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14265 SW 114TH AVENUE-1 i 4 jf .n ADDRESS: SHV � fK Ct-) ':lrecOrdslmicrOflm\targets\building.do C R1 LEGirIL1TY STRIP O i 2 3 a 5 6 7 8 9 io i i i2 X13 iIa 0mm■1 Lm is 17 118 19 210 2! 22 23 24 25 26 2'7 2A 29 30 6 01 MONI 11 IOZ !�1111�.!.�J�1l�ll�)11111111 ►.1.I�>wI�JLl1��11!lil.�_�Ll� ��1�r11 a ��1.� 1�J� lli� Oz25 )( „'' INi1Me�PP!M.rN1WtR'vl�MMl..a•Y'o�.w.w�w. —MvVI P .. "Y'f^!: .... 'SH•Mw9r•+Mei•e:.y.�.��`Rv,Anvnj. �°"�M.'�7:"7�P��'.".�A�,c '�F11�'�'IR'ge.'f,,. �/"•M ,�. ..���A� 4.9t7K'MN!SKJ•�41MkM�rT��M,�' 'hry'q�a "+.1M+W�MfW��..}nY. tl !rl u r n 1 ANDREWS b ' DESIGN ASSOCIATES 21835 S.W. 70TH I TUALATIN, OREGOIt,,I 97062 PHOIAE: (503) 638— 4499 I r DI21Yf:WAI f0 LOT leENINp% ' u Iz Y o r PATH � 11 Table Wo.R-402.3.2 +1 i �' I r,s'.,' 0.0 FASTENER SCHEOULF FOR STRUCTURAL MEMBERSa TABLE 010.53-P PRESCRUMVE COyp 14CE PATIOS FOR RESIDENTIAL BUILO(NGS - - -- ----r---- ---_ wfwrnaol(a axomNATO#" p"Tow#l1 is D /A/j�ll{� PATH 1 PATH 7 ►ABN 3 PATH! PAINS PATH! PATH) PA-,H a PATH 0 k,nl 1IU NII JI�on1W,wrI IMII -_ _+ I!d -- — ._—. boubdarve " M4� T 6n , Sui M."W V lan.y 1 .b' hro.e kw w,crh - 2MJ - -`- ---- r _ �,urpenw ianmataot uRwAd aunt Ttm6. atLc hLauera All-aWc Wcud...Ana e No Irk No Link He l kwa No Lush No Ilona N,t Loot( Nu t-1 121 Nu lrw- I � N�I r•� .� �� ��') I f•'I�%1 w f.!•L patr.Ire oral, 2 a •:I M� w6do.(lar 1 lMU e0 U-0 e0 11-0;0 U-0 70 (I-0 60 U-060 U-0 W il-0 W U-040 Wtdcr drn 1• • 6'eublhau w,to A I and Iran,Ofher Than Mata Nary U-0.30 U-0 20 U-0 DD U-0.20 U-0 20 11-120 U-020 (I-0 20 U•I)U pall.In c Md a Nrin►. I W' Will Ewy lmor.olaanw i ,24 W -0 H 10 -0 11-0 It. U 3• U-0 V-0 U 20 U-0 20 20 11-454 I1-0 20 (1.41 A � ' _ _. _ -_ 2•wl4k.ewpaNtaplder.MK11) -�_ --_4� -- WIRlrrtlrrura I III R I) K IIA K 17A K 24A R IIA K 21A k 15 _ uW Iwe MN ! 16J lklduAon Itt.(lklaan R-13 R 21 R ZS 11-21 R30 R-21 R-27 R 21 K W ,I 1,4.14rw, ,.yW.n bM.l,na PIMGittyt6 R N 1449 X 419 R 32 K 49A K NA R 49A K 4Y Rey V6a WCatknpw R 70 a)0 K 20 Ria R-4 R 3a R X R U a 38 1.4114 4,14.1e n..twl r,J nul Ifsl MW rt roc ylgc.I,c nr I 1MJ'r: 141 S►ybala Cor/ U-070 U-0.70 U-070 ti-0711 U-0W U-0.30 U-0 so (J-0 N1 U-4) Ia,tbleNud. Inc a•,I I W N Allybellol Ana llah Waw c 2% R•ic N R c.?%A-it is t 2% a 22~! R2% R 21 h.pplact lawcn,la.rurd 16J :1 5"Plow Uplrrtlaws, ■U R-17 R IS R-17 R-U a�13 a�13 a 17 R IS _ 1 1,tpPirr. liPt.rrlllaflr.11,111.. Ir,r Md 1..I _. - /acd Aa Dun Yrtiaooa_ 111-4 014 RJ 14R-a R-! 98 R! R-a t.rrtnoed haalkr,two paecca-.___..