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Permit I CITY OF TIGARD MASTER PERMIT PERMIT # • MST96 -087 V COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/14/96 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 1 S 136 C13- O82Q SITE ADDRESS...: 08240 SW STEVE ST SUEDIVISION • HERB & PEGGY'S PLACE ZONING: R -4.5 BLOCK • LOT • 1 Remarks: PATH I ADDITION --------- - - - - -- ------------------------ BUILDING -- --- - - - - -- -------____----____ -- REISSUE: STORIES : 1 FLOOR AREAS -- — BASEMENT...: 0 sf REQUIRED SETBACKS -- REQUIRED------- ---- CLASS OF WORK.:ADD HEIGHT • 14 FIRST • 640 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: 1 FINBSMENT: 0 sf RIGHT • 12 OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL : 640 sf VALUE.. f: 41382 REAR • 20 - ---------------- --- - -- ----- - -- PLUMBING - - - - -- ----- - - - - -- -- -- SINKS : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 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 CLOTHES DRYERS: 0 /GAS/ / / FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 1 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES : 0 GAS OUTLETS...: 1 --------------------- _________________________________ ELECTRICAL -- ________ _____________ — ________________ —__ _— __ - - -- - RESIDENTIAL UNIT -- — SERVICE /FEEDER - -- —TEMP SRVC /FEEDERS -- - -- BRANCH CIRCUITS - -- ---- MISCELLANEOUS - - -- - -ADD'L INSPECTIONS - - 1'''� SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 alp..: 0 W /SVC OR FDR..: 1 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 400 alp..: 0 201 - 400 alp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR : 0 LIMITED ENERGY.: 0 401 - 600 alp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0 MANF HM /SVC /FDR: 0 601 - 1s'' amp.: 0 601 +a.ps- 1m v: 0 MINOR LABEL -10: @ 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 /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK • INSTRUMENTATION : MEDICAL OTHR: •• HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL # SYSTEMS: 0 Owner: - -- - - - -- Contractor: ----- - - - - -- TOTAL FEES:$ 488.15 MICHAEL PANCHOT OWNER 08240 SW STEVE ST TIGARD DR 97223 Phone #: 620 -0530 Phone #: Reg #..: 13125 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 ------------- - --- -- _-- - Footing Insp Mechanical Insp Gas Fireplace Mechanical Final Foundation Insp Electrical Servi Insulation Insp Building Final Post /Beam Struct Electrical Rough Gyp Board Insp Erosion Control Post /Beam Mechan Framing Insp Rain drain Insp Crawl Drain Gas Line Insp < Electrical Fin P e r m i t t e e S i g n a t u r^ e: / /G�J�� Issued F y �.ar � 4 0 • Call for inspection - 639 -417E ."1 1;vb i.0- - `1tv ,4 ' (D( Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639 -4171 c-/6K/ Jobsite Address: d'-? YO � 5)� S /t 5 /. % r q ", ' Office Use Only Subdivision: /i1ri �1'ef, l' S Wet, Lot # Valuation: It /_J'r I x t G q 6G -- -- l 38 � ,(� Contact Date ic /10 / 46 Initials (T' , ' ' 7�' Result /_ ' C Y- M s<� . -1( New Construction Only: (Square Footage) Planck/Rec # ./idor; j Permit # //1Sf -c - O 2 8 +{ - ease: f go Garage: Reissue of Map & TL # I I • C —f2, - ()8'r3 -0l Corner Lot? Y 0 Flag Lot? Y 1 Zone V- `+.S Owner: /d' G t ' "/ a % /‘ a f Plat # �) y© Ste/ 5/eve s f Approvals Required OK Address: 000,-1-14- Planning Setbacks Solar - fb S r g. !/ '4 ,?