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10710 SW NORTH DAKOTA STREET 1S b1OHd0 HIMON MS UL06 r co a 0 x M Z m wo V- ti a 10710 SW NORTH DAKOTA ST CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00250 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 5/15/03 PARCEL: 1 S134DA-10900 SITE ADDRESS: 10710 SW NORTH DAKOTA ST SUBDIVISION: MLP96-0004 ZONING: R-3.5 BLOCK: LOT:002 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30-50 HP: WOODSTOVES: GAS PRESSURE: 50+ HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS _ OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installation of exterior A/C unit. Unit cannot be placed within required setbacks. Owner; FEES COOK, KENNETH RALPH +RENEE R Description Date i Amount 18380 NW CORNELL RD #C -- ALOHA,OR 97006 [MECHI Permit Fee 5/15/03 $72.50 [TAX]R%StateTax 5/15/03 $5.80 Phone: Total $78.30 Contractor: COMFORT MECHANICAL INC 17936 SE DIVISION STREET PORTLAND,OR 97236 REQUIRED INSPECTIONS Phone: 503-761-1500 Mechanical InspFinai Inspection Reg#: LIC 79558 CL OC H rN C J_ m WThis Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All worts will be done in accordance with approved plans. This permit will expire if worts is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued By: — Permittee Signature: c* Call(503)639-4175 by 7:00 P.M.for inspections needed the next business day -Mechanical Permit Application Reccived Mactanical DrIe/B : �" y o ermit Nv Ee° a�-DN(50 ECEl ED Planning Approval` Building City of Tigard i ate/D : _ _ Permi.No.. 13125 SW Hali Blvd. Plan Review Other Tigard,Oregon 97223 AY 2 3 �t - _ Permit No: Post-Review [and Use Phone: 503-639-4171 Fax: 503-598-196 palSDy; Case No.: _ Internet www.ci hpard.or.us CITY Contact 1 ''p See Page 2 for 24-hour inspection Request 503-639-40WI,-� Name/Method: _ / / s■ lemental Information.—COMMERCIAL.FEE•SCI1 EDULE-USL CRE(s7CLiSr New construction —� Demolition Mechanical permit feet'arc based on the total value of the work Addition/alteration/r laeeOther: performed. indicate the value(rounded to the nearest dollar)of all _ ment ^ mechanical materials,equipment,labor,overhead and profit. CATEGORY OF CONS'TRUCTiON 1 & _Family dwelling Commercial/Industrial Value: S _ See Page 2 for Fee Schedule Accesso Building Multi-Family RESIDEiY IAL lrS1J�I�PMENT/SY5TE.MS FEE-S(IiEDULE _ry g _ - Description it, I Fee es Total Master Builder Otber: _He*tinVWJCooiln _ JOB SITE INFORMATION and LOCATiON Furnace-add-on air conditioning" 14.00 ,faD Job site address: ULI Gas heat pump 14.00 Suite#: Bldg./Apt.#: Duct work 14.00 _1!)!q tunic hot waters em 14.00_ Project Name: _e•_Q�,__- _ -- Residential boiler Cross streetfDirections to job site: for radiator or h�dronic a emL _1_4.00 Unit heaters(fuel,not electric) in wall,in-duct sus ed,eta 14.00 Fluelvcnt for any of above) _ 10.00 Repair units 12.15 Subdivision: Lot#: Other Fuel Amillances _ Tax ma / !reel#: Water heater 10.00_ _ DESCRIPTION OF WORK _ Gas fireplace 10.00 Flue vent(water heater/gas fi Iscc 10.00 Log lighter�Raa) _ 10.00 _ _ -- Wood/Pellet stove 10.00 Wood fireplace/insert 10.00 - ,-� Chimne /liner'flue/vent 10.00 OPERITY OWNER TENANT Other_ 10.00 !^_ Environmental Exhaust h Ventilation _ Name: O Range hood/other kitchen equipment 10.00 Address: Clothes Clothes dryer exhaust — 10.00- City/State/Zip: 0Ci /State/Zi : _TJ r4C&Ack ('?