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Permit CITY OF TIGARD MASTER PERMIT 4 0I k *,,,a, DEVELOPMENT SERVICES PERMIT # • MST97 -0214 *wit DATE ISSUED: 06 / 34 / 97 L 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 PARCEL: 1S135DB -04100 SITE ADDRESS.••:11330 SW 92ND AVE SUBDIVISION....:DOGWOOD RIDGE ZONING: R -4.5 BLOCK.......... LOT •14 JURISDICTION: TIG Remarks: Addition to SFD --------- .��— _-- _— __-------- ---- -- BUILDING ------ - -_ - -- - - - - - -- -- ---- -- REISSUE: STORIES • 1 FLOOR AREAS-- - - - - -- BASEMENT...: 0 sf REQUIRED SETBACKS - - -- REQUIRED------- - -- CLASS OF WORK.:ADD HEIGHT .: 12 FIRST • 308 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT : 5 OCCUPANCY GRP.:R3 BDRM: 1 BATH: 1 TOTAL- -- - - -: 308 sf VALUE..$: 15m REAR : 72 PLUMBING --- _____— w_____r —_--- __________________ ____________ SINKS • 0 WATER CLOSETS.: 1 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES • 4 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 2 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 - -------- - ---------------------- - MECHANICAL ------------------------------------ FUEL TYPES FURN ( 100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 GLOMS DRYERS: 0 GAS FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 2 WOODSTOVES : 0 GAS OUTLETS...: .0 - -------------------------- ________ -- - - -- ELECTRICAL -- ______---------------------------- -- RESIDENTIAL UNIT - -- -- SERVICE /FEEDER - -- --TEMP SRVC /FEEDERS— - -- BRANCH CIRCUITS - -- -- MISCELLANEOUS -- - -ADD'L INSPECTIONS-- 1m SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0. PER HOUR : 0 LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 2 SIGNAL /PANEL...: 0 IN PLANT • 0 MANE HM /SVC /FDR: 0 601 - iw amp.: 0 601 +amps -10- v: 0 MINOR LABEL -10: 0 1000+ amp /volt.: 0 - - - -- -------- - - - - -- PLAN REVIEW SECTION --------- --------------- - Reconnect only.: 0 - )=4 RES UNITS.,: SVC /FDR) =225 A.: ) 6v V NOMINAL: CLS AREA /SPC OCC: — - -- - - -- ---- -- - ELECTRICAL - RESTRICTED ENERGY __ -_— A. SF RESIDENTIAL-------- -- ---- ----------- __— ���_—---- _____- -___ -- AUDIO 8 STEREO.: VACUUM SYSTEM..: AUDIO $ STEREO.: FIRE ALARM.....: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRI6: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK. • INSTRUMENTATION: MEDICAL : OTHR: • . HNC • DATA /TELE COMM.: NURSE CALLS : TOTAL # SYSTEMS: 0 Owner: ------------ ---- -- - --- Contractor: - - - - -- -- TOTAL FEES:$ 367.51 JOSEPH BUI D & E DWELLINGS This permit is subject to the regulations contained in the 11330 SW 92ND AVE PO BOX 666 Tigard Municipal Code, State of Ore, Specialty Codes and all TIGARD OR 97224 SHERWOOD OR 97140 other applicable laws. All work, will be done in accordance with approved plans. This permit will expire if work is Phone It: Phone 4: 803 -3131 not started within 180 days of issuance, or if the work is Reg #..: 101364 suspended for more than 180 days. ATTENTION: Oregon law - - -- ------- - - - - -- — requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -Y11 -0010 through OAR 952- 001- m0. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. --------- - - - - -- -- ------- - - - - --- REQUIRED INSPECTIONS ------ - __________________________________________ Footing Insp PLN /Underfloor Framing Insp Electrical Final Foundation Insp Mechanical Insp Low Voltage Mechanical Final Post /Beam Struct Plumb Top Out Insulation Insp Plumb Final Post /Beam Meehan Electrical Servi Gyp Board Insp Building Final Crawl Drain Electrical Rough Rain drain Insp Issued By % %V / /.' A AO./ Permittee Signature: , "/„.40A +++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + ++ Ca.11 639 -4175 by 6:00 p.m. for an inspection needed the next business day T O F TIGARD Residential Building Permit Application R Reed By Checx�% . ' 125 SW HML BLVD. New Construction Additions or Alterations Date Recd 4 4 3ARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. /Z 503- 639 -4171 Date to DST OA /(p 503-684-7297 Permit #M 27_ ()eft • Print or Type Ca ( I q9 >- g, I co lete or ille ible applications will not be accepted 5 p c Na of Project Name • A d s i ieI Ad s rk. i `" t Architect Mailing Address Name q a � ct t� Goa. i Owner Mailing Address Name N 11115 5•W " " q r j L. Engineer Mailing Address City /Mate Zip Phone g a p4! 