--- _ 11.1 _ _. _1 f to -r 7 \� t'cdtay paha to pMr.wt ala- r l,rNIflWlra headef le NW, - a all I .. I •,� A ytr��v� I� , wa Md ♦W I I•.i/17 I I!7 11 1-nity paM,ta{n over prtwwfa. I lace Itatl 1 141 I rthra paw w1 parallel rallm. I 1, Inr trtl l led Ra(kr W Pkk,love Md 2 16J 1 4: 1'brace to eaci*W aad phtr• - - - ! lW i lane 11111 2 a•Pka.I W' � ,� i I i' I I 1••6'therMlla w each IeanRa. 2 ad leu aul 2 I•to a=theatby w;m*6wnfa-_^- 2 ��� Ia a 1w1 1 atttplea.I vr' TIP, Wwkr Ih6R I'■ 1'Yteahoq Ill 3 W each bow".Iace rad _ 4"apka,14i WR upcwwamdo - l6d 24.11 C) ----_—�__ ------- - - 5210 _. __......._.___ �,__—_25 11 a v REVISIONS: aMb,awaraod r ,i ,i I N G -r... _ ._-.-------•----- -----r Nwh aV Tach a1r1 beaul 16J wgereJ Inn,20d .4 ends ani al cjh tplr e 1 plaRha _- _ 2 16d M each brans! ♦1+ •• •: 7 , ,a •� , _ I Raol4raasea ..1Jky act loop 4 1 W '':n v!:LAI 9 N t T;! 1 H ro C r I G�t I N U �h T rI tz D U M r face"ll -- -- 3164 '�I�% `'`�/! OLEO SIX WP-;.:.ro WIi.L b12i►IH YD - -- --------- R.hee tars,to rallen.lace aotl 3 ad I I Y C a r Y� v� l+ 1r ',,.+ --------- -- r=G F 1•+� W AT e� ~I�O M f H G I:X I J 1 I N(91 6v 5� N F�- fz t, _jl�?IrE ,tioT e:� _ NG i:Ay��MEtit� X1�r 0`i rME 4;?J6,j*j T 61TF, 4. TNsr prl7pOt-��h AF�nItION WILL CgA1'y i`p, IaUTE�'•.S IHr0 THF. Oi4arlN�A RAIN bpAIti �yYr�rEM, 3, THE PJ'OF10�75t7 AbtP1r!0N * I.OGAr5b ON A I.Ev U Pa0T'10N CF r;iE GPlrt'�,. . :�r 49 I;�Urclrh 6phrzD 'v 13r-, IEf:6� UIREp. 11~ MCN6r A0VIc121-:-,E Hr-ATH512 F � � G ?' 121 �. ,A L GOHpIrIDHS >;�D�IDN GONr1701 Mf✓A�Uf��ti AP-r.. 1215470 I p. V l MAY 0AI•EfVW I I,l, p.5 Ue;)P!2. E� GTn.ILi1'Y WILL• Y✓� p�UVlb� t� l�tzOM N ' w� ;, c�T 1�1 A M Wp LNv !`�Y`p�" SITE PLAN AYAIL?rii1,ITK � MAI`F, rot-1N>;6TjoN T� t'HE Pr�1Nt;L p,�x. H P, A "" I N GSI N � t +" • wltts r 16orOTA w r R r►� � o wN�� i� pt20►'DIMa o �x , ern ' e • , , a.*C ti rH� 9Ai6r71�4(A F©�-GP,tb ,�trz h��+rroMr G :5. a;31,�. 1 ...(n\• 11r0.0 . _-- MACK RESIDENCE IT 1GJ 0EGIbEC� 'rHA1■ TnE EXIhTtFi(a iJ`f�1'GM �.. 4 N ..tem '��i ' =� lel>o> all I� H.9J 6APPt PvI P, 0r- cpU rPvf IH(,I E HOU!lH _ , Ir � • � - �,� 611; ;� r I I � 6 HeoioT ro rHE Appt , IoHA . �F'AC-� 1 �I.�G�'�►G � � �. ,.�;� `*— r . � �•e � ��, hC: RI � • ! a �a11t A a 5 S F ADDITON HEAT +� ' n r Ir rtr S.W.Ar IT I C r �.: ��,w ta � .r r Fes. QTS 14265 � 114TH 'r"r31„ae ; ` ';' • fGARD s * • '�r'� •I'Ic,""'�I TIGARD, OREGON 97224 ac `` E'-><=�—�� w =r •' = �� • PHONE: 684-5816 ,V r ■re IX71+ �.1L a _ r , r 6 � �• / , A. loo .�-'"r, ,- ,, - ��.• �, r ♦ �`,� _ Dote: I I 15 3 ! + 'r,_L� ,� Scale: 1 s a ! aRla L-r amp ,,w•I�+�Q� I F t �l ' `n,. \� — � - -------y •T-,—� " , '�' e, -_ Drown blr J b A =: . t +rx 1 �N Checked by. _ ..