- A14�3 Single duct exhaust Phone: fo3U• 100_ Fax: (bathrooms,toilet compartments, APPLICANT NTACT PERSON utility rooms) _� 6.80 Name: �j t o ��hiyu_e L� Attic/crawlace fans 10.00 Other. � 10.00 Address: Roel plana city/state/Zip: •* sod I for first 4,$1. each additional) ---- Furnace,etc. IL Phone: Fax: Gas heat pump _- _- p� E-mail: _ Wall/su ded/unit heater F- CONTRACTOR Water heater N Business Name: Fireplace _ - Address: V I-m o k.Fi't Range City/ /ZI1 X11ate___ Clothes dryer(gas) UJ Phone: "1 ka 1 ' ISS Fax: 26a -5 3 Other: tal: " To _J CCB Lie. #: 1 C 91, - Mechardemi Permit Fuca• Authorized Subtotal: S � C Signature: 71 _Sl ._ Datc:54Minimum Permit Fee$72.50 S �l Plan Review Fee125%of Permit Fee S Strxc Surchar c(g°/.of Permit Fec) TE�q2 (Pleasc print name) ---- TOTAL FERMiT l?EF Notice: This permit application expires if a permit is wm obtained within 'Fee me hodolo`y set by Tri-County Building Industry Service Board. lgo days after It has been accepted as complete. "Site plan required for exterior A/C'units. is\D.1ts\Permit For m\MecPcrmitApp.doc 01103 Z -al b1369-29G-COS 'auI ` iti: ,IUVW)OW 4J0,4W03 d*S :20 E© f1 new LOT LINE: FIRST NAW: ]LAST NAME: Goa(L ADDRESS: /./b rk CM: STATF. ZIP: 0 7 O/L 9,;? INSTALLATION ADDRESS: CITY: STATE: -----PROPERTY IANE T— Fr- Vl: FRONT FT: PROPERTY LU4F X = OUTSWE UNIT atz 8L aip%mdmmW-ojtllms ft-sol-Ismow *669-291.-Cog *Oul ' lw0TUwt40vW -3.101IM03 d*S :20 co *1 now Y OF TIGARD 24-Hour BUILDING 1 Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 ---` — SUP — Received --- Date Requested. ? , AM PSA__�— BUF Location -7/ _ _ e — MEC 3 — 4d Contact Person — ��-�_ Ph(—_—) �'�� PLM _ Contractor _— _ Ph( —) SWR _ M' BUILDING Tenant/Owner _-- _— ELC Footing Foundation ELC Access: _—_— Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam -_ Shear Anchors - -- Ext Sheath/Shear Int Sheath/Shear 40 9 Insulation Drywall Nailing ---`--- Firewall Fire Sprinklor — ---- -- Fire Alarm Susp'd Ceiling - Roof Other: -- Final _ PASS PART FAIL - -PLUMBING Post Post&Beam I Inder Slab _ _- Rough-In Water Service - Sanitary Sewer Rain Drains — --- --- — -- - --- — Catch Basin/Manhole Storm Drain - - -- - ------ - Shower Pan Other: ------- ------ ---- __ - Final -- ----- PASS PART FAIL MECHANICAL Post&Beam Rough-In CL Gas Line Smoke Dampers � Ina PART FAIL - — -CTRICAL - m Service Rough-In W UG/Slab ---------- - ---------- Low Voltage Fire Alarm Final F1 Reinspection fee of$ required before next inspection. Pay at City Hall, 1312.5 SW Hall Blvd. PASS PART FAIL SITE _ Please call for reinspection RE: _ F1 Urable to inspect-no access Fire Supply Line ADA � Approach/Sidewalk Daft Other: Final DO NOT REMOVE this Inspealklen record from So job aft. PASS PART FAIL O � 1 � III lei CY coo cv II ASVW +1�4►ao .4 It ` CL N i to.06 � �.� lfr,CPl:.'PI t T?. i�0►� •fel :44A 4"4 31LA OI-WA IKNIJ CITY OF TMASTER PERMIT DEVELOPMENT SERVICES PEi-.MIT 0. . . . . . . : MS'T96-0460 13125 SW Nall Blvd.,Tigard,OR 97223(503)639-4171 DATE ISSUED: 02/22/99 PARCEL: IS134DA-10900 SITE ADDRESS. . . : 10710 SW NORTH DAKOTA ST SUBDIVISION. . . . :MLP96-0004 ZONING: R-3. 5 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :002 JURISDICTIONt TIG Remarks: PATH 1: New single family dwelling w/attached garage. Grade iss less than 10% -- ------- ------- ---------------- BUILDING - REISSUE: STORIES.......: 1 FLOOR ALAS--------_ BASEMENT...: o sf NEOUINiED SETBACKS--- REQUIRED-- —— CLASS OF WORK.:NEW HE.IGHT.......... 22 FIRST....: 2853 sf GAWIIi1GE.....: 624 sf LEFT..........: 15 9MDKE DETELTR9: Y TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 8 sf FRONT.........: 78 PARKINB SPACES: 2 TYPE OF CON5T.:5N DWELLING UNITS: 1 FINBSMENT: o of RISK.......... 12 OCCUPKY GRP.:93 BDRM: 3 BATH: 3 TOTAL------: 2853 sf VALUE..S: 168343 REAR..........: 5o ---.---_.___-- -- PLUMBING ___--_- SINKS.........: 2 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: o RAIN DRAIN ft: 238 TRAPS.........: o LAVATORIES....: 4 DISRAMERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 230 9F PAIN DRAINBs 3 CATCH BASINS..: 8 Tl1H/SHHOWERS...: 2 GARW DISP..: 1 HATER HEATERS.: 1 WATER LINE ft: 239 BCKFLW PREYNTR: 1 GREASE TRAPS-: 8 OVER F1XTURE9s 8 ---------------------------------------------- ------ MEGWNICAL FUEL TYPES---------- FURN ( 108K ..: 1 BOIL/CME ( 3HP: 1 VENT FANS.....: 3 CLOTHES DRYERS: I GAS FURN )=101K ..: 0 UNIT HEATERS..: 0 HOODS.........: 8 OTHER UNITS...s i MPX INP.: 0 BTIJ FLOOR FURNACES: 0 VENTS.........t 0 WOODSTOVES..... 