-2-13 Engineering Phone: ( SO 3 ) ‘..10-0.5-3e, Other PL-4-0‘..) 11J r,--- SZS Items Required Contractor: 5 &Ate 'f rik tie Subcontractors Address: ;i, I I Truss Details `g , A l Other v r (, Notes Phone: ■ . Contractor's License # J (attach c of c rent Oregon license) Contact Name: / J Contact Phone: ( ) Subcontractors: y� Architect/Engineer: Plumbing: 00 ' 4:' A5 i liEt Address: Mechanical: (attach copy of current OR Contractors License) . tieC, CAC--1 //�0 (il Phone: ( ) JOB DESCRIPTION: /JU GY € •'O si A (ao X 32') 'Ge,/,$` a11 d,<, Uf 9��e .46' ' A , ' O ( 503) ,ao o5 0 Applicant Signature Applicant Phone number Received by: Date Received: 054"7"7 lO H.UOgn■a..v..app Permit Account Description Amount Amt. Pd. Bal. Due t y, �5 6 —O 7 Bldg. Permit (BUILD) g1700 (��," Plumb. Permit (PLUMB) / C � c j Mech. Permit (MECH) q State Tax (TAX) 07 � 2 Bldg: 25;60 Plumb: Mech: l Z r r Plan Check (PLANCK) /6 0, > > 1 (00.5 Bldg: 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 (T1F -l) Institutional TIF (TIF -IS) Office TIF (TIF -0) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) Di L TOTALS: , / � I (oO. Permit #: M Si ( c= Address: T G /..,4 '_/C;/ — Issued by: Date: .6'/ V/ 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: /alb XI 1. I own, reside in, or will reside in the completed structure. A, /� l/ 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 Fel 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. (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: 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. 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 wi II 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, cal l 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 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. Ifyou fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs ifoneofyouremployees is injured onthejob. 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 ofrough- in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. Ifyou have additional questions, write or call the Construction Contractors Board (P0 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 -0287 MICHAEL D PANCHOT 08240 SW STEVE ST 02/24/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By . MSTA005 Application received / / / / 05/24/96 PASS JH 06/06/96 BT2 MSTA008 Permit Created / / / / 06/06/96 PASS RT 06/06/96 BT2 MSTA010 Check for prcl. restrict. / / / / 06/05/96 PASS BON 06/06/96 BT2 MSTA012 Plans routed to Plans Examiner / / / / 06/05/96 PASS BON 06/06/96 BT2 MSTA026 Plans approved by Plans Exmr / / / / 06/06/96 PASS RT 06/06/96 BT2 MSTA030 Reviewed plans routed to DSTS / / / / 06/06/96 PASS RT 06/06/96.BT2 MSTA080 (F) Ready to issue / / / / 06/10/96 PASS CJS 06/10/96 CJS MSTA092 (F) Issue combination permit / / / / 06/14/96 PASS JSD 06/14/96 JD MSTA098 Issue electric signature form ' / / / / 06/14/96 PASS JSD 06/14/96 JD MSTA700 Erosion Contol 06/20/96 / / 06/20/96 # -1- monolithic ftg /fdn APP KS 07/25/96 BT2 MSTA705 Footing Insp / / / / 06/18/96 usa 6 -18; FAIL RB 06/18/96 RB mono pour! drill & epoxy dowels; anchor bolts- 10 "; ventilation- 4 actual, 6 req'd; access req'd; low point drain; no shear design- ok, only if plans are to scale. MSTA705 Footing Insp 06/20/96 / / 06/20/96 -1- monolithic ftg /fdn A/N KS 06/20/96 KBS MSTA706 Foundation Insp / / / / 06/18/96 see footing this date FAIL RB 06/18/96 RB