i1
Builders
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
cz
01
ti
r
Inspector: Date: - L
r — _
___APPROVED �OIBAPPROVED APPRO--AD SUBJECT TO ABOV!
Call For Reinep.
ION NOTICE
City of Tigard Nuildinq Department
13725 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 634-4175 Business Phone: 634-4171
Inspection:_
Footing Plbg. Underalab Mech. Rough-in Aopr/Sdw.lk
Foand. Plbg. Top Out Gan Line FINAT -
Post/Beam etru`i•.t.�� San. .Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain insulation .Plumb.
Plbg. Underfloor Nater Lina Gyp. Bd. -Mech.
Date Requested: Timet =AM rPH
Addresses
Bul.lder:
TRX FOLLOWING COAARCTIONS APE REQUIRED:
Inspector
Ow
/ --- ` —..
APPROVED DISAPPROVED APPROVP.D SUBJECT TO ABOVE
__Call For Rainap.
IMSP_F,_CfIQ NOTIrA C'
City of Tigard Ihoildi g Department
13125 SN Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspections
footing J) Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp Bd. -Mech.
Date Requeated:_ — TiM& { PM
Address: 67 a5��
Builder& L) 7 7'7 /
THB FOLLOWING CORRECTIONS APE REQUIRED:
OQ
r
Inspect ?, 9Z
oc: .���- nate&_"- ✓
e "rW DD _ DISAPPROVED APPROVED SUBJECT TO AB(W?
Call For Reinsp.
CITY"OFTIOARD
CIIYOFTWARD
MASTER ER FERMI r- �- T
0
COMMUi49TY DEVELOPMENT DEPARTMENT 06�0 / P RMI I #. . . . . . . : M5'19c'-161411
L13125 SW Hall 13W. P.O.&w 23397,Tigard.OnVon 97223(1b03)63441 75 �
-- —J DATE ISSUED: 07/ES/92
C I TE ADDREGS. . . : 0660" SW ALFRED GT PARCEL- 19125DA-1�ri��r'.
SUBDIVISICIN. . . . : KINGS VIEW ZONING: R-4. 5
BLOCK. . . . . . . . . . . LCT. . . . . . . . . . . . . . 4
BUILDING --------------------------------------
RL
------_-__________-.______________.-.RL I S5UE: DWELA. I NG UNITS:0 BASFMF N'r. . . . . . . . :1b 131,
CLASS OF WLlRK. :A1)1) BEDRMS t 1 BATHS: 1 GARAGE. . . . . . . . . . :0 s F
TYPE OF USE. . . t SF FLOOR AREAS- REQUIRED
TYPE OF' CONST. :5N F1 REST. . . . :408 s;f LEFT. . : 1 1 ft R I GHT. :0 f t
OCCUPANCY GRP. :R3 SECOND. . . :0 s f FRONT. :e, ft REAR. . :,-0 1•t
STORIE . . . . . . . : 1 THIRD. . . . :0 sf REQUIRED-----_____._______
HE I GH1 . . . . . . . . .. 11. f r TQTA".-_.- ..----:4.08 S•F ]MOKE DETECTORS. :Y
F'!UOR LOAD. . . 14O psf VALUE. . . . . $: 18768 PARKING SPACES. . :0
Remarks: ADD 41213 SCJ FT TO EXISTING HOUSE_
------ PLUMBING
SINKS. . . . . . . . . . ..0 FLOOR DRAINS, . . . :0 BACKFLOW PREVINITRS. . ' 0
LAVATORIES. . . . . 41 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUE/S)HOWERS. . . . : 1. LAI)NDR'Y TRAYS. . . :0 CATCH BASINS. . . . . . 0
WATER CLOSETS. . : 1 SEWER LINE (ft) . s 0 GREASE: TRAPS. . . . . . . :0
DTSHWA5HERS. . . . .0 WATER LINE (ft ) . :0 OTHER FIXTURES. . . . . .0
GORBAC-3E DISP. . . :0 RAIN DRAIN (ft ) . tO
WNSH T NG MAOI-1. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL .______ ____..__.___ ______.__________-- FEES
r-1-0- TYr-'ES•_.____._..__.__..___ UNIT HTRS. :0 type amol.tr,t by date r or.pt
VENTS . . . . . 30 APRT $ 134. 50 BCR 07/28/92 -
MAX INPUT.0 BTU VENT FANS. . : 1 Br'LC $ 87. 43 JI_.H 07/15/92 952
FURN ( 100K _-0:0 HOODS. . . . . . :0 BSDC $ 6. 73 BCR 07/28/92 -
FURN ) =100K . . :Ir WOODfiI OVE 1. :16 MpHT t i?,5. V)0 BCR Q17/28/92 -
FLOOR FURN. . . . :0 CLO DRYERS. : 1 MPLC $ 6. E5 PCR 07/ 'fl/92 -
11011_./CMF ( 31.1PCO OTHER UNI TS: 1 M5pc; $ 1.. 25 B G R 01/28/9c
GAS OUTLETStO PPRT $ 52. 50 ACR 07/cE8/92 -
Owner: -_______ ._-___--_._____.__.__.---.. _._______- P5PC $ P. 63 BCR 07/28/92
LARRY AND SUE: L0REN7EN
660.5 SW ALPPED ST
TI GARD OR 97223
r
thane 4t C4-� 941£1
Cont ract or.
