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8845 SW AVON COURT
cirrOFTIFARD MASTER P,E*RMJT
COMMUNITY DEVELOPMENT DEPARTMENT
13 126 SW 149)1 1W. P.O.Box 23397.Tirwid.Orogw 97223(603)63"175
SITE' ADDRESS. 08845 13W AVON CT PARCEL 2S 1.1 IDD-01.6,00
mLucK. . . . ' ' ' . . . x LOT. . . . . . . . . . . . . v4c �
----------- --------------------- BUILDING ------------------------------------_
REISSUEn DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf �
CLASS OF WORK. iADD BEDRMSo@ BATHSx0 GARAGE. . . . . . . . . . :0 sf
TfPE OF USE. , ° xSF FLOOR AREAS---------- REQUIRED SETBACKS- - -------
TYPE OF CONST. m5N FIRST. . . . :281 f LEFT. . ::0 ft RIGHr. :6 ft
OCCUPANCY GRP,. :R13 SE"OND. . . :0 sf FRONT. :0 ft REAR. . :O ft
STORIES. . . . . . . : 1 THIRD. . . :0 sf REQUIRED-------------------
HEIGHT. . . . . . . . x15 ft :281 yf SMOKE DETECTORS. :
FLOOR LOAD. . . . x40 psf VMLUE. . . . . $o 12926 PARKING SPACES. . :(?)
Remarks: addition of 281 sq ft
---~~---... ......... PLUMBING ------------------------------------
FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAgATOR%ES. . . . . :0 WATER HEATERS. . . :0 TRAVIS. . . . . . . . . . . . . . :0
TUF'/8H0WER5. . . . :0 LAUNDRY TRAYS. . . -.0 CATCH BASINS. . . . . . . :0
WAT�R CLOSETS. . -.0 SEWER LINE (ft) . :0 GREASE TRAVIS. . . . . . . :0
0I@HWASHERS. . . . :0 WATER LINE (ft) . :O OTHER FIXTURES. . . . . :0
�
GARBAGE DISP. . . :0 RAIN DRAIN (f-L) . :0
WASHING MACH. . . ,-.0 SF RAIN DRAINS. . -0
---------------
MECHANICAL -------------- ---------------- FEES
FUEL. UNIT TYPES----------- UNIT HTRS. . :0 type amount by date recpt
/BAS/ VENTS . . . . . : 1 BPRT $ 88. 5'J JLH 10/24/91 -
MAX INPUTx0 BTU VENT FANS. . :0 BPLC $ 64.03 JLH 10/18/91 21»842
FURN ( 100K . . :0 HOODS. . . . . .. x0 B51:1C $ 4. 93 JLH 10/24/91 -
FURN )=100K . . :0 WOODSTOVES. :0 MI-IRT $ 25. 00 JLH 10/24/91 -
FLOORI FURN. . . . m0 CLO DRYERS. : 0 1715PC $ 1. 25 JLH 10/24/91 -
BOIL/CMP ( 3HP:0 OTHER UH1TS:0 MPLC $ 6. 25 JLH 10/24/91 -
GAS OUTLETS:0
Owner: -------------'---------------' ---'
MOHAMMAD ZEITOUH
08645 SW AVON CT
TlGAHD OR 972F.4
Phone #: �
� C t t �
Cli
CITY
13123SW"' swd. PLNCK/RECT #o T I GARD 110 Boa 23397
PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT Tigard,Oregon 9721.1
(503)639.4171 DATE ISSUED
,JOB ADDRESS: %7�' 5' S N'i4 Von'' G �%, _._ TAX MAP;LOT
SUB: —. LOT: _. LAND USE: - -.----___--
VALUATION:
OWNER SPECIAL NOTES
NAME: 'J'!/1'!�p �/yd/,L �'�74Gl/1/ REISSUE OF:
ADDRESS: �4✓Oh ec.^Ze LAST REISSUE:
_T� � �-' - -� FLOOD PLAIN/
PHONES SENSITIVE LAND:
CONTRACTOR APPROVALS-REQUIRED
NAME: /7PLANNING: —
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: — ---- - ---- -- - OTHER: A 1) .. 7K. --
CONTR. BOARD #: EXP DATE:
ITEMS RCaIREQ
SUBCONTRACTORS: PLUMB: — _ LIST/SUBCONTRACTORS:
MECH: � ,� ' _ BUS TAX: __---- -r-_--
ARCHZNGINEER CALCULATIONS:
NAME: v !> O�T/��' ��� -�� TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: �` '0'3 _. -2 1 Cog
PROPOSED BLDG. USE:
COMMENTS: -----
APPLICANT SIGNATURE
Received By: _ Date Received: %.� _
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Budding Permit Fees — )_
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees ✓ S,o� �.�-� �
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building _ o
Plumbing
1
Mechanical >
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-W Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
2.5-448-05 Mass Transit TIF Fees
52-449 00 Parks S_rstem Dev Charge (PDC) _
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24 -445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of', _^
TOTAL � � 03
nm/3587P.WPF
r
_ Permit No:
Address:
N 2 Issued by:-_ ____ Date:
n ,
•`'��% FOR OFFICE USE ONLY _.._
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicant;, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B.
