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11340 SW COTTONWOOD LANE-1 ADDRESS: 1/3 Va S i- Ce hbol wd!nd Lan e i:\records\microflm\targets\building.doc CITY OF TIGARD BUILDIN INSP CTION NOTICE (`l Inspection Line (Roc-O-Phone): 639-4175 Businoss Phone: 639 4171 1 v/ Inspection: Footing Susp. Ceiling Sprink. Rou in Appr/Sdwlk Foundation Plbq. Underslab ech. Rough-' Fireplace Post/Ream Struct. Plbg. Top Out Elec. Rough-in FiAAL: Post/Beam Mech. San. Sewer Gas Line -Bldg. Plbg. Underfloor Rain Drain Framing 4�°� -Plumb' Alarm Water Line Insulation I /r s ech. Underflr. Insul. Shear Wal GYP. Bd. SElect. Date Requested: •z (� ( Cj�G Time: PM Address: Builder: Permit M ��� Y) THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspertor:__X. Date: PROVED ,DISAPPROVED ,APPROVED SUBJE T TO ABOVE Call For Re,nsp. i INSPECTION N0TI(- Citi of Tigard Building Dc- pmt `✓ 13125 SW Hall Blvd. Tigard, reqnn 97223 Inepw-Lion Line (Rec-O-Phone): 639-4175 Bun inane Phone: 639-4171 Inspection:_ _ Footing Plbg. Urderslab Mach. Rough-in Appr/Sdalk Round. Plbq. Top Out as Line � FINAL: Post/Beam Strnct. San. Sewer Framing, Post/Beam Nech. Rain Drain Insulation -Plumb. Plbq. Underfloor QWate1r Line Gyp. Bd. -Hoch. Date Requested: /�_ I? Date 1���`I Time: _AN PH Addrwsa:1 1,2 o l_ 1rv�W Permit 1 e Builder= o 45 (I THE FOLLOWING CORRECTIONS ARE REQUIRED1 -A-belj 0_1Z jr Iv d 1�v1 �t%��-vim` �--►ti- �'l�'t..� c,c-. �,,,_._ . L �.� Inspector: � � ����` � Dates_ ---ACPROVED —� OISA7?PRC`VED APPROVED SUBJECT TO ABOVE r,1 C `_Call Por Reinsp. � ti, .tee MECHANICAL 1 ' CITY GF TIGARD PERMIT COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MEC94-02J, ! 13125 SW Hall Blvd.Tlpxrd,Oregon 97223e91* J5.P3)d1J9A171 DATE ISSUED: 08/05/94 PARCEL: 151348D-07002 RITE ADDRESS. . . : 11340 SIJ COTTONWOOD LN SUBDIVISION. . . . : ENGLEWOOD NO. 3 ZONING: R-4- 5 BLOCK. . . . . . . . . . . LO(. . . . . . . . . . . . . ,, .27 CLASS OF WORK. . sALT FLOOR FURN. . . . t EVAP COOLERS: 7`/PE OF USE. . . . :SF UNIT HEATERS. . a VENT C=ANS. . . OCCUPANCY GRP. . :R3 VENTS 'W/O APPL t VENT SYSTEMS: STORIES. . . . . . . . e1 BOILERS/COMPRESSORS HOODS. . . . . . . : FUEL TYPES--------------- 0-3 HP. . . . s DOMES. I NC I N: :/GAS/ / / 3-15 HP. . . . : COM"L. I NC I N: MAX INPUT: CITU 15-30 HP. . . . : REPAIR UNITS: FIRE DAMPERS7. . : 30-1.50 HP. . . . : WOODSTOVES. . : GAS PRESSURE. . . : 50+ HP. . . . ., CLO DRYERS. . t NO. OF lJN I 75- --- - -- -- - AIR HANDLING UNITS OTHER UNITS. . FURN ( 100K PTU: 1. <= looe l Vf%; GAS OUTLETS. : ! FURN )=100K BTU: t0000 c Fm: Remarks: ELECTRIC TO SPS CONVER^ION Owners - -___________-._-___-____._.___._ --....--__-----.---------__-- C=EEB FRED CARVER type amount by date reept 11340 SW COTTONWIiOD L.N. PRMT $ 25. 00 JF 08/05/94 - 5PCT 8 1. 25 JF 06/05/94 - TIGARD OR 97223 Fhore Ms 639-3333 Contractor: --------------------._.__-___--- OWNER ----------------------------------------- Phone 0: 26. 25 TOTAL Reg t4. . . -- ------- REOUIRED INSPECTIONS ------ 0c permit is issued subject to the regulations contained in bir Gals Line Insp Tiqard Municipal Code, State of Ore. Specialty Codes and all other Mechanical I n s p applicable laws. All Mork will bi donr in accordance with Final Inspection approved plans. This permit will expire it work is not started within 188 days of issuance, or if work is suspended for more than 180 days. Permittee S i g n a t u r e tr _ ""`""" Issued Bys rJ _ Z-11 for inspection -- 639•-4175 PIAN Ci!y of Tigard MECHANICAL PERMIT Planck/Rec. # 13125 SW Hall Blvd. APPLICATION Permit # Tigard, OR 97223 (503) 63- 4171 — - --- PAMT Table 3A Mechanical Code OTY PRICEJob tog » 1) Permit Fee -0- •Q- Address - ------ -- - --- 2) Supplemental Permit 3.00 umar a ;uw BIO- -- .Gt�Lf F� 1) Incl.du.is d vents - 6.00 Owner l(j�0�1� Furnace ;. 3b r+zQ 2) Incl. &acts 6 vents 7.50 rx`Fumanoe --- C_,c 3) Incl. vent 6.00 spa a ,--w--z ea or - � 4) or floor mounted heater 6.00 Occupant Ve—nrvO•'�'" 5) appliance permit 3.00 eperr oTF�ng. reTng:-- -" 6) cooling,absorption unit 6.00 i er or comp,heat pump,air co � �T ) 7) to 3 HP abaorp unit to 100K BTU 6.00 - r er or comp,heat pump,air cond. Contractor 8) 3 15 HP absorp unit to 500K BTU �oi - 1100 ` lei or cc np, ea Fwmj.-a! 07 ----I .