0 GAS OUTL.ETS...s 1 ELECTRICAL ----- - ___ --RESIDENTIAL UNIT--- ---SERVICE/fhE""9---- --TENP ERVC/FEEDERS- --BRANCH CIRCUITS-- ---MI9CELLAlEOl1S---- --ADD'L INSPECTIONS- 1080 SF OR LESS: 1 1 208 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: o PINK/IRRIGATIONS 8 PER INSPECTION: 0 EA ADD'L 581SF.: 5 291 - 400 amp..: 1 291 - 404 ago..: 0 1st W/0 SVC/FDR: o SIGN/Off LIN LT: 0 PER HOUR......: 0 LIMITED ENERGY.: 8 401 - 606 amp..: 0 401 - 600 amp..: 0 EA AIR BR CIR: 0 SIGNAL/PANEL....! 0 IN PLANT......: 0 MANE HM/SVC/FDR: 0 601 - 1080 amp.: 0 601+89ps-1008 v: 0 MINOR LABEL -18: 8 low alp/volt,: 0 ------------------------------- PLAN REVIEW SECTION --------- -_---------------- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)-25 A.: ) 600 V NOMINAL: CLS AREA/9PC OCC- ------ ELECTRICAL - RESTRICTED ENERGY ------- --- A. SF RE91DEKIAL ------ __-- B. CONERCIiE -- - AUDIO t STEREO.: VACUUM SYSTEM..: AUDIO L STEREO.! FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LND9C LT: BU%AR ALARM..: DTH: :: BOILER.........: HVAC...........: LAN'9CIWE/IRR1G: PROTECTIVE SIX: GARAHHE OPENER..: CLOCK..........: INSTWHENTATION: MEDICAL........: OTHR: Ss HVAC...........: DATAJELE COM.: NURSE CALLS....s TOTAL i SYSTEMS! o Owner: -----------------------------------Contractor: ---------------------------- TOTAL FEESO 5291.01 COOK, KEN b RENEE M, , KEN 6 RENEE This permit is subject to the regulations contained in the 18388-C NAW CORNELL ROAD 19380 Hol CORNELL RD OC Tigard Municipal Code, State of Ore. Specialty Codes and all BEAVERTON OR 97006 BEAVERTON OR 97806 other applicable laws. All work will be done in accordance with approved plans. This permit "ill expire if work is Phone A: Phone N: V--%37 not started within 181 days of issuance, or if the work is Reg 1..: suspended for more than 180 days. ATTENTION; Oregon lar ------------------•---------------------------------------- ----- requires you to fo'.low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in DAR 95?-W-1819 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNNC by calling (593)246-1987. ------- --- ---------------- - REQUIRED INSPECTIONS --- ---------____ Erosion 844-8444 C• ' Drain/Back Electrical Rough Insulation Insp Mechanical Final Footing Insp F ierfloor Framing Insp Rain drain Insp Plumb Final Foundation Insp C ical Insp Shear Wall Insp Water Service In Building Final Post/Beam lumb Top Out Low Voltage Appr/Sdwlk Insp Post, echan ctrl 1 rvi Gas Lille Insp Electrical Final Issued y : F'Prmittee Signatures_ ++++++i t f++.... ..........+++F++ .++h+i f++++++4 1 i++++++++++1 t++4+ -++++++++ Cel1 639-4175 by 7100 p. 0. for an inspection needed the next business day Plan Check# CITY OF TIGARD Residential Building Permit Application Reed By _ 13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. - V 503-639-4171 Date to UST f #� F 503-684-7297 Permit*f � O Print or Type /,/ 1-- ' Incomplete or illegible applications will not be acceptet: Name of Project me { ----- Job INC ' Mc16131f l Address Site Address o�)I0 Sw a.Za, Architect Mailing -- _ ��lG�r•�— it�rsia� zip Vnt Na Owner Mailing Address119 0-1�4 /• s ityStats Zip Phnne C Engineer Mailing Addrnsss-49 — City/State T_Ip Phone—� General ani �_ Contractor G Describe work -New)) Addition O Alteration O Repair O Mailing Address - to be done: _ Prior to permit Additional Description of Work: issuancb,a copy City/State Zip Phone of all licenses are required If O�egon Const.Cont Board Exp.Date PROJECT } 1 expired in COT 'ic.# VALUATION database Mechanical Name_ — NEW CONSTRUCTION ONLY: Sub- _ Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address __ I _ Prior to permit Comer Lot YES Nth Flag Lot YE NO issuance,a copy City/State Zip Phone ` (check one) (check one) _ of all lic,,nses Restricted Audio/Stereo _ Burglar are required if Oregon Const.Cont.Board Exp.Date Energy S stem Alarm expired in COT Uc.