16125 SW GRIMSON COURT-2 ,.. .:..,.... � ...:... ,� :... l t-.:'..... ♦ ...s, y.. F i,v. ��(TWT•'RM'►7•l�Mr'�"r('M'FAµRpr•,=Mr.11�tn�wilFYRY
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i INSPECTION MO,TICB
City of Tigard Building Department L
1.3125 an Ball Blvd. Tigard, Oregon 97223 j
Inspection Line (Roc:-O-•Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelab Neth. Rough-in Appr/Sdwlk
Plb
Pound, g. Top Out Cas Line FINALt
Post/seam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Intrulation -P).tmb.
Plbg. Underfloor Nater Line Opp. Bd. \-Hoch.
Date Requestedt ID _r� 3PN
Addreast �D�2S (L'� 11/V1�7(•1�r� l_ ^ I/_ Permit 1t
Builder: 1�i�_(I
TEM FOLLOWING CORRECTIONS ARE RRQUIRED:
I
1 Ins +ctors
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD
'COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hell Blvd.Tipard,Oregon 97223•e199 (603)639.4171
PLUMBING PERMIT >�
PERMIT #. . . . . . . " PLhl93—•0173
� 9-41 -71 DATE ISSUED: 09/01 /93
PARCEL. ;-::S 1 14BA01 100 1
SITE ADDRESS. . . : 161,25 SW IiRIMSON C'T
SUBDIVISION. . . . : PICKS LANDING NO. 2 ZUNING: R•--4. 5
BLOCK. . . . . . . . . . . LOT. . . .. . . . . . . . . . : 128 � r
I CLASS OF WORK. . -ADD GARBAGE DISPOSALS. . MOBILE HOME SPOLES, :
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLUOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . . s
STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : CATCH FS')SI"JS. . . . . . . :
1-.nUNDRY' T_RFaYS. . . . „ : CF POIN DRAINS. . . . . :
SA-NFINS. . . . . . . . . . . URINALS. . . . . . . . . . . . . Gr1EA,E TRAPS. . . . . . . .
LAVO.T(?RIES. . . . . : OTI-IER FIXTURES. . . ... .
TUB/SHOWERS. . . . - SEWER LINE (ft ) . . . . : 1
WATER CLOSETS. . : WATER LINE ( ft ) . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . .
Rer..ark s :
Owner: —____.____._____.________._.._.._...__.____________.______._______ FEES
JAMES MCCALMONT type amol_rnt by date recpt
16125 SW CRIMSON PRMT $ 15. 00 JH 09!01/93 -
5PC•T s 0. 75 JH 09/01/93 —
1f.CARD OR 972,24
Phone #:
Contractor: ---
OWNER
Phone #: 4 1 a. 75 TOTAL {
Req #. . : 00000
---- --- REQUIRED INSPECTIONS
Th s permit is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of (he. Specialty Codes and all other Final Inspection
applicaole laws. All work will be done in accordance with
apps-oved plans. This permit will expire if wort, is not started
within 188 days of issuance, or if work is suspended Fur more ___-.___
than 188 days.
F er-mitt. e ignat ,L . l
Call far inspection - 639--4175
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CITY OF TIVARU — PECErIPT OF P'AYME=N'T' REC:;E"IF,'T NCI. s93-243/63
CHECK AMOUNT a 1:5. 7S
NAME MCCAI._MCIhJT CASH AMOUNT a 0. Oki
ADDRESS r'AYMF::NT UA`l--'' a k'9%Qd1/9,,
�
WDD I !I.)ION s
PURPOSE OF PAYME=NT AW)UNT PAID PURPOSE OF POYMENT AMOUNT PAID
F'I._LIMBINC� GERM 15. 00 ST. I?UJIL.D PER 0.
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16125 SW CRIMSON CT
TOTAL. AMOUNT PAID 15. 75
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INSPECTION NOTIC7
City of Tigard Building Department 1
13125 Bq Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phoneys 639-4175 Business Phone: 39-4171
Gr i Inspection:
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
rl„". Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
p 1 Plbg. Underflcoc Water Line Gyp. Bd.
