Permit MASTER PERMIT
CITY,OF IGARD DATE 05/16/96
COMMUNITY COMMUNITY DEVELOPMENT DEPARTMENT
F�ARCEL:S14CA -c6��
SITE. fAL ) D R -EIS b Tigard, 1 - 1 71 S 9 L N
SUBDIVISION....: HILLSHIRE ZONING: R -7 PD
BLOCI'..... ...... . LOT. . . :026
Remarks: PATH I redoing basement installing floor and new walls in basement gaining 371 sq ft
-- - - ---- BUILDING — --- - - --
REISSUE: STORIES 0 FLOOR AREAS BASEMENT...: 371 sf REQUIRED SETBACKS - - -- REQUIRED -
CLASS OF WORK.:ALT HEIGHT • 0 FIRST 0 sf GARAGE 0 sf LEFT 0 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT • @ PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 0
OCCUPANCY GRP.:R3 BDRN: 1 BATH: 1 TOTAL - - - - -: 0 sf VALUE..$: 23989 REAR 0
- - - - - -- --------------- - ----- PLUMBING
SINKS • 0 WATER CLOSETS.: 1 WASHING MACH..: 0 LAUNDRY TRAYS.. 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES : 2 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS : 1 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
---------- _------ - - - - -- MECHANICAL ------- -- - - --
FUEL TYPES---- - --- -- FURN S 100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 1 CLOTHES DRYERS: 0
/GAS/ / / FURN ) =1 00K ..: 0 UNIT HEATERS..: 0 HOODS 0 OTHER UNITS...: 0
MAX IMP.: 0 BTU FLOOR FURNACES: 0 VENTS • 4 WOODSTOVES....: 0 GAS OUTLETS...: 0
------------------- - - - ° -- ELECTRICAL -
-- RESIDENTIAL UNIT - -- - -- SERVICE /FEEDER - - -- —TEMP SRVC /FEEDERS -- - -- BRANCH CIRCUITS— - -- MISCELLANEOUS - - -- - -ADD'L INSPECTIONS- -
1 %%0 SF OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HM /SVC /FDR: 0 601 - 1000 amp.: 0 601 +amps -1000 v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 - - - -- PLAN REVIEW SECTION -- - - - - - --
Reconnect only.: 0 ) =4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC:
--------- - - - - °— ELECTRICAL - RESTRICTED ENERGY - - - - - --
A. SF RESIDENTIAL — - - - - -- B. COMMERCIAL,
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRI6: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR:
HVAC • DATA /TELE COMM.: NURSE CALLS TOTAL # SYSTEMS: 0
Owner: - - - -- - -- Contractor: ----- -- - - -- --- - -- TOTAL FEES:$ 473.26
WILLIAM J BOHRINGER OWNER
13571 SW LAUREN LN
TIGARD OR 97223
Phone #: 590 -6395 Phone #:
Reg #..:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
------ - - ---- - - -- REQUIRED INSPECTIONS -- -
Post /Beam Struct Plumb Top Out Gyp Board Insp
Post /Beam Mechan Electrical Servi Electrical Final
Crawl Drain Framing Insp Mechanical Final
PLN /Underfloor Low Voltage Plumb Final
Mechanical Insp Insulation Inspp ) , Building Final
Per�mittee Signature: w ' __— Issued B � 4110"1"'
Cal for inspection -• 639 -4175
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cc- (tec( 6 -t(- r
,. Residential Building Pe Application
, City o Tigard
13125 SW Hall Blvd. ��� 5///q
Tigard, O 97223 1�
(503) 639 -4171
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: `::: Map: -i i4 : L # ?: ; 5 (0• q u ' : o < _;.
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Phone: 5O3 9 ° -S
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Contractor
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Address: n
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Phone:
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Contact Name: TIGA
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Plum �� YY)1 C u O&! -C) Address: 01 f - O < t�)/ Hi' / v
Mechanical: ➢�� c� T� ontractor -
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/ (attach c of current O R l C License
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FAN I &'N & E
JOB DESCRIPTION: Abr i F RI i�C i NI—
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I'IaOP C. !L r � ( � i 5 � , 'r 3 5 ' o - 639
Applicant Signature Applicant Phone n umber
Received by: g Date Re ceived._ ,.. C/‘
H:Vo sapp
Permit # Account Description Amount Amt. Pd. Bal. Due
m,tf S _c.2c( I Bldg. Permit (BUILD) / )Z' /(4. )V r
–
— -- - Plumb .-Permit - -- - (PLUMB) -_ -- - — `(�� °�-
Mech. Permit (MECH) 3 / 3/ 'u
Bldg: 6 /Z f
Plumb: l
Mech: /..r>
e
14 R 9'3
Plan Check (PLANCK) 7C6'0 7.6 6 ' 41
Blda: /'f 3
Plumb: •
Mech: 7_ 9r _ 7. 7r _
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 Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: i 2g ,q3 cjys(1,33
Permit #: tLA-6 1 9 ^ ii-77
Address: / 3 52( 5l Lau V /i9
Issued by: Date S /0 CD
- 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:
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
before or upon completion.
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
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 Ow rs about Construction Responsibilities on the reverse side of this form.
ljk..-) 51---._) __V3/ .6,
(Signature_of plekmit applicant) — __ (Date)._
(White copy to issuing agency permit file,
pink copy to applicant)
°
.
' ~
• Information Notice to Property Owners
About Construction Responsibilities
`
Note: This Information Notice to Property Owners about Construction Responsibilities
was de by the Consirucion Contractors Board in accordance with ORS 70.055(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.
EMPLOYER 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 , Asthe employer, you must complywith the following:
Oregon's withholdi tax law: As an employer you must withhold income taxes from enployee wage. aithetime 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 at945-809L .
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 Department 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 ifone of your employees is injured on(he job.Furmorcinfo«modou,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S. Internal Revenue Service: Asan employer, you must withhold federal income tax from employees' wages. You will be
liable for thetax payment even ifyou 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 p jcct,yoourcoxpoosiNnforreso|xingooyfai|unctomecicoden:quircmccKs
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 sufhcient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ofrough-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 Contractors Board (Pt) 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
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: Al — / 7 - C 7 A.M. P.M. ( MST: 96 _e2 '/
Location: / 3S7 hi9u /....7 4 A r BUP:
Tenant: Suite: Bldg: MEC:
ContractorE j L L-.(....... 13TS4 i tz::::'/E— • _ Phone: PLM:
Owner: Phone: ELC:
ELR:.
_ SIT:
BUILDING PLUMBING •-_ - !n •._.1! AL--- ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
'roved Approved roves Approved Approved
Appr /Sdwlk o .... ved Not Approved o pproved Not Approved Not Approved
IN FINAL (� / ® FINAL FINAL
- '' /� ` _4, / - ,,.G L .41(50 L2 LL age/ .. L —
C t
in Call for- reinspecti - -- - • O Reinspection- fee-of -$ required before next-inspection -- - - -- - -O- Unable -to- inspect - - - -- -- -
Inspector: Date: l — / 7 — 7 Page of