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10175 SW KATHERINE STREET-1 •a1�"r MDsktvw�$"' Ni� y. "4N�M�`da'�A11��'hfi�lrr hayjq„nyn '�d3�5�1 a��n� ", U;' low �°;y,• � k, ` ADDRESS: myt iArec r s' a a� . . .in. .. i 'r INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 inspection Line (Rec-(.)-Phone): 639-4175 Business Phone: 639-4171 Inspect ion t—_ t Ucl'1 ( lS C� )ye- Footing Pl.bg. Underalab Mech. Rough-in Appr/Sdwlk Fo,ind. Plbg. Top Out Gas Line FINAL& Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech Rain Drain Insulation -Plumb. I Plbg. UnderfloorWater Line Gyp. Bd. -Meth. Date Requested: G,,-;}ZIZ _ Z Ti et 11�1t PM Address: iUI�S � `UN ��/�Q Permit >)= Builder: TRF ?OLLOWING CORRECTIONS ARF. REQUIRED: IMP WIP --_ r 1'l• i H V- Inspector• APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. I y Apr CITYOFTIVARDC„„ „�ARD I+IE CMAIJ I C AL 'COMMUNITY DEVELOPMENT DEPARTMENT COMM PERI'll I T 13126 BW Hrl Blvd. P.O.Bax 23397,TOM,Oregon 97223(603)6344176 PERMIT #. . . . . . . . M L C c j 2—•QI;2 1 6 6129-4171 DATE IS;3UED: 08/31/92 SITE ADDRE:SS. . . : 10175 SW KATHLR I NE. ST PARCEL: 1 S i 35CC '':c'!31h0 SURD I V I S I ON. . . . : URF E_NSURG HEIGHTS ADDITION ZONING: R—/,. =i BLOCK. . . . . . . . . L.O T. . . . . . . . . . . . . : 1 1 CLASS OF WORK. . :ADD FLOOR FURN. . . . EVAP COOLERS: TYPE OF USE. . . . :SF" ON J: f HEA I ERS. . : VENT FANS. . . : OCCUF''CNCY GRP. . :R3 VENTS, W/O HPPL: VENT SYSTEMS: ■ STORIES. . . . . . . . : BOILERS/COMPRESSOR'S HOODS. . . . . . . : FUEL 7 YK'ES—______—____._.....___ 0_3 HP. . . . : DUI"IES. I NC I IMI: : /GAS/ / / 3-15 HP. . . . . COhIML. I NC I N: MAX INPUT: BTU 15-30 HF'. . . „ : REPAIR UNITS: ■ F I RE DOMP R;?. . : :316--50 1-1P. . . . : WOODSTOVES. . : GAS PRLSSURE. . . . 50+ HF'. „ . . . CLO DR`i'ERS. . . NO. OF IJh;T I.`i __..__.._....__._._..... AIR HANDL..I IJG UNITS OTHER UN ITS. : 1 FURN i 100K BTU: 10000 cfm: UPS OU'TLETE�,. - I TURN > =100K 13TU: ) LIZrI)II%0 cf,� f Remar^k a: GAS STOVE Owner: ___.__.______________._._....__.____—______ _.._____.__._,.______..._ FEES DI;:WEY 1--ai=1MIL'TON type amol.tnt by date r-'ecpt ! .. 10175 SW t'.0THERINE_ I-,RI1T $ 25. 00 JH 08/31/92 5F'C T' $ 1. ;:25 JH 08/31/92 TI:GARD OR 117223 Phone #: 639-63,32 Contractor: OWNER F'Ilor1e #: $ 26. 25 TOTAL Reg #. . : 00000 REGUIRE.D INSPECTIONS ------ This permit is issued subiect to the regulations cont;,ined in the Final Irrspection Tigard Municipal Code, State of Ore. Specialty Coles aid 5H other applicable laws. All work will be done in accordance with approved )clans. This permit will expire if work is not started within I8N 'sys of issuance, or if work is suspended for more than 188 days. P'ermittea Signa't�.tr /?, r � � ISS.-ted By : Cell f'or, inspection - 639 4175 r _J a CITY GIF:' T I GARD - RECEIPT OF PAYMENT RECEIPT NO. s 9c'-x'31 1 3 CHECK AMOUNT : Cc.5 NAME a HAMILTON, MARGARET CASH AMOUN i t 0. 00 ADI:)RF SE) s 10:175 SW KATHERINE P'AYME'NT DATE a 08/31/92 SUBDIVISION a 1 T I OARD, OR 417823— c. PURPOSE. OF PAYMENT AMOUNT' i:,r'►Ii7 V,URP,OSE. OF I-+AYWNT AMOUNT PATI) ME'CHANIC:AL.. PF.. ;,. oip ST. BUILD PF;R E 1) I y. C OAS STOVE, TOTAL, AMOUNT F,AID — ) 'f,, 11-15 4 Permit No: f?' �'1 G Address: Z 7,5' t- N t Issuec by:_� Date: lZ .� __._—__._FOR OFFICE USE ONS" _-- -----_. _-_, STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTIO'I 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 required for residential building, electrical, mechanical, and plumbing permits. Licensed Archittct and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement wil, be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313: 1 L� I own, reside in, or will reside in the completed structures. 2. L___. _ ] 1 understand that I must register as a construction contractor it the structure is sold or offered for sale before or upon completion A. =. 1 My general contractor is 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 2. Bre I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I 1 :,ir�iby certify that the above information is correct and that I have read and understand the Information Notice to Property Owner: about Construction Responsibilities on the reverse side of this form. Sign u e 't Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT I .,•i-: ..: 'n. ter.�..• .,. .:... .: ....:, .::i..,...• d. I� ii i. 1yq� i is I INFORM ,TION NOTICE TO PROPERTY OWNERS C ABOUT CONSTRUCTION RESPONSIBILITIES NOTE,- This Information Notice to Property Owners About Construction Responsibilities was developeo by the Const.uction Contractors Board in accordance with O.?3 701.055(5), j passed by the 1989 Oregon Legislature — a If you are acting as your own contractor to construct a new "come or make a substantial improvement to an �,r existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYEi! RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting A in the construction or improvement of a residential structure, you will, in rnr^t instances, be ruled to be an s "employer" and the people you hire will be "employees". As the employer, you must comply with the following: Bret on s Withholding Tax Law: As an ,=mployer, you must withhold income taxes from employee wages at I 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 unemployment Insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division DI-IR at 378-322.4. 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 DIF at 373-7434. U.S Internal Revenue Service: As an Prnployer, you, rnw�t 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 rnore information, call the Internal Revenue Servi,.;e at 221-3560 OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code_Compliance_ As the permit holder for this project, you are responsible for resolving arty ta;lure to meet i code requirements that may be brought to your attention through inspections. e Liability and Property age DamInsurance: Contact your insurance agent to see if you have adequate insurance rcverage for accidents and omissions such as failing tools, paint overspray, water damage from pipe punc- tures, fire or work that must be re-done. Time to Supervise Employees: Make sure you ha e sufficient time to supervise your employees. Expertise: Make sure you havt> the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify bc-tiding officials at the appropriate times so they can perform the required inspections. If you have additional questions, writa to: Construcflon Contractors Board 700 Summer St. NE, Suite 304 Salem, OR 97310-0151 Phone 503-378-4621 0244J ?0/24/89 I