9610 SW VENTURA COURT i
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9610 SW VENTURA COURT
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City of T- gar-' Ouild`._ng Oepart'wOt
33125 Bw Be]- Blvd. Tigard, Oregon 97223
InapectLon Line (Rec-O--Ptine): 639--4175 Business Phone: 639-4171
Inspection: -
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out ;as Lirs3 FINALS
Poet/Beam Struct. San. Sewer Framing -8149• /
Post/Beam Mach. Rain Drain Insulation -plumb.
/
Plbg- Underfloor Water Line Gyp. Bd. Q -Mech. r
Urate Requestedt, `3 _ __Nimes / '-' sr AMS)pI PN
Address:._ _1C� •'tGCLL�. Lid ---- Permit
TPE FOLLOWING Cr)RRECTIONS ARE REQUIRED:
Inspectors —_ Dates ,1�,� L'
I- APPROVED ^ DISAPPROVED APPROVEn SUBJECT TO ABO'M
Call For Reinwp.
FOR.
DATE _TIME---P.M.
m
OF---
PHONE.
AREA COVE NJMmF,-f EXTENaIGN
TEUP140NED 'LEAKSALL
CAME M SEF YOU V111 CALL AGAIN
WANTS TD SEE YOU RU H
RETUnNED YOUR CAU BFT'31ALATTENTION
MEB..
ta�
BIG ED
LITHO IN U.H.A.
TOM It FORM 3002P
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CRYOFTIGARDBUILDING
ratiWAY-OFTWARD
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COMMUNITY DEVELOPMENT DEPARTMENT :'LRM I T 4f. „ . . . . . : BUF'92--00,56
11125 SW lull Blvd. P.G.Box 23397,Tfpad,Orpon 97223(590175 %
'ATEISSUED: 03/O9/92'
X311-E AC)DRESS. . . . O9610 SW Vr.-.`N'il.si�ii t, 1 FxARCEL: 1S125DD.- 09130V1
SUBDIVISION. . . . : WASHINGTON SQUARE= ESTATES N0. 3 ZON 1 NG: R-4. 5
BLOCK. . . ,. . . . . . LUT. . . . . . . . . . . . . . 1O6
REISSUE: F=LOOR AREAS----.— EXTERIOR WALL CONSTRUCTION
CLASS OF WORK. :ADD FIRST. . . . .- S f N: S. E.- W.*
T'YP,E OF USE. . . :7F 5RCOND. . . : S PROTECT OPFNINGS?—_—__—.__.-.
1 YF-'F' OF CLINST. :5N THIRD. . . . : Sf N: S: E: W:
OCCUPANCY GRID. :R3 TO'TAI. — -- '21 5 f ROOF CONGT: FIRE RET',1 :
OCL:LIF-ANCY LOAD: BASEMENT. - s f AREA b G. RATED:
ST0R. :c_ 1{T, -20 ft GARAGE- - s f OCCU SEI`,.. RATED.
BSMT?: MELZ?: REOD SETBACKS---------
FLOOR LOAD. . . . :40 c)s f 1_.El'"T: f'` RGHT: ft F I R Sf'K1...: SMOK DET. . -
DWELL ING
ET. . :DWELL.ING UNITS: FRNT: fl REAR: ft FIR AL_RM: HNDICF' AGC:
HE:.DR19S: E21AT115: IMF' SURF=ACE:: PRO CORR: PARKING:
VALUE:. $: 31271O0
Remarks : enclosing top clec.k to b Used as a SLIT, room—not habitable Space
Owner-: _. _..._—._. .._._..___.._..___.__.__._._.----____._..____-. _______- ___---._.-. _.__. FEES _._.__._.._.._._.—_..._.._.._.
RCNALD BALSAMO type amoLlnt; by date recpt
';610 SW VENTURA CT E-IRM1 $ 36. `JO JLH 03/0;5/92 E241� .