Date Requested: -H>> 1� % Time: _AMM
4t Ir dk l 1
Addrese:1�. �l7'� 4. 6 Permit
Builder:
IF
THE FOLLOWING COR R [7!'SMS ARE REQL IRED: r M�t
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h 4 t.y
1
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Inspector
Date:_ �Z_ � 3
APPROVED A_ C 'SAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep,
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INSPECT[ON NOTICE
City of Tigard Building De{ux.tAwnt
13125 GW Hamel Blvd. Tigard, Oregon 97223
ti Inspection Ling (Rec-O-Phone): 639-4175 Businees Phc a: 639-4171
4
Inspection:
Footing Plbg. Underelab Mech. Rough-.in Appr/Sdwl.k I
1' Found. Plbg. Top Out ias Line FINAL:
1
rr Poet/Beam Strur_t. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Ineul.ation -Plumb. I
I
Plby. Underfloor. Water Line yp. Bd. -Mech.
�..r _Time: _AH PH
Date Requested:
r
Addreen•_� � �___G Permit 1:C? �I
Builders_—�
p ' THE FOLLOWING CORRECTIONS ARE REQUIRED:
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e-r I
i Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
i.
- _Call For Reinep.
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INSPECTION NOTICE :r }
City of Tigard Building Dopartoent „ •,
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Dosiness Phone: 639-4171
1
Inspection:_ — -- -----'� —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
A. ---------
ti�'IF "? 1�4 i6 Poet/exam Hoch. Rain Drain Insulation -plumb,
Drain
Plbg. Underfloor Water Line Gyp. Bd. -Rech.
3eY� �a f�� � �;�das�, Date Requested: -� �)_—_{Tii�mee: + SAH --__PM
Address: !1 / P�ir�it ,:L'' _ ��✓ ■
Builder: —
r
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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I
Inspector- Date:
Pe •, L J -- -- -- ----
"- APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
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S EC'f?ON NOTICE
IN
� City of ?igwrd Building DePartm20nt ,
/Y1 I 1317c 'M Hall Blvd• 21g+srd. Oregon 97223
�+//�Innpgction T.:ne (Rec-o-Phone): 6391-4175 Bunineso Phone 639-4171
i Inspect
FootAing Plbg. Underalab Mech. Rough-in PPr SdvIk
Found. Plbg. Top out
Can Line NINAL:
V PotiL/geam Struct. San. -Bldg.
Sewer Framing
Poet/Beam Mech. Rain Drain
insulation -Plumb.
Plbg. Underfloor Water Line Gyp. bd. -Mech.
P!t �
Date Fequeated: nI�L 4
L. - COY �V,1��fiV� L_ Permit
Addreea: I I
t. Builder:_ —
�i
THE FOLLOWING CORRECTION •O
UIRED:
t:
Datel
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Inspectors,
APPROVED DISAPPROVED
APPROVED SUBJECT TO ABOVE
call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Insper_tion Line (ROC-0-Phone): 639-4175 Business Phone: 639-4171
Inspection —
i
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plhg. Top Out G&B Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Ri Bin Drain ) Insulation -Plumb.
Plbg. Underflo- Watei Line Gyp. Bd. -Hoch. I
Date Requested: � Timo: — AH —PH
Address: f (. �� Permit Is_L._-a.
THF FOLLOWING CORRECTIONS ARE REQUIRED:
— r
w'
Inspector: � /.� ----____--__-.— Dato:--��--y�-
_ /
x APPROVED DISAPPROVED APPROVED SUBJRCT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Departreent
S 131115 go Hall Blvd. Tigard, Oregon 972Z_6?"--.`
1 Inspection Line jRec-0-Phone): 639-4175 nueineae Phona: 639-4171
Inspection:
Footing PlN. Undoralah Mech. Rough-in Appr/Sdwlk
i
Found. Plt.g. Top Out Gas :.ine FINALS
Poet/Beam Struct. Ban. Sewer 1 Framing -Bldg.
Poet/Beam Hoch. ttatn Drain Insulation -Plum,:.
Plbg. Undorfloor Water Line Gyp. Bd. -Nech• A
- `.{
Date F.oqueeteds �� TI.IIDBsLT1111 PN
Address: Z� "� (VIS _L� Permit it 1"�/►`�` q2_ lofq�__
7 n �
Builder=
THE FOLLMINr CORRECTIONS ARE REQUIRE):
t
Inepsctor: _ Dates L .