MSTA706 Foundation Insp 06/20/96 / / 06/20/96 # -1- monolthic fgt /fdn A/N KS 06/20/96 KBS # -2- locate fdn vent within three ft of corners # -3- install low point drain MSTA710 Post /Beam Structural / / / / / / 06/06/96 BT2 MSTA711 Post /Beam Mechanical / / / / / / 06/06/96 BT2 MSTA713 Crawl Drain / / / / / / 06/06/96 BT2 MSTA720 Mechanical Insp / / / / 08/12/96 see framing this date FAIL RB 08/12/96 RB MSTA720 Mechanical Insp 08/19/96 / / 08/19/96 PASS RB 08/20/96 RB MSTA723 Electrical Service / / / / / / 06/06/96 BT2 MSTA724 Electrical Rough In / / / / 08/08/96 9:24am NO ENTRY DIS MJR 08/12/96 BT2 MSTA724 Electrical Rough In 08/13/96 / / 08/12/96 J -box behind stove DIS MJR 08/13/96 MJR nail plates need notches for cable need sleaves for grounding conductors staple low voltage cables MSTA724 Electrical Rough In / / / / 08/16/96 gas stove needs hard wired PASS MJR 08/26/96 MJR staple low volt cables Page No. 2 CASE HISTORY FOR CASE NO.: MST96 -0287 MICHAEL D PANCHOT 08240 SW STEVE ST 02/24/99 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By • -- -- - -- -- - - - - -- --- MSTA725 Framing Insp / / / / 08/12/96 electrical cover; where's heat source ?; FAIL RB 08/12/96 RB venting for fireplace lacking; insulate & flame spread fireplace cavity; secure fireplace; no gas line test; studs missed w /in fireplace chase; strap corners & off sets; protect wiring; extend vent baffles upward; MSTA725 Framing Insp 08/19/96 / / 08/19/96 contingent to electrical cover re: PEND RB 08/20/96 RB fireplace hard - wiring MSTA735 Gas Line Insp / / / / 09/17/96 PRESS TEST ONLY, NO ONE HOME TO SEE TEST GS 09/17/96 GES • PIPING MSTA740 Insulation Insp 08/19/96 / / 08/19/96 electrical cover; chink upper horizontal PEND RB 08/20/96 RB glazing units MSTA745 Gyp Board Insp / / / / ,/ / 06/06/96 BT2 MSTA755 Rain drain Insp / / / / 07/17/96 PASS MS 07/23/96 MRS MSTA790 Electrical Final / / / / 06/19/98 PASS BRP 06/23/98 B *P MSTA795 Mechanical Final / / / / 06/05/98 SEE BUILDING FINAL THIS DATE FAIL RB 06/05/98 RB MSTA795 Mechanical Final / / / / 06/12/98 MEC96 -0361 (GAS OUTLET ONLY)- FIREPLACE FAIL RB 06/12/98 RB INSTALLED oovv" PLM96 -0313 (WATER HEATER) - GAS OR ELECTRIC X7777 USA EROSION FINAL- REQ'D ELECTRICAL FINAL REQ'D Time appointed not kept- no one home • MSTA795 Mechanical Final / / / / 02/12/99 See building final this date. FAIL RB 02/12/99 RB MSTA797 Plumb Final / / / / 06/12/98 see mech final this date FAIL RB 06/12/98 RB MSTA797 Plumb Final / / / / 02/12/99 See building final this date. FAIL RB 02/12/99 RB • Page No. 3 CASE HISTORY FOR CASE NO.: MST96 -0287 MICHAEL D PANCHOT 08240 SW STEVE ST 02/24/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By MSTA799 Building Final / / / / 06/05/98 MEC96 -0361 FAIL RB 06/05/98 RB PLM96 -0313 THIS AND THOSE PERMITS LISTED ABOVE HAVE NOT BEEN SIGNED OFF AS BEING APPROVED. INSPECTIONS: POST /BEAM STRUCTURAL, POST /BEAM MECHANICAL, CRAWL DRAIN, DRYWALL AND ALL FINALS ARE STILL OUTSTANDING. PLEASE MAKE ARRANGEMENTS FOR THE ABOVE INSPECTIONS ASAP. THANKS MSTA799 Building .Final / / / / 06/12/98 see mech final this date FAIL RB 06/12/98 RB MSTA799 Building Final / / / / 02/12/99 Left research notice on site- 1056 am. FAIL RB 02/12/99 RB MSTA799 Building Final / / / / 02/19/99 PASS RB 02/19/99 RB MSTA970 Case Finaled / / / / 02/24/99 02/24/99 JT MSTB708 Erosion Control / / / / / / 06/06/96 BT2