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8040 SW BONITA ROAD-1 ADDRESS: i\records\microtlm\tergets\building doc CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639.4175 Business Phone. 171 Inspection: FttA_n OL� Footing Susp. Crjlling Sprink. Rough-in A t/Sdwlk Foundation Plbg. Underslab a y,F3ou�i►�Irr� ace Post/Beam Struct. Plbg, Top Out Elec. Rough-in FINAL: Post/Beam Mech, San. Sewer Gas�L n -Bldg.r Pibg. Underfloor Rain Drain Framing -Plumb, Alarm Water Line Insulation -Mach. Underflr. insul. Shear Wall Gyp. Bd. -Elaot, Date Requested: er� -S 9J1 Time: AM PM st Address: 0 Uy(� i-�i �a jec/. Builder:ins)yvt L Permit 0: THE FOLLOWING CORRECTIONS ARE REQUinED: If-2-- Inspector: Date: L PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. CITY OF TIGARD MEPERMI T:AL 1=�RIh ) PERMIT 0. . . . . . . t MEC:95--0069 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUEDt 03/22/91 13126 aW Hall Blvd.Tigard,Oregon 97223.8199 (503)830-4111 r'ARCF�I..: c'.a11r'PC:-•0�►101h I T'F ADDRESS. . . : 06040 SW LION I i A RD -iUBU1VIEsION. . . . : I)URHAM ACRES, ZE)NINC s R-4. 5 . . . . . . . ` . -------------- .:LAGS OF WORK. . tADD FLOOR F-URN. . . . t EVnP COOLER!.t I YPE. OF USE. . . . %SF UNIT HEATERS. . s VENT FANS. . . : OCCUPANCY GRP. . :R3 VL14 1 S WID APPl_: 1 VENT SYS EMS: i1URICS. . . . . . . . t BOILERS/COMPRESSORS HOODS. . . . . . . .. UEL TYF Et3__-___.__......_ .. _ 0-3 HP. . . . t DOMES. INGIN t : /URici/ 3--15 HP. . . . t COMML. INCIN , MAX INPUTe ETU 15-30 HF"'. . . . : FtEPPIR UNI1'6t I RE DAMPERS 7. . : 30-50 HP. . . . t WOODSTOVES. . t i;>A5 1='RE:3fiURE . . , t �2-1F HP. . , . : CLU DRYERS. . t d0. OF AIR HANDLING UNITS OTHER UN I Ts. t URN ( 100K BTU-. 1 t= 10000 ct m t GAS UUTLL-"TS. :4 UHN > ---11A0K LAW 1 ) 10000 c f m : remarks : INSTPL.L FURNACE/HEATING SYSTEM EN DEKUR IL type amount t)y nat a 'ecpt '1040 SW BONITA RD PRMT ♦ 25. 00 SW 03/22/95 - GPC7 f 1 . ,=�i SW 0;:3/22/95 -• 11GARD OR 97224 !lone! 0.- .!WNER --------------- ----- e� #. . : 1(11jIlhl�iljl RLQU.IREU INSPECTIONS °tilt permit is I.stued subject to the regulations contained in the Gas Line Insp Jgard Municipal Code, State of pre. Specialty Codes and all other Mechanical Insp Applicable laws. All work will be dons in accordance with F lna.l In5ipectinn aproved plans. T7is permit will expire if work is not started 11thin 180 days of issuance, or if work is suspended for more days. 'ermittee Signature : d LA y t " , Caa; l for ina,)ection 639-4175 - -- - - E City of Tigard MECHANICAL PERMIT Planck/Rec. # 13125'SW Nall Blvd. APPLICATION permit # Wi!C, Tigard, OR 97223 (503) 639.4171 escnpuorr =7 Table 3A Mechanical Code CITY PRICE T AMT Job r'`�al © >l J ';�.ti 1) Ptimilt Foe -0- .0. .1 O.W Address , . ,, fJ�......�_ i��y�� 2) 9uppbamental Permit 3.00 - -trwt -'_ u macs ro'T 1U 1) Incl. ducts A vents 6.00 " - Furnace 100 STU+- �- Owner 2) Incl.ducts a vents 7.50 cx Fumanco 3) Incl. vend 6.00 4) or floor moumted hater 6.00 10fr" - vent not it-ZX15 - -- Occupant 6) appllance permit 3.00 epair ohealing,� reTig. 6) cooling,absorption unit 6,00 __ �..--- __-- ---- --- -...---- ter or comp,heat pump,au c n-d— _ -- i . 7) to 3 HP;absorp unit 0 100K BTU 6.00 Miler or comp,hea pump,air ca6cl. _...__ Contractor 6) 3.16 HP;absorp unit to 500K BTU 11.00 -� rnpras----- ------_.__.__—_ -*r or cr "" omp,F5-75a pump,air cood. G) 16.30 HP;absorp unit $-1 mil BTU 16,00 Boiler or comp,Tisa pump,Gtr co _ 10) 30 50 HP;absorp unit 1.1.75 mil BTU 22.60 oraby ackhow ge tha ave read us ap n-1Farlria NOW or con , iff'p ir�i p, FF co-n- Informntlon given Is correct,that I am the ownrrr or authorized agent 11) >50 HP;obsorp unit 1.76 mil BTU 37.50 of rho owno(, that plans submitted nre In comf Ilance with 8tnta v an ng urn to law",that I am registered with the Construction Contractors I3cwd, 12) 10,000 CFM 4.50 !hnt the number given Is correct. (If exempt from State registration, Air handing unit '- pleaso give reason below.) 