9620 SW FREWING STREET-1 ADDRESS:
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� `------ C E'R T I F"I C E?T F OF
C17Y CSF TIGARD OCCUPANCY
COMMUNITY DEVELOPMENT DF,P�R i I�E�uT PERMIT M. . . . . . . i MST93. -032'7
13125 SW Hall Blvd.Tigard,Orapn� 07223.81 '3 3)8 0- 71 DATE I�"'GUEI)a CD3,'1:4194
ITE ADDRESS. . . F 0119620 GW rREWING ST PAr7CE:l_a 2510$CD•-00310
i DID I V I S I ON. . . . a F'REW I NGS ORCHA'4D -TRACTS ZON I NG i f1--4. D
ttt..00I . . . . . . . . . . a LOT. . . . . . . . . . . . . a 95
CLASS OF WORK. :ADD
VYPE OF USE:. . . a 124-
OCCUPANCY GRP. :R:3
1:3CCUPONCY LOAD a S 13 4
1-E::NAN i NAME. . , :
Rem rksa F'ATH T 448 SG' FT ADDITION TO EXISIING HOMI
JON S AND KAREN K CONNOLLY
'?F+r O SW F REW i NO ST
"WARD C3ARD OR 97283
6F:14-9874
+_unt rawct or a —�•--•-.. .,.--- --W--__ ___._._�._—_.__,..__.._.
OWNER
c'hun�t #F
!leg ff. .- 00004
)r,-t.up,aricy of the above r-eferenced building is her•+eby given, aT,J c6:-tifiez
' lip compliance with t;hP estate Of Oregon Spe,.:iallty L,)des for the group,
and use under which the referenced pe •mit was A d.
LD I NG -^ PECTOP
'
R _D I-N4T&VA 1_'TAL
POST IN CONSPICUOUS PLACE
INSPZCTIOM BO'I'IC6
City of Tigard Building Departreot
13125 611 Ball Blvd. Tigard, Orwegm 97223
Inspection Line (Rec-O-Phones 639-4175 Business P n /
Inspections
F(c)ting Plbg. Underslab Koch. Rough-in Appr/Sdwlk
Found. P)bg. Top Out One Line % FINAL
Poet/Bean Struct. San. Sewer Framing
Post/ream Koch. Rain Drain Insulation - lamb.
Plbg. Underflc;or Nater Line Gyp. 9". -1[ec.
Date Request'ted: �7 i ' Time: ^'51 AM zz
.? _PM
Addreass (��'7Ll �1(�L� ���1 _ II Permit (!s P 632
`-''�
Builders �L`Vt-�^ -q d�J STT
THE FOLI.ONING CORRECTIONS ARK REQUIRED:
1
Inspector: Date:
APPROVED DISAPPROVED APPROVED SUBJKCT TO ADOVE
Call For Re:^ep.
lti@P�s�ION Maraca
City or Tigard Building Department -1
13125 BW Ball Blvd. Tigard. Oregon 97223�/ /
Inepe,7rion Line (ROC-0-Phone), 639-4175 Business P'jo 39-4
InePection,
V/ooting Plbg. Dnderalab Much. Rough-in ACpr/Sdwlk-- '
round. Plbg. Top out Gas Lina
SINAL,
Poet/Baan Strum. Ban. Sewer
rraming -Bldg.
Poet/Beam Meeh. Rain Drain IBmlldtloB
-Plumb.
Plbg. Dndarllocr Mater Line
Data Roqueated t_ U (2 -9-15Addreest VV 1 �—
TiIMt AM pm
Peruit 9i�-032 .7
4 In v� 1-10 0�l +___ � fr��( —
Builder, (/ ��
`PHM FOLLOWING CORRECTIONS ARE REQUIRED, b
i
Inapaetcr._ iDates_C��
APPROVED DISAP:NvyED APPROVED at-,"CT TO ABOVE
Call For Reinap.
MNMoN P—OTIC8
Citl of Tigard Building DV
.rtamst
13125 sw Ball Blvd. ,VUd, Otegon 97223
I�.Pection Line (A�c-p-Phone): 639-4175 Business Phones 639-
In.Peot on 171
Footing Plbg. Underelab
Mach. Rough-in Appr/Odalk
hound. Plbq. Top out
4u Line EINALs
Post/Besse Struct. San. Bower
Framing -Bldg.