OWNER
PI-rone #:
Reg *1.. . . 0000O
S 316. 29 TOTAL
This permit is issued subjoct to the regulations contained in the ------- REWUIRED INSPEC1101\15 --- --
T;;ard Municipal Code, State of Orr Spec-salty Codes ,rd all other Font/f oLtnd Insp Rain drain Insp
j applicable laws. All pev4 will be dent in accordance with aoproved Post/Beao. StrLtct Appr/Sclwl4( Insp
plans. This permit will expire if work is r,t started within 14 P1 M/Underfloor Mechanical Final
days of issuance. or if work is susperda for are than 188 nays, Mechanical 1 n s p R 1 t.tm b Final
Pllstab Top Or-rt BijAlding Final
f-'e> m! ttee Sigtna+tl_1re - fit' Framing Insp Eyesiorl t;nrrLrul
Iris!tlatirin Insp Crawl Drain
Iss1.(et B ryp Snarri Insp
Ca1l for inspectinn - 639-4175
Permit No: `1`n_e – bid
P w' Address;: –
,.� Issued by:---- :d"='�- Date:
•
L —.FOR OFFICE USE ONLY--
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is requited for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under OFFS 701.010(7), need not subrn t this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial bores 1 and 2, and either box 3A or 3B:
1 . I own, reside in, or will reside in the completed structure.
2. E - I I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A. _7 My general contractor
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. BI will be my own general contractor.
If I hire Subcontractors, I will hire only si ocontractors r'gistered with the Construc-
tion Contractors Beard. If I change my ,nind ,nd do hi,e a general contractor, I will
contract with a contractor who �s renistE 'ed with .ale Constriction Contractors Board
and I will immediately notify th- -:five issuing phis building permit of the name of
the contractor.
t +ouaehy certify that the Pbove Information erect and that I have read and understand
the Information Notice to Property 0w,!zrrs a.),ut Constr.-ction Responsibilities on the
revetse side of this form.
I nature o e it plicant J Di
CONSTRUCTIC"J .^NTRACTORS BOARD
0244,1 8191
WHtTE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction Responsibilities I
was developed ,y the Constnrcticr,Contra&)rs Board i,i accordance with QRS 701.055(5),
passed by the 1989 Oregon Legislature.
----------
It
------If you are acting as your own contractor to construct a new home or make a substantial improvement io an
existing structure, you can prevent many problems by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONSIBILITIES:
It you hire persons not registered with the Construction Contractors Board to do labor in constructing o,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 roust comply with the following:
Oregon's Withholding Tax Law_ As an employer, you must withhold income taxes from emp,ayee 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 Department of Revenue at 378-3390.
Unemployment Insurance Tax: As an employer, you are required to pay a tax for unempinyment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment Division DHR
at 378-3224.
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation �
must obtain workArs' 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 DIF at 373-7434.
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 221-3960.
OTHER RESPONSiB UTIES AND AREAS OF CONCERN:
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet I i
code regUil ments 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 punc-
tures, fire. or work that must be re-dorie.
