10693 SW KENT STREET-1 T.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspectioc:�_____� /—
Footing Susp. Ceiling Sprink. Rough-inVipr
dwikFound•ition Plbg. Underslab Mech. Rough-inace
Post/Beam Struct. Plbg. Top Out Flec. Rough-in FINAL: ■
Post/Beam Mech. San. Sewer Gas Line -Bldg. '
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Meeh. ■
UndP1Ir. Insul. Shear Wall Gyp. Bd. -Elect.
Date Rey jested:_ ( Time:_'X__AM PM
Address: Z �i L3 ✓L'y
guAiv: , Permlt #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
In ector:_ _ DatP: 4-7
_ �'„�T_���
�— PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
.. ....,. .,." ml.�1d16�W'i�h V�114�i:':�t'd4•'J4k7�aT�A791?°'�tC,�M':^Po�'YL'�F'd'SFP7'Ri.iEMOSRiARn+M1
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- CITE OF TIGARD
COMMUN!TY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.9100 (S03)639-41171
PLUMBING PERM;i'T
PERMIT #. . . . . . . : P1_M9`,-•Qllb'53
DATE ISSUED: 03/17/95 �
i"'1=aRC::LL: �a115f-<F�1--rIr:3:31II1Zl jf`
SITE ADDREEP3. . . : 10693 SW KENT 91'
SUBDIVIEi,1 JN. . . . : DOVER LANDING NO. .' ZONING: R-•-4. 5 M
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . . .i
CLASS OF WORK. . :AL F GARBAGE D 5"' OSALS. . : 1108I LL-' HOME SPACES.
TYPE OF USL. . . . :SE WASHIP46 MOCH. . . . . . . : BPUFFLOW 1"*-VNIRS. . 31 �
OCCUPANCY GRP. R,3 FLOOR DRAINS. . . . . . . TRr-P:S. . . . . . . . . . . . . . ..
STURIE:S. . . . . . . s WATER HEATERS. . . . . . : CNTCF-1 BASINS. . . . . . .
k)' FIX UF�E:i_» -- _.__ ._.__._._ LAUNDRY T'RF4YS. . . . . . . 3 FtA11\i DRAINS. . . . .
F .
;a1NK5. . . . . . . . . . .. URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVAI UNIL:5. . . . . .. O i iER FIXTURES. . . . . :
7US/SHOWERS. . . . : SEWER LINE: (ft ) . . . . -
WATER
ft ) . . . . :WATER CLOSE 1`5. . e WATER LINE (ft ) . . . . :
DISHWASHERS. . . . . RAIN ORAIN tr't ) . . . . .
Fiemar^1<s : Bar_kflow prevention (device installw: ion
Uwner: _. __-____ ._-__________ ____.__.__._..___ ___.._..__...__.____....__.__-- FEES - ......
VL_ASTIMIL LlrSEE0 type amo+..lnt by (JeAte rec_F,t
10693 SW KENT ST FIRMT $ 1`.,. 110 JD 03/17/95 95--2630"/0
`P`CT 4 0. 75 JD 03/17/9,5
TIGARD OR 97L&4
Phovie #:
UONTRACTOR NOT ON FILE
73 TOTAL
jReg #. .
RE UU I RE_D I NSPE L F 10Nb
This perait is Issued subiect to the regulations contained in the Final- n
Ispection
Tigard Municipal Code, State of Ore. Specialty Lodes and all rther _ __.,,��__,__•_______ ____ _._.
applicable laws. All work will be done in accordance with
approved plans. This perp+" w►'i expire if work is not started
within 188 days of issuarce, or if work is suspended for sore
than 180 days.
Pe1^m i t t e e EliR n �",. l f'` �/-'� _._...._._ _......_..r'.--.-�4___._. _~._.-.._._�___-•_--__..__�,.. �
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
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1312F -'"V Hall Blvd. r Permit # _i't 7.7
'Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N.-a 0..a•Pi.-1 New Single Family Residences Only �
..• /, ❑ 1 BATH HOUSE$140.00 O 2 BATH HOUSE$195.00
Job �� g 0. SCG n ❑ 3 BATH HOUSE$225.00
Address aM+au• m Fee includes all plumbing fixtures in the dwelling and the first 100 feet
":( 0� ��I sc of water serilce, sanitary sewer and storm sewer. See fees below.
