9605 SW NORTH DAKOTA STREET r
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9605 SW NORTH DAKOTA ST
CITY C)F T f G A�R D BUILDING PERMIT
PERMIT#: BUP2001-00130
DEVELOPMENT SERVICES DATE ISSUED: 5/9/01
13125 SW Hall Blvd..Tigard,OR 97223 (503)639-4171 PARCEL: 1S135CA-00303
SITE ADDRESS: 09605 SW NORTH DAKOTA ST
SUBDIVISION: ZONING: R-12
BLOCK: LOT: JURISDICTION: TIG
REISSUE: �/ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ��" FIRST: sf N: S: E: W:
TYPE OF USE: F o-' SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: a sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNIT: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,178.00
Remarks: Place.nent of 10'x 14'metal shed at rear of property.
Owner: Contractor:
GILLINGHAM,TERRY L AND OWNER
SHARON A SIGNED RESPONSIBILITY
9605 SW NORTH DAKOTA FORM IN FILE
TI AF 0! OR 97223 Phone:
U e.
Reg#:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
5PCT CTR 4/19/01 $5.00 27200100000 Foundation Insp
Post/Beam Insp
PRMT CTR 4/19/01 $62.50 27200100000 Framing Insp
PLCK CTR 4/19/01 $40.63 27200100000 Rain Drain !nsp
Final Inspection
Total $108.13
a
N This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. 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. ATTENTION: Oregon law
ED requires you to follow the ruses adopted by the Oregon Utility Notification Center. Those rules ire set forth in OAR
(7 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
J calling (503)246-6699 or 1-800-332-2344.
Permittee �fl
Signature:
Issued By:
Call 639-4175 by 7 p.m.for an Inspection the next business day
Building Permit Application �
Datereccived: V1,1l11 Permit-11.: -eevv
City of Tigard ��.
Address: 13125 SW Hall Blvd,Tigard,OR 97223 "ecdappl.no.: Expiredate:
CiryofTigard Phone: (503) 639-4171 Date issued: By: I Receipt no.: n
Fax: (503)598-1960 �/�„ Cwus file no.: - Payment type:
Land use approval: / / / I&2 family:Simple Complex: C
-01I &2 fwnily dwelling,. accessory U Commercial/industrial 1.1 Multi-family U New construction U Demolition
0 Addition/alterntion/replaclem"�- U Tenant impmvcmeni J Fire sprinkler/alarm (_Xher. (T�
L
Job address: ?6,0S sq� A10i0 TJfi` "T?yBldg.no.: Suite no.:
Lot: Block: Subdivision: _ Tax map/tax lot/account no.:0/
Project name:
Ikscription and location of work on premiscs/special conditions:� t 9 /O 1�/ to _
—
1 Name: S i '
Mailing address: Yt,nA h*kv �- I &2 family dwelling:
City: '&eirState: 7.1P: 2 Valuation of work.............�3.�..7.A..:.......... $ k
3 Phone: _ � Fax: - E-mail: - _ No,of bedrooms/baths................................. --•-
Owner's representative: e.,7V 'y _ Total number of floors.................................
Phone: - t7 o Fax:11 _ Z mail: '� New dwelling area(sq.R.) ..........................
Garage/carport area(sq.R.). . --
Name: Covered porch area(sq.R.) ......................... _
- -- Deck area(sq.ft.) .......
Mailinr,address: .._ '..•..•....
City: State: ZIP: Otter structure area(sq.R.).......... ...F
Phone: Fax: I E-mail:
tGNmmtercial/Indaatirlal/maill-fatdly: }
Valuation of work........................................ $Existing bldg.area(sq.ft.)............... ..........
Business name: 1
lie Z New bldg.area(sq.RJ ...... ............ _
Address: V 6,/ 0 4 o Number of stories .........
City: „ State: t7ZIP: `�22 of cons ....... -
Type traction
Phone: Fax: Email: Occupancy group(s): Existing:
CCB no.: — New:
City/metro lic.no.: Notke:All contractors and subcontractors aro required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be mgt.:.cd to be licensed in the
Address: jurisdiction where work is being performed.If the applicant is
IL State: ZIP. -- exempt from licensing,the following reason applies:
City: ---_ —
Contact person: — Plan no.:
Phone: Fax: E-mail
1-
Name: Contact person: Fees due upon application ...........................$
�j Address: _ Date received: _—
W City: State: ZIP: _ Amount recrived ......................................... $
-I Please refer to fee schedule.
