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12923 SW LAURMONT DRIVE-1 i N N W Cn a G tj O J rt d h N G N I I gAINCt T.mOt%2nVrJ MS F76ZI CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Picone: 639-4171 Date Requested: — (� I A.M _ P.M. _-- — MS1': j _� C%✓ 0 3 I ocation: 9 1 2— _ L �, -- 1 --^ BlJP: 'tenant: _ Suite:_ Bldg: _ MFC: Contractor: Phone: PI.M: Owner:— Phone: ELC: •ti SIT: _SI _ BUILDING $ �con't) PLUMBING MECHANICAL ELECTRICAL TE Site ost/Bemn Post/Beam Post/Beam Cover/Ser;i%x Sewer/Stonn Footing Roof UndFI/Slab Rough-In Ceiling Water bine Slab Framing 'I op Out Gas Line R-ugh-In UG;sprinkler Foundation Insulation Sewer Ilood/Duct Reconnect Vault Bsmt Damp Drywall Stonr. Furnace Temp Service MISC. Masonry Ceiling Rain Iain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/1'ound Ir I leat Ptmtp Low Volt Approved Approved Approved Approved Approved Appr/Sdwlk No�tA�>)roved Not Approved Not Approved No:Approved Not Approvel �FTIVAL�, FINAL FINAL FINAL FINAL .j ✓Jr __ `' 5~ �!Jl%' C t f�d►�, � d f� z s CBS► O Call for reinsl ti C]tillectio of$ ---required before n•rt inspection l7 t triable to inspect // _ Inspector. D ete:_ r Page_—__ol CITY CSF TIGAR® MASTER PERMIT COMMUNITY DEVELOPMENT D�P4RT4�14T F-ERMI1 #k. . . . . . . : 111ST93-0583 13125&W Hall EPA.Tigard,Oregon 97223.9199 '(503)639-4171 L)c)TE ISSUED: 12/02/93 PARCEL.: IS133DC- 15500 SITE kDDRLBS. . . : 12923 SW LAURMONT DR SUBDIVISION. . . . : VILLAGE AT SUUMMER LAKE PARK ZONING: R-12 SLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 10 BUILDING REISSUE: DWELLING UNITS: l BASEMENT. . . . . . . . :0 sf CLASS OF WORK. sALT BEDRMS.2 BATHSiO GARAGE. . . . . . . . . . ..0 sf TYPE OF USE. . . :SF FLOOR AREAS—,_____—_-- REDUIRED -ETBACKS-----­----------- TYPE OF CONST. s5N FIRST. . . . s sf LEFT. . :O ft RIGHT. -O l", OCCUPAN('.'r QRP. :R3 SECOND. . . : 10011 sf FRONT. :O ft REAR. . :O it STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED— HEIGHT. . . . . . . . :30 ft TOTAL------91000 s SMOKE DETECTORS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ li 1500 PARKING SPACES. . :121 Remarks : COMPLETI14G UP STAIRS -------------------------------------- PLUMBING SINKS. . . . . . . . . _-0 FLOO13 DRAINS. . . . CO BACKFLOW PREVNTRS. . :0 LAVATOR. 13. . . . . .0 WATER HEATERS. . . :0 TRAPS. . . . . �;. . . . . . . :0 TUB/SHOWERS. . . . :0 LAUNDRY TRAYS. . . :0 CA.*CH BASI . . . . . . . :0 WATER CLOSETS. . :0 SEWER 1-INE (ft ) . :121 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . :0 WATER LINE (ft ) . :O OTHER FIXTURES. . . . . :0 GARBAGE DISP. . . -O RAIN DRAIN (ft ) . :121 WASHING MACH.. . . :O SF RAIN DRAINS. . :O MECHANICAL FEES -- FUEL TYPES—-------------- UNIT HTRS. . llO type -imount by date v-ecpt VENTS BPRT b 25. 00 JH 12/02/93 MAX TNPUT:@ BTIJ VENT FANS. . :O BF —C16. 25 JH 12/02/93 FURN ( 11210K . . :@ HOODS. . . . . . :0 B5PC 1 . 25 JH 12/02/93 FURN )=100K . . :0 :ooDsToVES. -LA FLOOR FURN. . . . .0 CLO DRYERS. : 0 BOIL/CMP ( 3HP:0 OTHER JNITS:0 GAS OUTLETS:O Owner--. MARK IJOLD 12923 SW LAURMONT DR TIGARD OR 97224 Phone #: 503-692-5445 Coritt,actair-ii OWNER 11 42. 50 TOTAL This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing Insp applicable laws. All work will `p done in accordance with approved Insulation Insp plans. This permit will rilpire if work is not started within 180 Gyp Board Insp days of issuance, or if work, is suspended for more than INSys. Building Final Per-mittee Signature: Issued BY : Lal I fur- inspection — 639-4175 Permit No: �_— ,� Address: - -- ------ -- �r � Issued by: Dats: •,. • L�___�__ -- FOR OFFICE USE QALY. -------------- STATEMENT: INFORMATION NOTICE TO PROPERTY O NNLRS ABOU'r CONSTRUCTION RESPONSIBI, ITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants 10o are not re,,;stered with the Construction Contractors Board to sign the following statement before the building permit can be issued.This state- merit is required for residential buildir- Plectrical, mechanical, and plumbing permits. Licensed Architect and Engh plicaris, exempt from registration uncles ORS 701.010(7), need not subn statr;ment. This statement will be I filed with the permit. IFill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313: 1 own, reside in, or will reside in the completed structure. 