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document, the document is of marginal quality. MAY 1 9 1997
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'''+j' CITY OF TIGARD BUILDING INSPECTION NOTICE
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t t+�,{a►,t �, �+, .� a, Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL: m,
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Foundation Water Line Ceiling Plumb.
Post/Beam Moch. Shear/Sheath Framing ech
Plbg.Und/Fir Slab Plbg, Top Out Insulation -Elect.
Post/Beam Struct. Mach, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwik Reins. `. r Y `°
Other. ' '
Date: P.M. Entry:
Address: v
i Tenant: Ste: MST:
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Con/Own: MEC:
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ELC: �t`�
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector: Date
ROVED —DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639.4171
Footing Rain Drain Cover/Service FINAL:
oundation Water Line Ceiling - lumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab g. To Insulation -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd. -Bldg. ,
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: - -- -
Date: A.M. P. Entry:---------
Tenant:---------__- -- - Ste:-- - MST: L Z
Con/Own: _ -- BUP:
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELF:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footinc Rain Drain Cover/Service FINAL:
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Foundation
,�r � Water Line Ceiling -Plumb.
PosVBeam Mech. Shear'Sheath Framing Mech.
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Other: `
at�`�:, " ��"�ll: .:, Date: _ l� A. —_PM. Entry:_
Address: ■
Want: _ Ste: ` MST:
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s THE FOLLON/WG CORRECTIONS ARE REQUIRED: ELN:
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A APPROVED DISAPPROVED/CALL FOR REINSP. F CO
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Lina: 639-4175 Business Phone: 639-4171 Rain Drain Cover/Service FINAL:
h Foundation Water Line
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Post/Beam Mech, Shear/Sheath Framing
Plbg.Und/Fir/Slab Plbg. Top Out Insulation ec
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Date: �� A. �P. Entry: _
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THE FOLLOW G CORRECTIONS ARE RE UIRED: ELR:
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Date:
II APPROVED _DISAPPROVED/CALL FOR REINSP. C ' CO
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rP, fr CITY OF TIGARD BUILDING INSPECTION NOTICE
a Inspection Line: 539-4175 Business Phone: 639-4171
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Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb. ra � �
Post/Beam Mach. Shear/Sheath Framing -Mech.
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San. Sewer Gas Line Appr/Sdwlk Pains
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#� rirtrr t4su ' Date: 1 _ A _PIM. Entry:9 57
.' Address:
t� + Tenant: TP
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' THE FOLLOWING CORRECTIONS ARE REED: LR:
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PPROVED —DISAPPROVED/CALL FOR REINSP, CF CO
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 I
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Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Fir/Slab Plbg. Top Out Insulation ~ ct
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins. + t rf
Other: .__
Date: Z a 7 (o A.M.—_RM.-- Entry:
Address: f' +yrs
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Tenant. Ste: _ MST: 6 "0 3 7 1
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639.4175 Business Phone: 639-4171 ,
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I Footing Rain Drain Cover/Service FINAL: W n
Foundation Water Line Ceiling -Plumb. i i yp;f 4th'
st/Bea� Shear/Sheath Framing -Mach. y � 5�1
Pltg•'Jnd/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �n �.2— �-6 — A.M. P,M. Entry-• --— r 1 , ,
Address:
16 -103 l
Tenant: Ste: _ MST: 7
BLIP:
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mach. } .'
�fbgUnd�/Flr/Sla Plbg.Top Out insulation -Elect.
F'.)sUBeam Strutt. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk
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Date
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Address: 'OBJ �Su.� � + 51�i�r
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THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR,
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I APPROVED —DISAPPROVED/CALL FOR RE.INSP. CF CO
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Inspection Line: 6o9-4175 Business Phone: 639-4171
Footing Rain Drain
Cover/Service FINAL: i 1�
Foundation Water Line Ceiling Plumb. h '
Post/Beam Mech. Shear/Sheath Framing -Mech.
PIbg.Und/FIr/Slab Plbg, Top Out Insulation
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Date: A.M. P.M. Entry:
Address: l 3 GCJ y ryt
Tenant: �S�e:�_ _ MST:
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THE FOLL :
WING CORRECTIONS AELCRE REQUIRED: ELR:
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--- — -----------_____. Date:
—APPROVED�(DISAPPROVEDXALL FOR REINSP. CF CO
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CITY OF TIGARD
September 04, 1996 OREGON
Mr. Martin Davy
10395 SW Johnson Ct. ■
'Tigard, OR 97223 1
Re: CDC Review Fee
— MST96-0379
Dear Mr. Davy:
Your letter dated August 13, 1996 to Mr. Bill Monahan has been forwarded to me for
research and a response.
In reviewing your building permit application, it has been determined that the CDC review
fee, which was instituted on July 1, 1996, is not applicable in your case referenced
above. This fee is automatically generated on all MST cases, as the majority of our
applications are for new residences. This fee is appropriate for a new residence, and
certain internal remodels of single family residences that effect garages and therefore,
access, eggress and parking requirements. The CDC Review fee is for these case types
that requires verifying set-backs, zoning, lot easements, driveways, etc.
i
k. I have requested a refund of the entire $40.00 amount, which wall be forwarded to the
City of Tigard's accounting department for processing. Checks for accounts payable are t
generated every other week, which should be on Friday, September 13th. If you have
not received your check early in the week of September 16th, please contact me directly
at 639-4171 for assistance.
