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INSPECTION NOTIC,'E
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Pho )e 639-�41�75/ eueinese Phones 639-4171
Inspection:
Footing Plbg. Underelab Hech. Rough-ie /Appr/Sdwlk
Found. Plbg. Top Out Cas Line ( FINALr
Poet/seam Struct. San. Sewer Framing \ Bldg,
g,
Poet/Beam Hoch. Rain Drain Insulation ( �
P)l,g. Underfloor�]��/J nwater Line Gyp. Bd. \ -Hoch.
Date Requested t' t/`C JJ' /,�J .
- T t
AM
Address: ��,,
P rm 't iif777 � Q
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Builder:
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THE FOLLOWING CORRECTIONS ARE AiQUIRED: ry k
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Inspector:_ C
Dater
APPROVED DISAPPROVED ,
APFROVF..D SUBJECT TO ABOVE,
-_`Call For Reinep.
:
INSPECTION NOTICE
City of Tigard Building Depdrtskent
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13125 SW Sall Blvd. Tigard, Oregon 97223
Inspection Ltn (Rec-O-Phone): 639-4175 Business Phon 639-4171
Inspection:_ ? r /
Footing Plbg. Underelab Piech. � ugh-in ' Appr/Sdwlk
I.
Found. Plhg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing
-Bldg.
Poet/heam Mech. Rain Drain lnsulat'on -Plumb.
Plbg. Underfloor Water'Line
GYP• Bd. -!tech.
Date RequAst:eds—_'/w —Time-
A!t PN
Address:_ �,
guilder:_
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Ins
psctor: Date:
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APPROVED DISAPPROVED �— APPROt'N,D SUBJECT TO ABOVE
Call For Reinsp.
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MECHANICAL
FOTIFARD
7�X�TWAPJO
COMMUNITY DEVELOPMENT DEPARTMENT PER1111-
13125 SW HWI Blvd. P.O.Baa 23397,TigaId,Oregon 97223(603)6394175 PE Rlyl I T #. . . . . . . : MEC92--0240
639-41.71 DATE ISLUED: 09/22/921
Sl"TZE ADDREbS. . . . l4fir-1 SW KENTON DR PARCEL: L'S 112CB-14000
SURD I V I S I ON. . . . : ASHFORD OAKS 3 ZONJNG- R-7
BLOCK. . . . . . . . . . : LOT. : 149
CLASS OF WORK. . :ADD FLOOR FURN. . . . EVAP COOLERS:
TYPE OF' USE. . . . :SF UNIT HEATERS. . : I Vr-..'.N'f FANS. .
ULLUPANCY GRP— -R-; VLINITS W/O APPL: VENT SYSTEMS:
STORIES. . . . . . . . DO 1 LE RS/COMP RESSO R S HOODS. . . . . . . :
FUEL 0-3 HI.. . . . DOMES. INC11\1;
:/GAS/ 3-15 HP. . . . C011111L. IIVC IN:
MAX Ilqp,ul BTU 15-30 HP. REPAIR UNITS:
F I HE bi:)NPLRS':1. 30-50 1 iP. WOODST'OVES.
LjHb PRESSURL. . . 50+ HP. CLO DRYERS. . :
1\10. OF AIR HANDLING 1-)1\1 I T S OTHER UNITS. :
FURN ( 10LAK BTU. (m. 10000 ofin.. GAS OUTLETS. - I
FURN ) -:100K BTU.- i 10 0 10 0 c,f m -
Remarks,: FREE STANDING GAS FIREPLACE
Owner: FEES
BRAD NEWGARD type altio"Int by d at E? recpt
14621 SW KENTON DR PRIYIT $ 25. 00 JH 09/c:2 9L:
t)PIC T $ 1. L5 JH 09/:' /92
T'IGARD OR 97C,123
Phone #-
LontrActor:
OWNER
Phone #: $ 26. 25 TOTAL
Reg
REWIRED INSPECTIONS
This permit is issued subject to the regulati,,ns contained in the Final Inspection
Tigard Municipal Code, State of Ore, Specialty Codes and all other
applicable laws, All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
!':)i gnat 1-tre
Perm i b t e e
y
Lall for inspection 639-4175
71
Permit No: h2
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Address: P-42
Q:r- • �
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u�i z Issued by: _ 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
app!icants who are not registered with the Construction Contractors Board to
sign the following statement before the building perroit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed 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 applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
1 . I J 1 own, reside in, or will reside in the completed structure.
2. 1 1 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.I ___ J 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
3. B. I. 1 will he 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 hereby certify that the above information is correct and that I have read and understand
j the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
Sidd6ture of Peftit plicant Date
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CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
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I WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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WOO
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES 6
x
NOTE: This Information Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 Oregon Legislature.
