7775 SW PFAFFLE STREET A
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7775 S.W. PHAEELE STREET
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!NSPECTION NOTICE C
City of Tigard Building Department (
11 M-
13125 8 -ll Blvd. Tigard, Oregon 972.23 ��..YY
Inspection LLne (ReC -Phones 639-4175 Business Phone: 639-4171
Inepections 4-"
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
found. Plbg. Top Out LOaa Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Mg. Unds-rflocl Waters Line Gyp. Bd. -Hoch.
Date Resnsoatedc G —! d 1�/_ Ti mei �AX PM
Address: .Z 7 '2 ti ��4�C _�Pbria O/
Builders_
TBII FOLLOWING CORRECTIONS ARE RRQUIRED s
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C.
Inspector: Dntes��
APPROVED DISAPPROVPD APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
— - - - - MECHAN 1 CAL
PERMIT
c1mrf OF TIGARD OFT16ARD r T #. . . . . . . : MEL` 1 •-0301
COMMUNITY DEVELOPMENT DEPARTMENT � OREGON
13126 S%V HWI Bpd. P.O.Banc 23397,TOrd,Omrn 97M (5W)&39-4176 "ATE ISSUED: 1 / 1 /91
-:.,I TL ADDRESS. . . 0-7775 SW PFAFFLE CST PARCEL : 1 S 1.36CA--01 301?,
TONING.- R-4. 5
'3UBD I V I c)I ON. . . . :
13LOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :
(-LASS OF IdORK. . :ADD Fr_OOR FURN. . . . : EVAF' COOLERS:
TYPE OF IJSE, . . . :SF UN I T HE::ATE RS- - 1 VENT FANS. . » :
OCCUPANCY GRP,. R3 VENTS W/O AF'F'1-: VENT SYSTEMS:
73TORIES. . . . , . . BOILERS/COMPRESSORS I-iOOD5. . . . . . . :
i ULL T`.F'ES--___ __.__.__._..__ 0--3 F-IF'. , . . : DOME=S. INCIN:
: /(;As / 3-15 I-AP'. . . . : COMML.. INCIN:
MAX INPUT: L1TU 15-30 F-IF'. . . . : REPAIR UNITS:
I'IRF_ DAMPERS'?. . : ?�0__50 Hp, , , , WOOD5TOVES. . :
oAS PRESSURE. . . :L 50+ H1='. . . » : CLO DRYERS. .
NO. OF UN'rTS------- – _' AIR HnNDL_ING UNITS OTHER UNITS.
FURN ( 100K BTU: (- JOC-A00 cfm : GAS OUTLETS. : .i
FORN ) =Iooj ,, LTU: > 1170170 cfm :
Remarks : Install gas wall Heater' in SFD
(awn e r: FEES
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BILL CLARK type amoc.Int by date r"ecpt
'7775 SW F'FAFFL.E F'RMT t 25. 00 BCR 12/13/91
5F'CT $ 1. c:`3 BCR 1211.3/ 31 –
T IGARD OR 9 72c3
1,hnne #:
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OWNER
Phone #: ! 26. 25 TOTAL
Req 11. . : – –_.–_–_–
-------- REQUIRED I NSF'EC T'I ONS
Tn15 eereit is issued subject to the regulations contained in the Gas Line Insp
Tiqard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
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. ---~------ --
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[='p r m i t t e e
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BY: ___.__
Call for- inspection 639-4175
CITY OF 1*13FIRD REXEIPT (IF V-OYMENT FtFCEIFIT Nu. :91--220670
CHECK f)MC)UNT - 26. 215
CLARK, 1111-1- U)SIA AMOUNT 0. 00
A L)1)p L s a 77-15 c.,. W. PFAFFL.E' GTREFT PAYMENT DATE 1j,'/ 13/91
TIGARD. OR SUBD I v I El!ON
9 72'23
PLJF,PC'IGU- OF PAYMEN-r AMOUNT PA I D PURP06F OF PAYMENT AMOUNT F.'A 10
RE*.(.',+I(-)N I CAL PE MEJ, 91-17130 P5. 00 ST. BUILD PER 1. :-?5
11HOL AMOUNT PAID 26. z:",
Permit No: —2"- Vii_o zQ
�4•� _ \�"� Address: "' 2-45 -:5'
Issued b �� __
N •�I�!! � - .,r �., Date:
FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building perMit applicants
who are not registered with the Construction Contractors Burd to sign the
following statement before the building permit can be issued. 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 box 1 and either box 2A or 2B:
1. - 1 own, reside in, or will reside in the completed structure.
2. A. My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. I will be my own general contractor.
If I hire subcontractors, I will hlre only subcontractors registered with the
Construction Contractors Board. If I change my mind and do hire a general
contractor, I will contract with a contractor w`10 is registered with the
Construction Contractors Board and I will ,mmediately notify the office
issuing this building permit of the name o' the contractor.
I hereby certify that tyre above Information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
r _
Ignature,OPermr�t -6plicant11
Dat
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESNONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction
Responsibilities was ,Jeveloped by the Construction Contractors Board in
accordance wiih ORS 701,055(5), 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.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing
or assisting in the construction or ;rnprovement of a residential structure, you will, in most instancE s,
he ruled to be an "employer" and the people you hire will be "employees". As the employer, you must
comply with the following:
Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages
at tai , time snip yU ees 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.
Unemp oyment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on tt wades of alFemployees. For more information, call the Oregon Employment Division DHR
at 3783224.
Workers' Compensation Insurance: As an employer, you are subject to :he Oregon Workers' Compensa-
tion Lew,,and mustobta'Iri wor�cera' compensation insurance for your employees. If you 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 3737434.
U.5 Internal Revenue Service: As an employer, you must withhold federal income tax from empioyees'
wages fou wit eiiahle Tar the tax payment even if you didn't actually withhold the tax. For more informa-
tion, call the Internal Revenue Service at 221-3W_
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
CodeC2MIiance As the permit holder for this project, you are responsible for resolving any fa'lure
to meet co a requirements that may be brought to your attention through inspections.
Liability and Proptgy Dema a Insurance: Contact your insui ante agent to see if you have adequate
insurance coverage or arcT ent:; an36missions such as falling tools, paint overspray, wat(:r darnage
from pipe punctures, fire, or work that must be redone.
Time to Supervise Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as Your own general contractor, to coordinate
t ie worof tough-in and finish trades, and to notify I)ulldin:l officials at the appropriate times so
they can perform the required inspections.
if you have additional questions, write to: Construction Contractors Beard
700 Summer St. NE, Suite 300
Salem, OR 97310.0151
Phone 503.VQ-4671
0244) 10124189