Permit MASTER PERMIT
CITY OF TIGARD DATE ISSUED: . 10/01 /9E�6- Iz1423
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 25104AB- 17131 00
SITE ADDRESS--; 13283 SW SCOTTS BRIDGE DR
SUBDIVISION MORNING HILL NO.3 ZONING: R -4.5 PD
BLOCK. ..... . LOT :64
Remarks: 230 sq. ft. addition PATH I
---- BUILDING ---
REISSUE: STORIES : 1 FLOOR AREAS-- - - - - -- BASEMENT • 0 sf REQUIRED SETBACKS - - -- REQUIRED - --
CLASS OF WORK.:ADD HEIGHT : 0 FIRST : 230 sf GARAGE 0 sf LEFT : 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 0
OCCUPANCY GRP.:R3 BDRN: 0 BATH: 0 TOTAL -----: 230 sf VALUE.. f: 15387 REAR • 0
-- - - - - -- - - - -- PLUMBINii
SINKS • 1 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES : 0 DISHWASHERS...: 2 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 2 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 2
- - -- MECHANICAL - ---- -- - - - --
FUEL TYPES - -- FURN ( 100K ..: 0 BOIL /CVA ( 3HP: 0 VENT FANS : 0 CLOTHES DRYERS: 0
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
-------------------- - - - - -- ELECTRICft - -- -- - -• --
- RESIDENTIAL UNIT -- - -- SERVICE /FEEDER - - -- -- TEMP SRVC /FEEDERS -- - -- BRANCH CIRCUITS --- - -- MISCELLANEOUS - --- - -ADD'L INSPECTIONS -
1000 SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 1 PLM /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 asp..: 0 201 - 400 amp..: 0 1st W/0 SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 alp..: 0 421 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1000 asp.: 0 601 +asps- 1 v: 0 MINOR LABEL -10: 0
1002+ asp /volt.: 0 ----------- - - - - -- PLAN REVIEW SECTION — --
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 500 V NOMINAL: CLS AREA /SPC CCC:
----- --- - ----- - -- ELECTRICAL - RESTRICTED ENERGY —
A. SF RESIDENTIAL B. COMMERCIAL — - ---
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: „ BOILER !•{VAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: ..
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL # SYSTEMS: 0
Owner: --- - - - - - -- Contractor: - - - - - -- TOTAL FEES:$ 306.31
ROBERT KLAS OWNER
13283 SW SCOTTS BRIDGE DR
TIGARD OR 97223 -0000
Phone #: 590 -7160 Phone #:
Reg #..: OWNER
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 one in accordance with approved plans. This permit will expire if work is net started within 180
days of issuance, or if work is suspended for more than 190 days.
------------- -- - - -- REQUIRED INSPECTIONS - --
Footing Insp Electrical Servi Rain drain Insp
Foundation Insp Electrical Rough Electrical Final
Post/Beam Struct Framing Insp Plumb Final
PLM /Underfloor Insulation Insp Building Final
Plumb Top Out Gyp Board Insp Erosion Conn l
r'er��;ii.tze 3igr���t_:rec %������ I
Call for inspection — 639 -4175
g6_2)33373
i Plan Check # - qe/ f "' '
CITY0OF TIGARD Residential Building Permit Application Rec'd By
13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd R- 263 -9h
TIGARD, OR 97223 Single Family Detached or Attached Date to P.E. -
(503) 639 -4171 Date to DST 9 -4 Z -
Print or Type
Permit* 1 6 110 - b4Z
Called C4 I G- 9■
• Incomplete or illegible applications will not be accepted Pa ,_ - Kc
9 -i S -Y� i5SCv
Name of Subdivision Lot # Name
Job (Y):9¢4 Nice.. 3 C.+ "Ro'e r 4 ../...eog
A Mailing Address
Address Site Address tszes SVr Scorn g lcros..112a,er_.
( 323 SAY SSo'rrs $¢. ae . p f City/State Zip Phone
Name - 1 sD . an 22rs 5! O- 71(eo
- Q9sesGe ' , ec-o s Name
Owner Mailing Address 1
f 3293 S \VSagorrs B,yp.T7XatrE
City/State Zip Phone g E n Ineer Mailing Address
- TicD °Y) 22.5 690=2 !Go City/State Zip Phone
Name 4 / /► ��
General 6I I�ilri W V Describe work new 0 additio p alteration 0 repair 0
Contractor Mailing Address to be done:
Additional Description of Work:
City/State Zip Phone
Oregon Const. Cont. Board Lic.# Exp. Date A4 p` y 2s5(9(Y) - 2K e_ esr,
Attach Copy of Project $ /.5 387.0
Current COT Business Tax or Metro # Exp. Date Valuation
Licenses
Name NEW CONSTRUCTION ONLY:
Mechanical Sq.Ft _ ouse: �,y,� Sq.Ft.Garage:
Sub- Mailin A dress �( � VV
Contractor Corner Lot Yes No ( Lot Yes No
City/State Zip Phone (check one) '� (check one)
Restricted Audio /Stereo Burglar
• Oregon Const. Cont. Board Lic.# Exp. Date Energy System Alarm
Attach Copy of
Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC
Licenses Opener Systems
•
Name ` D u � . 1: ► - (check all that Other:
Plumbing Wi n � a:�.fiu/x A `12 ate C i apply)
Sub- Mailing Address � -- Will the electrical subcontractor wire for all Yes No ,
Contractor (J �' ` restricted energy installations? - 01.\E OEVED 6 WO -612
City/State Zip Phone Has the Subdivision Plat recorded? N/A Yes No
Oregon Const. Cont. Board Lic.# Exp. Date Reissue of MST# ,1 ^ hC _ Solar Compliance , , J 4
Attach Copy of N (Calculation Attached) - ' r' A "
Current Plumbing Lic. # Exp. Date I hereby acknowledge that I have read this application, that thg ■
Licenses information given is correct, that I am the owner or authorized agent of
COT Business Tax or Metro # Exp. Date the owner, and that plans submitted are in compliance with Oregon
State la .