°.+.l m.n•••) / FIXTURES QTY PRICE AMT I
/ ry,, ��P_C]✓c�_ Sink 9.00
M""AMM Ti77743 Lavatory 9.00
Owner 112 6 � �-? 4L Tub or Tub/Shower Comb. 9.00
UJIM•)• ze Shower Only 9.00
Water Closet 9.00
N•m•) •m•.)ww•••) Dishwasher 9.00
Garbige Disposal 9.00
Occupant p M.ro�••• P. Washing Machine 9.00
Floor Drain 9.00
r�rimn• _ zip Water Heater Y 9.00
Laundry Room Tray 9.00
Urinal 9.00
Other Fixtures (Specify) 9.00
M..,,Ad*- Ph.. - 9.00
Contractor
9.00
c«r)s)•)• tw 9.00
Sewer 1 st 100' 30.00
91.x.Rapan.uan ho C.r&�• N. Sewer-ea. Addit. 100' 25.00
_ 1
Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water S,3.-vice ea. Addit. 200' 25.00
information given Is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention f
Device or Anti-Pollution Device 9.00
sw••••)• M M•••}✓ Dw. Any Trap or Waste Not
Connected to a Fi•.wre _ 9.00
Des a work new Q addit n U a,reration Q repair Q Catch Basin 9.00 a
to be done residential non-residential 0 Insp. of E.ist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of , n
building or property Rain Drain, single family dwelling 3C 00
"`�`"' ��`'"' � _
Residential backflow prevention �,
devices 15.00 /I-
Proposed
tiProposers use of �G�� dQ
building or property •(hxcept residential backflow
prevention devices)
i
NOTICE "Minimum Fee $25.00 SUBTOTAL
n
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
r
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED y
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS t
COMMENCED PLAN REVIEW 25% OF SUBTOTAL j
_-•-_-_-__ TOTAL
Special Conditions
Date Icctued /! by
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Permit#: /L ry, en
Address:
Issued bj- -" Dee: 7 S'`
■
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 a
following statement before a building permit can be issued. This statement is required
for residentiol building, electrical, mechanical, and plumbing permits. ,iccnsed
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:
EI own, reside in, or will reside in the completed structure.
.;.
l1.
2. 1 understand that I mus;register as a construction contractor if the structure is sold or offered for sale
+1 before or upon completion.
3A. My general contractor is —————
L_J "'w•ne) Contractor regis. #
I will instruct my general contractor that ai; ,ubcontractors who work on the structure must be
registered with the C'oastruction Contractors Board.
OR
® 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 conti::ctor 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 011 ners about Construe n Responsibilities on the reverse side of this form.
ignature ofpe rt plicant) (Date)
( ilt copy to issuing agent- permit file,
pink copy to applicant)
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Information Notice to Property Owners
About Construction Responsibilities
Note: "I'lris Information Notice to Prorerty Owner,-ubmi. 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: s
If you hire persons not registered with the Construction Contractors Board to do labor in constricting 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 law: As an employer,you must withhold income taxes frol i 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,rall 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 ohtain workers;'compensation insurance,y it 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 RESPONSIBILITIES AND AREAS OF CONCERN:
Cade 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.
`a
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 he
re-done.
Time to supervise employees: Make sure you have sufficient time to supervise y(rnr 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 Consmiction Contractors Board(PO Box 14140,Salem,OR 97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite 3(X), in Salem.
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CITY (IF' T I f3F1E<I1 '- TC
RE;CE:I F'T OF PAYMENT k[:f.0`x PT NCS« a 95 ' �'fY:3070
C I•( AMOUNT 0.1 >�0►
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NAME a L_F;IRF.UA, VL_ASiTIMIL CASH AMCII.IN'r is 0. 00
ADDRESS'J�� a 1(r~F� W KENT ST PAYMENT DATE 03/17/9 a
SUAD c
TIGARD OR
l,PURPGC.4F. OF PAYMr%'NT PMOUNT Klnll) PURPOSiF OF PA"ME•:NT AMOUNT PAJU
'L.UMBING PF:HM 15. 00 `T BUILD P R P+. 75
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10692, SW KENT Sl
TOTPL.. AMOUNT PAI)i ) 15b 75
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INSPECTION NOTICE 91
City of Tigard Building Department
13125 OW P tll Blvd. TigarA, Oregon 1.7223 �1l.11
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Inspection Line (Rec-O-Phone)s 639-4175 Business Phoned 639-4171
Inspections
Footing Plbg. Underslab Xwh. Rough-in Appr/Sdwlk i ~•
Found. Plbg. Top Out Olin Line INAL:\
St r
Post/Beamtact. San. Save Framing g g
r
Poet/Beam Mach. Rein Drain Insulation -Plumb.