# ----- database Installation Garage Door HVAC Plumbing Name —� Opener S stems Sub- ��`� (check all that Other: Contractor MailingAddress dross ap-W Will the electrical subcontractor wire for all YE NO Prior to permit City/State Zip Phone restricted energy installations? Issuance,a copy Has the Subdivision Plat recorded? N/P, T NO L of all licenses aro Oregon Const.Cont.Board Exp. Date r required if Lic.# Reissue of MST#: Salar Compliance expired in C07 _ (Calculatkm Attached) n database Plumbing Lic.# Exp.Dates I henrby acknowledge that I have read this aFolication,that the information given is rorrect,that I em the owner or authorized ,j ------ - Name ----- — agent of the owner, and that plans submitted are in compliance n Electrical with Pinon State laws. �,. 9n of Uwneu/Age —� at Ll Sub- Mailing Address - J Contractor Cwt ct Person Name OJ CoDL i g City/Stets Zip Phone -'1 Prior:o permit F OFFICE USE ONLY: issuance,a copy Plat#: Mep/TL#: of all licenses are Oregon Const Cont.Board Exp.Deft /,5-/.3 3/m -/09O(1 required if Lic.# asks: --_` Zone: expired in COT z database Electrical Lic.# Exp.Date E,ngi�jr�ing Approval: Planning Approvals �L/39!'� 000 r" eao LSFREW DOC MST) 4A7 Solar Balance Point Standard Workshmet Address r Box A calculations: North-South dimension for the lot. Box A: This dimension is determined by finding the midpoint of the North lot line and drawing 1 1 an intersecting line perpendicular to that point. First, determine which property line is the North lot line. The North lot line is the line with the smallest angle from a line drawn east-west and intersecting the northern most point of the lot. Oro-► ° ' North-South N Dimension for Lot: Measure the distance from It-- midpoint of the North lot line to the South lot line along the described line. �l 05 feet 1 \N ` F-FNMaanM Box B calculations:, Shade point height for your residence. Box B: 1. Determine whether measurements will be based on the peak or eave of your Which describes structure. The orientation of the ridge is also important. your residence? 1 a: If the roof line runs North-South, measurements will .00.4MM (circle one) be based on the peak of the roof. a Mau o het CL Hem -W D.A 1B 1C oc H 1 b: If the roof line runs East-West and the roof pitch is less than 5/12, measurements will be based on the Co U eave. !u0[�OM1EM4. w 1 c: If the roof line runs East-West and the roof pitch is 5/12 or steeper, measurements will be based on the ,: , peak. Box B. continued Box B: 2. Measure change in elevation from front property line to finished floor elevation. If the lot slopes up from the front lot line to the foundation, the figure is positive. if the lot slopes down from the front lot line to the foundation, the figure is negative. - -�—'--- - ft 3. Measure distance from finished floor elevation to the affected peak/eave. + -�-- ft 4. If the roof line runs North-South, deduct the.:. feet. If the roof line runs East-West, - --- ft deduct nothing. 5. Subtract one foot for each foot of difference in elevati%m from the front property line to the rear property line, if the lot slopes tip fmni the front to the rear. If the lot has no slope or slopes up from the rear to the front, deduct nothing. Q _ ft 6. Total figure for box B: _ ft Box C. Distance to the shade reduction line. box C: 1. Measure the distance from the North property line'zo the foundation near the f off- ft affected peak/eave. 2. Measure the distance from the foundation to the affected peak or eave. + _ ft 3. Total figure for box C: ft It is most useful to draw a vertical line to represent the appropriate figure found in boot'r;'and a horizontal lire to represent the appropriate figure found in box 'C'.The intersection of the vertical and horizontal lines determines the value found in box'D'.The value in box'D'should be compared to the value in box'B'; if the value in box"5'is less than or equal to the value found in box"D Hien the building is in compliance with the solar