Phone: Fax: E-mail• _ _ -
I hereby certify I have read and examined this application and the Nm an iodusedan rxep t"'caft pkv an iurfadlectbn for more+^rormtIon
attached checklist.All provisions of laws and ordinances governing this U Visa U MasterCard
work will be complied ith,wether s died herein or n (rceir card nem:
8:plrcr
Authorized si tureA Date: O __ tv.n,rd d on card s
Print name: I' ; �' -- - c -- Aasoorpt -
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. wo rau MMc!pt,tl
T GS Z.S C< �r4 -pt_ X3
/1�t Z=�G Lf L � �►��, , �:.i; � f.t..,•����.-' ,ore ri� 5'�,6 3.J
One-and Two-Family Dwelling
Building Permit Applicatlyon Checklist Rtfertnctno.:
Ctrvo/Tigard Cit of Tigard Associated permits.
City b U Electrical U Plumbing U Mechanical
Address: 13125 SW Hall Blvd,Tigard,OR 97223 / U Other:
Phone: (503) 639-4171 --
Fax: (503) 599-196:)
I Land use actions completed.See jurisdiction'criteria for concurrent revic S.
2 Zoning.Flood plain,solar balance points,seistiMc soils designation,hist is district,etc.
Verification of approved plat/lot.
4 Eire district approval required.
-5 Septic system permit or authorization for remodel.Nisting syste apacity _
6 Sewer permit.
7 Water district approval.
9 Soils report.Must carry original applicable stamp and sign ure n file or with application.
9 Erosion control U plan U permit requirrd. Include drainage- y protection,silt fence design and location of
a cfi-basin protection,etc. _
10 Complete sets of legible plans.Must be drawn to scale sbo\ingonformance to applicable local and state
O building codes. Lateral design details and connections must intted into the p'ans or on a separate full-size
sheet attached to the plans with cross references between pl n locnd details.Plan review cannot be completed
if copyright violations exist.
I I,,Site/plot plan drawn to scale.The plan must show lot and ilding setback irnensions;property corner elevations(if
there is mors than a 411.elevation differential,plan must s w contour lines 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location f wells/sepuc syste s;utility locations;direction indicator:lot
area;building coverage area;percentage of coverage;im rvious area;existing skictures on site;and surface drainage.
12 Foundation plan.Show dimensions,anchor belts,a hold-downs and rein fo 'ng pads,connection details,vent
v size and location. _
13 Floor plans.Show all dimensions,room identifica on,window size,location of s oke detectors,water heater,
furnace,ventilation fans,plumbing fixtures,balco ies and decks 30 inches above gr Ie,etc.
14 Cross section(s)and details.Show all framing-rn her sizes and spacing such as floor ams,headers,joists,sub-floor,
wall construction,roef construction.More than on cross section may be required to Clea portray construction.Show
r details of all wall and roof sheathing,roofing,too slope,ceiling height,siding material,f ngs and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new co struction;minimum of two elevations for ad 'tions and remodels.
Exterior elevations must reflect the actual grad if the change in grade is greater than four foot building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acce table. _
16 Wall bracing(prescriptive path)and/or latetal analysis plans.Must indicate details and locatio for
non-prescriptive path analysis provide specifi4ations and calculations to engineering standards. _
17 Floor/roof framing.Provide plans for all flrs/roof assemblies,indicating member sizing,spacing,an aring
` locations.Show attic ventilation.
} 19 Basement and retaining walls.Provide crosi sections and details showing placement of rebar.For engineered
systems,see item 22,"aigineer's calculationk.11
19 Beam calculations.Provide two sets of calcutions using current code design values for all beams and multiple joists
0- over 10 feet long.nd/or any beam/joist ci a non-uniform load.
OC 20 Manufactured floor/roof truss design details.
H
N 21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is requited
?- for four or more appliances.
J22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
m architect licensed in Oregon and shall be shown to be applicable to the project under review.
C7
� 2� Five(5)s plans are required for Item I 1 above. Site plans must be 9-1/2"x I I"or I 1"x 17".
