Permit 1 � r
CITY O F TIGARD MASTER PERMIT
PERMIT # MST98 -0305
%�, �k DEVELOPMENT � 6
LOPMENT SERVICES DATE ISSUED: 07/21/98
13125 PARCEL: 1S134DD -00700
SITE ADDRESS...:10895 SW TIGARD ST
SUBDIVISION • ZONING: R -4.5
BLOCK LOT • JURISDICTION: TIG
Remarks: Enclosed front porch
BUILDING
REISSUE: STORIES • 1 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED
CLASS OF WORK.:OTR HEIGHT • 10 FIRST 96 sf GARAGE • 0 sf LEFT : 0 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT : 8 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT : 0
OCCUPANCY GRP.:R3 BDRI: 0 BATH: 0 TOTAL 96 sf VALUE..0: 2280 REAR • 0
PLUMBING
SINKS • 8 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 8 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 (108K ..: 8 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 8 BTU FLOOR FURNACES: 0 VENTS • 0 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 - 208 amp..: 0 0 - 280 amp..: 0 W /SVC OR FOR..: 8 PUMP /IRRIGATION: 8 PER INSPECTION: 0
EA ADD'L 5 .: 8 281 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDA: 1 SIGN /OUT LIN LT: 8 PER HOUR • 0
LIMITED ENERGY.: 0 481 - 608 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 2 SIGNAL /PANEL...: 0 IN PLANT • 0
MRNF HM /SVC /FDR: 0 601 - amp.: 0 601+amps- 1m v: 0 MINOR LABEL -10: 0
1008+ amp /volt.: 8 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 608 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 SIB:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: ::
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL A SYSTEMS: 0
Owner: — Contractor: — TOTAL FEES:$ 112.71
MARILYN R BERNHARD OWNER This permit is subject to the regulations contained in the
10895 SW TIGARD ST Tigard Municipal Code, State of Ore: Specialty Codes and all
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: 583- 639 -4733 Phone A: not started within 180 days of issuance, or if the work is
Reg N)..: 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 952-001 -0818 through OAR 952 -881 -0888. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
REQUIRED INSPECTIONS
Footing Insp Shear Wall Insp
Foundation Insp Insulation Insp
Post /Beam Struct Electrical Final
Electrical Rou. Building Final
Framing Insp Min WA
Issued : : A_ ! Permittee Signatur . EPALW . .li_
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business da
i ' Plan Check # _ __-f
CITE r\ -- GGARD Residential Building Permit Application Rec'd By
13125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd 07/Y
TIGARD, OFt 97223 Single Family Detached or Attached (Duplex) Date to P.E. 7 —
V 50-639-4171 Date to DST _4 q pe
F 503 - 684 -7297 Permit # ( - • - O
Print or Type Called 1- J '
Incomplete or illegible applications will not be accepted
I
Name of Project Name
Jobe
Address sit c Ad es c� � � Architect Mailing Address
1- ` " b - City /State Zip Phone
Na 1�
M A"al Lyt J e.� -I\\ WM -c Name
Owner Mailizgy4d ess
�` � C ' J En ineer M ailing Address
*ate A Zip Pho ne
e g
C_ g 771? C° F 33 City /State Zip Phone
General Name ,M 2-1 1. y
Contractor t]V.e.., a ER N 1 Describe work New 0 Addition 0 Alteration g Repair 0
Mailing Address to be done:
Prior to permit Additional Description 9f Work:, ^�
issuance, a copy City /State Zip Phone E MC lose 'Fti'.c� � 1 ' o R cr.
of all licenses
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# VALUATION $ , p_s_2 Q 0
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: ' . Sq. Ft. Garage
Contractor Mailing Address
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City /State Zip Phone (check one) (check one)
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon Const. Cont. Board Exp. Date Energy System • Alarm
expired in COT Lic.#
database Installation Garage Door HVAC
Plumbing Name Opener Systems
Sub- (check all that Other:
Contractor Mailing Address apply)
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A YES NO
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# Solar Compliance
expired in COT (Calculation Attached) '
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this ap• .— •.n, that the
information -en is correct, that I am the ow er or a thorized
Name agent of ' e •wner, and that plans submitte • are in ompliance
with Or gore State la r•.
Electrical SAe - • - w v ; �a = g : nt OF Date
Sub- Mailing Address _ OA• V' - X /3 /q"
Contractor Co act Person — a : Ptf #
i r
City/State Zip Phone S a l ,l( - �L'4 X39- `173.3
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat #: Map/TL#:
of all licenses are Oregon Const. Cont. Board Exp. Date i5k-t I S \ 766
required if Lic.# Setback): _ Zone: w So
lar �
,
expired in COT !A'
database Electrical Lic. # Exp. Date i v
Engineei g Approval: Planning TIF :o_
cr t — " ilEk— AES/Cler,V . C/e / 1 7 Y '''I S I:SFREM.DOC (DST) 4/97
P
. Permit #:
OF O
_,a � Address:
;7�xtr�s� _ l :
•' LX,6 7 - 9t
� �85 � Issued • � Date:
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:
r , 1. I own, reside in, or will reside in the completed structure.
Ti 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
'�_i before or upon completion.
r i 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
r ( ,--;;71
Ill 3 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 cer;i fy that , e . bove i s ormation is correct and that I have read and do understand the Information
Notice to P • rty. I w • rs �'o ., nstruction Responsibilities on the reverse side of this form.
41 Pi . / / / i< 74 z ,e..
„loopy (S of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
,
Tlorrna2liti EVi ticce 20 Proper y Owners
About Cons rruic on FlesponsbNiies
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.
•
EMPLIYER I ESPONSl flLO a lES:
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 oine of your enmployees'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 O IESPONSMOLOTIES 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 darnage- insurance: Contact your insurance agent 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 gg 'COWQS
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7---€0-q/ AM PM BLD
Location 1 0% S �� w1(1, _ Suite MEC
Contact Person Sc )* Ph PLM
Contractor Ph SWR
(UIL�D I14 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:
i�ani � w
ASS PART FAIL
• _ • • BING
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL •
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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: _ A ] Unable to inspect - no access
ADA —G I
Approach /Sidewalk
• Other Date I 0 Inspec �
Final
PASS PART FAIL DO NOT REMOVE this inspe • n record f-j• m the job site.