balance code. If you have any questions, please contact us at 639-4171,x304 or at the Community Development Counter. MAXIMUM PERMITTED SHADE POINT HEIGHT In FOM Distance to North-south lot dimension(in feet) shade 100+ 95 90 85 80 75 70 65 60 55 50 45 40 reduction line from northern lalimon feet) 70 40 40 40 41 42 4.3 44 65 38 38 38 39 40 41 42 43 60 36 36 - 37 38 39 40 41 42 55 34 34 34 35 36 37 38 39 40 41 50 32 32 32 33 34 35 36 37 38 39 40 45 30 30 30 31 32 33 34 35 36 37 38 39 40 28 28 28 29 30 31 32 33 34 35 36 37 38 35 26 26 26 27 28 29 30 31 32 33 34 35 36 30 I4 24 24 25 26 2'i 28 7.9 30 31 32 33 34 25 22 22 22 23 24 25 26 27 28 29 30 31 32 20 20 20 20 21 22 23 24 25 26 27 28 29 30 15 18 18 18 19 20 21 22 23 24 25 26 27 28 10 16 16 16 17 18 19 20 21 22 23 24 25 26 5 14 14 14 15 16 17 18 19 20 21 22 23 24 Box D. Maximum allowed shaae paint height: feet h',dcx-s\nancy\ventura\solar.chp Rovised 2/26/96 • Permit #: "' Ad ss: ej Ay� IF zJ Issu b Date: 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 regist-red with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement 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 appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: liq1. I own, reside in, or will reside in the completed structure. Lg I 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale ��J before or upon completion. ❑ 3A. My general contractor is (Name) Contractor regis_ # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR Iii 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 contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby cer+ify that the above information is correct and that I have read and do understand the Informati-m Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (Signature of permit applicant) (Date) (White copy to issuing agency permit file., pink copy to applicant) information Notice to Property Owners About Construction Responsibilities h we: This In for{notion Notice to Property Owyers aboat Construction Responsibilities was develope(I by Nue,Construction Contractors Board in it cordance with ORS 701.045(5) If you are acting as,your own contractor to construct a new home or make a s1.117stantial improvement to an existing stria aurc, you can prevent mwiy„krobicin,by being aware of the fol!owing responsibiliti,-s and ar s of concern. EMPLOYER RESPONSiBiLITIE . If you hire persons not registered wi the Construction Contractors Board t dor labor in constructing or assistinj� in the construction or improvement of a residen stnicture,you will, in ml)st instar -es,he riled to be an employer and the people you hire will be employees. As the employer, ou must comply with the foil ving: Oregon's withholding tax law: As an employer,y must withhold inco taxes front employee wages at the time employees are paid, You w ill be liable for the tax payments eve if you don't actuall withhold the tax from your employees. For more information,call the Oregon Dept.of Revenue at 945 1. Unemployment insurance tux: Asan er+,ployer,you are fired to ay a tax for unrcnpicyment insurance purposes on the wages of all employees. For more informatitm,call the Oregon ' pi yment Division at the Department of Human Resources at 378-3524. Workers'compensation insurance: As an employer,you are s jest t e Urcgon Workers Compensation Law,and must obtain workers'compensatio n insurance for your employees. If oil fail to twin workers'compensation insurance,you may he subject to penalties and will he liable for all claim costs if one f your emplo w is injured on the job. For more.information, call the Workers'Compen,ation Division at the Department Consumer and siness Services at 945-7888. U.S.Internal Revenue Service: As an ernploycr,you mus withhold federal incom ax from employees'wages. You will be liable for the tax payment even if you didn't actually with d the tax. For more inform t ion,call the Internal Revenue Service at 