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8930 SW O'MARA STREET !p A y{pyF�r^•_-W.LI'K'�^�1'•AyaDk96rrlK lNnM'�.1.,s .,n � f a e-+ S�k) I. I � i r i i ' t I 'I i i l i A i I i I f i:\records\microfilm\targets\building.doc .. _,F .�c.w,a7GA�p�INiaM t Y3 INSPECTION NOTICE city of Tigard Building Department j 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-/Phone): 639-�4f175 Business Phone: 639-4171 Inspection.-__- Footing nspection:_Footing Plbr7. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. poet/Beam Mech. Rain Drain Insulation -plumb. Plbg. Underfloor Wnter Line Gyp. Bd. -Hoch ,3L1 � I � � 1 � , Date RequeCe�ted): / �• ^ ,,� Times 1111 PM Address: ()r( 1, 0r Ma-� xx� Permit ts, / w Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: j; { r r,/ ` late.- . -- Date: �. APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. r ��_ j V4 V CITYOFTIFARD (c,fYME_CH AIVTCAL_ '' a COMMUNITY DEVELOPMENT'UEPARTMUT ORt?ON 13126 SW kdI Bt41. P.O.Box 23377,Tlpodd,Oregon 71223(6W)634 417b F'E R11 I T #. . . . . . . : 639-4171 DATE ISSUED: Vi.l i 1 1/93 SITE ADDRESS. . . a 08930 SW O' MARA ST TrARCELa RS1O2DC-00600 SUBDIVISION. . . . s EDGEWOOD ZONING: R---4- 5 BL.00K. . . . . . . . . . : LOT.. . . . . . . . . . . . . :9 CLASS OF WORK. . :ADD FLOOR TURN. . . . : EVAP COOLERS: TYPE OF USE. . . . :SF UNIT HEA"FERS. . : VENT FANS. . . : OCCUPANCY GRP. . :R3 VENTS W/O APDL: VENT SYSTEMS: STORIES. . . . . . . . : BOILERS/COMPRESSORS HOODS. . . . . . . : 11 FUEL TYPES-------------~. 0- ':z HP. . . . : DOMES. INCIN: f : /WOD/ / / 3--•15 HP. . . . : COMML. INCIN: MAX INPUT: BTIJ 15-30 HP. . . . : REPAIR UNITS: .. F I RE: DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . : 1 GAS PRESSURE. . . : 50+ HP. . � . : CLO DRYERS. . : NCI. OF AIR HANDLING UNITS OTHER UNITS. : FURN ( 10' PTU: (= 1O000 cfm: GAS OUTLETS. s FURN > A PTU: > 10000 cfm: Remarks: WOODSTOVE Owner: ______ FEES ROGER JOHNSON — ___.___._—__—_._.. type aoiol.rnt by date r~ecpt 8930 SW O' MARA SJ PRMT $ 25. 00 JH 01/11/93 — 5PCT $ 1. 25 JH 01/J1/93 — 'TIGARD OR 97223 Phone #: Contract or a OWNER Nllorle li: $ 26. 25 TOTAL kerT $I. . : 00t[rrL'i1[t - - -- -- RLUUI RED INSPECTION8 this permit is issued subiect to the regulations contained in the Final 1 n s p e c.,t i o n Tivard 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 Mur is not started -- within 180 days of issuance, or if work is s .spanoid for more than 180 days. P e r mi.t t e e S i g n a t i.t r e _ T ,,s l.t e d B y : Call for inspection - E,-39•-4175 --- Permit No: :-- cam, f Address: Issued by:_ Date: 1_._____FOR OFFICE USE r STATEMENT: INFORMATION NO?:CE TO PROPERTY OWNERS ABOUT CONSTRUCTION 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 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 3B: 1 . 1 own, reside in, or will reside in the completed structure. 2. ( _ l 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. AJ L_ 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 3. B. f �, 1 I will be my own general contractor. / If I hire subcontractors, I will hire only subcontractors registered with the Construe- 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 Constructioo Contractors Board and I will immediately notify the office issuing this building permit of the narne of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side fthis forms gn�rof__Perryrll Applicant 'bate ( (,� JSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT I a a� i INFORMATION NOTICE_ TO PROPERTY OWNERS . ABOUT WNERS - ABOUT CONSTRUCTION RESPONSIBILITIES NOTE. This Information Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5)1 passed by the 1989 Oregon Legislature. 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. IND EMPLOYER RESPONSIBILITIES: It you hire persons got registered with the Construction Contractors Board to do labor in constructing or assi;,ting 4 in the construction or improvement of a residential structure, you will, in moat instances, be ruled to ho an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: ," I Oregon's Withholding Tax Law. As an ernploycr N ,)u n.ust withhold income tax(--, from 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 Department of Revenue at 378-3390. UnemIployment 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 DHR at 378-3224. Workers' C,�mp(.nsation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must o }fain workers' compensation insurance for your employees. If you fail to obtain workers' compensation inc trance, you may be subject to penalties and will be liable for all claim costs if one of your employees rs 'njured 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 holde, for this project, you are responsibl `or resolving any failure to meet code requirements that may be brought to your attention through mspe dons. Liability and Property_Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omisuions such as falling 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 io supervise your employees. Expertise: Make sure you have the experti: � to act as yov 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 Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 973 (1151 Phone 503-378-4621 i \ 0244J 10/24/89 la` i 'A 1 i1 I w (.NY (')F-:' 1"WOR1.1 WCE:IPT OP I*Wf'MF`.NT 'REC;i:"IP"Ir NO. mrj: CNr':Cil AMOUNT NAME':. m JOHNSON. RODE P CWEA-F FIM(JIJNl' p ALrIikF:SFii m 8930 Sw 01 MARA f;.+ F'AYIVIVNT 001T.' m 03 rU8D I V 1.c-k I ON m T:r0ARD, 0R 97c' PURPF: SF OF PAYMF:N1 i1MOUNT I'E'lII) PLIF?I''C1Sl: CIF PAYMENT AMOI.IN'r (,Cl]I-) t MECHANICAL PU 0.1.7-1. 0 0 6a. F4.11AT PER P5 II jl a , W(.)0D',l0VE INSERT TOTAL. AMOUNT POIU i t 1; �A f