V,LCK $ 25. 03 JLH O3/05/92 224154
TIGAPD OR 97223 5PCT $ 1. 93 .JLH 03/05/94 ,•::234114
Phone #:
Contractor:
OWNER
I '.7ane #: $ 65. 46 TOTIaL.
Rep #. . : O012+1n0
- — _-- REGUU 1 RE-L) I NbOE L I 101\
--•--•-_—
This oereit is issued sutier.t to the regulations cor:elned in the Foot/foLind Insp
Tigard Municipal Cor State of Ore, Specialty CadeE and ait other F',~aminq InSp
applicable laws. G,l Mork will be done in accordance wit', I rx S u 1 at: i on I n S to
approved plans. ih:s permit will expire if work is nt started Gyp hoard Insp
within 180 .jays of .ssuavice, or if work Is suspended for more Rain dt-a: n I n s p
than 180 days. Final InspPr..tian
F,er,mittee 13ignat1.lr,e :
IS'.'11ed Fav : '
Call for inspection - 639-4175
�( t-7 1):75 SW all Blvd. I-LNCK/RECT #
CITY OF 1 I`TRD PONix23397 PERMIT # •�u/� ll S�
COMMUNITY 1)I;;1V1?LOI'�.tl?N'I'F)I?I'ARTM11`,N1 Tigard,Oregon 97223
(503)639-4171 DATE ISSUED _—
JOB ADDRESS: e -- TAX MAP/LOT /-5 2 1-0P, - cl U0
SUB: __ _ LOT: �06 _. LAND USE: _
VALUATIO14: -Woo -------
OWNER SPECIAL NOTE,
N#%ME:
F o oq6 b Ls.��? U _ REISSUE OF: -- __---
ADDRESS: ���� SGy V�w7vA� C/ LAST REISSUE:
FLOOD PLAIN/
PHONE.
SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME:
Ou,w 6K. PLANNING: ( -------
ADDRESS: ENGINEERING:
FIRE DEPT: --- ------.__
PHONE: ,_-- —. OTOER: A)O .___ ��= --
CONTR. BOARD #: — EXP DATE: _
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: .__—_ _ _ — — LIST/SUBCONTRACTORS:
MECH: —--- BUS TAX: -
ARC.� ENGINEER CALCULATIONS:
NAME: _ TRUSS DETAILS: ._ -------___---
ADDRESS: _ — OTHER: __.— -------- -
PHONE: —.—---- -----
PROPOSED BLDG. USE:
COMMENTS: _
oe
e '6
APPLICANT SIGNATURE
-- Date Received: ��=-
Received By: -- _ - ---_— 4
PERMIT # ACCT # DESCRIPTION
AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees ;k. ,u
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Bui ldii,g Tar. (5%) /y
Building _
Plumbing
Mechanical
10-433 00 Plans Check Fee ,2
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25 ,48-02 Commercial TIF Fees
25-448-04 Inde,strial 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 Dev Charge (PDC)
31-150 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445 -01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
nm/3587P.WPF
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F- Permit No: _. --------- --
/� Address: -----
of = Issued by:__.. _-___-- Date:
\.� ''•• ��'• •� --____--FOR OFFICE USE ON
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Nate: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Beard 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 either box 2A or 2B:
1. 1 own, reside in, er will reside ire 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 Boa,d.
OR
B 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 -! the contractor.
I hereby certify that the above Information Is correct and that I have read and understand
the Information Notice to Property Owners about Construction ReE,)onsibilities on the
reverse side of this form.
L!