1-800-829-1040. OTHER RESPONSIBI TIES AND AREAS OF CON ERN: Code compliance: As the permit holder for this pr ect,you an r� .pon�►hle for resole ia�f ani I iinre to rneetcode requirement that may be brought to your attention through i pections. a Liability send property damage insurance, .ontact your insurance agent to see if you have.adequate insurance coverage 1 or F- accidents and omissions such as falling t s,paint overspray,water damagg from pipe punctures, tire,or work that must be re-done. Time to supervise employees: ke sure you have sufficient time to duper fist' yorrr rmplinivees. m WFxpertise: Make sure you a the expertise to act tis your own general contractor,to coordinate the work of ra ria€h in and finish -a trades,and to t»tify bui ng officials At the apprdiiriattr tithes so they can perform the required inspections. if you have addition i questions,write or call the Construction C:ontractbrs Board(Fn Box 1 1140. Salem,nTt 97'(01-5052, 503/378-4621). The Board is located at 700 Summer St. NF Suite 100, in Salem. prop-own.pm4 1/94 h ti. .�,q a i, r7 CITY OF TIGARD CERTIFICATE OF OCCUPANCY PERMIT#: MST98-00460 DEVELOPMENT SERVICES DATE ISSUED: 02/22/1999 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARSEL: 1S134DA-10900 ZONING: R-3.5 JURISDICTION: TIG SITE ADDRESS: 10710 SW NORTH DAKOTA ST FILE COPY SUBDIVISION: MLP96-0004 BLOCK: LOT:002 CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TEMANT NAME: REMARKS: PATH I: New single family dwelling w/attached garage. Certificate of Occupancy Approved 11/15/99 by Rick Bolen, Building Inspector Owner: Phone: Contractor: COOK, KEN t RENEE 18380 NW CORNELL. RD #C BEAVERTON, OR 97006 Phone: 533-0637 Reg#: This Certificate grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and useu der whic the referenced permit was Issued. BUILDING INSPECTOR BUILDIN FICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST e 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 UP _ Date RPquested ( ' �� AM PM BLD Location ] / U _ �uite MEC Contact Person Ph PLM Contractor Y�� _ pt, SSR _— BUILDING Tenant/Owner ELC — Retaining Wall ELR Footing Access: ' Foundation FPS _ Ftg Drain SGN Crawl Drain Inspection Notes: — Slab 31T Post R Beam - () ' Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall / Fire Sprinkler — Fire,Alarm Susp'd Ceiling Roof Misc: -- - --- S PART FAIL ----------- -- RING Post& Beam -- - -- Under Slab Top Out Water Service S.nitary Sewer - Rain Drains Final .-- PASS PART FAIL MECHANICAL Post& Beam - --- -- - - - Rough In Gas Line - -- - -- - ------ - Smoke Dampers Final -- -- PASS PART FAIL ELECTRICAL Service ----- - ----__�_ _.� - Rough In UG/Slab - — ---- - - - - -- -- Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain ( J Reinspection fee of$ required b, a next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin P Fire Supply Line ( I ease call for reinspection RE: [ ]Linable to inspect no access ADA e1_1 Approach/Sidewalk 1 AppyOtheDate ` ~ Inspector_ - Ext) Appro Final PASS PART FAIL fjV NOT REMOVE this Inspection record from the job site. CITY QF TIGARD DEVELOPMENT SERVICES SE4'ER CONNECTION Armam 13125 SW Nall 81vd.,77gard,OR 97223(503)M4171 PERM,'T PERMIT N. . . . s SWR98-0264 DATE ISSUED: 09/24/98 PARCEL: 1S134DA-10900 SITE ADDRESS. . . : 10710 SW NORTH DAKOTA ST SUBDIVISION. . . . iMLP96•-0004 7-ON I NG: R-3. 5 B1...00K. . . . . . . . . . LOT. . . . . . . . . . . . . 3002 JURISDICTION: TIO -----------------------------------------------------------------•----------------- TENANT NAME. . . . . :COOK, KEN b RENEE USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0 CLASS OF WORK. . . :ALT DWELLING UNITS. . : 0 TYPE OF USE. . . . . :8F NO. OF BUILDINGS: 0 INSTALL_ TYPE. . . . :LTP IMPERV SURFACE: 0 sf Remarks : Install sewer line, for future single family dwelling. Owner: -.-------------------------------------------------- FEES -------------- COOK, KEN & RENEE type amount by date recpt 18380-C NW CORNE LL ROAD PRMT f 2300. 