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13010 SW KATHERINE STREET d� 11.7 i r. w rr 'r ro h r.1. w rt i 7 vrt '7 d II HNIVSH VM PAS OTO)£1 Y CITY OF TIGARD 24-Hour BUILDING Inspection Line: 639-4175 MST INSPECTION DI` ISION Business Line: (503)639-4171 - BLIP Received -- Date Requ s ed U AM_— PM BUP —_- Location (C� WV'-C'-_-__Suite c l MEC _ ontact Person "� — Ph(—) Contr _ -- ----- Ph( ) ---- SWR _._-__--_------- ILDING - TenanVOwner 47-) L, Y�-�' ELC _ Food � -_� L t__,.' �• '.--- Foundation Ftg Drain ELC -- AcceF, ' Cis ELR Crawl Drain _ ' ✓ -'� - ---- -�T Slab Inspection Notes: SIT Post& Beam Shear Anchors Ext Sheath/Shear -- Int Sheath/Shear Framing — -- - - Insulation Drywall Nailing - - - --------- ---- --. ---- Fireweir Fire Sprink,er --- -- Fire Alarm Susp'd Ceiling Roof / Fin _6IBeam ART FAIL �� _ _.,'_ _Post& Under Slab Rough-In Water Service - - Sanitary Sewer Rain Drains — --- Catch Basin/Manhole Storm Drain --- ---- --- Shower Pan Other: --- _P T FAIL --- ---- -- -- dam Rough-In - -— -- ----- - -..__- Gas Lire S,A]pisa Dampors 1 - ---- ----- -- — — --- Fin an 0 RT FAIL --- -- —_ - —_ ----- LECTRICA _-- Rough-lr. -- -_ -- - _ — UG/Slab Low Voltage 4Fk2j�Alarm L_J Reinspection fee of$_ _- -_required bet•.jre next inspection. Pay at City Hall, 11125 SW Hall Blvd. —SSj PART FAIL �-- ! — v L_j Ple.ace call tnr reinspection RE:-- L] Unable to inspect no access Fire Supply Line / ` V/ ADA /u Z )� Approach/Sidewalk date -__ Inspector Ext Other. __ Frn,•.l DO NOI REMOVE this inspection record from the Job site. LAS PART FAIL MASTER PERMIT CITYOF T I G A R D PERMIT#: MST93-0(?256 DEVELOPMENT SERVICES DATE ISSUED: 5/18/93 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 SITE ADDRESS: 13010 SW KATHERINE ST PARCEL: 2S104AA-09900 SUBDIVISION: BELLWOOD NO. 3 ZONING: R-4.5 BL-OCK: LOT: Ill) JURISDICTION: TIG REMARKS: PATH I BUILDING, REISSUE: STORIES: 2 T-LOOR AREAS REQUIRED SETBACKS REQUIRED CLi SS OF WORK: AJD HEIGHT: 25 FIRST: 194 sf BASEMENT: 0 sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 806 sf GARAGE: 0 of FRONTPARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: 1 11OFn 1, sf RIGHT: n .16,000.rA) OCCUPANCY GRP! R3 BDRM: t BATH: 1 TOTAL: 10VALUE:00 sf REAR: i PLUMBING A SINKS: 0 WATER CLOSETS. i WASHING MACH: n LAUNDRY TRAYS: 0 RAIN DRAIN: a TRAPS: 0 LAVATORIES: I DISHWASHERS 0 FLOOR DRAINS. 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0 TUBISHOWF.RS, GARUAGE DISP: 0 (NATER HEATERS: 0 WATER LINES: 0 BCK LW PREVNTRr I GREASE TRAPS: 0 OTHER FIXTURES: " MECHANICAL _ FUEL TYPES FURN<TOOK: 0 BOILICMP<AHP: 0 VENT FANS, I CLOTHES DRYER: Ii Gtr. FURN>-100K: 0 UNIT HEATERS: 0 HOODS: 0 OTHER UNITS: i, MAX INP. 0 btu FLOOR FURNANCES: 0 VENTS: i WOODSTOVES GAS OUTLETS: 0 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFFEDERS _BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF CR LF!}S: 0 0 -200 amp: 0 0 200 amp: 0 WISVC OR FDR: W PUMPIIVRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500-SP: 0 201 - 400 amp: 0 201 - 400 amp. 0 tet W/O SVCIFDR: 01 SIGNIOUT LIN LT: 0 PER HOUR: 0 LIMITED ENERGY: 0 401 - 600 amp: 0 401 WO amp: 0 EAA-IDL BR CIR: 000 SIGNALWANEL: 0 IN PLANT: 0 MANU P4,0,VCIFDR! 0 601 - 1000 amp: 0 601+amps•1000v: 0 MINOR LABEL: 0 1000.amp/volt: 0 FLAN REVIEW SECTION Reconnoct only: 0 >=4 RES UNITS: SVC/FDR-225 A.: >600 V NOMINAL: CLS AREA/SPC OCG,: ELECTRICAL•RESTRICTED ENLRGY A.SF RESIDENTIAL _ B,COMMERCIAL AUCIO 8 STEREO: VACUUM SYSTEM: AUDIO d 81 ERF.O: _ FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC LANDSCAPEIIRRIG: PROTECTIVE 810NL: GARAGE OPrNER: CLOCK: INSTRUMLNTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: 0 Owner: Contractor: TOTAL FEES: $ 633.25 This permit is Subject to the regulations contained In th3 KIN MARKOZAN LYNN TOAUS T;dard Municipal Code,State of OR. Specialty Codes an.: 13010 SW KATHERINE ST. 2123 CAMELOT all other applicable laws. All work will be done in TIGARD,OR 97223 COURT accordance with approved plans. This permit will expirE If PORTLAND,OR 97225 wcrk is not started within 180 days of issuance,or if the wof k Is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow;ules