47 ?le NamB I - City/State Zip . I Phone General • D C E jJ w t t ` N . Describe work New 0 Addition eration 0 Re air 0 Contractor M lli geddress (/� to be done: / y ,s p f Jam, i : 'K )( 22 Yr a - C x Additional Description of Work: C' /State Zip . Phone I 91.s..4./ utova € / 4/ v $63 / a Oregon Const. Con Board Licit Exp. V • Attach Copy of ( / / Q i � J _ Current CO ax or Metro # p. Dat / PROJECT Licensed / +`1-� VALUATION $ 0 Name - . . / 00 Mechanical 6 t,,, Ai 'C./I.'" NEW CONSTRUC ONLY: Sub Mailing Address Sq. Ft House: Sq. Ft. Garage Contractor Comer Lot YES NO Flag Lot YES I NO City/State Zip Phone 1 (check one) (check one) I Oregon Const. Cont. Board Lt.* Exp. Date Restricted Audio /Stereo Burglar .:tach Copy of Energy System Alarm Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC Licenses Name Opener Systems Plumbing - 0 w N ..4/1/ - (check all that Other Sub ) Mailing Address Will the electrical subcontractor wire for all YES NO Contractor restricted energy installations? Has the Suodivision Plat recorded? N/A YES NO City/State Zip l Phone • Oregon Cons. Cont. Board Lic.# 1 Exp. Date Reissue of MST#: Solar Compliance :attach Copy of Current Plumbing Lic.* p. Date (Calculation Attached) Licenses I I hearby acknowledge that 1 have read this application, that the information given is cored .- - t 1 am the owner or authorized COT Business Tax or Metro # Exp. Date agent of th ner, and • •tans submitted are in compliance • Name with Ore! • tate law Electrical S'■ na;`-- of Own •. •ent Dat 0 w �u ?/ / 747 p S ub- Mailing Address Co act on Name) Phone # -:.,ontractor 4 , a at -1" 50 3 313/ City/State Zip I Phone FO F' USE Orvilit' ' ) / Plat . , 4, 7 e( r (Ma p /1 6 , o '( f7� Oregon Const Cont. Board Lc.# 1 Exp. Date 1/ / '.�: Copy of Setbacks: ,kj7 Zone ( ( Solar. Current Eiectncai Lic. # I Exp. Date 7 / • Cu / Licenses (� , COT Business Tax or Metro # Exp. Date Engl 1 4,prodmiv Planning .Approval: TIF: i:\sfapp. oc (dst) 1/97 Permit # Account Description Amminy Amt. Pd, Bal. Due - oq /0 ST. Permit (BUILD) / /D. 110, e. Plumb. Permit (PLUMB) 163 w , �� Mech. Permit (MECH) 02.S 02.S ELC /ELR Permit (ELPRMT) s�, State Tax (TAX) /Z. • / Z . LY-- V -- Bldg: S. 5 - Plumb: 3. . Mech: /, v -- .....__ . - -- . -- - - - - . .. . _ ELC /ELR: 1 Z'=_� - - - -- ._— - . . _ . Plan Check MST: _ .. (BUPPLN), 7/. ' , • - Plumb: "_ • : - (PLMPLN) _ _ . _ - _ ____ - - Mech: - -- x,1-,,.1.. (MECPLN) // VO - CDC Review - - — C. ( S) . ,,,�'� C% Sewer Connection - (SWUSA) - Reimbursement District - - ( ) - Sewer Inspection • . (SWINSP)- Parks Dev Charge (PKSDC) Residential TIF (TIF -R) Mass Transit TIF - (TIF-MT) Water Quality (WQUAL) Water Quantity (WQUANT) - Erosion Control Permit (ERPRMT) Erosion Planck/USA (ERPLAN) / • Erosion Planck/COT (EROSN) • ;� Fire Life Safety (FLS) , Al ,.�_ , TOTALS: 367, s/ s' 1 G2.y �� - i:ls - pp.doc (dst) 1/97 Permit #: 1 1 7 '"02-1 Li OF O t,41414% Address: 1 ( �U 61A) q2-- I (j ��� Issued by: a-�/'— Date: 7 X859 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(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: \► fir / . I own, reside in, or will reside in the completed structure. is � 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 �• t i ric_s l c( aka (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. I OR B. I w ill be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my 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. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. �� q » (S g 1 ure of permit applicant) ( ate) (White copy to issuing agency permit file, pink copy to applicant) 1Inlorrn 4lon f ©Rice © Propeoly Oensea , t b!ru2 CConstruc©Uon ResponsifaoDu46c s Note: This Information Notice to ,property Owners about Construction Responsibilities was developed by the Construction' Contractors Board in accordance with ORS 701.055(5). 