We appreciate you calling this billing error to our attention and apologize for any
inconvenience this has caused you. i
I
Sincerely,
J�VAldrich
Customer Service Supervisor
Community Development
a
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684 2772
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MASTER K,ERM11
CITY OF TIGARD E=L--"REIT SUED 0 7/96 379
DA"f l; Icar�uE1): /1717/96
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL:
: 1 Ei1a I�ir711]c_:T, •
13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171
6I1-E: ADDRESS : 10395 SW JOHNSON CT
SUBDIVISION. . . . : BROOKSIDE P'HRK NO. ZONING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1
Remarks: Converting existing utility -oor and furnace room to bathroom and
utility/furnace combination room
-----------------------------------------------------------------------------------------------------------------
REISSUE: STORIES.......: 0 FLCOR ARERS-- -- --- BASEMENT,..: 0 sf REQUIRED SETBACKS---- REQUIRED------------- a
CLASS OF WORK.:ALT HEIGHT........: 0 FIRST....: 0 sf GARAGE.....: 0 st' LEFT.......,..: 0 ;,,n,E DETECTRSs
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.,.......: 0 PAkKi4G SPACES: Y
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT.........: .1
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 1 TOTAL------: 0 s`r VALUE..$: !200 REAR..........: 0
--------- ------------------------------------------------- -- PLUMBING ------------------- ------------- ------ ------------ ---------
— —
SINKS.........: 0 WATER CLOSETS.: 1 WASHING MACK..: 1 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 1 DISHWASHERS...: 0 FLOOR DRAINS... 0 SEWER LINE ft. 0 Sr RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 1 GARBAGE DISP..: 0 WATER HEATERS.: A WATER LINE It: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
---------------•---------------•------------------ ------- ---- MECHANICAL ------------------------------------------------------------------- i
FUEL TYPES----------- FURN ( 100K ..: 0 BOIL/CMG ( SHG: 0 VENT FAITS..,..: 2 CLOTHES DRYERS: 1
/GAS/ / / FURN )=100K ..; 0 UNIT HEATERS..: a HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VE1TS.........: r WOODSTOVES....: 0 GAS (YUTLETS...: 0
-------------------------------------------------------------- ELECTRICAL -----------------------------------------------
UNIT---
----------------------•------------------UNIT--- ---SERVICE/FEEDER---- TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1000 SF OR LE55: 0 0 - 200 amp..: 0 J - 'A0 amp..: 0 W/SVC OR FOR.,: 0 PUMP/IRRIGATION: 0 PFR INSPECTION: 0
EA ADD'L 506F.: 0 201 - 400 amp..: d 201 400 amp..: 0 lst. W/O SVC/FDR: 1 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - (00 amp..: 0 401 - 600 amp.,: 0 EA ADDL Bk CIR: I SIbNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/fDR: 0 601 - 1000 amp.: 0 601+a1ps-1000 v: 0 MINOR LABEL -10: 0
1000+ .lop/volt.: 0 ---------------------------------— PLAN REVIEW SECTION ----•--------.------------•--------
Reconne;t only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A. ) 600 V NOMINAL: CLS AREA/SPC DEC:
------------•------------------••--------------------- ELECTRICAL - RESTRICTED ENERGY ------------------------------------------------_
A. SF RESIDENTIAL----------------------------- B. COMMERCIAL----------------------------------------------------------------------------------
PAJDIO I STEREO.: VACUUM 3Y5TEM..: A'.JDIO B tiTEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNOSC LT:
BURGLAR ALARM..: 0TH: :: BOILER.....,...: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE U,JENER..: CLOCK........... INSTRUMENTATION: MEDICAL........: OTHR: :.
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL 0 SYSTEMS: 0
Owner: ------------------------------ ------Contractor: --__.._______-----___- -- TOTAL FEES-4 1n8.55
MARTIN P. DF.VY OWNER I
10395 SW JOHNSON C1
y;
TIGARD OR 97223
Phone N: 6e0-9750 Phone #:
Reg k..:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All w_rk will be done in accordance wi'n approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days.
---------------------------------------------------------•- REQUIRED INSPF.CTION5 ---------------------------------------------------------•-
PLM/Underfloor Framing Insp Building Final _
Mechanical Insp Gyp Board Insp
Plumb Top Out Elect, ,cal Final
Electrical Servi Mer,sanical Final �• _.
Electrical Rough Iiumb Finai
1'e r•m i -,t e e S i g n,�t 1.r v- . /.�:../_.l. _ I s s l-red B y : :.--_A
C,R11 17 ?n pect iorr - 639 41 7
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Permit #: AA 61 IL
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Address: _
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`•.,•. Issued by: _ C a' Date:
i
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 70/.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors hoard to sign the �
following statement before a building permit ran be issued. This statement is r•eauired
for residential building, electrical, mer-hanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this sta►ement. This statement will be filed with the permit.
