Permit BUILDING PERMIT
CITY T I G A R D PERMIT #: BUP2002 -00197
*Dwai DEVELOPMENT SERVICES DATE ISSUED: 5/21/02
•. °�' �� ` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12753 SW 68TH AVE 100 PARCEL: 2S101AD -02400
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 032 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: UNK TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: it g c i i .'o ,
Remarks: Reroof - permit includes inspection of (6) acrylic skylights
Owner: Contractor:
GEORGE FOX UNIVERSITY COLUMBIA CONSTRUCTION SERVICE
1101 VILLA RD 28395 SW BOBERG RD
NEWBERG, OR 97132 WILSONVILL, OR 97070 -6769
Phone: 503 - 554 -5020 Phone: 503 - 684 -9123
Reg #: LAC 116607
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT CTR 5/21/02 $689.60 27200200000 Ponding Before Tear -Off In
Final Inspection
5PCT CTR 5/21/02 $55.17 27200200000
EXPIRED
Total $744.77
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 than 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 52- 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 00- 332 -2344.
Pe rm ittee
Signature: ���, „„,. . _._._____----
_l
Issued By: t , --e4i'Ll2-e--e----
Call 639 -4175 by 7 p.m. for an inspection the next business day
. A . ' Building Permit Application r
Datereceived:.7 di ' Oa— • AZ)-- 67a f'1
ii City of Tigard
Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:. I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: I, a:7 5 5, t ( P i i - --3-3 - Bldg. no.: Suite no.: d
Lot: I Block: (Subdivision: Tax map /tax lot/account no.:
Project name: 6-Lo - i C fn 1` u IN t Uri h
Description and location of work on premises /special conditions: `i A- M --- )? Pi oF ii - o2.►L
_9•01-i• Q *mil l -2..0 el-
OWNER FOR SPECIAL INFORMATION, USE CIIECIiLIST
Name:((A 9 • i In ( Q�S (Floodplain, septic capacit }, solar, etc.)
Mailing address: 1 (D ( U . ( l (..) t 4,-A 1 & 2 family dwelling.
X City: 1 ti State: p r : 9 i3')- . Valuation of work $
Phone:505 -5 ?OIFax: 1E -mail: No. of bedrooms/baths
Owner's representative: 'an n r te. 1 Total number of floors
• Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: 'State: ZIP; Other structure area (sq. ft.)
Phone: Fax: E -mail:
Commercial/industrial/multi-family: $ SOD
Valuation of work $ /
Existing bldg. area (sq. ft.)
Business name: CO (U, 1 J I A Comf, $e cps -1 --nC • New bldg. area (sq. ft.)
i. , • • -� .1O .. _ - G.,
Number of stories
City: 1)...)11 so n t/ ,1 e s . : Or ZIP: 91 C» 0 Type of construction
X Phone.'w . y Fax: n ,y . .. E -mail:
// r Occupancy group(s): Existing:
CCB no.: (. O� New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: I State: I gyp: exempt from licensing, the following reason applies:
Contact person: Plan no.: -
Phone: Fax: E-mail: MI 011 J ..4 .,
ENGLNEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: IZIP:. Amount received $
Phone: I Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions aoxpt credit cants, please call jurisdiction for more information.
attached checklist. All provisions • laws and ordinances governing this 0 visa 0 MasterCard
work will be complied , whethe • -; fi , herein-or not. Credit card number: Exp'mea
Authorized signature: _ 7 //J/ .! t ' „ Date: S - (- Name of cardholder as shown on credit card
Print name: , if phon r e. eison Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ADlt/COM)
�(4 °� x,11 zzitt
RE- ROOFING PERMIT CHECK LIST
RESIDENTIAL ONLY - Class of Work: Alteration
❑ REPAIR (MAJOR) (plan review required by plans examiner)
Building permit is required when spaced sheathing is covered by solid sheathing and /or
changes are made to roof line.
SUBMIT TWO (2) SETS OF PLANS SPECIFYING:
A. Roof area and nearest street.
B. Attic vents: Provide 1 sq. ft. for each 150 sq. ft. of attic space. Vents shall be located in
the upper 1/3 of the roof. Provide 1 sq. ft. for each 300 sq. ft. when eave and attic
venting is provided.
Note: No permit is required for residential re -roof if, (1) not more than three layers of
roofing will exist upon completion of the re- roofing or, (2) sheathing is not being applied over
spaced sheathing (spaced sheathing usually exists when wood shingles were initially
applied).
COMMERCIAL ONLY - Class of Work: Repair
STEP 1:
❑ RE -ROOF (circle A, B or C):
A. Existing built -up roof covering to be REMOVED and deck repaired.
B. Existing built -up roof covering to REMAIN. Note: Applicant must submit an engineer's
review of the roof structural elements. Review shall bear the seal (or stamp) of the
architect or engineer licensed in Oregon.
C. Asphalt or wood shingle /shake. (PROCEED TO STEP 2)
COMMERCIAL ONLY''- Class of Work: Repair
STEP 2: ' NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix 15)
Please fill out applicable section and a ch copy of roofing specifications.
Listed Assembly (Circle and complet A B or C):
A. 1 . Specification #: 04 S A L L A S " 7 ,,N/ 1 "2
2. Manufacturer: 6, A
3a. UL Classification: G1 'A" 4: 1244 - (PI
Listed UL Building Materials Directory Page #: 11Z f 1'14 p I��aCo
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page #:
'COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
(Review required by plans examiner.)
VALUATION OF PROJECT: $
sq. ft.(,pOO of roof area
Permit Fee based on valuation: $
(see Building Permit Fees chart)
8% State Surcharge: $
65% Plan Review Fee: $
(Required for major repairs of Residential or
Assembly item "C" above.
TOTAL: $
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