00 B 09/24/98 98--309464 BE:AVE:RTON OR 97006 INSP f 35. 00 B 09/24/98 98-309464 Phone #: 533-0637 Cont ractor^: ------------------------------ OWNF_R ------------------------------------------------ Phone #: $ 2335. 00 TOTAL Rey #1. . ------- REQUIRED INSPECTIONS ------- This Applicant agrees to comply with all the rules and regulations S- - -or Inspection of the Unified Sewage Agency. The permit expires 190 days from _ tho date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from - r the distance given. If not so located, the installer shall purchase _ a "Tap and Side Sewer' Permit and the Agency will install a lateral. nTTENTION: Oregon law requires you to follow rules adopted by the CL Oregon Utility Notification Center. Those rules are set forth in OAR _ p� 952-01-011 through OAR 952-0011 000. You may obtain copies of _ these rules or direct questions to OLK by calling (503)246-1907. T s s u e d m bY:_�� Permit t o S i g n a t u r e. `--�,+�•'v�. C7 W ++.+++++++t++++++t+4•+++++++•*++++++++++++++++++++4.t t+t t+-F+++t t t+t t t++t++++t t+++++. Call 639-4175 by 7:00 p. m. for an inspection needed the next business day ++Fl+++F4•++++.+++.+.......tt++t++++t+•#t+t+... Ft+t++++.++++++...........++++t+.... CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT 13125 SW Hall Blvd.,Tlgard,OR97223(503)63.44171 PERMIT #. . . . . . . s PLM98-0350 DATE ISSUEDa 09/24/98 PARCEL: 1S134DA-10900 SITE ADDRESS. . . : 10710 SW NORTH DAKOTA ST SUBDIVISION. . . . : MLP96-0004 ZONING: R-3. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :002 JURISDICTION: TIG CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE-HOME- - SPACES. s0 _ - TYPE OF USE. . . . eSF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . s 0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 TORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . s 0 FIXTURES------------- LAUNDRY TRAYS. . . . . s 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . s 0 GREASE TRAPS. . . . . . . s 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 300 WATER CLOSETS. : 0 WATER LINE (ft) . . . a 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . a 0 Remarks: Install sewer line, for future single family dwelling. Owner: ------------------------------------------------- FEES -------------- COOK, KEN 11 RENEE type amount by date recpt 18380-C NW CORNELL ROAD PRMT $ 80. 00 B 09/24/98 98-309464 BF_AVERTON OR 97006 SPCT $ 4. 00 B 09/24/98 98-309464 Phone #: 533-0637 Contractor--------------------------------- JOHN FRANK 16780 SW BULL MT RD TIGARD OR 97223 ------------------------------------- Phone #: 628-0155 • 84. 00 TOTAL Reg #. . : 62819 ------- REQUIRED INSPECTIONS -------- This permit is issued subject to the regulations contained in the Sewer Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all ether Final Inspection applicable laws. All work will be done in accordance with 4. approved plans. This permit will expire if wor4 is not started within 198 days of issuance, or if work is suspended for mire - _ ��— ai than 188 days. ATTENTIONS Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are J set forth in DAR 952-MI-011 through OAA 952-!811-1/81. You may m obtain copies of these rules or direct questions to OIX by calling (a (583)246-1987. LU .JA. -- Tss,.Sed By — �l__� _ Permittee Signature: �f i+++++++++++i++++++++++++++++++ii•++++++++++.++++++t+++++++++++++++++++.+++++++ Call 639--4175 by 7:00 p. m. for an inspection needed the next business day i++++++++++++++++++++++++++++++++++++++++++t+t+++++t+t•}4+++++++++++f++++++++++ CITY OF TIGARD Plumbing Permit Application Plan Cher*0 13125 SW HALL BLVD. Commercial and Residential Recd By_ -�- TIGARD, OR 97223 Date Recd (503) 639-4171 Dale to P.E. Print or Type Date to DST_ r Incomplete or illegible applications will not be accepted Permit: !0-0 Related SWR Called. Name of Development/Project Job U sink -9.00 Address Street Address0414",§ ,.