9
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.
■
ii EMPLOYER RESPONSIBILITIES-.
i
If you hire persons not registered with the Construction Contractors Board to do labor in constructing 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:
s
Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages ali
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.
j'
Unemp!ament Insurance Tax: As an ernployer, you are requiv- to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment Division DFIR
at 378-3224.
_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 lou 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 RESPONSIBILITIES AND AREAS OF CONCERN:
Code 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 insp,?ctions.
Liability and Property Damage Insurance: Contact your inscrrance agent to see if you have adequate insurance
coverage for accidents and omissions such as lalling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re-done.
Time to Supervise Employees: Make sure you have sufficient time to supervise your employees F
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 to: Construction Contra,,or:, u
700 Summer St. NE, 3u,1e '":J
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10/24/139
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CITY OF' T I GARD — RECEIPT OF PAYMENT RE«C U I PT NO. a 92-2,32 138
CHECK AMfTIJNT' c 26. 2;°i
NAME s NE"WBARD, SPAD CASH AMOUNT a 0. 00
ADDRE::rM a 14821 SW KE NTON DR PAYMENT DA'L'E:: a 09/29,,192
SUBDIVISION a
rico :j, off 97224--
PURPCIf.�E" OF PAYMENT AMOUNT PAID PUK'OSEr OF PAYMENT AMOUNT PA I D
__... .. ..__ _.. .,.
........... _.,..._.__..._...._.._.._ .._.._._. __..__ ....._. ._..._..�_... ._ _ . _.._.__.._•. �._
ME'C;wIANIGAL PE 25. 5T. BUILD -'E R 1. 25
s
-MANKS!
! TOTAL AMCJow F'AI17
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CITYOFTIGARD aff WARD
COMMON" DEVELOPMENT DEPARTMENT ancon
1 1312618W Hrl Blvd. p.0.Boy 23307,Tigard,O►pon 97223(603)639-4176 —/
PLUMBING PERMIT
f,'3y._r,.1.7! I)r1lk r.+ UE_D: iliF3/CMCJ').'
ADDRESS 1488'1 ';3W KEN TON DR PARCEL-; 2S 1 1 i?CP--AO 14 9
Af34-If'-!".RD C it S 3 ZONING„ R
i�LC)C }<. . . . . . . . . . s LOT. . . . . . . . . . . . . .. 149
:LASS OF WORK. . ;ADD GARIN)GE DISFIC)SALS. . MOBIt_E HOML SPACES. : �
f'YPE OF USE. . . . .GF W0C', lylli1.1I1. . . . , . . 13OCKF'I_f]W F'REVNTRIS < 1
OC U)PANCY URP. . :R3 FLOOR DRAINED. . . . . . . . TRAPS. . . . . . . . . . . . . . .
TORIE=Sa. . . . . . . . a, l4nJ4ER HEATERS f. A'1r;Pi BASINS. . . . . . . .
FI 1_AUNDRY TRAYC. . . . . . : SF RAIN DRAINS. . . . . : �
c;INW::'i. . . , , . . , . , 1JRINPI-S. . .. . . . . . . . . .. (3RE:ASF TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . :
fUB/vF40WEw:RS. . . . 4 S WER LINE'S (ft ) . . . .
WWF E.R CLOSETS. . : WAI ER LINE (ft) . . .
I')IGHWAMAE'RS. . . . : DPAIN ('ft) , . . .
Rem,AY-ksa spr•ini(ler system
B14-11) Nt:.W6'l4 D type am0I.tnl: by elate! r-ec:pt
14&--'1 SW KLNION DR PRINT $ 15. 00 JH 08/21/92 S
E t GARD OP 97r"r23 j
Phane eke
,..)WNL H
Rey ti. .
RLUU1 R D I NS�'t;=U 1 1 uNS
This persit is issued subject to the regulations contained in the Top--ol.rt Insp ,_,____,__•,__.__„•..._�_,_____ ,__
Tigard Municipal Code, State of tire. Specialty Codes and all other Fi tiat) Trit ppCt i on
awiicabie laws. All work will be done in arcordance with
approved plans. This ptreit will expire if work is not started
within 180 days of issuance, or if work is .vsvended for eor•e
than 196 dans.
