15625 SW SUMMERFIELD LANE-1 E
a
,r
�,..Jr ,w ",f"'..�
r., '�C 41.n k. �, r g..,M. rr:,�.:r e..y,�.« ... .. e w s�,,� -ry.•r. :ryn.Y
d
Iw
M9
/
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)= 63^-4175 Businesu Phone: 639-4171 '
Inspection=
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwll.
Found. Plbg. Top Out Gan Line FINAL=
Poet/Beam 5truct. San. Sewer Framing -Bldg.
_•� '
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Hater Line Gyp. Bd. -Hoch.
Data Requested= -f� Time= J1M PM
Builders
THE FO"LOWING CORRECTIONS ARE RSQUIREU:
I
Inspectors
APPROVED DISL^PROVED APPROVED SUBJECT TC ABOVE
I
Call For Reinsp.
rnw,.ce,...mw...,,,:..»wr....dYw,.,., r r -.,,....,.,.. -.,.,•,..:..ox . •,+rw:xwu•+rm:a�rer♦ 1
www
a. w r
`y
r �
INSPECTION NOTICE _y '
City of Tigard Building Departswnt
13125 9M Hall Blvd. Tigard, Oregon 97223s
Inspection Line (Roc-O-Phone)s 639-4175 Buoinese Phones
Inspections. — —
Footing P!bg. Underslab Mech. Rough-in Appr/Sdwl.k
Found. Plbg. Tor. Out Gan Line FINALS
Poet/Beam Struct. -in. Sewer Framing � -Bldg. �
Post/beam Hoch. Pain Dr Ain Insulation J -Plumb.
Plbg. Underfloor Nater Line gyp. Bd. -Hoch.
Date Requesteds ^ c=P— j Times AN
Address: fC9I it s
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRUDs _
Inspectors Dates
APPROVED DISAPPROVED APPROVED 80BJECT TO ABOVE
Call For Reinsp.
e i
w
F.
r
r
I '
• INSPECTION NOTICE.
City of Tigard Building Department
13125 Sp Ball Blt+4. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171
Inspection:_
'Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. 1 Plbg. Tip Out Gas Line FINALS
Post/Berm Struct. San. Sewer Framing -Bldg.
Post%Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
—�—Data Requested: Timet AH PH
Address:—
Builder:
THE FOLLOWING CORPE.CTIONS ARE REQUIRED:
I
I
IR
1
Inspector Dates r -
APPROVED DISAPPROVBD —_ APPRUPSD SUBJECT TO ABOVE
_`Call For Relnep.
r
y
1 0
•
0 �
•
Permit No:
Address: ,��?._�rq �LsS��/a�in
• z 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.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
1 . 1 own, reside in, or will reside in the completed structure.
2. C 1 understand that I .r,ust register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.[ 1 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. 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 cor,tractor, 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 1
the Inforrretlor No+ioe to Property Owners about Construction Responsibilities on the
reverse sloe o! this form.
is
r1Bn ure of Permit �q plicant ba
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
^svM: +,y..w.-�y.�.�.� -a„„y.•v,,,.-„ ^ray. 1'
AL
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 gregon 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 p,event many problems by being aware of the following responsibilities and areas
of concern.
EMPLOYER RESPONSIBILITIES: Ix
If you hire persons not registered with the Construction Contractors Boar to do labor in constructing or assisting
in the construction or improvement of a residential structure, you will, in most instant,^s, 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 muss vithhold income tF xes from empioyee wages at
the time employees 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 378-3390.
Unemployment Insurance Tax: As an en,,�royer, 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.
'!orkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Comperr--ation
Law, and rYpen sat ion insurance for your employees. If you fail to obtr.in workers' ,
compensation insurance, you may be subject to penalties and will be liable for all claim costs it 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.
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 221-3960.
OTHER RESPONSIBIL,''IES AND AREA;. OF CONCERN:
,ode Compliance. As the permit holder for this project, you are responsible for resolving any failure to meet
ode re-ruirements that may be brought to your attention through inspections.
Liability and Property Damage Insurance: Contact your insurance agent to see 4 you have adequate insurance
coverage for accidents and omissions such as falling tools, paint overspray, w�;►er 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- ;n and finish trades, and to notify building officials at the appropriate times so they can perform
the requi;-od inspections.