Post/Beam Mech. Rain Drain
� In.ulatlon -Plumb.
Plbg. Underfloor Water Une
Orp• Bd. -Meeh.
Dare Requestedi_
Addre..t
Permit Ps
Builders I
TB= YOLLOWINo COPMC'TIOMS ARE RE()UIRRD3
-- ---—— ------------
----------------
-
Inspector r
e Datas
PROMM tTSAPPROvgn
!APPROVED SUBJRCp TO PAWS
-_-Call For Rsinsp.
;NCPECfION IiOTICB �
City of Tigard Building Department
13123 aw gall Bled. Tigard, Ocugon 9722
depoction Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbq. Underslab Mach. Rough-in A
q ppr/Sdi,olk
Pound. plbg. TOp Out gas Linc lINALz
Post/Beam Struct. Ban. :over Traniifq -Bldg.
Post/Beam Mech. Rnin Drain Insul&tion -Plumb.
Plbg Underfloor Mater Line Gyp. Bd. -Koch.
Dass Roquost/ad s� 6 Tlsl�t w!1 ..'7PK
Addrosmt �I (L''�{,� (��1�(�tl (�f / PBrsLLt #s
Builders
THE FOLLOWING ODRR3CPION3 ARE RSQUIRRDI
Inspectors Dates A p
APPROVED DISAPPROVED APPROVRD BUBJCCT To ABOVE
------Call For Relnep.
INspsCTION �.��e
City of Ttgard BuildLog Departasnt
13135 Bw Nall Blvd. Tigtrd, Oregon 97223
Inspection Line (Rec-o-Phone)t 639-4.'75 Buelner■ Phones 639-4171
Inspection:_—
Footing Plbg. Underelab Aech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Noah. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Koch.
Dote Requested) -23-93 Tit
Adds-son: 7 Y ( Permit 0t� '
Builder: I� l� l OJOJ✓��(l( (1 7 ��~o f
THE FOLLOWING CORRECTIONS ARE REWIRED' �
r
coo-
c
=p
Ins" go-OTAY-P0110 nate:
APPROVED -- DISAPPROVED APPROVED SUBJECT TO ABOVE
��Call For Reinep.
F�Y�crzoN noTzcs
Citi of Tigard Building DRrt�t
13128 OF Ball Blvd. Tigard. � .egoe 972,7
Inspection Line (Mo-O-Phones 639-4175 Business f1h -4171
Inspections
rooting Plbg. Underalab Noah. Rough-in Appr./Cdwlk
Found. Plbg. Top Out pas Una FINALs
Post/Beam Struct. San. Sewer �hawliB� -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. underfloor Nater Linea pip. ad. -mph.
Date Requesteds 9 -2-Z. f Tlsms h m PDCY�pl(
Addreses _ VOW fyr-w� ( M Jr �3"()jZ 7 �
1Pas�i! 1 s_
Bu l Idem-1,V l.y _'yYNt Li
THE ROLLOWINa OORREr-"TIONS ARE REQUIRED:
Inspector! L JIL Datat_
___APPROVED DISAPPROVED APPROVED SU9JECf To ABOVE
�'Call !or Reinsp.
INSPECTION NOTIQE
City of Tigard Building DaPsrts—t
13125 ON Ball Bled. Tigard, Oregon 97:223 �� ►��
Inspection Line (Rec-O-Phones 639-4175 Business Phones 639-4171
Inapectl.on s —
Footing Plbg. Underslab Koch. Rough-in Appr/Sdwlk
round. Plbg. Top but Gas Line FINALS
c
San. Sewer Framing -Bldg.
(Rain Dr• insulation -Plumb.