__. . ._ �,, _.._ • r � v: l.,....; , :/�►`ti o Job P�o.: q 3 ,-1) •n r �'6l = -%�� " '• '4, `�h Drawing No.. JDA—TITL _ • ••a oor 36 t faaARlh $,: CRR .,..r '7-".._�1`' � _ � �*._ply li�_ A� _" a1 �1 R1. �/ .L_�11P' ..•a, . ! ~1rw'(''�i�1 t6111mrx ! s a a Is •, .,a I or h p w� r�allp•w ►Tl �• � r 1� R. 1 `T, let I r w 1wK i fir n �.. - r 11, "�� _•e a-*. R r,rr.nv 2► aaYL y^ �1iJ�.,d`"� ■•e�r 1. VICINITY MAP SHEET OF: 14265 SW 114"'AVFiNUF 1Ki I of I a l 1 . ... _... .. .Ill ........... I _._.... ... - ..,_..,..,....,..-.�_...._.._... __ -_.._.__._.....,..�.._...._.._..-- ---_-._.,_...`.-,lid„a...,.Y„.-.n....................._... - ... ..-... __._._._...._.......,.__.� .�..._.�._._ - .. .__. _._ _..,.__.__..__•_ _.... _ _. .. _._._._... _.._.-. .. . .._-..... . Kwl,nee.a,,a�l,,. �. LEGIBILITY STRIP Cm .,,..... . • I III. o i 4 s � 9to II 12 II i IIII1I8IIII IIII1�7IIIII wIIoII I8Ilil I IIII IIIII I II2Ic IIIII I IIII I I10mma1 cfn I3 14 IIII I IIII�1111 I IIII�I�III I IIII�IllllillliI llil i Iln�IIII I Ilil�IIII�!III Illllilll�lil!I 22 23 24 25 28 27 28 29 30 I a1 I I OI b HONI C IOZ . 1 .1.III L14(. J.. 1.14111,L4,j.1111LLW�ildl11111d I al ' �L�JIJI�Oe •,�,.Aw.»,'n��rn�++.....�.,w�•..,.....,..rr.._..._.. ..,..,...,,.....,.... _ ilk y °l 4 1G ...:�.. „•., .. .'-._,.... r .,i.. 1 �.:-�..,. ...•„. .. _,:r. .... ... ..,. ....-._, .. _ _ -_ - - _- - -- '"� J{f�lj,rya•'+xwrrnwx '�.,,�.�a1""vyt7'�'Yv�"`,"",ta .. � . ._.. ....,; +e�111'rypR2M11�u�lnalar�_ "+�nr+�a+fR'�atlwpJr -.�R•� �IM�” �r+�"h�zl ADDRESS: )SA-U15 SW-Ilq? AVkt44'E J G] C!1 W J 1:lrccordslmlcroilmltargetsltwildin g.doc E C c W-L r v - cl F m-! as� o E ❑'v c M.E N 2U o c c 1 c � o O cvcs ��) om c N.y Q.Q�� O T O f9COL 0 E N �- m zJ Y Ss i1u C Nov W 3N UDW N c ax n.� O d m N Q W 2 N %V R >0 y ago U7-OWvtmaaioms � c_ o a vi k000 E aci n �' a o z 3 �2 QUF-0a- vav 4; a) O a) a) O V K i Y Q7 Oj C=i Q� O) a) a) O� iT O cn a) O� 01 Q� m ip cn c 5 Z6 o e C �. < ti a N M N is c3 v c3 cD ti v R v V CL v F I- F F (n (n N U d F F F F h- N �` J J J J W W W m m u m m J J J Q' J J J a m m m m m (� (� C7 C� i- m m S m m m vd o x m J ul cn v) v) V) F O J V) 'n cn (n tll (n Q n (n (n V) (n a c_n a ° z V) m cn cn Z N o a a nn- m Q m a a Q a '� LL a a a a Z a M � m cf) c J J F C9 cn cn cn (o m cn m W w a m m m m > U U O U m c9 cr H cr o' p N c O - ro L 0 ui 0 30 o a a L a a N t�A V rn d r� 1 O = R' N ti rJ.. m10ry 10 d U L9 .0 a Q yN� L p -j yy Fn N 3 N C U acl s V a N 8 c 7 ❑. n N in C O D y o m v i v7 O N c c c c ii c1. c E in c 'E c a v E E N 5 o c c c c c ii (aj 8 E E R v ❑' a N O m ¢N� N E F cT ❑ f9 jl N t0 N v ch vi cr3 m � m n 5 m n o # coJ� a c7 � fi E E n c { E _ p " f° L g c c -j N m in > a y 2 3 ❑ ca v S 2 B U (1 S (i s (D S a WCL a as :Da m oa LL a s a d co 0 0 o n o o N a n `(� 0 1- (7) 10 1 _ N o N n =Ny p Z., a N m O [VN N It V ko c 0 al m O a) - •- (V 1- O 1- /- t- f.