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 re4uired inspectioris.
If you have additional questions, write to: Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10124/89
11{ `
1
f CITY OF T I GARD — RFCE I PT OF. PAYMENT RECEIPT NO. e 92 w'< 99`r,4
CHECK AMOUNT o 17,00. 26
NAME t LORENZEN, MERRIANN S. CASH AMOUNT a 0. 00
i ADDRESS t 6605 5W ALFRED PAYMENT DATE. a
f TIGARD, OR SUBDIVISION a
97t?P3--
PURPOSE OF POYMEN-r AMOUNT PAID PURPOSE OF' PAYMENT AMOUNT PAID
BU I i_D I NG PERM 134. 50 PLUMBING PERM _ 52. :50 �
MUCHANICAL PE 25. 00 PLAN CHECK FE --22. 35
` ST. BUILD PER 10. 61
i
I
1 :
92-0 1 413
T ! ! AL. AMOUNT PA 1 D -- - — ) P00. c.'6
i
i
CITY OF T I GARD RECEIPT OF PAYMENT RFf;E I AT NO. a 9E—2;'.9526
CHECK AMOUNT a 116. 03
NAME a I._ORENZEIN, MERRIANt �;. CAtiN AMOUNT a 0. 00
ADDRESS a L(')RF-NZEN, LARRY L. PAYMENT DATE a 07/ 15/9;?
I
6605 SW Al.F RED '3UHDI V I:�T nN
T I GARD OR 9 7c'c'.3 -
PURPOSE. OF F'(aYMFNT AMOUNT PAID PURPOSE: OF PAYMENT AMOUNT PA I D
PLAN CHECK FF 1 16. 03
i
i
I
IRESIDENTIAL ADDITION PLAN CHECK #ti7--26R
IT'UTAL AMOUNT V'A I D - > 116. 03
13175 SWIlanoNd. PLNCK/RECT CITY or TIGA RD MBox vJ97 PERMIT a ih54 Z— OLIIy
COMMUNITYDfyEL91'MI:NT I)EI'ARTMENT 7igarQOregon 97123 J�---
(503)6194171 DATE ISSUED
JOB ADDRESS. � ` ._SLt�� �� ��-} �� �� TAX MAP/LOT 151-25"D4
SUB: LOT: —_ LAND USE:
VALUATION:
OWNER ` SPECIAL NOTES
NAME: C L-OC �l2 ✓�/ REISSUE OF: _
ADDRESS: Q��__—n� � Lf LAST REISSUE:
-]Z l — FLOOD PLAIN/
PHONE: —_. ` � �� ___ SENSITIVE LAND:
CONTRACTOR `\ APPROVALS W UIP.ED
NAME: _ �.� AQ EInc- %A-- �lb PLANNING: r7L� y'G
ADDRESS: �7�,Q lh _ `�C-- `�� E L� __ ENGINEERING:
FIRE DEPT. _-- --
PHONE: v_—_- ' —`� `I 1 -- _ OTHER: ,�,JD
CONTR. BOARD : _— � EXP DATE: 7- ��
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: LA _ `�0 , 1�. LIST/SUBCONTRACTORS: —
MECH: _ BUS TAX: _
ARCH/ENGINEER CALCULATIONS:
NAME: _— TRUSS DETAILS:
ADDRESS: _ OTHER:
PHONF:
PROPOSED BLDG. USE: `��D
COMMENTS:
CL
AP ,LI AN SIGNA
Received By: _ — ^ _ Date Received:
PERM'T # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE: ,I
L. I
to I'f2-014 10-432 00 Building Permit Fees /3 . .So
10-431 00 Plumbing Permit Fees `� SZ,So S �, I
10-431 01 Mechanical Permit Fees :k f,0"
y:
10-230 01 :,tate Building Tax (5%)
Building _ 7� '
Plumbing Z U-
Mechanical
10-433 00 Plans Check Fee3k
Building 7, y�
Plumbing
Mechanical
10-21^, 06 Fire
30-202 00 Sewer Connection
30--444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25--.448-04 Industria'. TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Dr,I � ,age Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (; a in lieu of)
TOTAL a7�/ �O fLG� :i.
nm/3587P.WPF