9232 SW MARTHA STREET-1 IS VHIHVW MS ZEZ6 —'
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9232 SW MARTHA ST
CITY OF TIGARD BUILDING INSPECTION DIVISION MST •2�y. G�/Gs
. 24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
_Date Requested U — AM PM BLD _
Location_14: Z 56--' 'Wdj X4-- Suite
MEC
Contact Person _ Ph .St 07f U PI-M
Contractor ( "-./4 -cin �� _ Ph SWR —
BUILDING Tenant/Owr.er ELC
Retaining Wall Y ELR _
Footing Access:
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: --
Slab — A SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing —_
Insulation
Drywall Nailing
Firewall
Fire Sprinkler _—
Fire Alarm
Susp'd Ceiling —_
Roof
Misc: - — - --- ---- —
Final
PASS PART FAIL - -- -- ---- -
PLUMBING
Post&Beam
Under Slab
Tap Out ..---
Water Service
Sanitary Sewer --
Rain Drains
Fina, -
PI,SS PART FAIL -_—
MEL•HANICAL
Post& Eparn --- --- --
Rough In
Gas Line --- — — __-------
Smoke Dampers
Final --- --
PASS PART FAIL
4' Service
� Rough In — __ ---___---- -----. -�— --- -
N UG/Slab -
Low Voltage
J F' arm ---- ----- -- - --
m i
ART FAIL
W SITE
Backfill/Grading —J-- --` --- --
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: Unable to inspect-no arress
Fire Supply Line
ADA
Approach/Sidew?In
Other Date _ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 539-4171
00, BUP
Date Requested_/O Ag/aO AM PM _- BLD M
Location 2 5764./ Suite MEC
Cc ntact Person Ph PLM
Contractor Ph SWR
ILDIN Tenant/Owner ELC
Ro mg Wall ELR
Footing Access:
Foundation FPS
Ftg Drain Sf3N
Crawl Drain Inspection Notes: ,p ",
Slab 0 /�e� �U.« SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof _— /� 26 [beW� !I ( �T� - U
Misc: _ -
Ina
PART FAIL —
UMBI
--
Under Slab
Top Out ——
Water Service
Sanitary Sewer —^
R in Drains
Final - --- - -- -
FAIL - ------- -- - — -- -- --
Post&Beam --
Rough In
Gas Line --- - -- --- -------
Dampers
F i
PART FAIL
a service
� Rough In
U) UG/Slab --- _-- - ---- -- ---- - - -
Low Voltage
J Fire Alarm - --- -- --- ----- - --- — - --—
CID Final
PASS PART FAIL
W SITE --- - — `.— — —.----.—— _-.----
"� Backfill/Grading -- — -
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: _-- --- [ ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date 16110101) inspector _I (�_ Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection reco.-d from th- lob site.
I
CITY OF TlGARD MASTER PERMIT
PERMIT 0: MST2000-00165
DEVELOPMENT SERVICES DATE ISSUED: 717/00
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171
SITE ADDRESS: 09232 SIN MARTHA ST PARCEL: 2S114AB-09900
SUBDIVISION: KNEELAND ESTATES NO.2 ZONING: R-4.5
BLOCK: LOT:085 JURISDICTION: TIG
REMARKS: Addition to SF dwelling.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT. 20 FIRS': 288 of BASEMENT: of LEFT: SMOKE DETECTORS: Y
TYPE.OF USE: SF FUJOR LOAD: 40 SECOND: 288 of GARAGE: of TRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINBSMFNT: of RIGHT: 5
VALUE: S 40,818 72
OCCUPANCY GRP: R3 BDRM: 1 BATH: TOTAL: 57600 of REAR: J8
_ PLUMBING
SINKS: WATER CLOSETS: WASHING MACH 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: GARBAGE DISP: WATER HEATERS- WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOILICMP<SHP: VENT FANS: 1 CLOTHES DRYER: 1
GAS FURN>•100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: Mt. FLOOR FURNANCES: VENTS, 5 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS �MISCELLANEOUS ADD'L INSPECTIONS _
1000 SF OR LESS: 0 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L S00SF: 201 . 400 amp: 201 400 amp: tot WIO SVCIFDR: SIGNIOUI LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 680 amp: EA ADDL RR CIR: AIGNALIPANEL: IN PLANT:
MANU HM/SVCIFDR: 601 • 1000 amp: 601-amps-1000V: MINOR LABEL-
1000-amplvolt:
PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS: 9VCIFOR>•229 A.: >600 V NOMINAL: SLS ARFA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL _ B.COMMERCIAL
AUDIO S STEREO: VACUUM SYSTEM: AUDIO S STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNLSC LT:
BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPFARRIG: PROTECTIVE SIGNL
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA7TELE CG;w4c NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 879.63
This permit is subject to the regulations contained in the
VEIARDI,JEANNETTE OWNER ��/TO.--.rd Municipal Code,State of OR. Specialty Codes and
9232 aW MARTHA ST all other applicable laws. All work will be done in
TIGARD,OR 97224 ` accordance with appmved plans. This permit will expire if
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION
Phone: Phone: r Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Roo 0: vVV forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
J OUNC by calling(503)246-1487.