2. i i understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A. My general contractor is - -- Contractor registration number I will instruct my general contract,-)r th?t a;l subcontractors who work on the struc- ture must be registered with the Construction; Contractors Board. OR 3, B.A"t-] I will be any own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- Oin Contractors Board. If I change my mind and do hire a general contrac'.or, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify he office issuing this building permit of the name of the contractor. hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -� JLI .,i Date Kure of er lit Applicant CONSTRUCTION CONTRACTORS BOARD 0244.1 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TC APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONS-'RUCTION RESPONSIBILITIES NOTE: This Information Notice to Property Owners Abort Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 7010.55(5), +� passed by the 1989 Oregon Legislature. It you are acting as your own contractor to construct a new home or make a substantial irtinrovement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas 31 c..ancern. EMPLOYER RESPONSIBILITIES: It you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer" anc: the peopfti you hire will Ido "employees" As the empi4ver, you must comply with the following Oregon's Withholding Tax Law. As an employer, you must withhold income taxes Irorn employee wages o t the time employees are paid. You will be liabie for the tax paym•3nts even if you don't actually withhold the tax from your employecs For more information, call the Oregon Department of Revenue at 378-3390. t)riernployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance putIpo �.as on the 11 wages of all employees. For more information, call the Oregon Employment Division DF at 378-3224. Workers' Compensation Insurance: As an employer; you are subject to t1i3 Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers c ompoi­: (ion insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the j For more information, call the Workers' Compensation Division DIF at 373.7434. i k.) .'; Intetnal Revenue_ Service .As an employer, you must withholl `ederal inconne tax from employees' wages. )"'mwill'be l ab)e for thWtax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 2.21.3960 OTHER RESPONSIBILITIES AND AREAS OF CONCERN. � C'r:io Compliance, As the permit holder for this project, you are responsible for reralving any failure to meet ui( roquirements that may bA brought to your attention through inspections. i_.i�ii iiiity and Property Damage insurance Contact yot,.rr insurance agent to see if you have adequate insurance - rn 0t,rge for accidents and omissions such falling tools, paint overspray, water damage from pipe punt i .io, lire, or work that must be re-done. Time to 5up9.vise Employees. Make sure you have sufficient time to supervise your employees. f Yhe�rti�a Make sure you have the expertise to act as your own general contractor, to coordinate the work 0 rough-in and finish trades, and to notify building officiFils at the appropriate times so they can perform the required inspections. It you have additional quesi,,)ns, write to: Construction Contractors 3oard 700 Summer St. NE, Surae 300 Salem, OR 97340-0151 Phone 503-379-48.1 0244,1 10/24/89 Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639- 1171 I Il IS/ 33.�C- /5500 Jobsite Address: 3 lJ I � Office Use only � bl t i wr-n lM� � ��.K 2 (ko, Lot #Ji� Valuation: _ Permit# Owner: - + �i_ c � )I)J Reissue of Address: Approvals Required _ c. (' � Up Planning ` Phone: _ S2 _ . Engineering Contractor: Other Address: Items Required Suk contractors Phone: -- Tniss NUN Contractor's License # _ (attach copy of current Oregon license) the f ibc,3ntractors: Plumbing: N echanical: _ (attach copy of current OR Cot. -actor's L.icenset ArchltectrEnglneer: Address: Phone. COMMENTS: c,-z`f —S¢uu lica Signature & Phone number Received by: _ __ _ — Cate Received: _ Permit 4 Account Cescripticn Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) Plumb. Permit (PLUMB) _ Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: 1 Mech.- Plan ech:Plan Check (PLANCK) -- Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) Residential TIF (rIF-R) Mass Transit TIF (T!F-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-O) Water Quality (WOUAL) Water Quantity (WQUANT) Fire District (FIRE) TOTALS: