13010 SW KATHERINE STREET d�
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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