1. � I own, reside in, or will reside in the completed structure.
C
2. A. My general contractor is _ ----- — -- - ----
L%
Contractor registratio i number
I will instruct my gP;ieral contactor that all subcontractors who work on
the structure mu,,t be registered ,pith the Construction Contractors Board.
OR
B. ] I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registerea with the
Construction Contractors Board. If I change my mind and do hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I 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 understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
Signature of` ermit Applicant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
vy
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), passed by the 1989 Oregon Legislature.
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 ::`!I, 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 Withhulding Tax Law: As an employer, you must withhold income taxes from employee wages
at Te time erripic�yees are p2id. 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 DepartrTient of Revenue at 373-3390.
Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on (The wages 6T affempioyees. For more information, call the Oregon Employment Division DHR
at 378-3224.
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Conipensa-
lion Law. and must o tain workers' compensation insurance for your employees. If you fail to obtain workers'
I compensation insurance, you may be subjeci 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 DIF
at 3737434
U.S. Internal Revenue Service: As -an employer; you must withhold federal income tax from employees'
wages.You will be Iia eb the tax payment even if you didn't actually withhold the tax. For more informa-
tion, call the Interna; Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code Compliance As the permit holder for this project, you are r'nsponsible for resolving any failure
to ,Heel cadP requiremPnts that may be brought to your attPn.tlon through inspections.
Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate
insurance coverago ar acs erits and orrilssions such as (Ailing tools, paint overspray, water damage
from pipe punctures, fire, or work that must be redone.
Time to Supervise Employer's. Make sure you have sufficient time to supervise your employees.
E^pe_rtise: Make sure you have the expertise to act as your own general contractor, to coordinate
P work of rough-in and finish trades, and to notify building officials at the appropriate times ��o
they can perform the required inspections,
If you have additional questions, write to: Construction Contractors Board
700 Summer St. NE, SultE 300
Salem, OR 97310.0151
Phone 503.378.4621
0244J 10/24/89
Page No. 1 CASE HISTORY FOR CASE NO.: MS'C91-0169
MOHAMMAD ZEITOUN
08845 SW AVON CT
01/27/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Dcne Date By
MSTA007 Application received / / / / 10/18/91 PASS JLH 10/24/91 BLT
MSTA010 Plan check deposit paid / / / / 10/24/91 10/24/91 BLT
MSTA020 Plan check by / / / / 10/24/91 PASS RT 10/24/91 BLT
MSTA030 Check for prcl. restrict. / / 10/24/91 10/24/91 PASS RT 10/24/91 BLT
MSTA092 (F) Issue combination permit / / / / 10/24/91 PASS JLH 10/24/91 JLH
MSTA105 Foot/found Inst; / / / / 11/20/91 PASS TLP 11/27/91 ^ P
MSTA710 Post/Beam Structural / / / / 11/25/91 PASS TLP 11/27 LP
MSTA711 Post/Beam Mechanical / / / / 11/25/91 PASS TLP 11/27/91 TLP
MSTA725 Framina Insp / / / / 12/24/91 PASS TLP 12/27/91 TLP
MSTA740 Insulation Insp / / / / 12/31/91 PASS TLP 01/02/92 TLP
MSTA145 Gyp Board Insp / / / / 02/03/92 PASS TLP 02/10/92 TL.
MSTA970 Case Finaled / / / / 07/13/94 PASS TLP 08/09/94 TLP
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
C0NTa,AC,T0R:
Pursuant to Section(s) of the Uniform Building Code, the
following Item(s) require correcting:
0010,
"7
late: l� - � �-"- � Permit No. —
Inspector _
CALL FOR REINSPECTION
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