Plbg. Underfloor Mater 'Ane Gyp. Ed. -Hoch. i
Date P.equestedt c/ ( TlaNls AH _ _PH
Adlreen: 1,0g3 IL2V Pa..,.:t !t F�"-�3 U ).O i ■
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Builders7_ �0 L cr- L���Z
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TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors
PPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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MECHANICAL
CITY ®F T I GARG PERMIT
PERMIT #. . . . . . . : MEC93-0320
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUE : 11/10/93
�
13128 3W Hall Blvd.Tigard,Oregon 47223.8190 (503)839-4171
PARCEL: 2S1 . 5AA-03300
SITE ADDRESS. . . : 10693 SW KENT ST
SUBDIVISION. . . . : DOVER LANDING NO. 2 ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . :72
CLASS OF ' .4K. . :ADD FLOOR FURN. . . , EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . -
OCCUPANCY
ANS. . . :OCCUPANCY GRP. . :R3 VENTS W/9 APPL: VENT SYSTEMS:
STORIES. . . . . . . . : 2 BOILERS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES-.--.--_--__-- 0-3 HID. . . . : DOMES,. I NC I N: �
:/GAS/ / / 3-15 HP. . . . : COMML. INCIN:
MAX INPUT: BTU 15-30 HFA. . . . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . :
' GAS PRESSURE. . . : 50+ HP. . . . : CLO DRYERS. . :
NO. OF UNITS------------- AIR HANDLING UNITS OTHER UNITS. :
FURN < 1O0K BTU: <= 10000 cfm : GAS OUTLETS. : 1
FURN )=1O0K BTU: 1 10000 cfm:
Remarks : GAS LOGS
Owner: —________.._,.-.---_.._-_----__.____._____._._..___.__...__..._.__-_-----_-----_._._ FEFS --------------
VALSTIMIL LEBEDA type amo,Mnt by date recpt
10693 6W KENT PRrIT $ P5. 00 JH 11/10/93 — "
' SPCT t 1. 25 JH 11/10/93 —
GARD OR 9'7224 ,
)ne #:
Contractor: __.________.____________.--•___--
HOT SPOT FIREPLACE ft PATIO
1152, Sid CANYON RD
BEAVERTON OR 97005
Phone #: 6c'_--465�.:.' >l 26. cb TOTAL
Reg #. . c 71792
------ REQUIRED INSPECTIONS
This perait is issued subject to the regulations contained in the (Say Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all ether Final Inspection
applicable laws. All work will be done in aTordancr with
approved plans. This perait will expire if work is not starter+
within 188 days of issuance, or if work is suspend.,:d for more
than 188 days,
P e r m i t t e e S i.g n a t r r e
Issued B y y---
q
Call for, inspection — 639-4175
r
City of Tigard MECHANICAL PERMIT Pianck/Rec. # _
13125 SW Hall B' J. APPLICATION Permit # _
O Box 23337
Tigard, OR 97223
(503) 639-4171
Description
Table 3A Mechanioal Code .TY PRICE AMT
Job /06q
(,c-) ��Yl7 1) Permit Fee _ 0- 0- 10.00
Address caws-160
r c l),- 2) Supplemental Permit 3.00
-+T�l
Furnace to ICO,000 BTU
Z`_ 1) incl.ducts&vents 6.00 w
umace tUO�U 4
Ownr+l U , 1 ��! �- j ') incl.ducts&vent, _ 7.50
- Floor Furnince
r -
3) incl. vent 6.00
Suspended seater,wa I eater
Yr�, 4) or floor mounted heater 6.00
Uaiv «. �— Vent not incl. in
OCCUpc',nt 5) appliance permit 3.00
epahr of eating,re ng.
6) cooling,absorption unit 6.00
--- — Roiler or comp-haat pump,air con .
I-,U4 ,yA f:71 re to E__ 7) to 3 HP absorp unit to 100K BTU 6.00
)AWEV Boiler or comp, teat pump,air con .
_,L
8) 3-15 HP absorp unit to 500K BTU 11.00
Contractor J;,. Boiler or comp,heat pump,au con .
P v br1 Vi I/ A) 9) 15 30 HP absorp unit.5.1 mil BTU 15.00
w. ....� ., ..w Boiler or comp,heat pump,air coed.
,7 j 3G,--1 1 10) 30-50 HP absorp unit 1-1.75 mil R rU 22.50
"re y acknowledge that I have read this application,that tie Boiler or comp,heat pump,air cond.
information given is conect,that I am Use owner or authorized agent 11) >50 HP absorp unit 1.75-nil BTU 31.50
of the owner,that plans submittad are in compliance with State hr andling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give rea.on below.) 13) 10,000 CTM i- - 7.50
Non portable
�) 14) evaporate cooler 4.50
Vent ian connecieed
15) to a single duct 3.00
VO—R71--lb—on system not I
16) included in appliance permit 4.50
Hood servedy
17) mechanical exhaust -4 4.50
Describe Work new addition alteration-0alteration-0 repair 0 commercial—' cr industrial
to be done -�reside�ntial 67) nor)-residential Q 18) type incinerator 30.00
i XILUng tl5e PI L� ler Le.,W Stove,water
building or property 19) heater,solar,clothes dryers,etc. 4.50
I `
Proposal use of 20) Gas piping one to four outlets 2.00 C
building or property -
21) More than 4-per outlet
Typo of fuel-oil 0 natural gas , LPG 0 electric Q
NOTIIC�
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION e
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE C-
IF CONSTRUCTION OR V1 ORK IS SUSPENDED OR
ABANDONED rJR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. —"--
TOTAL _
Special Conditions
�— _._____�----------------._.___-- Date Issued by ---
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