adopted by the Phone: 503-524-7424 Phone: Oleg^n Utility Notification Center. Those Piles are set forth In CSAR 952-001-0010 through 952-001-0080. You asp N: may obtain copies of these rules or direct questions to CUN+,by calling(503)246-1987. REQUIRED INSPECTIONS Foot/found Insp Mechaniral Insp Framing<REINSP> Insulation lnsp Misc. Inspection Plumb Final P-ost/Beam Structural Plumb Top Out Gas Line Insp Insulation Insp Electrical Final Final inspection Post/Beam Mechanica Plumb Top OL:'. Insulat,on Insp ,yp Board Insp Electrical Final Final inspection PLM/Underfloor Electrical Roug)In ;nsulation Insp Gyp Board Insp Mechanical Findi Final inspection Mechanical Insp Framing Imp Insulation Insp Misc. Inspection Mechanical Final Final irspection n Issued By :l 4l Permittee Signature Call (503) 639-417 y 7:00 p.m.for an inspection needed the next business day CITY C" TIGARD 24-Hour // ��qq�� BI -DING Inspection Line: (503) 639-4175 MST ( q Z G 6 INSPEC r wN DIVISION Business Line: (503) 639-4171 BUP Received .___—_ Date Requested__ �� �� AM PM�____-_ BUP Location _mss1- — �:.Q �-. Suite MEC Contact Penson �'� _ Ph .t -�S-~' --7 W-L/ PLM Contractor _ —_ Ph(__ ) -. SWR BUILDING Tenant/Owner ELC - - -- ---- - --- ------ Footin— g Foundation ELC --_---_- _-- _. - - -- Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: A _ SIT Post& Beam Shear Anchors - Ext Sheath/Shear �„ y Int Sheath/Shear Framing -- - - Insulation Drywall Nailing -- - Firewall Fire Sprinkler -- Fire Alarm Susp'd Ceiling - - - - --- ---- Roof Other: - - - - PARI FAIL - - --- Post&Beam Under Slab Rough-In Water Service Sanitary Sewcr Rain Drains - - - - Catch Basin/Manhole Storm Drt in -- - - - Shower Pan Other. Final PASS PART FAIL - - - ------____._.-_--__- - ---.------___-- MECHANICAL Post&Beam Rough-In - Gas Line Smoke Dampers --------- Final --Final PASS PART FAIL -- - - _ELECTRICAL Service - Rough-In UG/Slab -- - -- - - - -- Low Voltage Fire Alarm Final Reinspection fee of$--- - required PASS PART FAIL before next inspection. Pay at City Nall, 13125 SW Hall Blvd. SITE Please:.all for reinspection RE:_ _ ___- -_ �� Unable to inspect-no access Fire Supoly Line ADA ''�� Approach/Sidewotk Date� U Inspector / - -- -'- --_( - _ -- EYA Other: Final DO NOT REMOVE this Inspection recon. from the job site.. PASS PART Ft.;L Permit No: �^ Address: (0 : z Issued by:_ Caste: 5 7L ---- _____FOR OFFICE USE ONLY- STATEMENT: NLY STATEMENT: IV ORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.955(4) , rEquires residential constructior permit applicants w�o are not registered with the Coniti ^tion Contractors 3oard to sign the following statement before the building permit can be issued. This state- ment i:, required for re.3idential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not suthmit this statement. This statemant %vi!I be filed with the permit. Fill in the applicable blanks, and initial boxes 1 cnd 2, and either box 3A or 3B. 1 . ';" 1 own, reside in, or will reside in the completed structure. 2 . i 1 understand that I must register as a coristrt'ction c,:,ntractor if the struc(urc- is bold or offered for sale before or upon completion. 3. A.I My general c-)ntractor is _ Contractor registration numher I will instruct my gen-ral con'ractor that all subcontractors who work on the struc- ture must be registered with ,he Construction Contractors Board. OR 3. B. i `" 1 will be my own general contractor. If I hire subcontrac,,)rs, 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 hereby certify that the above information is Lirrect and that I have read and understand the Information Notice to Property Owners abc.