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. EMPLOY :1R G ESPO SA UTES: If you hire persons 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 will be employees. As the employer, you must comply with the following: Oregon's awithitnoka1ing tax flaw: As an employer, you :rust withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance r .,x: 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 at the Department of Human Resources at 378 -3524. Workers' coanpeaisation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, a.nd'rrrust obtain 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 of your employees is injured on the job. For more inf ornaatrbn, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. later llatemal.Rev Service: As an employer, you Must-withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actual }y withhold the tax. For more information, call the Internal Revenue Sep vice at 1- 800 -829 -1040. OTHER R SPONSillE TES AIND AREAS OF COMICERM: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to 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 punctures, 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 or call the Construction Contractors Board (PO'Box 14140, Salem, OR 97309 - 5052, 503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.pm4 1 /94 CITY OF TIGARD BUILDING INSPECTION DIVISION " MST ��'04 / T 24 -Hour Inspection Line: 639 -4175 Business Line: 639-41716 � ` I: BUP • *2 Date Requested ? 1. PM i re BLD Location /1330 5,4.) q c ,i d Suite MEC Contact Person 90Sreph - 436,�./ Ph j3 V- 5096 PLM Contractor Ph /,( 4 74 Q SWR >C�3 0 ELC / BUILDIN Tenant/Owner l l O Retaining Wall ELR Footing Access: Foundation Al p /� t FPS Ftg Drain �d'(•�- r(�u� SGN Crawl Drain Inspection Notes: Slab �, IT Post & Beam ����% '`-e � a/ � C- Ext Sheath /Shear { Int Sheath /Shear / 2i2 Framing Insulation Drywall Nailing `i G--« - 1-( Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: r - Final PART FAIL BING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PA FAIL ECHANICA Post & Beam Rough In Gas Line Smoke Dampers Fina RE SS ) PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date Z""'' Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 1 BUP Date Requested /"/ l G $ AM PM BLD 12® i Location / / 53 6 ( A-J e4( Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab 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 Top Out Water Service Sanitary Sewer Rain Drains PART FAIL HANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL .ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm . Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk / � Other Date Inspector � Ext-3 Final PASS PART . FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 d�aaf(lt ` / C� Owl __ Date Requested ! 5 / AM >( PM BUP Location 8 0/6 %2n( Are, Suite MEC Contact Person Ph q.40 l ` 7 p 30 p PLM Contractor 9 e jf Oik Ph SWR BUILDING v Tenant/Owner 6 84" gb* ELC Retaining Wall ELR Footing Foundation Access: N _ Lk� FPS Ftg Drain / SGN Crawl Drain Inspection Notes: cc '� Slab �J �� SIT Post & Beam Ext Sheath /Shear cav bo -/1.e / � Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final ____P-ASS—R411,1 FAIL PLUMBING ) Pos eam Under Slab Top Out Water Service Sanitary Sewer c - ain"Urams • PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm - Final PASS PART FAIL 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 Other oach /Sidewalk Date / ,/" 7 Inspector Ext -3/<- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY-OF TIGARD BUILDING INSPECTION DIVISION 7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �` / c / BUP /72-1 Date t Requested /o2 / AM PM BLD Location 11330 ) s.- 9o) - // ° Suite MEC Contact Person 111 43.66& ,- , Ph qye - 193 PLM Contractor Ph� SWR BUILDING Tenant/Owner ?u i 7c3 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: _ SGN Slab nu z _ 6 .- 77 -- SIT Post & Beam � - �e „ n Cale. / � , C Ext Sheath /Shear � ! L�l/ (/L ff& 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 Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL �. `ELECTRICALS -s ervice oug n UG7SIab Low Voltage • - • larm 'ASS PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / 2 9/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site