24 'two(2)sets each are required for Items 16, 19,20&22 above. _
25 Building plans shall not contain red lines or tape-ons.
26 No rolled,reversed or mirrored building plans will be accepted.
27
29
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 4404614(fiMCW
Permit#: _&6 601-001.96
j —
• Address: _Lwv;!�_
Issued by: Date: S kle,
a, 1 -(���
Statement: information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.05.5(4), requires residential construction permit appli-
cants who are not registered 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:
1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
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
C 3B. I will he my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change ray 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.
U I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Propert Owners about Construction Responsibilities on the reverse side of this form.
onatre of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
Information Notice to Property Owners '
About Construction Responsibilities
Note: This 11yonnaliun Notice lu Property Owners about Construction Responsibilities
-
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you areacting as your own co tractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many proble ins y being aware of the following responsibihiles and areas of concern.
EMPLOYER RESPONSIBILITIES:
if,you hire persons not registered wi the Construction Contractors Board to do labor in const'ruaing or assisting in the
construction or improvement of a resid tial structure,you will, inmost instances,be ruled to bean emplbyer and the people
you hire will be employees. As the empl er,you must comply with the folldwing. .
Oregon's withholding tax law: As an emplo r,you must withhold income taxes from employee wages at this time employees
are paid. You will he liable for the tax paymen . even if you don't actually withhold the tax from your empl)yees, For more
information,call the Oregon Dept. of Revenue at 5-8091,
Unemployment insurance tax: As an employer,you a required to pay a tax for unemployment insurance purposes on the
wages of al I employees. For more information,call the Or on Employment Division at the Department of Htunan Resources
at 378-3524.
Workers'compensation Insurance: As an employer,you are s .ect to the Che orkers'Compensation Law,and nrait
obtain workers'compensation insurance for your employees. If yo ail to .in workers'compensation insurance,you.ma
be subject to penalties and will be liable for all claim costs it one of vo iployees is injured on the job. For rr►ore informadotA.
call the Workers'Compensation Division at the Department of C su r and Business Services,at 945-7888.
U.S.Internal Revenue Service: As an employer,you . withhold feder inct,.,re tax from employees!wages. You will he
liable for the tax payment even if you didn't actuall ►thhold the tax. For mo information,call the Internal Revenue Service
at 1-800-829-1040.
OT RESPONSIBILITIES AND AREAS O CONCERN:
Code complidnce: As the permit holder for this x oject,you are responsible for resolving ny failure to meet code requirements
that may be brought to your attention through inspections.
a liability and property damage insurance: Contact your insurance agent to see if you have uate insurance coverage for
Faccident.;and omissions such as falling tools,paint overspray,water damage from pipe punctur fire,or work that must be
to re-done.
-� Time to supervise employees: Make sure you have sufficient time to supervise your employees.
m
WExpertise: 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 inspectkAns.
If you have additional questions, write or call the Construction Contractors Board(PO Boxy I4140,Salerh,OR,97309-5052,
5031378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
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• CiTY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST ——
BUR ���-•-rel�
Date Requested ; AM A""I—PM BLD
Location & ) Sw IVVtA a/4y'�lti S1- Suite MEC
Contact Person _— /(re►j _ Ph U PLM
Contractor Ph _— SWR
Tenant/Owner 94011,0 �'�/ ^� ELC
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: 'GN
Slab — 3IT
Post&Beam -
Ext Sheath/Shear
Int Sheath/Shear /
Framing _ 0,41 C4 A G r t S�r ��.Lw//i+ �� /34c
Insulation --
Drywall Nailing lir c c � 7 StT� G,�-S r l� ri'' ,c
Firewall -
Fire Sprinkler _ C/C e'.0 O'l-e
Fire Alarm
Susp'd Ceiling _
Roof
Misc: _
53 PART FAIL �y�''�j't?—r
91Nf0 (;y e/l C"r t .Syn /GkV
Post& Beam
Under Sleb
Top Out —
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL �45� xi Ast
MECHANICAL _
Post& Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL ---- -�
Service
p� Rough In �-
UG/Slab
Low Voltage �—
Fire Alarm
J Final
m PASS PART FAIL
W SITE --
J Backfill/Grading -----
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ requirad before next inspection. Pay at Gay Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE:______ [ ]Unable to Inspect••nn access
ADA
Approach/Sidewalk
Other Date —Z Inspector_ �'� Ext _ cp
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site.