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Permit y w�~ MASTER PERMIT OF � c11 DATE ISSUED: 04/01/9S COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd. Tigard, Oregon 97223°819e (503) 639-4171 . PARCEL: 2C110CC-1547.a SITE ADD 12375 SW KING GEORGE DR ZONING: Reoar;is: =ITEM B5SO FT PATH I ---------------------------------------------- 88ILD��� - ------------------------- --------- REIS��: S7JRIES.....,.: 1 FLOOR AREA: --- BAS[KENT...: G sf HECUIREO 6ET6ACKG---- kEOUIRED------- CLASS OF K:RK.:ADD HEIGHT........: 24 FIRST....: 23S sf GgRADE.,.,.: 0 sf LGFT.,........: 5 ROE 8ETECTHS: Y TYPE OF UEE...:SF FLOOR LOAD ' 4t SECOND...: C sf FRONT.......-: 20 PARKIN: CPAC[S: C TYPE OF CONS7.:5N D%ELLIN3 UNITS: 1 FINDSMENT: 0 sf RIGHT... ------ 5 OCCUPANCY 6RP.:83 BDRM: 0 BATH: C TCTAL : 235 sf VALUE-t: 151-15 REAR ... ,...,..x 15 ____ S���.........: & WATER CLOSETS.; G HASHING NAM.: 0 LAUNDRY TRAYS.: W RRIN DRAIN ft; C TRAPS.........: Q LAVATORIES.... : 0 DlSHW0HERS..1 Q FLOOR DRAINS..: 0 SEVER LINE ft: N SF RAIN DRAINS: CATCH BREINS..; 0 TUE/2S]2ERC .. 6AREREE DISP..: N EATER HEATERS.; 0 WATER LIN: ft: W KELW PREVN3R: GREASE TRAPS..: 0 OTHER FIXTURES: 0 ------- --'--------------------------------'---- �E���I[AL ---------------------------------' ------ FUEL TYPES---'------ FDRN ( \@N ..: 0 BOIL/CMP < 3HP: G VENT FANS,....: W CLOTHES DRYERS: D FUR >=18%x .,: 0 UNIT X[AT[HC..7. 0 K8JDS.........; e OTHER UNITS...: Q NDXINP.: 03TU POOR FURNACES: 0 VENTS : t NOODSTOVES....: 0 GAST]LETS...: e ----------------------------------------'--'----- ELE��RICXL ----------'-------''-------------'--------- --RESIDENTIAL UWlT--- ---SERVICE/FEEDER---- --TEMP 53JC/FEE3ERS-- —MANY, OlRCUITS--- --MISCELLANEOUS-- --ADD'L IUSPECTIC[E- 1322 CF 38 LESS: 0 C - 200 acp..; Q 8 - a% app..: 8/SVC C8 B@..: PUMP/IRRIGATION: 0 PER ]NSPECTICMr 0 EA AWL 522JF.: 0 201 - 400 app..: C. 2t1 - 425 a:p..: % It W/U SYC/F88: l 6%6N/0] LIN LT: 0 PER HOUR--; C LIMITED ZNERGY./Q 421- bee aop.,:0 I:01-GDOaop..:0 EAAQDLDRMR: N SlGNAL/PAXEL.../W IN PL8K7.,....: O SX/GYC/FDR; 0 6-01 - aop.: N S014.aaps-1Cia y/ 3 MINOR LA8EL -10: 0 1Q�s acp/vsit.; --------------------''-'--'--- PLA% REVIEW SECTION '---------'---- 3nc:nn»ct only.: 0 }=4 RES UNITS-: 8VC/FDH}=225 A.: > 6t0 V NOMINAL; CLS AREA/SPC QCC: --' ---'----' '--------------- ELECTRICAL - PE3T0}CTED ENERGY ----- ------------'----- -------- A. Er RESIDENTIAL------------------ �� C���XClAL---------'--------------------------'---'--- -- -- AUDIO D STEREO.: VACUUM SYSTEM-: AUDIO & STEREO.: FIRE ALARM--; }%TE8CCWASlN6: CUT[OUR LNDCC LT, BUHGLXR 0DILER.........: ,......: LA#DGCAPE/lR0IG: PROTECTIVE SIGML: SARRG[ CPENEQ .: CL8CK,.........: INSTRUMENTATION: MEDICRL........: Ora: :; N��C..........� DATA/TElECOMM.: NURSE CALLS--; TOTAL 0SYSTEMS; '1 Qzzprx ------ ------------------ TOTAL FEE00 234.81 CxnaL[S #IKlNG QXXE3 12375 T.! KIM OEORS[ MS CITY UX 97224 Phcnp DI .6Z3-8232 Phone #: Se; 0..1 =Tao This perait is issued stkjoct to the poyolstians contained in the Tigard Municipal Csde Statc Ore. Specialty C:in and all other applicable ia:;s. All xrk will be Jxoe in accordance with apprcved plans. This percit All expire if :opk is not started within IOC days of issuance, or if ucrk is suspended for o:re than 18t days. ---------------------^--'--'---''-------'----- R�QUl�� �N2�Z7�9�S --'---------------' 7cotin :nsp Insulation Inyp Erceia Control F::zdsticn I:sp Cyp Cocre ln:a? Past/Dean Strict Rain drain Iosp 22ctrical Serd Elcct Final Franin; Ixsp Ezildi:g Final /* / ��er�i�tee Cign�ture: �` ' �� ` Issced � y: ~ _ ` �� /� / • '-- Call for inspectior. - 639-4175 • Residential Building Permit Application • City of Tigard C 13125 SW Hall Blvd. ,y0 Tigard, OR 97223 ' (503) 639-4171 Y12 C' (//r1474 tli 1 j ° bsite Address: )5 O ffice Use Only Subdivision: 'Xu-1-1, , Lot* Valuation: /5 /.• Permit #/05/ 0 / Corner Lot? Y Reissue of Flag Lot? Y :Map • - • ,,, Owner: C/6 4/11/A1S Approvals Required Address: M3 36- 4 ( -- 7 / -74) ./ 2 /1 Engineering .,••• • ....• • Phone: YO 3 3 9 Other • • • "••••••••••: ,, •••-••••••• ,,,,, .-- • Contractor: Items Address: c: -_f;$-Y - t") e__ Subcontractors Truss Details . . Phone: - 5 9— Other, -•• • . „„:..„. . . . .• . . .