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPF.CTIC" NOTICE
City of Tigard Building Department � t
33125 SR 9x1.1 Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-p fie): 639-4175 Business Phones 639-4171
Inspection• f'I
Footing Pl (/Underalab Mech. Rough-in Appr/Sdwlk I
Found. Plbg. Top Out Gas Line FINALS '
Post/team Struct. San. Sewer Framing -Bldg.
Poet/Beam Rech. Rain Drain Insulation) -Plumb.
Plog. Underfloor Water Line Gyp. 8d. `-Hooch.
Date Requested: Q T Time: X AM PN
( Address:
G� Permit (ft
Builder: G- (p ��
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STHE FOLLOWING CORRECTIONS ARE REQUIRED: 4
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Inspecto : _
—— _-� Date: -
__APPROVE'D _, DISAPPROVED APPROVED SUBJECT TO ABOVE
i
Call For Reinsp.
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INSPECTION NOTICE
CLty of Tigard Building Department
1312: SM Hall Blvd. Tigard, Oregon 97223
F,
Inspection Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171
Inspect ion• _-- -— —
i
Footing Plbg. 'lnderelab Hezh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
et/Beam Strutt San. Sewer Framing -Bldg. ' ,
Post/Baam Hech 5' Rain Drain Insulation --Plumb.
11Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Data Requested:_
_Cr Timet — / ` AH PMI
Addrenot--Z Permit #: ��
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Builders C 2 n
TfiR FOL1.(Ki1NG CORRECTIONS ARE REQUIRED:
7
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Inspector: J Date:
NPPROV"ED DISAPPROVED APPROVED SUBJECT TO ABOVE
--call For Reinsp.
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3 INSPECTION NOTICE
City of Tigard Building Department
13125 SR Ball Blvd. Tigard, Oregon 97223
1
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: — --- i
Footing Plbg, Underslab Me `i. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL•
■
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb. '
��Plbg. Underiloor`� Nater Line Gyp. Bd. -Mech.
Date Requested:_ -_/�.L Times _AM PH
Address:
�1 `7 C ��> O7 c-� G�L -Permit
■
Builder .. ��.�.
THE FOLLOWING CORRECT-ONS ARE FRQUIREUs
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Inspector: yy Date:
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AP ROVED ISAPPPOVBD APPROVED SUBJECT TO ABOVE
_Call For Reinap.
• i. ."9Z'+1��'71�R'� .'., '::'':"' '7Ali
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�TNSPECTION NOTICE C�
City of Tigard Building Department
7 13125 SW Ball. Blvd. Tigard, Oregon 97223 L�—
lnopectios. Line (Ree-O-Phone): 639-4175 dunineae Phore: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found Plbg. "op Out Cas Line FINAL&
Pmost-/Ream Struct. San. Sewer Framing -Bldg.
1
Poet/Beam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp. .'d. -Meeh.
Date Requested: 2 c-2 3,— /T�im�er AH PH
AddresB:.-1 w c-P f `� t i PeYmi
/ % 1 ��
/ Lam-_,
Builder: d �(P
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TBE TOLIANINO OORRECTIORB ARE REQUIRED&
Inepec_o : / Da
tee
�] 7
_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
41a
Calt. For Reinsp.
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CITYOFTIFARD MAST'EF? PERMIT
GTYOi1KIIRD OERMi I #. . . . . . . : MST92-0142
COMMUNITY DEVELOPMENT DEPARTMENT «nooN
13125 BW Hrl Btvd. P.O.Bam 23307,TOW,Or$Vn W293(503)61x4176
`R
'',ITE ADDRE ISri. . . : 16125 SW GR I MSON CT r'ARf'E I...: %a i 14BA•-11�1 10k,
SU14DIVISION. . . . : PICKS LANDING NU. 2, ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 1'E,8
-------- -------------------------- BUILDING
QE;I SSUE: OWEI_J.-T NG UN I TS : I BASEMENT. . . . . . . . :0 S f g
CLASS OF WORK. iADD NEDRMS: 1 BATHS: 1 GARAGE. . . . . . . . . :0 Sf
TYPE OF USE. . . -SP FLOOR AREAS-__.___.__.--. REQUIRED
TYPE OF CONST. :5N FIRST. . . . :780 sf LFF•T. . 17 ft RIGHT. 17 ft
OCCUPANCY GRP. :R3 TiLCUND. . . :0 s f FRONT. :u` Ft REAR. :20 f L 1
i'f1'1RIE_a. . . . . . . : 1 THIRD. . . . -0 sf RE QUIP.EL�-
w y HEIL•HT. . . . . . . . : 14 ft TUTAL_.___. __-:7814 sf �3MOKE DF_T'E=(:1"ORS. 1Y
h . ;
FLOOR L ,.OAD. . . . :40 psf VALUE. . . . . � 1 5880 PARKING SPACES. . :N �
Romarks : PATH T ADDITION 780 SU FEET e
PLUMBING
SINKS. . . . . . . . . .
