Permit CITY OF TIGARD REROOF PERMIT
_ COMMUNITY DEVELOPMENT Permit#: RER2022-00019
T I(;ARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/25/2022
Parcel: 2S110DC01000
Jurisdiction: Tigard
Site address: 11210 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 $423.53
Specifics: 12%State Surcharge-Building 03/01/2022 $50.82
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
Project Valuation: $22,586.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $474.35
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: Hothj Va+ti Pe- Wee- Permittee Signature: Ow AYpn t't' ,
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.
Builtrlin Permit Applieatio I V E L,
allo
Re-Roof wiz OrFI('FI ,E0\1,A
DEC 2 3 2021
City of Tigard ReceDate/By: \\\\\ZZ �V PerauitNo.:RZRZo.2.-oe�aIel
't 13125 SW Hall Blvd.,Tigard,OR 972 iITY OF I IUHHL NPlan Review Other Permit
;' Phone: 503.718.2439 Fax: 503.598. DateB}<
1 ��14.DING DNISI01` DateReadyBy: \`\\\ZZ eirc•lel 7 : ta See Page 2for
1 1 c;:1l:I) Inspection Line: 503b39.4v75 Notified/Method: �� Supplemental Indrmadon
Internet: www.tigard-or.gov Q1iZ�nher+--
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
Demolition0 Permit fees*are based on the value of the work performed.
New construction Indicate the value(rounded to the nearest dollar)of all
Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION Valuation: $
[]1-and 2-family dwelling [a,Commercial/industrial
Number of bedrooms:
❑Accessory building Multi-family
Number of bathrooms:
0 Master builder 0 Other:
dOB SITE INFORMATION AND LOCATION
—
Total number of floors:
t a.ke 6� t ,h- k b fic.vc 0 c' New dwelling area: square feet
Job site address: t,J '"14+ j��,U -
City/State/ZIP: '1-lit cps-$ 0 a, q nil Garage/carport area: square feet
Suite/bldg.apt.no.:I IZiO-11 , roject name:So co. eNA ' Q,-'c DQ 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 WORK work indicated on this application.
Valuation: $ ,�
�,.,,.\ ,, Q�. ��,� Existing building area: square feet
k1c` c °o`` Q� New building area: square feet
[�
Q QhU" PROPERTYism OWNER f�} 0 TENANTNumber of stories:
Name: (NU.;) >C1\yk--\\w e&' U Type of construction: - °C4f)0 p
Address: 4, a C 53 c.
[} 4S .i .6' e• L J OccupancyOccupancygroups:s:
City/State/ZIP: tip cc QI�... l,rc.®q Existing:
Phone:EARLi59, -c)q'"Li] `Fax:( ) New:
g APPLICANT 0 CONTACT PERSON NOTICE
1 Business name: .Q \S`Cyn,�jt:&. All contractors and subcontractors are required to be
Ct1.�'nclti,\-I (>
� Y licensed with the Oregon Construction Contractors Board
Contact name: L. t C 19.c�1' L • �' under ORS 701 and maybe required to be licensed in the
r b0 eW , i _ / p jurisdiction in which work is being performed.If the
Address: ,� (�" �Q C`3 [.�y_ «ram i applicant is exempt from licensing,the following reasons
City/State/ZIP: VAS\In Oct.. -L T k vt,. MAY:
Phone:t 4-0,,1 tgr(, �M @Q CM: 1( 1 Fax::( )
E-mail: (�.rl9v C M � }(\SC" 4 .(Or \
CONTRACTOR A
Business name: �"�b6/p�,� ��1c i c\,i (}b.Y\QQ��1'j Iac., BUILDING
I LD G se PERMIT
EES*
Address: I" Q`Q CJS a C V i"t 1C r('n Structural plan review fee(or deposit):
City/State/ZIP: c Q 10 "{ 12,Z
FLS lam review fee(if applicable):
k\ P
Phone:c_rta g Li Le 16-35 Fax:( )
Total fees due upon application:
1 G �cry
CB lie.: � Amount received:
Authorized signature: +s ; This permit application expires if a permit is not obtained
i//'� � /+
Print-;;;;;;El? l within I80 days after it baa been accepted as complete.
(�JI„Llll...+XXC!!!!llC �• 'ate: 12- -� * Fee methodology set by Tri-County Building Industry
! Service Board.
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