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Permit CITY OF TIGARDIII REROOF PERMIT i Ai I COMMUNITY DEVELOPMENT Permit#: RER2022-00017 Date Issued: 4/25/2022 T I•G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 110DC01000 Jurisdiction: Tigard Site address: 11130 SW MEADOWBROOK DR 1 Project: Summerfield Re-roof Subdivision: WILLOW-BROOK-FARM Lot: 17 Project Description: Re-roof:remove and replace(2)layers of asphalt shingles and install new Certainleed Landmark asphalt shingles roof system Contractor: CARLSON ROOFING CO INC Owner: SUMMERFIELD ASSOCIATES LLC PO BOX 1695 BY GREYSTAR RS NW LLC HILLSBORO, OR 97123 1125 NHW COUCH ST STE 450 PORTLAND, OR 97209 PHONE: 503-846-1575 PHONE: FAX: 503-640-2122 FEES Description Date Amount Permit Fee 03/01/2022 $464.97 Specifics: 12%State Surcharge-Building 03/01/2022 $55.80 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Load: Stories: Height: 0 ft Project Valuation: $25,041.00 General Information Building Area: 0 Re-Roof Area: 0 Roof Class: Tear Off: Overlay: Existing Roof Layers: Parapets: Total $520.77 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Hc-t.y Va-w Dew Wege, Permittee Signature: Qw A Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. _. _ Building Permit Application CEIVED (to Re-Roof DEC 2 3 7_OZ1, FOR OFF1( F [SIT 0y1.1 City of Tigard Ct �± Received \ \` 2 2 Permit No.:Re'2Zozz_cxxDo III 13125 SW Hall Blvd.,Tigard,OR 97223 ITV OF TIGARD Plan Rev �+ Plan Review Other Permit: Phone: 503.7I$_2439 Fax: 503.598.1960DILDINr DIVISION' Date/BY: Inspection line: 503.639.4175 Date Ready/By: \\\\\2Z eys-cs t. r 0 See Page 2 for 1 1 C;P,I:I? Notified/Method: \i •.• Supplemental Information Internet: www.tigard-or.gov 2 TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DWELLING 0 New construction ? ❑Demolition Permit fees*are based on the value of the work performed. - Indicate the value(rounded to the nearest dollar)of all 1'N Addition/alteration/replacement 1 ❑Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1-and 2-family dwelling aCommercial/industrial Multi-family Number of bedrooms: ❑Accessory building y ❑Master builder Number of bathrooms: [3 Other: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: It 20 151,V 1 I ubf O f , New dwelling area: square feet 1 . City/State/ZIP: , - Q 9129.q Garage/carport area: square feet Suite/bldg./apt.no.:illy-it Project name:So oMtA Q'.1A `ill,' Cc,z Covered porch area: square feet - Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF W ORK ```` work indicated on this application. Q.+jAoki : A1.0b Q Qfi \ `T ak►n�leS I Valuation: $ �� \ �\. (1(2- `) ao c.\ '` Existing building area:.5`DO square feet i �s c ©� 1 �e�. New building area: square feet S�`>Q\Rt3,� 5 �i 0 PROPERTY OWNER © TENANT Number of stories: nn [t�_� n � n t Name: �~Z 1�,.tt��c1t'1l�l"�� Type of construction: Q- Aso(� Address: k� 1v 0 ,?..A. u e Li f 4,1 Occupancy groups: City/State/ZIP: I*c ( ql`.o� Existing: Phone:(E ) L q t ..`. t si Fax:( ) New: APPLICANT 0 CONTACT PERSON NOTICE Business name:os's A. Ck t.f CO 0,,,9ri{1,',j l(1 o All contractors and subcontractors are required to be Contact name: Ev`Z� s `n _ licensed with the Oregon Construction Contractors Board under ORS 701 and maybe required to be licensed in the Address: ,, �.1� "�1,� ak., 1 I x k t„,6- jurisdiction in which work is being performed.If the applicant is exempt from licensing,the following reasons City/State/ZIP: *A1,5 Ci.1- ‘2:1 apply: Phone:Stki. sgiAG, t ( I Fax::( �y) E-mail: O,oi c� C 1, c t- • co(r\ CONTRACTOR Business name: �c r� /� f \, BUILDING PERMIT FEES* Address:,, L�1YV 1" hp` 4 't. (J C''sX � ttz teviewfee( rdsschetuk ). Structural plan review fee(or deposit): City/State/ZIP: `♦{�t{‘ r 1 t cri1�, FLS plan review fee(if applicable): Phone:( ) s l� l5-3 6- Fax:( ) Total fees due upon application: t CCB Iic.: i Vei G q t, Amount received: Authorized signature: A WAT 1,% This permit application expires if a permit is not obtained J, x,L,�p cl2.c 1 u ja 2a ac .J within 180 days afterit has beenr acceptedBu as complete. Print name: u Date: * Fee methodology set by Tri-County Building Industry VAT Service Board. I:\Buildmg\Pezmiu1ROOF-PermitAPP,dOt 10/01/09 440-46131111/02/COM/WEB)