.0 FI-DOR DRAINS,. . . . CO 13ACKF1_UW F�'E�EVNTRS. , :0 •1.
i._NVAT0RIE13'. . . . :2 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . ..0
i TUB/al-1OWCRa. . . . : 1 t_.AI..INI)PY TPAYS. . :. rV, GATI:I•i BASINLi. . . . . . . ..11'
WATER CLOSE::T'S. . : 1 SEWEIR LINE (ft) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . 10 WAT'R LINE %ft) . :0 OTHER FIXTURES. . . . . 10
6ARk;AOL UISP. . . :0 RAIN DRAIN (ft) . :0
inlAriH 1 NG MACH. . . : 1 SF RAIN DRA I N5. . :oil
MECHANICAL __..__._.___.-__.__.__ FEES _.___.._._-____-._.__ s
(=I.JE.L TYF'G5- ---_._____.__ UNI T HTRS. . :0 t ype amount by date recr t
VENTS . . . . . :4 BPRT t 2,R0. 100 JH 07/22/92 X
MAX INPUT-0
PTU VENT FANS. . : [3PLC; 4 14;3. 01,71 JI._H 04/0t /92 2290°;4
FIJRN < 100K . . :�10 HOODS. . . . . . ..0 LA5PC $ 11. 00 JH 07/22/92 X
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FUQN -0 WOODSTOVES. :0 MPRT $ 41. '.70 JH 07/,22/92 X
t-LUUR FURN. . . . :0 CLO DRYERS. : i MPLC $ 10. 2-a JH 07/22/92 X
FOIL/CIhI-' ( 3HP.0 OTHER 1j1\11TS:0 MTjPC $ 2. 08 JH 01/2 '/92 X
GAS UU•R_E:.TS:O PPRT t 37. 50 JH 07/2x'2192 X
Owner: -- -- - --_._..---._._-•__-... _____..__.__.__._______._ P5PC s 1 . 813 JH (4)7/22/9e- X
MIKE: MC::/(:,'ALMONT 0
16125 SW CRIMSON CT
IIUARD OR 97224
1•71hone #: 639--6886
C:nntrar_-torn
OWNER
f
Phune tF:
Ii'ey ##. .
4 46 7. -114 TOTAL
This aersit is issued vitiect to the regulations contained in the - -- - -- REOUIRED INSPE=CTIONS - - ----
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found I n s p Gyp Board Ins p
a oli^_able laws. All work will be done in accordance with approved Wost/beAm Btruc:t Rain drain lnsp
Glans. This permit will eroi-e if work is not started within 168 Post/Beam Meehan Mer_hanical r• inal
days of isBUatice, or if work is suspended for more than 168 days, PL.M/Underf 1 oar Plumb Final
Mec_h< •al tnsp Suilding Final
Permittee SiglRatur-N: E-11timb lop Out E-_rosaon Conrrn.l ¢,
I. Framing Insp Crawl Drain
s s U e d 13Y .., _.- --_ Ins'.i 1 a t i o n I n A p
Call for .inspection - 6:39--4175' a
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CITYOF TIGARD BUILDCITY TWIRD PERMIT ' t
COMMUNITY DEVELO1rMENT DEPAMIENT -'E FoM I T' #. . .. . . . . : M8T92 -iD 14.=
12126 6W HO Blvd.P.O.Bow 2,M7.14W.Onto^0722 (T !W4171 7! i>+, i L. ISSUED: 7/ /92
A
16125 SW GR I MSDI-I CT PARCEL: 251 1411A--01, 10('� "
SURD I V I S I uN. . . . : PICKS LANDING NO. 2 Z.ON I NG: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 128
---------------------------------------------------------------------------------------------
RETSSUE: 1 0 0 1 0 FLOOR ARC-AS.--------..---- Ex-rERIOR 14PI-L CONSTRUCTION-
CLASS OF WORK. :ADD FIRST. . . C, S N: / S. E: W:000 6
TYPE: OF USF:. . . :SF SECOND. . . :80 s;f PROTECT OPE N I NGS")_.._—_._.