-it Construction Responsibilities on the reverse side of this form. Signature of Permit Appl_ r�_ - Gate CONSTRUCTION COM RACTOPS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notre to Property Owners About Construction Responsibilities was developed ay the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If ,ou are acting as your own contractor to consiruct a new home or make a sub0antial improvement to an p-, sting structure, you carr prevent many problern s by being aware of the following responsibilities and areas of concern. E161PLOYER RESPONSIBILITIES: If you hire persons riot registered with the Construction Contractors Board to do labor in constructing or assisting .n the construction or improvement of a residential structure, you will, in most instances, be ruled to he an employer ar,J the people YOU Hire will be "employees". As the employer, you nusi comply with the following. Orejon's V1 ithholding ran Law_ As an employer, you must withhold income taxes from employee wages at the tilde employees are paid. You will be liable for the ta, .)ayrnents even if you don't actually withhold the tax from yo— emplovees. For more information, call the Or:=gon Department of Revenue at 378-3390. Unernploy, mt Insurance Tax As an employer, you are required to pay lax for unemployment insurance purFloses ori the wages if all employees. For more information, call th,, Oregon Employment Division DHR at 378-3224. Workers' Compensation Insurance: As an employei, ;you are subject to the Oregon Workers' Compensation Law, and must obtain Workers' compensation insu►an e for your employees. If you fail to obtain workers' compensatior insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is ,, cured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. t_I.S. Internal Revenue Servwe Asan errlployer, you roust withhold federal income tax from employees' wages. You wifl h Il bl +Icer the tdxpAyrnent caved if you didn't actually withhold the tax, For mora., information, call the Internal Revenue, Service at 221 1960 fJT'NER RESPONSIBILITIES AND AREAS OF CONCERN: Compliance: As the permit holde, for this project, you arra responsible for resolving any failure to meet r-rrcte regc irernents that may bQ brought to your attention through inspections. I.-jahi qty snd Property Damage Insurance. Contart your insurance agent to sPir: if you have adequate insurance r'c,veraye for ac;c:idents .1.1nd omrrsrons Paich as falling tools, paint overspray, water damage from pipe punc- tures. fire, or work that must be re-done. Tir,,e to auperv;,e Employees: Makict sure you have sufficient time Ic_ supervise your employees. Fxl—rri w Ma' _ sure you have the expertise to act as your own general contractor, to coordinale the work f 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 to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem. OR 97310-0151 Phone 503-378-4621 02,6 4J 10/24/89 P' NCK RECTCIIN OFVGARD 13125 SW / COMMUNITY OIVELOf MENT U .I ARTMENT Tp�ons«,9771-3PLRM I T # �� � (30))6)9-+n' DAIE ISSUED JOB ADDRESS: DOIy Sw 1671r�er4-c S _ TAX MAP/LOT _ _� A SUB: 1%a'l;(,vrju,L - ----- LOT: _ Ir �—_--_ LAND USF: -------- VALIJAI ION: UU OWNER PEC IAL_NOTES NAME: �� I"l�U __ _. _ISSUE OF: --^- - ADDRESS: a 1�(.v �''L "�r�� __ LIST REISSUE: c' -j a ----- _ FLOOD PLAIN/ PHONE--" ��� SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED NAME: PLANNING: -- - ADDRESS: ENIIINEERING: FIRE DEPT: PHONE: OTHER: NQ UF- � CONTR. BOARD #:: EXP DATE: ITEMS RE UQ IRCU SUBCONTRACTORS: PLUMB: r' LIST/SUBCONTRACTORS: MECH: C. I _____ BUS [AX: `. ARCH/ENGINEER CALCULATIONS: NAME: LtA Gt" -Cr TRUSS DETAILS- ADDRESS: q cl-7 S S' T r,ylt�f'"- b OTHER: V\ of- 61 PHONE: - Lfa U PROPOSED BLDG. USE: f \�'`�' '1 q�l Ab E c5 _- _ I COMNLN1S: ��\�`� C� eC� IS _ �h�f 2 Gv � ---------- APPLICANT SIGNATURE _ �� ec -f`�" ��Y Oate Received: ft-c_T v . 1 By: ._____ � Received- i PFRMII # ACCI N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10-432 00 Building Permit Fees 441 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit r,es 10-2.30 01 State Building Tax (5%) Building /1'. 21- Plumbing �. 21Plumbing /, n Mechanical / L r 10-433 00 Plans Check Fee Building Plumbing Mechanical 10--230 06 Fire _ 30-202 00 Sewer Connection 30-444 00 Sewer Inspection — 25-448-02 Commercial TIF Fees 25-448-04 Industrial TIF Fees 25-448-06 Institutional TIF Fees 25-448-03 Of:'ice TIF Fees 25-448-01 Residential Traffic Fees 25-448-05 Mass Transit TIF Fees 52-449 00 Parks System Dev Charge (POC) 31-450 00 Stam Drainage Syst Dev Chrg (SSOC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02. Water Quantity (Fee in lieu of) TOTALS nm/3587P.W111