•
Name Sig s, �r/Age i / Date
nth/ E Electrical
lectrical �& I / L 71.14 , gpgct Person Nam AO/ �o^ � 9c,.:..
Sub- Mailing Addres $ t.-.4.5 GA-4 7 -e,
Contractor
FOR OFFICE USE ONLY: Afy— City/State Zip Phone Plat # Map/TL #: Oregon Const. Cont. Board Lic.# Exp. Date �j i0 - - 5 3 3L/ Z51 l J j 00 .
Attach Copy of Setbacks ) Zone: Solar.
Current Electrical Lic. # Exp. Date , V -(5o ig - s- (2 A, I $ t
Licenses k( h I J
COT Business Tax or Metro # Exp. Date ngine�ng Approval: Planning Approval: TIF:
;tsknstapp.doc 1 l K. ` ) /�I,1--
` .
Permit # Account Description Amount Amt. Pd. Bal. Due
pp .6 y21ST. Permit (BUILD) /1 / o . i v I / , . ,)-v
f °42 - 3 Plumb. Permit (PLUMB) a i 2
Mech. Permit (MECH)
ELC /ELR Permit (ELPRMT) L/ 0 crl)
State Tax (TAX) • C?
Bldg: S 8 3
Plumb: f ,
Mech:
ELC /ELR:
. Plan Check
MST: (BUPPLN) `7 73 7 5. 7 3
(-)
Plumb: (PLMPLN)
Mech: • (MECPLN)
CDC Review (LANDUS) L/ C7
y D
Sewer Connection (SWUSA)
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)
TOTALS: 3 �. f 15` 0230.5 rGA' (/
is \dsts mstapp.doc (�" ,.
Rev. 7/96
Permit #: fi 4 -01-0_3
A' �' Address:
t 3 3 4 - 0 C 1)- L . !k A , a
ti V I I
Issued.by: Date:
L- 5 •
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:
pl 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 1 I before or upon completion.
Ell 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
IJ 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 R sponsibilities on the reverse side of this form.
.../ x _„eS ,/:/
.' 0 cS/ 'D G
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
Note: 7L 1c: /.,rnratiou Notice to Property Owners about Construction Responsibilities
,vti developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If ou are acting as y our own contra( Inc to construct <, new home cu 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 ,,f a residential structure, you will, in most instances, be ruled to he an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax lati4 As an employer, you must withhold income taxes from employee wages at the time employees
arc paid. You ill he 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 fax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For , r ini or m lion, 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 :nsurance for your employees. If you fail to obtain workers' compensation insurance, you may •
he subject to penalties and w ill he liable for all claim costs if one of y our 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 v ithhold federal income tax from employees' wages. You will he
liable for the tax payment ever 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 tile peril tit 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
Page No. 1 CASE HISTORY FOR CASE NO.: MST96 -0423
ROBERT KLAS
13283 SW SCOTTS BRIDGE DR
09/17/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA005 Application received / / / / 08/28/96 RECD JH 09/04/96 BON
MSTA008 Permit Created / / / / 09/04/96 PEND B 09/04/96 BON
MSTA010 Check for prcl. restrict. / / / / 08/28/96 09/04/96 BON
MSTA012 Plans routed to Plans Examiner / / / / 09/04/96 PEND B 09/04/96 BON
MSTA026 Plans approved by Plans Exmr / / / / 09/12/96 PASS RT 09/12/96 BT2
MSTA030 Reviewed plans routed to DSTS / / / / 09/12/96 PASS RT 09/12/96 BT2
MSTA092 (F) Issue combination permit / / / / 10/01/96 PASS DRA 10/01/96 DRA
MSTA097 Issue plumbing signature form / / / / 10/01/96 PASS DRA 10/01/96 DRA
MSTA098 Issue electric signature form / / / / 10/01/96 PASS DRA 10/01/96 DRA
MSTA705 Footing Insp / / / / 10/07/96 SLAB APP GS 11/08/96 RB
MSTA722 Plumb Top Out / / / / 10/28/96 PASS MS 10/28/96 MRS
MSTA724 Electrical Rough In / / / / 10/25/96 PASS MJR 11/01/96 MJR
MSTA725 Framing Insp / / / / 11/01/96 # -1- complete roof ventilation A/N KS 11/04/96 KBS
MSTA740 Insulation Insp / / / / 11/04/96 APP KS 11/04/96 KBS
MSTA745 Gyp Board Insp / / / / 11/08/96 PASS RB 11/08/96 RB
MSTA755 Rain drain Insp / / / / 06/17/98 connection to existing PASS WDJ 06/18/98 J *H
MSTA770 Misc. Inspection / / / / 06/04/98 Called and talked with owner, she was NOTE WDJ 08/06/98 WDJ
unaware that the project had not been
finalled, they will call and schedule an
inspection.
MSTA770 Misc. Inspection / / / / 06/15/98 Called owner, will meet on 6/17/98 with NOTE WDJ 08/06/98 WDJ
all disciplines to complete all final
inspections at onetime.
MSTA790 Electrical Final / / / / 06/17/98 PASS CD 06/17/98 CD
MSTA797 Plumb Final / / / / 06/17/98 PASS MS 06/18/98 J *H
MSTA799 Building Final / / / / 06/17/98 Elec. and Plumbing were finalled PASS WDJ 06/17/98 WDJ
06/17/98