i'YPE OF CONST. :5N THIRD. . . . -0 0 S f N-0 S:0 E:O W:
OCCUPANCY GRP. :R3 HYI"(--4I_---•-•- -;0 7 7 s f ROOF CONST: 4 FIRE= RET''s
OCCUPANCY LOADs114 4 BASEMENT. :020Y 5f ARLA SEP. RATEL)s3 0 e
"A OR. :0 HT. : 1 t ft GARAGE. . . - s f" CiC:CU SE-P. RATED-0 1
E+SMT'' : MLZZ_'':7 REQil SETBACKS--------- REQUiPE
FLOOR LOAD— . : 1 p';f LL:F T: / ft RUH1 : f t FI R SPKL: SMOK DE--T. ; 1.
DWELLING UNITSs 70 FRNT: / ft REAR: ft F'IR AL RM: HNDICP ACC;
1
VEt RMS:O BA ri•i4: it I IY P SURFACE-0 0 0 G!R0 C011E2: PARKING:
VALUE. $ : 35880
Remarks : PATH I ADDITION 7P0 Sr.) FE=ET
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Owner: -- --________._ ____. . _.. _ _...__ .. .__.... FEES _ .._...._.
__.__._-w._.____.
MIKE MC/C"ALMONT type tmount L7y (late rec-pt
161PS SW CRIMSON CT BPRT $ 220. 00 JH 07/22/92 X
BPL_(_: $ J 43. 00 JL.H 04/01/92 2c '4
TIGARD OR 97a.24 B5PL $ 11. 00 JH 07/2L/92 X
'hone! #s 639-6886 MPRT f 41. 50 JF, 07/22/92: X
11Rl_.0 $ 10. 38 JH 07/2P-/91= X
Contractor: ---------------------------------- MSPC_ $ 2. 08 JH 07/22/92 X +'
DWNE-'R PPRT $ .37. 50 JH 07/2 /92 X
F'SPC $ 1. 88 JH 0i /22/1)2 X
Phone #: $ 46 /. 34 TOT(4L
Rey #. . : 01000
---------- REQUIRED INSPECTIONS ----_-_ _ t
Th's permit is issued subject to the regulations contained in the Foot/fotmd Insp Building Final
Tigard Municipal Code, State of lire. Specialty Codes and all other Bost/Beam Struct Erosion Control
applicable laws. Gli work will be done in accordance with Post/Beam Mechan Crawl Drain
approved plans. This permit will expire if work is not started PL_M/Underfloor
within, 180 days of issuance, or if work is suspended for more Mer..hatn i ca 1 Insp
than 180 days. Plumb Top U�tt
F r a m i n is Insp
. {a, I n s u l a t: i o n In-,p
frll� C• Gyp Roi.tr�td Insp
V'er'mittee+ SiIIT'At iV-13 ^ Rain drain Insp
Mectiatnir_al Final
► ,;,- .t� r1 Rc e�� F='lamb f=iin].
' C a 1 1 for i n-,o e c:t i o n - 6 3 9-41 i'S
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Permit No:
Address:
h
t Issued by:__ Date:
FOR OFFICE USE ONLY
STATEMENT:
INFORMATION 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 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.
Fiil in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313:
I own, reside in, or will reside in the completed structure.
2. i - 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.L _. l My general 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.Cl I 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 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 Inf r ation Notice to Property Owners about Construction Responsibilities on the
revers s Is
of this foam/.
(
nature of Permit Applicant 9 pp Date
\ F
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
w�
INFORMATION NOTICE TO PROPERTY OWNERS ,
i
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction Responsibilities
i
was develcped 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 lahor in constructing or assistingI
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 emp:oyer, you must comply with the following: ,
Oregon's Withholding' gemployer,
_ _ _g_ thholdin Tax Law: As an you must withhold income taxes from employee wages at
the time employees are paid. You will be liable for the tax payrnents even if you don't actually withhold the
tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390.