Sig ature o Permit Applicant a.t
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISIEUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFORMATION NOTICE TO PROPERT-(ABOUT CONSTRUCTION RESPONSIBILITIES
ES
� E. This Information Notice to Property Owners About Construction
NO
Responsibilities was developed by the Construction Contractors Board in
accordance with OPS 701.055(5), passed by the 1989 Oregoo Legislature.
nt
It you are acting as your own contractor to y pro fernct bybP ng aWsrmof the following re pons bie a substantial rl ties
to an Pxisting structure, you can prevent many problen.s y 9
and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered the tof sion res dentialcs�ruc•Bu structure,
dWilaborf11p5�instances,or assisting in the construction improvement
be ruled to be an "'employer" and the people you hire will be "employees". As the empioyer. You must
comply with the following:
Ogee o_n's Withholding Tax Law. As, an employer, you must withholdots1even8 you from
actually withhoyea ld
at the time emrii"ayaes are paid. Yo, le Ii:4Cle for the tax pay Y
the tax froin your employees. For rr `or ,ation, call the Oregon Department of Revenue at 378-3390.
ance
Unemployment_Insurance Tax: As�aQeSmpoloYn�re nfor naare etgion,�cal�t►�ya tax OreganoEmpt Employment Division rDHR
purposes on tie wages of aTi`em_ Y
at 378-3224.
Workers' Co_m.Qensation Insurance: As an amployer, you are Subject to the Oregon Workers' Compensa;
tion�aw, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers
rampen cation insurance, you may be subject to penalties and will be liable for all claim costs if one of
your employees is ;njured on the job. For more information, call the Workers' Compensation Division DIF
at 373-743A.
I.S. Internal Revenue Service: os an employer, you must withhold federal income tax from employees'
wages you will be liable o the tax ;payment even if you didn't actually withhold the tax. For more informs
tion, call the Internal Revenue Service at 221.3980.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code C'-ompliance: As thy, permit holder for this pro;lect, you are responsible for resolving any failure
lc=meet code requirements that may be brought ti,) your attention through inspections.
L�abilit�nd Propert Dami ge_Insurance: Contact your insurance agent to see if you have adequate
insurance coverage tar accidents ancdomissions such as failing tools, paint overspray, �+ater damzge
from pipe punctures, fire. or work that must be redone.
Time 10 Supery;se Employees: Make sure you have sufficient time to supervise your employees.
E�;�' t�rt'se: Make sure you have the expertise to actasyour own general cuntiactr, coomes to
t�N-5To' rough-in and finish trades, and to notifybuildingofficials at the appropriate
so
they can pE:rform the required inspections.
If YOU have additional questions, write to: Construction Board
mer St, NE Suite00
Salem OR 97310.0151
Phone 503-378.4621
0244J 10124189
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CITY OF TIGARD RE.1'PIPT OF PAYMENT RF.,C[-IV.*,*t NO. 192--P241554
CHECiAMOUNT c 65. 46
NAME t BALW)MC), RONALD CASH AMOUNT x 0. 00
ADDREOSi a qf.%tO ;3W VENTURA CT PAYMENT o 3, o ri gfi-I
97223
T I GA R 1), OR -- SUBDIVISION
PLJRV-,0!3E OF PAYMEN r AMOLIN I PA 1 PLIRI,"Oh'E OF P9VMENT OMOUNT PA I D
iUf a. 50 PLAN CWCk FE 25. 03
91'. BUTLD Plr—R
TOIAL PIMOUNT PAID 65,. 46
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CI'T'Y OF TIGARD
STOP' ' WORK ORDER
BUILDING DIVISION
13125 SW HALL BLVD.,TIGARD, OR 97223
639-4171
JOB ADDRESS: __ _ PERMIT
OWNER: _ _ � CONTRACTOR:
YOU ARE IN VIOLATION OF THE FOLLOWING:
AND HEREBY NOTIFIED THIS DAY OFy 19Tr_., AT f' }M,
THAT NO MORE WORK SHALL BE DONE ON THESE PF(EMISES UNTIL THE ABOVE VIOIJATION HAS
BEEN CORRECTED AND VERIFIED BY THE CITY. CORRECTIONS SHALL BE MADE WITHIN
DAYS OF THF ABOVE DATE. FAILURE TO COMPLY WITH THIS NOTICE WILL RESULT IN THE
ISSUANCE OF A CIVIL INFRACTIONS SUMMONS.
-DO NOT REMOVE THIS NOTICE-
BUILDING INSPEC7'OR