13) 10.000 CTM+ 7.50 on poriabra-` 14) evaporate cooler _ 4.50 Vent fan connecta x 1 Lo t4la/'t. 16) to a single duct 3.00 en a on sys em^T'n F 1R) Included in appliance permit 4.60 sorva'asy _ _ w,A sr 17) mechanical exhaust 4.50 upeceNo worx naw a Rion a ern on repair Commercial or inchs a to'bu dbme residential(31.ol15on-residential 16) type Incinerator 30.00 x e ng usee ____ - _ - terwa19r— building or property_M 19) heater, solar,clothes dryers,etc. 4.50 Proposed use of 20) Gait piping one to four outlets 2.00 7- n building or property Type of fuel -oil CJ natural gnsI_Pfi 0 electric 0 21) More than 4-per outlet t - Minimum Foe$25.00 SUBTOTAL PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZFD 19 NOT COMMENCED WITHIN 160 DAYS,OR 6%SURCHARGE IF CONSTRUCTION OR WORK 19 SUSPENDED OR -- ABANDONED FOR A PERIOD OF 160 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL � AFTER WORK 19 COMMENCED. -- -- roTAL l� Spacial Conditions `. Date Issued Z �L_by eft Yr4�PdIMAT Pcrmit#: Address: t Issued by: 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: P-11",1. 1 own, reside in,or will reside in the completed structure. [U . I understand that I must register as a construction contractor if the structure is sold or offered for sale =� before or upon completion. F11 3A. My general contractor is �-1 (Name) Contractor regis. # 1 will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contrwtors Board. If I change my mind and hire a gener ' 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. /, 1'%-K- C CX — -- 3— z Z—��' (Signature of perm; applicant) (Date) (White copy to issuing agency pernut file. pink copy to applicant) r 1• iformation Notice to Property Owners Ab,,ut Construction Responsibilities Nati This information Notice to Property Owners about ...onstruction Responsibilities was a.veloped by the Construction Contractors Board in accordance with ORS 70I.055(5). ' ot. ,-. actmy;as your own contractrr to construct a new home or make a substantial improvement to an existing structure, y. an pruvet,tf many problems by tieing aware of the following responsibilities and areas of concern. EMPLJYER RESPONSIBILITIES: If yi, i-, persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improver --nt 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 hr liable for the tax payments even if you don't Laually 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 Resource.. at 179-3524. Workers'compensation insurance: As an employer,you are subject to the Oregon Workers'Compensation Law,and must obtain •orkers'compensation insurance for your employees. If you fail to obtain workers'compensation insurance,you may be subject to per.alties 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 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. E tpetrtise: Make sure you have the expertise to act as your own general ccntractor,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 cal I the Construction Contractors Board(IBJ Box W 140,Salem,OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. iYE Suite 300, in Salem. pmp-own.pM 1/94 r 1r CITY OF 7 10AND — Rt'.f:E I PT OF PAYMENT RFC'E"I PT NI3. G F.'.'..;K AMOUNT NAMC t Dt Kr)RTr-, KrNNETN .T,, CASIH AMOUNT' i m« QJf t`1DDRESS t 8040 CW BONITA RD ;,AYME"NT DA'M TIGARD, ON SUBDIVI€ION t 9 PPP-- PIARP(A'o OF PAYMENT AMOUNT PAID PURPOSE Off PAYMENT AM01INT PA'. D hit.1 r if 4rJ 1'(.::AE.. E F'I ,.._.....,....... ..._._.__.......,_...,_.._.... ..__.....,......_.....__.�_,:............._....,.,_. .._._..._...._w...__...._,..... MlEr95— MAW) P5. 00 ST. BUILD PFR :',040 PsW BON I TA 1 07'Ai. AMC.II.INT PAID - - -•> PE,« 251