1 Nater Dina Gyp. ad. -Koch.
Date Requestods_ / C Times _AN _ PN
Addresses _ Permit 4s 1.5 x•31
Builders
TRT. FOLLOWING ODRRECTIONS ARE REQUIRED:
Inspector:C_ Da.es
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
CalI For Re-Inep.
jtlBPECTIO)1 NOTIC>w �W�(�•
C.itT Of Tigard Building Departn nt
13125 RW [Hall Blvd. Tigard, pregoa 97223
IDapec-tion Line fRec-O-Phoneys 639-4175 Business Phone: 639-4171
Iospectioal
PootLng Plby. Underslab Mach. Rough-in
Appr/Sdwlk
•_ Plbq. Top out� Gas Line FINAL:
Post/Beam Struct• San. Hewer draninq -Bldg.
Post/Beata Mech. Rain Drain
Insulation _ply•
Plbg. Underfloor Nater Line Gyp. Bd.
-Meth.
Date, Requesteds l0 r
// _Timet Ar PM
Addresst (� U
Builder►
TRS t'OLIAMING CORRECTIONa IRED:
-E� V • .n
!' Y "71
t -
Inspectors
Datee���
APrMc0M DIB/1PPROVED APPROVED SUBJECT TO ABOVE
_____Call For Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Wd.TI9ard On►0on 97223.8199 (803)630.4179
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114 IANI KAREN ;'> t bl4NL,,
l-'i('1
b plersit. i4 151i4ed eubjILL U the regJlati:!1S contained in the
4a-d Mjmcipai rade, 446te of-Orf, Sgocialtf Cadea and all other f oot/fo+- od nQo "' fit Yta Nuar►cf 'Insta
)yeti, .ani. Al. alk hill bt :are ,,-t o.da c1 Kat' approved Post/90ikm S1;r4eti Fzaai L1-ili.n 111x;
' ,s �m f1t 7.711 expire if 0401•K .r a+at'1ir i�9E Frost/bea1m Mechan N,echani.cal Fitiai
at 1ssc�r:r; or .' work . : rar .dQ+ 3acS. PL's IJndwrr.l4t w 1"'lut�!ia F` xlrarl
1,60Fi.l.�i) liatp '.�i1ny
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Permit No:/-h C7?�— G' 2
Address: 20 t
r, Issued by: Date:
.FOR OFFICE USE ONLY--
STATEMENT:
NLY—STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who ars ioi registered with the Construction C(,^tractors 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 stateme;it. 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. 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.C _,_) My general contractor is .____._ _ _._ ----_____ ___.__—_—
Contractor registration number--
I
umber_I will instruct my general contractor that all subcontractors who work on the struc-
ture rust be registered with the Construction Contractors Board.
OR
3. B. C i I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the CZ)nstruc-
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
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 hlotice to Property Owners about Construction Responsibilities on the
reverse X10 of 1�h1g f r
0 U 3
Sign ture of Permit licant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
i
I
INFORMATION NOTICE TO PROPERTY OWNERS
i,BOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction Responsibilities I
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 Oregon Legislature_
If you are acting as your own contractor to construct a rew 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.
.I
EMPLOYER RESPONSIBILITIES:
If you hire personfz not registered with the Construction Contractors Board to do labor in constructing or assisting
in the construction. or improvement of a residential structure, you will, in most instances, be ruled to be an
"employer and the people you hire 011 be "employees". As the employer, you must comply with (tie following:
Oregon's With hoidinQ__Tax Law_ As an employer nest withhold income taxes from employee wages at
the time employees are paid. You +vill be liable tax payments even if you don't actually withhold the
lax from your employees. For more informatic -ill the Oregon Department of Revenue at 378-3390.
Unemployment 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' Comp( tion Insurance: As an employer, you are subject to the Gregon Workers' Compensation
La.w, and must sir workers' 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 o! your
employees is injured on the joh. For more information, call the Workers' Compensation Division DIF at 373-7434.
U.S. Internal Revenue Service: As an employer, you must with,sold federal income tax from employees' wages.
V6-6—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 holder for this project, you are responsible for resolving any failure io meet
code requirements that may be brought to your attention through inspections.
Liability and Property Damage Insurance Contact your insurance agent to see if you have adequate insurance
coverage for accidents and omissions 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 to supervise your employees.
Expertise: 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 inspections.