,l
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 313:
� I. 1 own, reside in, or will reside in the completed structure.
F7/W2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
,
j� -- - ---- -------" 3A. My general contractor is
(Name) Contractor regi;. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
n� 3B. I will be my own general contractor.
�.I
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify (tic office issuing this building permit of the
name of the contractor.
I
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property ners about Construction [responsibilities on the reverse side of this form.
(Signa r of permit applicant) ( ate)
s /
(Whit(, co1e in issuing ugencY permit,/ile,
pink copy to applicant)
,
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Information Notice to Property Owners
About Construction Responsibilities
► Note. ThI rmation Notice to P,-oliei-oy 0)vners about coristruction Responsibilities
wn.s'ele'relopf"I hY 61f, C'ootrm fors Boo?-Jin ac•co?-dant e ivith ORS 7701 055( ).
ow o? 1,it k:,ntrattov I(1 consinict a new horne or maku a .sul)sl<tnnal improvement to an ey I'0111C StRICtllre,
it yell ilrt iaCfll'1 7715 y'
you can prevent many prohlcins by being aware of the. followinf and wvwn of
EMPLOYER RESPONS181Lt e'IE"13.
if you Hire 110-Sons It'd I'Ceistcrrd W1111 the C'un:,tru1,'u+w C olltraclnr" IW". Id In do latl(7r in con,,tructing..or assisting in the
L'Un5tnlCLlU(1 Or Iln11r1)G(I11C111 rtf a rc�idi_'lliltll Ifllllllf( . y!7(t %l 01, in moSt 1r!St71rl;_�";, hC I'llh;(' tlJ h.',J11 t'n11YIC1ycr un(1 the people
,
vuu hire will he cinployces. As (h(: employer, you must comply with the fullov,int': ■
Oregon's% Abholding tax Itrw: Asan on)pinyoi,yon must withhnk.l inconle iF1<(s from emhl, r,,,a(,r+s.It the time einplm
,arc paid, YOU ss ill he Iiahlt for the tax payments even if you don't ,IcInally withhold 01v !.!4 I'1' 11+ '.+'111 eltlployev"'. i'��I iI'll lc
infurnlatie�n, (,all thc. Oregon Dept. OI'Revenu(, at 945.8091.
Unemployment insurance tax: As.In employer,you aic re(!uircd to pity a 1:i% fur nnempirryrnent insurance purposes on til,,
wages of all employees. For more information,call the Oregon Employment i)iii;ion al the Depailinent of Human Resources
it 378-35214.
r
Workers'compensation in!;uranre: ;\ al,rnlpluk(:'I,vuu arc.ni,ic(:1 to the C-)rcf;nrl iOrkers'COrnpensatiorl l,air and trniat ;
VR
Obtain wOrkcrs'.('u+npc)tsatlun insurance fol' war eJill?luyCcit y1)II fail to(Main work-er.s'compensation mstivanc(', you may
he subject to penalties and +ill he liable for all claim _usls 11 !nlr.;,f uuretnhiOyccs is injured on the job, Vor Olin(:infrl inati'nn,
r'k, call the Workers'+ ompensation Division at thr 1)ep;lrtnlcnt of Cun'tlnler 211(1 BUSinegq'.40 bio t at 045-70,k.
tJ..S.Internal Revenue Sey-vice: As:an oI,)ploycr,yuu MLI ithhuld fcxlcial IIwoInc tax from enlpinyee§'wages. YOu will he
liable for the rax p.ty"rent even if vuu didn't at.twtliv l,%illihold the.tax. For inorc information.r;.III the internal Rc%,enue Ser-;U
rr at 1-80(,-819-1040.
140.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
hOIL!01'fir Ih
Crxle c(lmpliancrs ;�,�the pet'mi1 i::prn
uicct,voti are respu '.iNt,fur r(',,ulviu :,Inv faihne to meet cock 1'equirements 1
ll that may he hruught to your attention through inspV01011s.
h Liability and property damage insurance: Contact your insurance agcnf to�:ee. it you have adequate insunince.c(!vcrnge fur
: ac'cident.i and n111iSSi011S SLICh its lAlln g tools, paint oversprll , Wi1ICC(177111111 4 fl"C!Il'1 pipe 11111'1lalYS, f11'C,Of IN'(lrk that ,14151.he
g I ' 1 y g' 1 1 P
re-done,
Time to supervise erxl Ir)yees: Make sure,you have sufficient time II)su L lvise your ern llov('es
+' i ' p Y p'' )' i
Expertise: Make suer ti uu ltravc the cxpertis+>lu clef a' yul!rr)(vn grnernl cnntractnr.t(�cnnttiinate flte tvnrk Of rrnlf*h-in imd finish
tnides, and to nntiN huilding olfiicials at the apprnpriiite tinges ttin they can perfon-In the retinired inspections.
4 If you have additional questions, write or call the Consinlcliun Contractors Boars)(110 Bur 14140,Salem,OR 97309-5052, a
a 503/378-4621). The Board is located at 700 Summer St. NE Suite 3(X1, in Salem.