„. • .. Contractor's License # '•••• • ".. " " (attach copy of current Oregon license) Contact Name & Phone: Subcontractors: Architect/Engineer: Plumbing: • Address: Mechanical: (attach copy of current OR Contractor's License) Phone: JOB DESCRIPTION: 3 f t 3 0 Applicant Signature & Phone number ', Received by: ( lCA/' Date Received: Permit # Account Description Amount Amt. Pd. Bal. Date rn 5/ Bldg. Permit (BUILD) / aU t 57) /16.5 Plumb. Permit (PLUMB) Mech. Permit (MECH) sax rem " _ 3L5 Bldg: S 8 3 Plumb: Mech: 7- 0-1 '7 i � Plan Check (PLANCK) � ' 8� C 3, 9o. Bldg: '75 73 7/,?-3 Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF -R) Mass Transit TIF (TIF -MT) Commercial TIF (TIF -C) Industrial TIF (TIF -I) Institutional TIF (TIF -IS) Office TIF (TIF -O) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Pl (ERPLAN) Erosion PlanckICOT (EROSN) s / 4,2 U TOTALS: ,�_' " , ' <• � /�� '� Permit #: 1 ' J ` ' I (q ( t OF O o r Address: �2 -J�� GU) f`1( 6d2fr � Issued by: L ' ( ' 59 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: 0.4 1. I 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 I I before or upon completion. ri 3A. My general contractor is (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. OR &11,0-1 3B. I will 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. 4, -) (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Into , ation ;',Jotice to Property tnrs o Constructi *; 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. EMPLOYE'' RESPONSIBILITIES: 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 withholding tax law: As an employer, you must 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 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 wages 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, you are subject to the Oregon Workers' Compensation Law, and must 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 information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue 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 actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: 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 5/10/99 Activities for Case #: MST96 -00139 1:54:05 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA005 Application received 3/14/96 JA PASS BT2 3/29/96 MSTA008 Permit Created 3/25/96 JA PASS BT2 3/29/96 MSTA010 Check for prcl. restrict. , 3/25/96 JA PASS BT2 3/29/96 MSTA012 Plans routed to Plans Examiner 3/25/96 JA PASS BT2 3/29/96 MSTA026 Plans approved by Plans Exmr 3/29/96 RT PASS BT2 3/29/96 MSTA030 Reviewed plans routed to DSTS 3/29/96 RT PASS BT2 3/29/96 MSTA705 Footing lnsp 5/14/96 TLP PASS TLP 5/14/96 MSTA706 Foundation lnsp 5/14/96 TLP PASS TLP 5/14/96 MSTA710 Post/Beam Structural BT2 3/29/96 MSTA723 Electrical Service BT2 3/29/96 MSTA725 Framing Insp 6/7/96 TLP PASS TLP 6/10/96 MSTA740 Insulation Insp 6/10/96 TLP PASS TLP 6/11/96 MSTA745 Gyp Board Insp 6/12/96 KS APP KBS 6/12/96 MSTA755 Rain drain lnsp BT2 3/29/96 MSTA790 Electrical Final BT2 3/29/96 MSTA799 Building Final . BT2 3/29/96 MSTB708 Erosion Control BT2 3/29/96 MSTA080 (F) Ready to issue 4/1/96 CJS PASS TMP 4/1/96 MSTA092 (F) Issue combination permit 4/1/96 B PASS BON 4/1/96 MSTA724 Electrical Rough In 6/10/96 6/10/96 TLP PASS BT2 7/25/96 MSTA9,70 Case Finaled 8/4/98 RC DONE No Hold JT - 5/5/99 completed & finaled • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST � / BUP 62-6 3 P- v 0,3 ` Date Requested ( T " 9 ? AM PM BLD a Location 12.371/45 1(vn .4' i Suite - 00 ) 7 Contact Person Ph r0 ' I3/ PLM Contractor Ph 2�j SWR Tenant/Owner g-L eS K-1 ADD / N1 ELC Retaining Wall ELR Footing Access: �^� Foundation I'"t1r /� a c(I ( Ftg Drain / a�--v J SGN Crawl Drain Inspection Notes: CSC- 6 u - .-r Slab SIT Post &Beam , I ^ p Al IT U E-0 Ext Sheath /Shear ��I (f F Int ami nath /Shear t p n 6o' / T 6 D p &g n „ g �f f� /T It /''I (gyp pC� /�� Insulation <=91(‘-f. 2 � 8 6 f` ' - 1 [b Drywall Nailing 2 �J 1[J Firewall n t ' p Fire Sprinkler �/L Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL S n p PLUMBING £,11,.- : z M 7f Cf b ' OZ/2A Post & Beam Under Slab 141(‘ G Top Out Water Service Sanitary Sewer Rain Drains Final FAIL • & Beam as s noke Dampers 'ASS PART FAIL EL ECTRICAL f j, ", &° ° ft m Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 Please call rens ection RE: Fire Supply Line [ ] Pl ll for i p [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.