If you have additional questions, write to: Consiructio i Contractors Board
700 Summar St. NE, Suite 300
Salem, OF, 97310-0151
0244,1 10/24/89 Phone 503-378-4621
�s!rrgfat�rWirk;��
.el.,. I�•. .;� . .r. . .. r,.,.l,... .rrwl.. ..m•a fir.«,., ,.�s.. a. •.,,y . .,.yM y .. ..� v ,w. .r' ..+,,. ..w. 4h1:.�'
I f,
y '
9177
I'1
CrrYOFTIFARD ��Im
COMMUNITY DEVELOPMENT DEPARTMENT oaoon BUILDING PERMIT
IN268V11HWSWd.P.0.eo.sW,no■d,0-W MAO t603►e39•,76 P F RM I T #. . . . . . . . SUP92 •0210
i:)ATE ISSUED: 0f1/07/9c� '
c- T
SI�r>=. ADDRESS— :. s 1562�� SW .._uMM�RFI�L_� LN
SURD I VISION. ,. . . SUMME RF I E'LO NO-7 ZONING: R-7 ■
SL.00N.. . . . . . . . . . : LOT. . . . . . . . . . . „ . . 347
REISSUE: rI-OC)R-ARFAS� _-- ----_��—EXTERIOR WALL_ CON TRUCTION
CLASS OF WORK. :NUL) F I RST. . . . :224 s f N: S. E: W: �
TYPE OF USE. . . :5F SECOND. . . : 5f PPOTECI CIPENINGS?--__--_._...-.
TYPE: OF' r'0NST. :5N THIRD„ f N; 5: E: W:
OCC;UPANI.Y GRP. .R3 TOTAL,------- : 21xP4 5f ROOF CONST: f-IRC RET'.' :
O C;UPANC_:Y LOAD: BASEMENT. : 5f AREA SEF'. RATED:
STOR. : 1 HT. : 12 'Ft GARAPE. . : 5f OCC U SEP. RATED:
BSMT?: MEZZ?: REDO
FLOOR LOAD. . . . : p5f LEFT fI: PGHT: ft FIR SPKI-.: SMOH AFT. .
DWELLING UNITS: FRNT: ft REAR: 10 ft FIR ALRM: HNDICP ACC:
BEDRMS. PATHS- IMP SURFACE: PRO CORP. PARKING:
WA-UE.. f : 10:104
,1
Remarks: 224 SO FT ADDITION TO EXISTING HOME
Owner: __......_.___....___..._. _._..__. ..._.._ _._. _.._ _-_.._ . ... ........ _.______ .._.._.__._._...._..- -.__.._.__.____.. . _�.__..
I`F'FY'
RALPH CAIRREY type amaur,t by date reept
1562'75 SW SUMMERFIELr I.-H PRMT I. ,TFC 013/07/92 --
PLCK $ 56. 2: JLH 07/10/92: 2 ��>
s TIGARD nR 97224 5PC:T $ 4. 3.3 .IH 08/07/9L:
[. Phone #t 684-1619
Contractnr: _._____.._.-•---______.._.__.�.__.�__�.__-__
OWNER
F'
Phony' Lt: < 147. uhf• 1 OTI'.+L
Rep #. . : 00000
RFDU I RF:D I NSPErT IONS
'his pertit is issued subject to the regulations ronteined in the Foot/fot_tnd Inspa
'►yard Municipal Cede, State of Ore, Specialty Codes and all other Fram i n u I n si p
:;ool icable laws. All work will be done in accordance with I n tr I -t t i n n I n s p
r^proved plans. This pertit will expire if work is not started Gyp iXoard Ins4:r
iithin idA dans of issuance, or if work is suspended for more Rain drain I n s p
than 188 days. Final Inspection .......
' 'ermitte,e Fic3naturee
lssi-ted By:
f0, inspect inn - �-39-4175
i
f
1
CITY OF 1 .�lJ C1�.`.� 111' Box 23397d PLNCK/RECT # -z -� f�
PERMIT #
COMMUNITY DI:'VIsLOPMI?N't DEPARTMENT
Tipnl Oregon 97113
(503)639-4171 DATE ISSUED _
SOB ADDRESS: TAX MAP/LOT 2,5Z 'll1Q –oleao
SUB: �it /?�4 LOT: LAND USE:
VALUATI N: �1� O
>t
OWNER SPECIAL NOTES
NAME: e-<40t--, REISSUE OF. _
ADDRESS: / S -��� ����.ar�r�r/�%��'� LAST REISSUE:
FLOOD PLAIN/
PHONE: _z�' — _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: ���/,�J�r. _ _ PLANNING: 0e77yPG7
ADDRESS: ENGINEERING:
FIRE DEP''i:
PHONE: OTHER: t)V Tir -SPG
CONTR.. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCJNTRACTORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: BUS TAX:
Apal_, ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: _
COMMENTS:
Ali ANT SIGNATURE
Received By: _ _ Date Received:
I
I
PERMIT N ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
&L7g`o210 10-432 00 Building Permit Fees 860,SU'
10-431 00 H umbing Permit Fees
10-431 01 Mechanical Permit Fees ,�
10-230 01 State Building Tax (5%) 4_.3 3
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee f6-
Building
•Building 5. 4-
Plumbing —
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
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 Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-415-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL r0 (o B3
nm/3587PYPF
C,.
i