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Plan Check#
04TY OF TIGARD Residential Building Permit Application Recd By
13125 SW HALL 3LVD. New Construction Additions or Alterations gate Rec'd
TIGARD, OR 97223 Single Family Detached or Attached Date ton E
303 639-4171 Date to DST
1 Permit#�r
Print or Type Called
Incomplete or illegible applications will not be accepted Yis I
elza Cd LW
u;,t1n MVI V1f
Name of ib ivision ( Lot# Name
Job �7� gylll f.+�.� '.Yl ti ��. 1 �
Architect Mailing Address
Address Site Address
I V >' `w ru? w\ L� City/State Zip °hone
Name .
Name
Ownerr -
Mailing Address
1 ` S,J H PJ tiU N Mailing Address —i
ty/State Zip Phone, Engineer g
_� --- C tylState
ame
Zip Phone
N
Gc^eral �-t l /L l'P-• Describe work new O addition O attar;tici repair O
Contractor Mailing Address — to be done.
Additional De.acnption of Work:
t'{ �� (Jl ty/Stale Zip Phone tf Yf,.-. �•rf L.1
7Y R w'�,ti.�
I'�� tt iii GQ Trf'cit,A'r C. VTk1r.`i /F-L1R/1/hc
Oregon Const. Cont. Board Uc.# Exp. Date ` 0 'r S t'"c.,' -,L-:-ty — 1
Attach Copy or Project (r , 2v c1
Current UOT Business Tax or Metro# Exp. Date Valuation �P
Licenses Name NEW CONSTRUCTION ONLY:
Mechanical Sq.Ft. E`Iouse: Sq.Ft.Garage.
Sub_ Mailing Address -
Corner Lot Yes No Flag Lot Yes No
Contractor r
City/State Zip Phone (check one) (check one)
_ Restricted Audio/Stereo Burglar
Oregor Const. Cont. Board Lie# Exp Date Energy System Alarm
Attar ropy of Garage Door HVAC
Current COT Business Tax or Metro# I Exp. Date Installation 9 —
Licenses Opener Systems
Name i (check all that Other
-
N apply)
Plumbing
Sub- Mailing Address -- Will the electrical subcontractor wire for all Yes No
Contractor restricted energy installations?
Has the Subdivision Plat recorded NIA Yes No
City/State ZiD Phone
Oregon Const Cent Board Lie# Exp Date Reissue of MS r# Solar Compliance
Attach Copy of (Calculation Attached)
Current Plumbing Lie.# Exp Date I hereby acknowledge that I have read this application, that the
Licenses information given is cc rrect, that I am the owner or authorized agent of
COT Business Tax or Metro# E.xp Date the owner, and that plonc- bmitted are in compliance with Oregon
State laws
-,re — Signature of Owner/Agent—— Date
Electrical 0(-" K)` �
Contac'Person Name Phone
Sub- Mailing Address
Contractor FOR OFFICE USE ONLY:
C tytSta'e To Phone Plat# Map/TL#.
Oregon Const Cont Board Lir,# Exp Oate
i Attach Copy of Setbacks Zone: Solar:
Current Electrical L:c # Exp Date Al [�
Licenses _ r'
COT iness'Tax or Metro# Exp Date Engineering Approval, Planning Approval. TIF:
I
,tstmstapp dor
t
Permit# Account DescripAmount Amt. Pd. Bal, Due
}3� MST. Permit (BUILD) u' 2 3
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT) 410 qu
State Tax TAX
I
Bldg: . Z
Plumb:
Mech:
ELC/ELR: �L .
Plan Check
MST: (BUPPLN) --
Plumb: (PLMPLN)
Mech: (MECPLN)
CDC Review (LANDUS) O
Sewer Connection (SWUSA)
Sewer Inspection (SWINSF)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Qi;ality (WQUAL)
Water Quantity (WQI.'^,";T)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ER; LAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
Cldsts\mstapp doc
Rev 7196
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, . IrrTY r.. TrGAkD I' JP1 t.►F' PcwMF.:Nr Rt~r':.l 11.,'1 I\41,•
AMUIFN 1 a 1
NAME x DAV Y, MARTIN r:' t ;H NIS'ULIN f a o'. '00
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N ( ta1 Tt- kc3/i !! 3�>•N�i ALliR- i 1039".# f1J tCil
1•J:WARD OR
v1 Jul�CiC3f OF �'f�YtMIC N 1" 1�'i. RPU>;3E lite PkYk+E N l c�MC1tJN'f I ,.