m REQUIRED INSPECTIONS
WErosion 84:-8444 Underfloor insulation Plumb Top Out LDly Voltage Water Line Insp Building Final
—I Footing Insp Crawl Drain/Backwater Electrical Service Gas Line Insp Electrical Final
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Fireplace Mechanical Final
Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Plumb Final
Post/Beam Mechanica Mechanical Insp Shear Wali Insp Rain drain Insp Final inspection
Issud B Permittee Signature
Call (503) 39-4175 by 7:00 p.m.for an Inspection needed the nex`c business day
CITY 01= TIGARD Residential Building Permit Application
Plan Cheqe�1 !u' ons 3:25 SW ALL BLVD. Additior Alterations Recd By
Date Rec &D
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.-�L-_ _
V 503-03-4171 Dotc to DST • 11
F 503-684-7297 1 r Perm"#M A-2#'V-Oro!
Print or Type Caned V/ z
Incomplete or illegible applications will not be accepted
Nime of Project Na
r��� A�✓�5 �Fsr=c�J.
Job �J L{ r'�,�%1 >� 1. Architect Melling Address
Address Site Address .7 a,L'4 �- r✓x. /r<►� Z V
J M CRy/State Zip" Phone
Name ())? `17 32. Srg-o) o7L
An/ ✓EL ficb1 --_-- N
Owner Mailing Address
3 Z S•`" Engineer Mailing Address
City/State Zip Phone_ Z?.
• ;y i,•9 r) Ole, y 712' �J 9-S e City/State zip I Phone
General Name Ni,� �xc= p�? »�1"� -�•�'�7
Contractor e GINGie — w..l:L �jol? Describe work New O Addition Alteration O Repair O
Mailing Address to be done:
Prior to permit Additional Descdption of Work: ., — �
Issuance,n copy City/State Zip Phone �_ A (
of all licenses
are required If Oregon Const.Cont.Board Exp.Date PROJECT
expired in COT LIc.# VALUATION ,
database --
Mechanical l Neme NEW CONSTRUCTI I N ONLY:
Sub- Wil(We-0 Sq. Ft. House* /- Sq.Ft. Garage
Contractor Mailing Address v � Indicate the restricted energy Installation by the electrical
Prior to permit
Issuance,a copy City/State T_ip Phone subcontractor in the followin areas
If an licenses Restricted Audio/Stereo
are rc•,,aired if Oregon Const.Cont. Board Exp.Date Energy .1larms
5 stem
expired in COT Lic.# Installations Vacuum Irrigation
database _ System System
Plumbing Name (check all that Other:
Sub- apply)
_
Contractor Malang Address — Corner Lot YES NO Flag Lot YES NO
check one eck one
Has the Subdivision Plat recorded? N/A YES NO
Prior to perms City/State Zip Phone
issuance,a copy
of all licenses are Oregon Const.Cont.Board Exp.Date
required H Lic.# I hearby acknowledge that I have read this application,that the
expired in COT
database Plumbing Lic.# Exp.bate information given Is correct,that I am the owner or authorized agent
of the owner,and that plans submitted are in compliance with
a Oregon Slay laws.
Name SignWre of Ownr,[/Ag¢.n7— �— �a
N Electrical _ if,, /< /- / !/
n�Ict Person Na Phone#
Sub- Mailing Address !/s�C'7
0o Contractor
City/State Zip Phone
W Prior to permit
J issuance,a copy FOR OFFICE USE ONLY: _
of all licenses are Oregon Const.Cont. Board Exp.Date Plat#: MapITL#:
required if Lic.# 1, �" /�QQ
expired in COT k►1 P� (4• '/ rSJ* t — _ y��J" 09900
database Electrical Lic.# Exp Date Setbacks: Z.one:n Solar:
Electrical Supervisor Lic.# Exp.bete Engineering Approval: Planning Approval: TIF:
n-3.