If you have additional questions, write to: Construction Contractors Board
700 Summer St. NE. Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10!24!89
t
C I T'Y OF T I CARD - RECEIPT OF PAYMENT RECEIPT NO. c 9"'r- 41 I A6
CHECK AMOUNT ; 246. 91
'nmE : CONNOI.I.Y, JON CASH AMOUNT' A. 00 >
DDRES5 : 9620 SW FREWING PAYMENT DATE 06i10/93
SUBDIVISION
TIGARD, OR 97132--
URPOSE OF PAYMENT AMOUNT PA I D P'URP'OSE OF PAYMENT AMOUNT PAID
U I LD I NG PE RIh 146. 5121 PLUM b I NG PERM 52.
ECHANICAL_ ISE :=5. 00 ST. BUILD PER
LAN CHECK FE 11. 70
r
f
i
i
"OTAL AMOUNT RAID — — — —> 246. 91 �
n a tUl
/'� TIGARD
to u SWHap D� PLNCK/RECT If '3 ---------
CITY `1JF PERMIT / z 7
COMMUNITY DEVELOPMENT DEPARTMENT TWcd.Orgpn 9 227
(503)""41" DATE ISSUED
JOB ADDRESS: 9 690 60 TAX MAP/LOT 9-5 I Ua2 C D - O 0-300
SUB: ,�'—"'�''-} OY-a,,A 77A C/ _ LOT: Z- LAND USE:
VALUATION: 500
OW�ItyR
SPECIAL NOTES
NAME: �tJ S juA 4.,WAJ ocL�t REISSUE OF:
j ADDRESS: 150 FieCW iV 6 lr LAST REISSUE:
FLOOD PLAIN/
PHONE: _���_4�7 _ SENSITIVE LAND:
CONTRACTOR / APPROVALS REQUIRED
NAME: _ �oN �til hdA _ PLANNING: Oe"�ek=
ADDRESSSW r"-t01#JC. ENGINEEPiNG: !_
97ek;13 FIRE DEPT:
PHONE: ��'14 ` 5V?Ll OTHER: A" 7lf -
CONTR. BOARD 0: EXP DATE:
ITEMS REQUIRED
SUBCONTrcACTORS: PLUMB: �J ��-,,..,.o�� LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH/ENGINE�ER / CALCULATIONS:
NAME: /�1 L� (._-7 ofL TRUSS DETAILS:
ADDRESS: �� 3� `- Cr S-0 ji '=
PO-1- 1-� V---Q
PHONE: Z 5 --7 -
PROPOSED BLDG. USE: bcnrL0o►►1 6414
COMMENTS:
1
APPLIC T SIGNA URE
f
Received By: _ Oate Received: _
PERMIT # ACCT DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
/MsfQ9-o3Z1 10-432 00 Building Permit Fees L74,'� I/!&'
10-431 00 Plumbing Permit Feesi�_�/ SZ,So
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) Hal / ll•Z/
Building 1.33 6 /
Plumbing3
Mechanical I'LS
10-433 00 Plans Check Fee
Building :2-
Plumhinq
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25•-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) _
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-"45-02 Water Quantity (Fee in lieu of)
TOTAL &J
I)
PERMIT # ACCT" # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
/ns �-o3t2. 10-432 00 Building Permit Fees L4:5 " _ /c/ 0 ,
10-431 00 Plumbing Permit Fees SLS / SZ.So
_ 10-431 01 Mechanical Permit Fees �-
10-230 01 State Building Tax (5x) 1.2 _l�•u
Building 7.33
Plumbing x•63
Mechanical .L
10-433 00 Plans Check Fee
Building :L3
Plumbing
Mechanical
10-230 06 Fire
_ 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fc�s
52-449 00 Parks System Dev Charge (POC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSOC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
nm/3587P.WPF
CITY OF TICARD RECFIPT OF PAYMENT RECEIPT NO. :143-240719
CHECK AMOUNT t 63. 53
NAME t CONNOULY, KAREN & JON CASH AMOUNT t 0. 00
AL)T)RP-SS t 9620 SW FREWING PAYMENT DATE t 06/01/93
SUBDIVISION
TIGARD, OR 97223--
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOLIN'r PAID
PLAN CHECK FE 63. 53
PL(4N(-lH0CK # 6-13P
TOTAL. AMOUNT 83. 53