>E+lJILDIN(-o FSEFSMIT r",. 1n,r, 'P UMAINN F•'1.1+14
Mf~;CH Ml II:Fit.. PE U: 4L, PC%W11I i �►tn. ►Ake �
k1Ui L U r+Ft f « .i11 L.Flhll� l.lr:tlr. Flr�l`4.. 4kI, ktI'
J0.399 13W 3r1NNSCIN CT
M91 96-03,79
79
TU'1AL NMOUNT PAID - - > 17 �,O
G) CY of IJ`;!!141) ki. I l II'1 rr! I : tr1,41 I'll I") t .l II I IM4f Irrt,,
nit It9F a 1.)Flt1'•I, MbTI'+C .I N & (.. l'9f 1 i,,•,�,1 1 ��1.1t It.!I'I t : 4;t, alr�;t
10, '.: 43.1 JOHNSLN (.'l F'f,YI+IFtIlI !!t11I.., A 0lr'�:'"+., th
1 [t: !iF•(C),
P(.JRPUlHIC: OF F'F4 W N 1 i4l'it.11-11111 F'f't 1 1) F!t f1lr't.l,,:t. lit 1 r4'r 0t 1:1 1 ►-1M1.;ll.IN 1 PAI U
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I
INSPECTION NOTICE �'r
City of Tigard Building Department
13125 BW Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections
, I
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk 11�
Found. Plbg. Top Out Can Line FINALS i
Poet/Balm struct. San. Sewer
Framing -Bldg. 6
Post/Beam Koch. Rain Drain Insulation -Plumb. t
Plbg. Underfltjor Water Lino Gyp. Bd. -Koch.
AM
Date Requested s_� —�,� Timet PM F
Address:, ermit
Builders o -_ B
s
THE FOLLOWING CORRECTIONS ARE REQUIRED:
R •
Inspector
Date:
\—APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
__Cell For Relnsp. t
.r
r ;
„ INSPECTION NOTICE
City of Tigard Building Department
13125 SA Ball Dlvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: -''�”J —d�^ —
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gats Line FINAL:
Post/Been Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb. E
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: z -/ - Time: _AM PM i
m5/ _
Addreen: ~ Permit
Builder:
THE FOLLOWING OORRECTIONS ARE REQUIRED: -
`y
Inspectors ---- Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
—_Call For Reinsp.
L
INSPECTION NOTICE
City of Tigard Building DepartAlent
13125 BW Ball B7-vd. Tigard, Oregon 97223 1
i
Inspection Linc (Rec-O-Phone): 639•-4175 Business Phone: 639-4171
Inspections p
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
f Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. X-Mech.\
Date Requested- Time: �� AM PM
7
AddrasssIZ) f.� ��� �1/�j� Permit i: —�11s_L�
/ —
� Builder: _ of ■
THE FOLLOWING CORRECTIONS ARE REQUIREDt
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4
1
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Inspectors i t<.-._;� Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap. i
CITYOFTIFARD
f 1 COMMUNITY DEVELOPMENT DEPARTMENT MASTER PE RM I T
' F'15RM I T #. . . . . . . : hIST92-0055
13126 6W FWI 614 P.O.Ba 23307,TOW,ONW 07223(609)690.4176
639-4171 DATE- ISSUED: 09/14/92 M
SITE ADDRESS. . . : 10395 SW JOHN%1\1 GT PARCEL: c_'S 102BB-00OL5
SURD I V 15 1 ON. . . . : BROOKS I DE PARK IVO. ` ZONING: R-4. 5
FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1
REISSUE: DWELLING UN 1 TS: J BASEMENT. , a 0 sf I
CLASS OF WORK. :ADD BEDRhIS:0 BATHS:O GARAGE. . . . . . . . . . : 120 sf
TYPE OF USE. . . :SF FLOOR AREAS-- ----__- REQUIRED SETBACKS-•---------
TYPE OF CONST. :5N FIRST. . . . ..0 sf LEFT. . :20 ft R I GH T. :0 ft
OCCUPANCY GRID. -R3 SECOHD. . . :0 sf F'RONT. :20 ft REAR. . a0 ft
STORIES. . . . . . . . 1 THIRD. . . . .0 sf REQU IRED-
HE:IGHT. . . . . . . . : 12 ft TOTAL-------:0 sf S11OKE DETECTORS.
FLOOR LOAD. . . . :0 psf VALUE. . . . . $ : 2500 PARKING SPACES. . :0
Remarks : enclosing yarage into craft shop Lrnheated adding new carporet
0_.__._......_.-.FLOOR_.DRATN� -VIYIB16G -•--.-BACRFEOW-PREV19TRS::e.0_._._._.-----.-
L_AVATORIES. . . . , :0 WATER HEATERS. , . :O TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :0 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . , . :0
WATER LLOSETS. . :0 SEWER LINE (f•t ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LINE (ft ) . :0 OIHER FIXTURES. . . . . :0
GARBAGE DISP. . . :0 RAIN DRAIN ( ft ) . .0
WASHING hIACH. . . : 1 SF RA I N DRA 1 NS. . : J.
