Permit CITY OF TIGARD REROOF PERMIT
11 ... COMMUNITY DEVELOPMENT Permit #: RER2010 -00018
T I G A R L7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2010
Parcel: 2S 102 DA00701
Jurisdiction: Tigard
Site address: 13405 SW HALL BLVD
Subdivision: Lot: 0
Project: Tigard Christian Church
Project Description: Remove existing roofing and install newTPO membrane over 1/4" Georgia Pacific Densdek.
Owner: FEES
TIGARD CHRISTIAN CHURCH Description Date Amount
13405 SW HALL BLVD Permit Fee 09/30/2010 $553.13
TIGARD, OR 97223 12% State Surcharge - Building 09/30/2010 $66.38
PHONE:
Contractor:
BOB CARLSON INC
PO BOX 63
HILLSBORO, OR 97123
PHONE: 503 - 640 -3623
FAX: 503 - 640 -4840
Specifics:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
General Information
Building Area: 0
Re -Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $619.51
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 acco • - •• - - : •ved 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. A ' TION: Oregon law req. 'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -e - -0010 through OAR 952 -001 ! i s Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I sued By: k y Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that b iness day.
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 FOR OFFICE USE ONLY
City of Tigard r�`, \•{D Dat 7 . %� / Permit No.: / / 4 ,4 D.. ��I •
13125 SW Hall Blvd., Tigard, OR 97�}1CD vv BD Plan Review
Phone: 503.639.4171 Fax: 503.598x906' ier oovo ,•; DateB : Other Permit:
Inspection Line: 503.639.4175 '• ) .../.14,. ^'I I I Date Ready/By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us V
_ ® t Notified/Method: Supplemental Information
C
Y r�s vjy REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction 'BOLD 133 ❑��'Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement g Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I- and 2- family dwelling Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 3 q j S) /*a , /// New dwelling area: square feet
City/ State/ZIP: T ., /3 / 92 9 7.2 2 Y Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Ts>/}.j,a( 4 `Ie, , rc4 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.
RteAr ✓e g / s Ti.J y a �i.v fie- ..Z.cT -MiC 6 Valuation: $ .3 j, 3 g-
/VF�J
Tie c9 £�4a E .®U Existing building area: �� p square feet
%' if /e 04- , /`` Ojs_04-4 /4 New building area: square feet
IS PROPERTY OWNER ❑ TENANT Number of stories:
Name: r/9 a/ p/ e4 ..• • �j t eh-ee/' Type of construction: c rx u
Address: / / j 4 /0f' s CAS /1L1.4-[,L /3l ad Occupancy groups:
City / State/Z)P: .70ryg C / / eft - 972247°' Existing: e 4,„ A .....4
Phone: (So,) /, 3 q _91 7 Fax: ( ) New:
't APPLICANT ❑ CONTACT PERSON NOTICE
Business name: fI 0 3 CA- - �, ( 1 - N c All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: A,,,g C 4-4._ L s" under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: apply:
PP Y:
Phone: (SU3) ', o - j(o1-3 I Fax:: (3--‘03 )Gyd -� �d y � 5 . /
E -mail: �
CONTRACTOR 7
/h r„,/,- Business name: 13(9 c2 , c BUILDING PERMIT 41q.
EES*
Address: )7p /01C 63 Please refer 10 fee schedule
City/State/ZIP: Az 0/10 / o 9 7 /
Fees due upon application
Phone: (.$v3) ( 2424 Fax: (. t3) ego -6
Amount received
CCB lic.:
Date received:
Authorized signature: „�Q_ / / This permit application expires if a permit is not obtained
/ `W �/ within 180 days after it has been accepted as complete.
Print name: 7() e. (-v a,. Ls�/t- Date: 9/2 y //O * Fee methodology set by Tri - County Building Industry
Service Board.
i:\Building\Permits\BUP•Pe mitApp.doc 12/03 440- 4613T(11 /02ICOM/WEB)
Building Division
��y *��rr Plan Submittal Requirement Matrix
"'I I� Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03