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City of Tigard '� PLUMBING PERMIT Planck/Rec. #
13125 SW Nall Blvd. APPLICATION Permit #
PO Box 23397
Tigard, OR 9722.3
(503) 639-4171 /// 4
[Adjdo
..„, asrnption
C L( A- ORS 81d-21.610 _ OTY PRICE AMT
( ` J �• -Nin/ i FIXTURES
ss �• "t
T—( C)� lam'_:) 1 f722,4 --7.3U—
Lavatory
«.« .. L �� u or u T lowerComb.r �`� -i� Shower Only 7.50
... --Water Closet
Owner
Dishwashw
Garbage.,, Disposal _
Washing Machine 7.50
arw«Orn.ern �/
Water eater 0
•o «. ui ry Hoorn I ray —
Occupan! Urinal _ .50
,„. ther Fixtures( pea )
7.90
7.50
MISCELLANEOUS
Contractor 77
;ewer 1st 100' 30.00
...«. . N. T. Sewer-ea. ddit. 100' 15.00
haler Service 1 st 100' 20.00
hereby ackn3�vlodge that I have read is ap icatuxi,t`thatt gio Water Service ea. Addit.200' 15.00
information given is correct,that I am the owner or authorizod agent of
the owner,that plans submitted are in compliance with State laws,that I Storm It Rain Drain 1st 100' 30.00
am registered with the Construction.;ontractor's Board,that the number Storm 1t Rain Drain Addit. 100' 15.00
given is correct (If exempt from State registration,please give reason -- —
below.) Motile home Space 25.00
"— Back Flow Prevention
Device or Anti-Pollution Device 7.50
n.>.. « •• Any Trap or WiistnNot
Connected to a Fixture 7.50
w r '.1jea ion alt mfiw repair Catch Basin
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to be oone residential 0non-residential O 50
40-00
Insp.of Exist. Plumbing per hr —
40.00
Specially Rrquested Inspections per hr
Existing use of m rain, sigl77,r y M
building or property —�—_ _ dwelling — 15.00
Residential backflow proven.ion
devices 15.00
Pruuse of
buildingding or
or property
'(Except re.' ential ac. crow
prevenfion devices)
NOTICE *Minimum Fee$25.OU SUBTO-i AL
PERMITS BECOME VOID IF WOPK OR CONSTRUCTION 5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF —
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED PLAN REVIEW 25%OF SUBTOTAL
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS _
COMMENCED. 1
TOTAL
Special Conditions
Dale issm-A Y--- __—by_.
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{ CITY OF T I GARD RECEIPT Or PAYMENT R(=C;Fl P1- NO,
CHECK AMOUNT z U5. 7 r
NOME NE:IdCiAftL?, BRAD CASH AMOUNT LA. 00
ADDRESS 14821 SW RENTON DR PnYM1+NT 1)f1TF. n 08/0.'1;S(P
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"I�.ii'�fT1)„ OR 9 t 224--
Of= f,i-4YMEN I' AMOUN"f PA r L) PURPOSE-7 OF PAYMENT PMOUNT PAID
f ILI.IMB I NC+ PERM 1;i. 00 ST. BUILD PER r_w�.._._.. 0. 75
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1 �-,YSTEM PERMIT
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TOTAL AMOUNT PAID 5'. i 5
INSPECTION NOTICE
City of Tig:3rd Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223 +•.e:
Inspection Line (Rec-O-Phone): 9-4175 Business Phone: 639-4171
11
Inspection: 1.� 1�-- ;,+' 1
Footing Plbg. Und alab Mech. Rough-in Appr/Sdwlk
Found.
Plbg. Tap Out Gas Line FINA
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Post/Beam Struct. San.: Seaver 2raming -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water. Line Gyp. Bd. -Mach.
` Date Requested:-_— ��� _-( I- —
/ Time: ��AM'` PM '
Addcesss
Permit
Builder:
THE FOLLOWING CORREcri S ARE REQUIRED:
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- S'ner�7�K
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Dates-
aAPPROVED DIBAPP IVIED APPROVED SUBJECT To ABOVE
-_call For Reinap.
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INSPECTION NOTICE
City of Tigard Building Departaesst
1.3125 SW Ball Blvd. Tigard, Oregon 9722
Inspection Line Re---O-Phone): 634-4175 Businetrs Phone -4171
Inspections
FootingPl Urderslab Mech. Rough-in Appr/Sdwlk
Pound. 7
Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer 111Fting -Bldg.
Post./Beam Mech. Rain Drain � L
-Plumb.
Plbg• Underfloor Water Line Gyp, Bd. -Hoch. S
Date Requested: Time: �AM PM
,Address:
--_//- Permit 1:__v C1 r�',:' i + THE FOLLOWING CQ CTIONS ARE REQUIRED:
i�� Itt �sr�tp�� �' •
m c c�5 S lr oAr 3,ALI^7 671
a� �kt�yiiU F
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isle.. i t:
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Inspectes _ Dates f
APPROVED DISAPPROVED APPROVED SUAJECT TO ABOVE
i
--Call 4or Reinsp. A
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