� 2-!:'•-� _ �Qi'� ' 9) 15-30 HP abuorp unit r•1 ,nil BTU 15.00 Bailor or cnmp, e-Tpump,air cond. 10) 30.50 HP abmp unit 1.1.75 mil BTU 22.50 hereby ac w a VR re�9 �n13 A•.plicaTi,' �e i or or comp, ea pump,air coni- -- ge information given is correct,that I am the r-anrx or autr 1 agent 11) >50 HP absorp unit 1.75 roll BTU 37.50 of the owner,that plans s rbmitte J are in complianrw wtL ;ate Air handling unit to- laws,that I am regishned win the Gonstniction Contractor's Board, 2) 10,000 CFM 4.50 that Gle number giver,Is correct (If examp'.from State registration, ,ran ing wnif-- -' - - please give reason below.) 13) 10,000 CTM+ 7,50 Non portmble -•-- - -_�-_- 14) evaporate cooler _ 4.50 Vont Ian c`ronec --- - 15) to a single duct 3.00 1 ) -VenWation system no --- - ��� c�/ 16) Included In appliance permit -- 4.50 —moo -serve3Tiy--- 17) mechanical exhaust 4.50 �escn worknew -r+7di ion a eranon repau - --'Goommer- cunt-or in3is nn-aT-'--- to be done residential Q no-residentlal Q 18) type inrineratnr 30.00 •xis ny use of -tier i.e.,w s ve,water - building or property -�, --c_ - 19) heater,solar,clothes dryers,at:-.. 4.60 Proposed use of 20) Gee piping one to four outlets 2.00 building or propefil --------- — Type of fuel - oil(') natural as (pG 21) More than 4-per outlet -- g• Q electric 0 PE►ih4fMinimum Foe$25.00 SUBTOTALfS BECOME VOID IF WORK OR CONSTRUCTION - AUTHr)RIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHA IGE IF CONSTRUCTION OR WORK IS SUSPENDED OR - - ABANDONED FOH A PERIOD OF IAA DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL AFTER WORK IS COMMENCED. ------- -- Toi..i_ (-2S Special Carditions ----' ' ' / --�--- - -- _. ..—- � •_ / Date Issued ( ( by T- _- �.Msas+rr wrbswwv Permit No: Address: x Issued by: Date: --- --FOR OFFICE USE ONLY._____J STATEMENT: ';:rORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued.This state. ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architrci and Engineer applicants, exempt from reg'ctration 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 boxes 1 and 2, and either box 3A or 313- I . 8-1 . C_—_1 I own, reside in, or will reside in the completed structure. 2. L- 7 1 understand that I must register as a ,.onstructicn contractor if the structure is sold or offered for sale before or upon completion. 3. A.r1 My general contractor is -- -- - - - ------ Contractor ---Contractor registration number _ I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.C4IFI will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is regis'erQd with the Construction Contractors Board and I will immediately notify the r,;fice issuing this building permit of the name of the contractor. I w3rebyr ::-Xy that the above Information Is correct and that I have read and understand the InformaCon Notice to Property Owners about Construction Responsibilities on the reverse 31de of this form. Signature of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244,1 13!91 WHITE COPY TO ISSJING 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), 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 cu.i pre+vert many problems by being aware of the following responsibilities and areu,; of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with'he Construction Contractors Board to do labor in constructing gr assisting in the construction or improvement of a residential structure, you will, in most instahces, 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: AA 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 Department of Revenue at 378-155.0. Unemployment Insurance lax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employeas. For more information, call the Oregon EMployment Division DHR at 378-3224. Workers' Compensation Insuranc3: As air employer, you are subject to the Oregon V►rorkers' Compensate-m 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 for all dram costs if one of your employees is injured on the job. For more information,call the Workers' Compensation Divisi--n DIF at 373-7434. 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 221-3960. 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 br, hrought 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 failing tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Sunprvise Emplo ryees: Make sure you have sufficient time tb 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 to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4821 0244) 10/24189 s s f� CITY OF TI©AR1) NF':CFIP!' O PAYMENT Rt-t ! lPT NU). 1414- �!iw:3tn1 ME CK AMOUNT NAME: a t',.APTER, PUNKA C (,'ASH AiM'JUNT AUC1>•tE-99 M 11 340 E+W rOTTONWOOD LANE PAYME MT DAT F: 4 T I OARI), OR MAD I V I W I(IN K PUEt{-°OSk OF PAYMF:N 1 AMOUN"I t4411J POR110k.1k `)F PAYMKN I AMLJI IN 1 P0411) MF.tHF1NIl::tal... faF; Ml:t:i4 �•k9.:'c::1 '`•'" IPA 81. IMILD Pull TOTAL AMOUNT PAID > P6. rP5