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 DHR
at 378-3224.
p — � I
'Norke_6 Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation
Law, and must obtain workers' compensation in, .-ante for your employees. If you fail to obtain workers'
f 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' wages
lia .
You will be ble 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:
..ode Compliance. As the perr.iit holder for this projPct, you are responsible for resolving any failure to meet P
ode 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 ornis-ions such as falling tools, paint overspray, water damage from pipe punc-
tures, 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 to: Construction Contractors Board
i 700 Summer St. NE. Suite 300
Salem. OR 97310-0151
0244) 10/24/89 Phone 503-378-4621
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CITY OF T I GARD — RECEIPT n PAYP FNT RECEIPT NO. a 901--212975.0
CHECK AMOUNT 3F--!4. 34 I
NAME o MC; CA...MONT CASH AMOUNT 0. 00
ODDRESS a 1 C•125 SW GR I MSON CT PAYMENT DATE a 07/82/92 �
SUBDIVISION �
r I OARD, OR 97224--
PURPUSE: OF PAYMENT AMOUNT PAID PURPOSE_ Of-PAYMENT AMOUNT PAID
{ BUILDING' PEhM- 2210. vim PLUMBING PEEtM__ _._. .. .37. 50
MEC:HANICe-li— PE 4.1. 561 ST. BUILD PER 1 4. 96
PLAN CHECK F'E 10. 38
92-•0142 ADDITION
r(l T r1l AMOUNT PAID _ -- — —> 32-4. 34
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2JJ9' PERMIT N M5it
COMMUNITY D[:VEI.01'MGN'I'I)EI'AIZ'I'MGNT Ti�r�Ore23
(SOJ)6J99-4171-4171 DATE ISSUED -
JOB ADDRESS: A L9 /At/0 /I TAX MAP/LOTSUB: �11J �(� LOT: I uC-� w?�� LAND USE: —
{ � VAL 4ION:
OWNER SPECIAL NOTES
NAME: M ,Kc !"�� �O��M `�' REISSUE OF:
ADDRESS: 1 Z �w_ ��-✓r /AQ, � '� G LAST REISSUE:
-C�[2 7 z 2 FLOOD PLAIN/
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PHONE. — VE LAND ,
CONTRACTOR APPROVALS REQUIRED
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NAME: -�< -—(' J O`O a`'� PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:�
PHONE: — OTHER:
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CONTR. BOARD N: _ EXP DATE: —.
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ __ LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH/ENGINEER CALCULATIONS: _.
NAME: hII/t _ TRUSS DETAILS: —_
ADDRESS: _ OTHER:
PHONE:
PROPOSED BLDG. USE: !�(�� SIO_ - �ef I ehC —
COMMENTS: ��-_ �� .1p
AP"'T SIGNATURE
lece i ved By: ----__--- _.._._ Date Received: _-__--
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT P0. BAL. DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Permi'� Fees 57, 7V
_ 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building YL�
1 Plumbing
Mechanical �•a�
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10-433 00 Plans Check Fee /53 �3� ���-j• U ��
Building
Plumbing
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Mechanical 0
10-230 06 Fire _
i 30-202 00 Sewer Connection
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30-444 00 Sewer Inspection '
25-448-02 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
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Oev Charge (POC)
31-450 00 Storm Drainage Syst Oev Chrg
(SSOC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL / 3•"' 3N
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CITY OF "C I ffARD -.. RECE I F''C OF f='t1YMENT REC:F'=.I f='.f NO. s 92•.-4�29034
CHECK: AMOUNT a 143. 00
NAME a MC: CALMONT, MIKE CASH AMOUNT a 0. 00
ADDRE-SS t 16185 SW CRIMSON CT PAYMENT DATES a 07/01/92 �
SUSD I V I 51 ON a
T IGARD, OR 97224--
PURPOSE
7224•—
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID H
j FLAN CHECK F"E..._..__,. _.___.....__143. 0q, —_._...._.._.W._.._..._._......__.w..._....._....._. ...._._.......,_.._.__.._._
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PLPN CHECK #(,--•6!514
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TOTAI... AMOUNT PAID — — - — > 143. 00
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