MECHANICAL __..___..___-__.___.__.-•---._._._ _________________ FEES _._._._.._.___......_.......___.-__
FUEL TYPES------------ UNIT HTRS. . :0 type amol_rnt by date recpt
/GAS/ / / VENTS . . . . . :0 BPRT- $ 38. 50 JLH 03/27/92
1y1AX INPUT:O BTU VENT FAIVS. . :.' BPL_C $ 25. 03 JL 03/r7/92 t
FURN ( 100K . . :V_i HOODS). . . . . . ..0 B5VIC., $ 1. 93 JLH 04/07/92 -
FURN )=100K . . :0 WOODSTOVFS. :0 MPR1• 1, 25. 00 JLH 04/07/92
FLOOR FURN. . :0 CLO DRYERS. . 1 Mf--!LC G 6. 25 JLH 04/07/92 -
ROIL/CMP ( 3HP:0 OTHER LINITS:O M5P(, 4 1. L5 JLH 04/07/92 -
0El9eAhID-HEM�SE-bdfiRH_ PBR(C $ 21. 00 JLH 04/07/92 -
1. 0395 SW JOHNSON C-1
TIGARD OR 97 213
Phone #: 620--3033
Contractor;
t
CONTRACTOR NOT ON FILE
r
1
Pyrone #:
Reg _._...._..___.---_--•--•--.___.______..__________----•_-
124. 211 TOTAL i
This permit is issued subject to the regulations contained in the --- - - REQUIRED INSPECTIONS -------- 4
ligard Municipal Code, State of Dre. Specialty Codes and all other FI1l_rmb Tup Omt ,_•� _� � j
applicable laws, All Mork will be done in accordance with approved Framing I n s p
plans. This permit will expire if work is not started within 180 PlLrmb f=inal
days of issuance, or if work is suspended for more than 180 days. BLi i 1 d i n g Final _
Erosion Control
i� Permittee Siynatt_rre :
#[ I s s i_r a d B y :
I-Al. l for inspection - 639-4175
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. awOF TIGARD r
led no
11AIRD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT 1-1r RMI T #„ , , « , , . ; MST92- 0055 ■
13126 SW FWI Blvd.P.O.Ba 28397,Tipvd,Otrpon 0722.1(603)639.4176
17-1 SSUED: 04/07/92r
3I TE ADDRESS. . . : 10395 5W JOHNSON CT PARCEL-,
SUBDIVISION. . . . . BROOKS I DE PARK NO. 2 ZONING: R-4. 5
BL_OCK. . LOT. . . . . . . .. . . .. . . : 1
BUILDING ---_.__---_._.—_____._._______________._.____ ___W ■
REISSUE: �7 dd DWELLING UI'd I TS: 1 BAS'_14ENT. . . . . . . . :0 9f
CLASS OF WORK. r►� BF..DRMS:O PATHS:O GARAGE. . . . . . . . . , : 12,0 s f
TYPE OF USE. . . :5F FLOOR AREAS _ _.____.___-- REQUIRED
FYPE OF CONST. :5N F I RST. . . . :O s f LEFT. . :E:0 ft R I GHT. :O ft
OCCUPANCY GRP. ::f• 3 SECOND. . . :0 S f FRONT. :20 ft READ. . :17) f t
STORIES. . . . . . . : 1 THIRD. . . . :0 S REQUIRED-----
IiEICiI•4T. . . . . . . . : 12 ft TOTAL— _- " :O y'F SMOKE DETECTORS. :
FLUOR LOAD. . . . ..0 psf VALUE. . . . . � : `"00 PARKING SPACES. . :O ■
iF)ema0( enclosing gavage into h9aksCh�u 5°kT adding new car-por-et
PLUMBING ----------------
S 1 NKS. . . . . . . . . . :0
_________—.__S1NKS. . . . . . . . . . :0 FLOOR DRAINS. . . . :0 BnrKFL_.OW F,REVNTRS. . :O
LAVATORIES. . . . . ..0 WATER HEATERS. . . .0 TRAPS. . . . . . . . . . . . . . :0
TUO/SHOWERS. . . . :0 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . .0
WATER CLOSETS. . :0 SEWER LINE (ft) . :O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LINE= (ft ) . :0 nTHER FIXTURES. . . . . :O
GARBAGE DISC'. . . :0 RAIN DRAIN (ft) . :0
WASHING MACH. . . : 1 GF RAIN DRAINS. . : I
----------------- MECHANICAL _._.---_.___.______ _.__________.____._ FEES
F=UEL 7YPFS---------•-.---- UNIT HTRS. . :0 type amut_Int by date recpt
/GAS/ / / VEATS . . . . . :0 BPRT s :x8. 50 JLH 03/27/92 .
MAX INPUT:O STU VENT FANS. . :2 BPLC f 25. 0:3 JL 03/217/92 .
FURN ( 100K . . :0 HOODS. . . . . . :0 85PC t 1. 93 JLH 04/07/92 —
F'URN ) =100K . . :0 WOODSTOVFS. :0 ;14PRT ! 'S. 0171 JLH 04/07/92 -
1-:1_OOR FURN. . . . :0 CLO DRYERS. : 2 MPLC $ 6. 25 JLH 04/07/9i? —
130IL/CLIP ( 3HP:0 OTI.IER UNITS:O 115PC $ 1. a5 JLH 04/07/92 -
GAS OUTLET5:0 PPRT $ 25. 00 X-H 04/07/9;
Owner-: -_._.______.___._._-._..__ _.___.___._.___._____._....__ P5PC f 1. 25 JLH 04/07,192
BOB AND DENISE WARD
a 10395 SW JOHNSON CT
T I GARD OR 97223
Phone #: 620-30.7,3
Contractor,:
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CONTRACTOR NOT ON F=1l._E: I
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#:
Reg #. . . —.__.____.__._-__.________.._______.___.._......_.---.------
124.