��tn^ We Lavatory 9.u? 15 1)" ��' V '^ Tub or Tub/Shower Comb. 9.00 Bldg f .City/State Zip Shower Only 9.00 ame Water Closet 9.00 .r -}�C� e cooDishwasher^ 9.00 Owner Mail( Address Suite Garbage Disposal 9.00 1 RS C wV3 CO - Washing Machine 9.00 City/State Zip P orw - ��G4,y�� Floor Drain/Floor Sink 2" -_ 9.00 Name / 3" 9.00 4" 9.00 Occupant Malting Address Suite - Water Heater O conversion O like kind 9.00 \0 _ Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 Name - �V\ CkOther Fixtures(Specify) _ 8.00 Contractor Mailing Ad ress (�oSuite 9.00 7W r,k 9.00 Prior to permit City/Stale Zi Phone Sewer-tel 100' 30.00 r� issuance,a copy A 5,10-0,500 Sewe,-each additional 100' 25.00 of all licenses are OregoOAV n Conssttt.. ontyBoard Lic.tf Exp.Date _ required if Water Service-1st 100' 30.00 expired in COT "Itl 84OMPMi# Exp.Date Water Service-each additional 200' 25.00 database cleo yk Storm$Rain(rain-1st 100' 30.00 Name Storm d Rain Drain-each additional 100' 25.00 Architect Mobile Home Space 25.00 or Mailing Address Suite Commercial Fuck Flow Prevention Device or Anti- 25.00 Pollution Device Engineer City/State Zip Phone Residential Backflow Prevention Device' 15.00 (Irrigation timing devices squire a separate Describe work to be done restricted energy permit. New V Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 Residential G; ' Commercial O Calcil Basin 9.00 Additional description of work. Insp.of Existing Plumbing 40.00 per/hr IL Specially Requested Inspections 40.00 _ erRtt - Rain Drain,single family dwelling 30.00 U) Are you capping, moving or repla Ing any fixtures? Grease Traps 9.00 Yes O No If yes,see back of forst to indicate work performed by '- QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram M required K OuantM Total Is >o WORK COULD RESULT IN INCREASED SEWER FEES. - is •SUBTOTAL Lu I hereby acknowledge that I he-,e read this application,that the Information _ _ -1 given is correct,that I am the owner or authorized agent of the owner,and - 6%SURCHARGE that plans submitted are in compliance with Oregon Slate Laws. _ Signature of Owner/Agent Date **PLAN REVIEW 25%OF SUBTOTAL 6 Required on M fixture .total Is>9 TOTAL U/ Contact Person Name - Phone 7J/ r^I �y\C,N,� CvU� j?� 'Minimum permit fee Is$25+5%surcharge.except Residential Backflow � Prevention Device,which is$15+5%surcharge **All New Commercial Buildings require plans with isometric or riser diagram and plan review I.ldslalplumapp doc 7098 O PLEASE COMPLETE: Fixture Type _ Quantity by Work Pe Red New Moved Replaced Removed/Capped Sink Lavatory Tub or Tub/Shov(er Combination —, Shower Only Water Closet _ Dishwasher _ Garbage Disposal Washing Machine _ Floor Drain/Floor Sink 2" 411 Water Heater Laundry Room Tray _ Urinal Other Fixtures (Specify) COMMENTS REGARDING AB E: J m - w J !w$ft4 wn8w ftc 7I7M CITY OF TIGARD BUILDING INSPECTION DIVISION M 24-Flour Inspection Line: 639-4175 BusAM--- Mess Line: 639-4171 _ �l _Date Requested ) � f AMD BL I-ocation- ) U -150 w� _ iliit@ MEC Contact Person 6 _ Ph 7 PLM Contractor Ph S �� BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post&Beam Ext Sh,iath/Shear int Sheath/Shear Framing Insulation Drywall Nailing i Firewall �-1/ti• / Q Fire Sprinkler _. -C-,Lf Fire Alarm Susp'd Ceiling Pool F ina: PAS RT FAIL --- P — Ontlor Slab Wate ce nit � ain Ur ins __ Fin W PART FAIL WVC-HANICAL Post& Beam Rough In Gas Line - Smoke Dampers Final - PASS PART FAIL ELECTRICAL -" d Rervice Rough In ~ IJG/Slab Low Voltage — -�- - Fire Alarm 4 Final m PASS PART FAIL - - - -- - W SITE 'a Backfill/Grading - -- _ - Sanitary Sewer Storm Drain ( t Reinspection fee of$ required before next inspectloc. Pay at City Hell, 13125 SW Hall Blvd Catch Basin [ ]Please call f-r reinspection RE: [ ]Unable to ins"rt-nn access Fire Supply Line -�-- ADA Approach/Sidewalk Date Inspector EO � Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.