-j,/74/ e\datatrom,.�faddalt.doa 11/20198
Permit#: 000
Addres • 302 S t /�-j�R TXf.} ,j j
Issued Date: _%-7-Ut^) ---
Statement: Information Notice to Property Owners
About Construction Responsibilities
Nate: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board tr sign the
following statement before a buildink permit can he issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licenced
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed k A the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 313-
1. 1 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.
F] 3A. My general contractor is
��JJ (Name) Contractor regis. #
1 will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
EJ 36. 1 will he my own general contractor.
If 1 hire subcontractors, 1 will hire only subcontractors registered with the Construction Contractors
N Board. if 1 change my mind and hire a general contractor, I will contrncc 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.
m
w
I hereby certify that the above information is correct and that i have read anri do understand the Information
Notice to Property Owners about Construction Responsibilities on the revers-side of this form.
(Signature of permit applicant) (Pate)
(White copy to issuing agency permit.file,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
Note: This Information Nonce to i'ropert>>Owners abc o; Construction Responsibilities
was developed ky the Construction Con.trartors Board rn accordance with ORS 701.055(.5).
if you are actingas your own contractor to construct a new home or make a substantial improvement to an existing structure,
yrns can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
ll' You hire persow, not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction err improvement of a residential structure,you will, in most instances,be ruled to be an employer and the people
cnI hire %%ill he employees. As the employer,you must comply wiih the following.
Oregon's H ithholding tax lave: As an employer,,you must withhold income taxes fromemployee wages at the time employees
;ono paid. 1'ou 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 Dept. of Revenue at 945-8091.
Unemployment insurance tax: As an employer,you are required to pay a tax for unemployment insurance purposes on the
wales of all employees. For more information,call the Oregon Employment Division at the Department of Human Resources
at 378-3524.
Workers' compensation insurance: As an employer,yea are subject to the Oregon Workers'Compensation Law,and must
ohl<Iin workers'compensation insurance for your employees. If you fail to obtain workers'compensation insurance,you may
he suhiect to penalties.Ind will he liable for all claim costs if one of;oor employees is injured nn the job. For n1ore informption,
call ttte W,rrker,�'Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S.internal Reienue Service: As an employer,you must withhold federal income tax from employees'wages. You will be
liahle for the tax payment even if you didn't actually withhold the tax, For mors information,call the internal Revenue Serv;ce
at 18W-829-1040.
OTHER PESPONSIBII_ITIES AND AREAS OF CONCERN:
t'ode compliance: As the permit Molder for this project,you are responsible for resolving any failure to meet code requirements
if at may be brought to your attention through inspections.
4. Liahilit:r and property damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage For
n' accident., :Intl omissions such as falling tools,paint oveuspray, water damage from pipe punctures,tire,or work that must he
H
to re-done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
to
WExpertise: Make sure you have the expertise to act as your own general contractor,to coordinate the work of rough.in and finish
—t trades, and to notify building.officials at tfie appropriate times so they can perform the required inspections.
if you have additional questions,write or call the Construction Contractors Board(PO Box 14140,Salem,OR 97309-5052,
5031378-4621). The Board is located at 7(X)Summer St.NE Suite 300, in Salem.
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NORTH
CITY OF TIGARD lJ'Z-t Qo
13125 S.W. HALL BLVD. RFC -T���'
TIGARD, OR 97223 I
AUG 2 3 2000
IMPORTANT PERMIT NOTICE
i
CHEROKEE ELECTRIC CO
PO BOX 230230
TIGARD, OR 97281
Electrical Signature Form
I
Permit#: MST2000-00165
Date Issued: 717100
Parcel: 2S114AB-09900
Site Address: 09232 SW MARTHA ST
Subdivision: KNEELAND ESTATES NO.2
Block: Lot: 085
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Addition to SF dwelling.
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
I
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
•
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No electri:al inspec .ions will be authorized until this completed form is received
I
OWNER: ELECTRICAL CONTRACTOR:
VELARDI, JEANNE TTE CHEROKEE ELECTRIC CO
9232 SW MARTHA ST PO BOX 230230
TIGARD, OR 97224 TIGARD, OR 97281
Phone #: Phone #: 638-1515
Req #: LSC 00035681
SUP 2616-5
ELE 3-127C
7 I
AN INK SIGNATURE IS (REQUIRED ON THIS FORM
x
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310