._--_1r4. 2A TOTAL
4 This permit is issued subject to the regulations contained in the - - -- -- REQUIRED 1NSPF C'T'IONf3 ------ -
Tigard Municipal Code, State of Ore. Specialty Codes and all other FT"A-'440' P PI Limb Final
applicable laws. All work will be done in accordance with app,oved I+M1ercfitetTMi c,er3 i nstr Bu i 1 d i n g F i.r1 a 1
plans. This permit will expire if work is not started within 190 P1i.Imb Top LTi-(t Erosion Control
days of issuance, or if wore is suspended for more an 190 days. F'r,am i.n g I n s p
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i.t t e e l.yc rl �t
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- Rain d r^m i n I n,h
1 -a'sl_ied key
(_call for inspection 639-41..-75
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MR^W1M{btlntYmM......
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F Permit No:
Address: --
m '• ' Z Issued by: Date:
FOR OFFICE USE ONLY----
INFORMATION
NLY--- -
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
t; and Engineer applicants, exempt from registration under ORS 701.010(7), need
a not submit this statement. This statement will be filed with the permit.
F
Fill In the applicable blanks, and Initial box 1 and either box 2A or 2B:
1. E* 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.
1 f
i
OR
To B. [ I will be my own general contractor.
i
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and do hire a ggeneral
contractor, I will contract with a contractor who is registered wlthffihe
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 Info tion Notice to Property Owners about Construction Responsibillties on the
reverse Ido of this form. r
Signature of Permit Applicant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT .1110
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4
MECHANICAL of Tigard
PERMIT Pia-icki'Rec. ;r
13125 sw Has Blvd. APPLICATION Permit #
PO Pox 23397' �
Tigard, OR 97223
(503) 639-5171
Description
Table 3A Mec halcal Cade f]TY PRICE AMT
.�
.lOb t) Permit Fee -0- -0- 10-00
Address 3.00
2) Supplemental Permit
unlace io 1
1) nd.ducts a vents, 6.00
.... unit=e 1 +
2) nd.ducts A vents 7.50
Owner o FGM-Fu-mance
3) nd.vent 6-00
r r—•�.r s heater,wall heater
4) or floor mornted heater 6.00 r
Vent-not ixiin
O=pant 5) appliance permit 3.00
Re—W-@ heaW g.
Ming-
6) cooling,absorption uric 6.00
er or=nip,heal pump.air conr-
7) to 3 HP absorp unit b 100K BTU 6.00
Moder or carne,hwat pump,of=enol
0) 3-15 HP absorp unit to 500K BTU 11.00
cW "Mr ,y Z. Er or comp.Fiat pane.of conci.
9) 15-30 HP aCsorp unit.5-1 mf BTU 15.00
TZ A.".. Gr or Comp,heat pump,of Cont.
10) 30.50 I4P absorp unlit 1-1.75 mil BTUread
tt,rs appicabon,that me Boderorcomp.how pump,of gond
ir",ne" grove is correct that I am the owner or authorized agent 11) >50 HP absorp utu 1.75 mi BTU 31.50
of to ow w.that pians subffvmd are in compliance with State Ar harking unit b
Wm,that I am regaured woh to Construction C.ontracioes Board. 12) 10.000 CP1t 4
ttsat I*mr.+ber given is sorted (if exempt from Stan registration, Air g unit
.
please gnv reason below.) 13) 10,1100 CTU 7.50�.
Non portabo
14) evaporate coder 4.50
ent an con rsec -
15) to a single d,ct 3-00
Veno aow system not_Ccm 6. -G r� t
16) included in apofanoe pe" .� 4.50
I- me-chanica:Alaust 4.50
w7rk new 0 iKMOrt 0 WWat&CO repay Commercal or rldusblaf
5e done restx:nta)✓ -on-r2s:dental "I incrnra=r 30.00
_xrstug usa d Omer i.e.w-oc;teve.water
1-ea1drg or prop" —
19) heater,solar.d=oles dryers.etc 4.50 ll
- cFcsed se of 2� Gas pipe_:re tc lour outlets 200
tci)dng or y
21) ?.lore than 4 per onlet
i Type of fuel-of O naural gas O LM U 'K O
NOTICE
i m,rc--num Fee 525'00 SUBTOTAL
PERI.KTS SEC:.ME VOID I-Mn-K 0;;CONS i n'JC 0':
