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InitiallyGood 1 ADDRESS : i:\records\rnicroflm\targets\buiIding.doc CITYOFTIGARD COMMUNITY DEVELOPMENT DEPARTMENT OF TIMRO Z/ 13125$W tiWl Blvd. P.O.Bar 23307.Tip",OreqDn 97223(61X1183 -4176 PLUMBING PERMIT r-"E R M I T #. . . . . . . : PLM922-0078 639-4171 DATE ISSUED: 06/01/92 SITE ADDRESS. . . : 12550 SW BELL CT PARCEL: RG104AP-00800 SUBDIVISION. . . . : BELLWOOD ZONING, R-4. 5 BLOCK. . . . . . . . . . t L01.. . . . . . . . . . . . . :57 CLASS OF WORK. . :ADD GARBAGE DISPOSALS. . : MOB ILE H014E SPACES. TYPE OF USE. . . . iSF WASHING MACH. . . . . . . : SACKFLOW PREVNTRS. . : l OCCUPANCY GRP. . :R:3 FLOOR DRAINS. . . . . . . : TRAPS. . . . . . . . . . . . STORIES. . . . . . . . i WATER HEATERS. . . . . . I CATCH BASINS. . . . . . . FIXTURES----- L.AIJNDRY TRAYS. . . . . . - !:.)F RAIN DRAINS. . . . . : STINKS. . . . . . . . . . i URINALS. . . . . . . . . . . . a GRE.ASF-". TRAPS. . . . . . . LAVATORIES, . . . . : OTHER FIXTURES. . . . . TUB/SHOWERS. . . . t SEWER LINE (ft) . . . . : WATER CLOSETS. . I W('TF;'P 1-11\IF- (ft ) . . . . DISHWASHFRS. . . . I RAIN DRAIN ( ft ) . . . . Remarks : 11PRINKLrR SYSTEM Owners ---- ---------------------------------- FEES LEONARD CURRIER type amol-int by date rocpt 12350 SW BULL CT PIRMT $ 15. 00 JLH 06/01/92 5PICT $ 0. 15 JLH 06/01/9e TIGARD OR 97223 Phone #: Contractor OWNER -------------------------------------- Phofle 15. 75 TOTAL Req #. . : 00000 REWIRED INSPECTIONS This wreit is issued subject to the regulations COrt4in@d in the Top-ot-it Itisp Tigard Municipal Code. State of Dre. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for sort thin IBA da". Permittee B i.qyiat 1-ire BY : Call for inspection F,739-4175 i CITY OF TIGIARD — RECEIPT OF PAYME=NT RE G:F1CST 1,40. a9;P—c.27914 CHECK AMOUNT a lb.00 NOME s CURRIER, LEONARD CASH AAOUNT n 15. 75 AWR1:SS a IR':-!'50 SW BELL CT PAYMENT DATE:. A 06/Ql1 /92 ;3ULxD I V I E3 I ON T IGARD, OR 13722.3— ` PURPOSE OF Pl)YME NY AMOUNT PAID PURPOSE OF PAYMENT HMOLINT PAID {K.1.IMD I NG PE FdM 15. 00 5T. BUILD PER N. 751 i srnn I NKLE:R rYF 1'E::M TOTAL. AMOUN-E G-` )X V) Permit No: , Address: C issued by:_ �__ __ Date: L - /'f - \„ __—__-_FOR OFFICE USE ONLY_.___._-__ STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note:Oregon Law, ONS 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 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 applicable blanks, and Initial box 1 and elther box 2A or 28: 1. F= I own, reside In, or will reside in the completed structure. 2. A. = My general contractor is -----_---.------- --.__._._-_----_ --- - , Contractor registration number ..___�___�._..�. I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. 9EEC-1 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 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 havo read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. q 2- Signature of Permit Applicant _._ Date CONSTRUCTION GONTR/ � 'ORS BOARD 0244J 1190 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT T INFOR11'MON NOTICE TO PROPERTY OWNERS ABOUT CO.''STRUCTION RESPONSIBILITIES I NO r- Th13 Information Notice to Property Owners About Construction L ' Resuonsibilit'es was developoJ by the Construction Cc..,tractors Board in c^ordanct, with (')HS 701.055(5), pas3ed by the 1989 Oregon Legislature. t' Ddu are io tl s yoar own contractor to construct a new home or make a substantial improvement t.., -,r til; a aruc' .ro you can prevent many problems by being aware of the following responsihillties an,1 'AS ,oricerrl EIVirLOYER If YOU hire pet, not registered with the Construction Contractors Board to do labor in constructing or assisting in the constructior 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: e on's Withholding Tax Law. As an employer, you must withhold income taxes from employee wages ,a t o t m Amp1o­yees 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 3783390. Unemployment Insurance Tax: As an employer you are required to pay a tax for unemployment insurance purpose ' on the wages 65Femployees. For more information, call the Oregon Employment Division IBNR a t 378.3224. Workers' Com unsation Insurance. As an employer, you are subject to the Oregon Workers' Compensa- fio 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 one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' vva esYuu w I be Ia lP_Tor the tax payment even If you didn't actually withhold the tax. For more Informa- tion, 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 co a 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 coveta►accidents an7c 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 ti,,)e to superv'se your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the W&Tof rough-in an(' finish trades, and to notify building off+cv, Is at the appropriate times so they can perform the requirr , Inspections. If you have additional questions, writE, to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10124189 City of Tigard Building Departssnt 13125 9M Ball Blvd. Tigard, Oregon 97223 Inspection Lina (Roo-Q-Phone): � )639-4 745 Buri9ness Phone: 639-4171 Inspection:_- 1 d�G" \ KJw X k /��Y -------- _..- Footing Plbg. Underelab lMch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/beam Atruct. San. Sewer FraoLng --Bldg. Poet/8gam Hoch. Rain Drain Insulation -Plumb. Plbq. Underfloor �nWater Lino Gyp. ad. -Hoch. Data Requeated: w � 4 L� � Timet � AH PM G a Address f 1�7 5� o wu Permit 1 f 1 I O ` Builders TBE FOLLOWING OORRECTIONS ARE RRQUIREDI InspectorsOe- APPROVED DISAPPROVED APPROVP.^ II:1 IPM TO AnOVE Call For Reinep.