- < Q Q Q Q Q Q Q Q Q Q Q Q Q L Q Q Q m M Q Q Q Q Q F F- F I-- 0 0 V) ul V) V) V) V) 0 V) w V) w V) cn V) V7 in in V) 0 I ) \ ® 0 7) t o® \ ƒ \ � £ 2 E 2 } § _ §\ ! ru 0 ® ) ru /_ 0 3a= \ a z / 13 2 2 7 7 7 $ $ 7 2 t / / / /£ ƒ ƒ ƒ ) % % \ CL � > _ � 4) 0 � � LO ( / / \ 2 z o LL ±7 ƒ/ £ cn c 4 4 F- 0 $ $ $ L ( 7 ~ z/ ° @ # m & 7 } 7 7 § } / a � k cu § & 2 ® \ { § $ ,, w � 2 > o v Q � 2 0 cl ) $ ` S ƒ v / n k E E k \ f � k ƒ E \ \ r2 2 � / ( § / � w § § CITY OF TIGARD OREGON June 1, 1995 RE: BUILDING PERMIT # YY) 5 e7 U S-7 -7 Inspection(s) have been conducted on this project. However, we have no record of any subsequent or final inspections within the past 180 days . Please note that permits become void if there has not baen an inspection performed for over 180 days. In that case, the Building Division may require a new application and fees to continue work. A notice of non-compliance against the property may also be recorded by the City. Please advise the Building Division, IN WRITING, within 15 days of this letter, the status of this project. You may request additional time to complete the project . Respond 1N WRITING to: Building Division, 13125 SW Hall Blvd. , Tigard OR 97223 . Be sure to include the following information: 1 . Building Permit # . 2 . Address of property. 3 . Your name. 4 . Your phone number 8 :00 a.m. - 4 : 00 p.m. If you are ready to schedule your next inspection, please call our 24-hour Inspection Recorder at 639-4175 . LD �1J J logiMadd_inspectio" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 MD (503) 684-2772 MASTER PERMIT CITY OF T I CARD PERMIT #. . . . . . . : MST93-0577 COMMUNITY DEVELOPMENT DIEPAMIMT DATE ISSUED% 11/17/93 1312.5 SW H;1l Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL: 251 10AB-03-3010 SITE ADDRESS— : 14265 SW 114TH AVE SUBDIVISION. . . . : COLES ACRES ZONING: R-2 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . : I C, BUILDING --------------------------------- REISSUE: DWELLING UNIT,'3: 1 BASEMENT. . . . . . . . :el 5 f CLASS OF WORK. :ADD BEDRMS: 1 BATHS: 1 GARAGE. . . . . . . . . . .0 sf TYPE GF USE. . . :SF FLOOR AREAS------------- REQUIRED SETBACKS---- TYPE OF CONST. :5N FIRST. . . . :750 sf LEFT. . : 13 ft RIGHT. -.0 ft G�CUPANCY GRP. R3 SECOND. . . :0 5f FRONT. :0 ft REAR. . :5c'-' ft STORIES. . . . . . . : 1 THIRD. . . . :0 sf REQU I HEIGHT. . . . . . . . : 