AUTHOPLIZED 5 NOT COLIMENCED 1'.9 i-!IN 130 CAYS.Oa 5%SURCHARGE
IF C;':='RUC-ON OR YlCaK!S SIJC7=':JEC
A?AR:AtiED;:OR A PERYJD C= 130 CAYS AT A.'. TiVE PLAN REVIEW 25%OF SUBTOTAL �
TOTAL
City of Tigard PLUMBING PERMIT PlanddRec. •
13125 SW Hap Eftd APPLICATION - Permit#.
PO Box 23397
Tigard. OR 97223
) 639-4171
5=;" —J
ORS 614-21.610 On PRICE AMT ■
Job FLXWRES
Addy
so ■
Showw O* 7 so f
azar ckwAt
■
�NMadrAM 750 1�
750
a1Bf i
7.50
730
i
\MM•s.M
Staww 1st 10(r 3QAo
-e&JUdk lar
s{pr. tft ww
wm w Srvwe aa.AddlL 200► 11S ao
i�Iwauioa pna bR mrwat,lhnt 1 s 6,.owaar or errfrcriaad a9«�t d
'"`" ora atiaiat tl.t pbr�c►�rbnil6d an in �Stab tsrrs,tint 1 _ Saxra:Ra:'+oral+1st lar 320
ao wgicurd wi6 b f Oaad<rcion Careaaoh fiord!oe M ar.ab.r SkXM R Rain Draw AddL MW 1S1D0 r
is aarwa to asw I baa Stats rrapissrafon,o t +-
Mobs.Nom.q;pam 2SA0
92&Flow Pgevwom
Oaviou«Anif taolltrtioa CkrA n 7.90
Any Imp or Viam
Carracbd b a Fat" 750
aar nwar gas�m —7:9— 1 li
to M dans mil rri�i Q ndr40si1rrtial Q LOAD
brsp.d Ewst.Pkmd irq pr br
-- IQa1
_ �iah R�� pK Mr
Rases pmv
dwioas MOD
PmpmAed um at
Grp«pupwV - —
provwwon devices/
NOTICE 'Minimum Iva$2S.o0 SUSTOTAL -
PERNfTS BECOME Vt710 IF WORK OR OONSTRUCTION Sx StXV34ARGE ?
Aur* uzm IS NOT COMMENCED W1TMN too DAYS.OR IF --
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
POR A PES OF 160 DAYS AT ANY TVAE AFTER WORK IS PLAN REVIEW ZSx OF SUBTOTAL
COMMENCEd I 7
TOTAL � •��i `r
Sped.d Cor►6ticxis.
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I
Permit No:
d
• Address: I
z Issued by: __ Date:
■
—FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS ■
ABOUT CONSTRUCTION RESPONSIBILITIES
I
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit r
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
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
I own, reside in, or will reside in the completed structure.
t
i
2. -7 1 understand that I must register as a construction contractor if the structure is sold
j or offered for sale `afore or upon completion.
3. A. My general contractor is
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. general contractor.
Com] I will be m Y own
If I hire subcontractc;rs, 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 nodi,,/ the office issuing this building permit of the name of S
the contractor. I
I hereby certify that the above Information It correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
Si nature/of Permit Applicant Date
CONSTRUCTION CONTRACTORS BOARD
0244) B/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
f
i
i
'T
MSI f".
a,
C I T'v f.IF. r T(.;Ar4D - RECEIPT OF- PAYMENT RECEIPT NO.
CHECK AMOUNT 0. 00 I
NAME: : WARD, 80ft CASH AMOUNT 3. 71
ADDRESS C"'FIYNIE=NT DATE: 04/01/';t'
SIJ1fI)1 V I S I ON
w
r �
PURPOSE OF PAYMENT v.,A I D PURPOSE OF PAYMEN'T' AMOUNT PA I O
BUILDING PERM 38. 50 5T. BUILD PER 1. 92 �
!
PLAN CHECK F'Er •--36. 71
,w
R
1.03()5 SW .JUTAN50N I"T
TOTAL AMfJl1h;T PA 11) _ — �) 3. 71
Si
�a
CITY 0F' TIGARD REE.CE PT OF F'AYME::NT REi:(,'E::I:E''1' 140. --9P-21:.?:ii Cry
CVIE.Cl% AMOUNT a 36. 73 d
NAME a WARE), DENISE, CASH AMCIUN 1,
A 1)D R E.8S a 10395 SW J(4::-!;;(:1N CT PAYMENT 140 1". a t)3/R7il92
SUBDTV: SIGN
11of)RI), UIrti '•??n.3.-
pI.1RFOSL OF F''rlYl'IF:h1T AMOUNT PAID PURPOSE OF 6'AYME bll AMOUNT PAID
E°ION C'Ei E.C:.I�_..f.`,'_......._...,.... .,... 36. 73 m....._,,,._,...._..__..._.__.._,._..._..,,.._.__..w._.._.._
TOTAI.- AMOUNT PAII) — —) 36.73
I;
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f � k
YY
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3
R
y n,{
Y'- I
T;I'TY OF TIGARD RECEIPT' CTF" F'AYI`IF.:"'T RE' F_TF�T hlfl. c'~ 4t1'I'a
CIAEC'K AMOUNT'
�, CASH AMOUNT AIS
( PaArI a WAIT), F(7T+JOH S T)F:CIA - E:: PAYMENT DATE c 0:.3/1.9/92
I F1T)DRLSS a 10395 SW J'CrtIN�#ClN CIA :311E+1)F4/If3rlaN
w,
TIUARD, OR 972,
Pulkf:'i7i3E:: UP' PAYMENT AMOUNT PAID PURPOSE' O PAYMENT AMOUNT PAID
........... .._......,
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