14 ft TOTAL--------- :750 s SMOKE DETECTORS. :Y FLOOR LOAD. . . . .40 psf VALUE.. . . . . $ : 34500 PARKINC SPACES. . -0 Remarks : PATH I PLUMBING SINKS. . . . . . . . . . :0 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0 LAVATORIES. . . . . :C'-' WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . — :0 TUB/SHOWERS. . . . : 1 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . 90 WATER CLOSETS. . : 1 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . :0 WriIER !INE (ft ) . :0 OTHER FIXTURES. . . . . :C GARBAGE DISP. . . :0 RAIN DRAIN (ft ) . :O WASHING MACH. . . :0 SF RAIN DRAINS. . : 1 MECHANICAL ----------------------------- ------- FEES FUEL TYPES-------------- UNIT HTRS. . :0 type amount by date recpt /GAS/ V*-:-"N T S . . . . . :3 BPRT $ .:-:'15. 50 JH 11/17/93 -- MAX MAX INPUT:0 BTU VENT FANS. . : 1 BPLC $ 140. 08 JLH 11/1.5/93 93-245966 IURN ( 100K — :0 HOODS. . . . . . :0 B5PC $ 10. 78 JH 1t/11/93 - TURN ) =100K . . .-@ WOODSTOVES. :O MPPT $ 26. 50 JH 11/1.7/93 -- F LOOR FLOOR FURN. . . . .-O CLO DRYERS. : 0 M5PC $ 1. 33 JH 11/17/93 - MOIL/CMP ( 3HP:O OTHER UNITS:O PPRT $ 45. 00 JH 11/17/93 - GAS OUTLETS:O P5PC $ JH 11/17/93 - Own L-r: JOSEPH NP17K 14265 SW 114TH TIGARD OR 97224 Phone 0- 684-5816 Contractor. OWNER ['Hone #: 00000 --------------------------------------.- J $ --------------------------------------- $ 441 . 44 TOTAL this permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Gyp Board Insp applicable laws. All work will be done in accordance with approved Past/Beam Struct Rain drain Insp plans. This permit will expire if work is not started within IEZ Post/Seam Meehan Water Line Insp days of issuance, or if work is suspended for more than 160 days. PLM/Underfloor Mechanical Final Me -:hanical Insp Plumb Final Permittee Signature . Plumb Top Out SUi Iding Final Framing Insp Erosion Control Issued By : I I/V Insulation Insp Crawl Drain JCall for inspection 639-4175 0 CITY OF TIGARD BUILDING INS-'ECTION NOTICE Inspe tion Line Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspe­:aion:, Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. l Jnderfi. �r Rain Drain Framing um' Alarm W�ta�lrr—z Insulation -Mech. ? Underflr. Insul Shear Wall Gyp. Bel. -Elect. I � Fate Requested: _j l ( Time: AM _PM Address:— l3"rlde�ftL�1?�1S�n P9rmit u: THE FOI.LOWING CORRECTIONS ARE REQUIHED: Inspector: Date: �OVED DISAPPROVED APPROVED SUBJECT TO ABOVE `Call For Reinsp. IV'( OF PAYW�.Nl' Ri t'K�I P't I. V,0 CHECIA All(')LINT Wt -ib NAME MACK, CASH AMOI IN'r R F:'.'-'k' 14�=6!.`# 1 H PAYMENT ))ATF IJ /17/9.3 ori 9URD I V I S I VJN IRPngU-. OF' PAYMENT AMOUNI I-'A I D VIL RPO�,[ OF PAYMt.--Nl AMOHN'l PAID rL, E I SO PLUMSING3 F+RM 451. IAO o CHANTCAL Pl- c:r.» `50 S1. BUILD Pl--R 14. Sb C-0 ul li)TW.. AMI IL)Nt PAID :a01. 36 Wilt (I I IfA y Of I I,I 1 .1 411 NI,1, I II I -K PINI'AhAl 144.1. 1/11-3 NOW b WAj)I*:.W!j, 11 m .11 1,MI R IN 1 N. 00 PIvl,-Il 111 14-01. !A.Jllfl) I.V 1') 1.1 114 PURPOGOF PAYMV'Nt 0P11 lUW' PAID PLJRPCJf-*.-- 014 PW-Av%.N1 1IMI)IJ1,41 Pfil )) PLAN 1.TW.(;K FE 140. 01 142^_65 SW 114TH UTOL AMOUNT PAID 014 Residential Building Permit Application City 9f Tigard — 13125 SW Hall Blvd. Tigard, OR 97223 (503) 635-4171 O.3.3 c) Jobslte Address: 14 2[�5 �.I�• 114 T.OW Office Use_Only Subdivision: Lot # ?Y r �, U U PlancklRec# Valuation: _ Permit # _ Owner: _ J r Gvr,�p1-i Y_I'! ALK _ Reissue of Address:__ 14?to6 A�pr�v_s�s R_equtred TI ca A�. �. � � 2 2 4 —._- --- Planning _W Phone: ro P�-1 - 5 P,I L., r Enginuent ig Contactor: 0 W M E- tz _ Other Address: :tuns Required Subcontractors Phone: i Truss Detal!s Contractor's license #_ rattach copy of current Oregon license) Otho,' Subcontractors: J ri Plumbug Mechanical: (attach copy of current OR Contractor's License) d lls�'#Nte�EfEft¢111E�r: .� lel l�nncln.�._n_� _ R: Address: 21 35 G .yi -10 to 7— Phone.- Phone.- N (0 3i,- 44gq w4•. (a 2U -20E,(,o W _J COMMENTS: /7) nt Sig ture & hone n0rnber ZI.—Received by: Date Received: /� . Permit # Account Description Amount Amt. Pd. Bal. Due /�5f ff�o 5' 7" Bldg. Permit (BUILD) ��1,S"y (/ 13-V Plumb. Permit (PLUMB) ' 46-� Mech. Permit (MECH) 1-? State Tax (TAX) 3 C, Bldg: /0' -?L Plumb: Z >� Mech: / 3 3 C Flan Check (PLANCK) /(lo,r, Bldg: / U,a Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) ^� Commercial TIF (TIF-C) _ Industrial TIF (TIF-1) _ Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WOUAL) J Water iDuantity (WOIJANT) Fire District (FIRE) TOTALS: �— Permit No: ht �� , - 6,5 2 7 Address: (h' o — z Issued by:_ Date: FOR OFFICE USE ONLY_ STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS -'01.055(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 applican!s, 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 . I own, reside in, or will reside in the completed structure. 2. L I 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 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 will be my own general contractor. e 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 N 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 :' the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. J Sja2tlu of e m t Applicant Dat CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT I