Permit CITY TIGARD BUILDING PERMIT
" = " '�` ' PERMIT #: BUP2008 -00125
J ° - . COMMUNITY DEVELOPMENT DATE ISSUED: 4/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111CD -04100
SITE ADDRESS: 09500 SW BRENTWOOD PL ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.9 LOT: 500 JURISDICTION: TIG
PROJECT: SUMMERFIELD
Project Description: Reroof, remove and replace. This permit is for addresses 9500, 9510, 9520, 9530 & 9540 SW
Brentwood PI.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: ME SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 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: $ 31,034.00
Owner: Contractor:
ARCHIBALD, BESSIE W TR INTERSTATE ROOFING
PO BOX 146 15065 SW 74TH AVE
DUNDEE, OR 97115 TIGARD, OR 97223
Contact #: PRI 503 - 684 -5611
Phone: FAX 503 - 639 -3056
Reg #: LIC 55485
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUILD] Permit Fee 4/16/2008 $266.08
[TAX] 12% State Surcha 4/16/2008 $31.93
Total $298.01
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 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
Issued B J� : - ' . i ' Permittee Signatu • . �, � `L I , .._/
Call 503.639.4175 by 7:00 a.m. for an inspection that business 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.
t
' Re -Roof
r! - -.
Buildin2 a�''ermit Application ® i olz of i ici usE one .,,
City of Tigard
ece‘J‘;-; Received Permit No.: /
13125 SW Hall Blvd., Tigard, OR 973 Plan�Review /
DatBv: ( o e �u '/ 'ate /a
Phone: 503.639.4171 Fax: 503598.1960 `) �� * ?//1 h Other Permit:
Q �ilr',;'JJ I y
Inspection Line: 503.639.4175 . AP R a . s'1 � Date/By
Date Ready /By; tu H :
Internet: www.ci.tigard.or.us � Notified/Method: �/L a Supplemental See Page information
VOA t pAS,py
!� rrsn®857�"'�
TVg. a ~WORK ,. • •,. ;:. :,: " ��;LLREQUIREDDATA 1 : AND;2- FAMILL'.DWELLING .
12 New construction ✓ 4 ❑ 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 tm Other: equipment, materials, labor, overhead, and the profit for the
•_ _ -•. ; , CATEGORY`.OF CONSTRUd'ION.? : „ •µ, „ • wor • indicated on this application.
❑ 1- and 2- family dwelling El Commercial /industrial Valuation: $
ID Accessory building El Multi-family Number of bedrooms:
❑ Master builder IN Other: Number of bathrooms:
JOB' SITE ; INFORMATION:,AND'r L OCATION `'`' , „ - ' •' ' Total number of floors:
lob site address: 95Cj D ?S f/0 L 3 7 f 7 0 t p L A New dwelling area: square feet
City /State /ZIP: 77 0 R. / p ` j eri. , 5 7 7 Z Y Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 5 to /wry• j--( t 5' ez., 0 Covered porch area: square feet
• Cross street /directions to job site: Deck area square feet
9 500, 95 /o i 95• 995.5o a ' L 55/6 Other structure area: square feet
REQUIRED DATA COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
R L ~�'LG� Valuation: $ 3/ i) 3 (/
L°,4 L e / ,�F1AIC 7Z> /; - cic - L� / l
AO /(3, /„- L L7— FL.,, _ 5li ,� /` :s Li mi t 5 3 r ei - ' Existing building area: square feet
C i 5 f/ t - ey 5 / -f' L c�- L gA,�,4J New building area: square feet
W., PROPERTY,, OWNER .. »?® - TdENANT .= Number of stories:
Name: 5 l „ l ,`9 ER/ c O ASSci C1..4 76 , 3 Type of construction:
Address: Occupancy groups:
City /State /ZIP: • Existing:
Phone: ( ) . Fax: ( ) •
New:
AnPPLICANT ” ^`: + ® <:CONTACT PERSON`' r
Business name: /A) ` /Z l L i q r.:2 /1i 6 All contractors and subcontractors are required to be
Contact name: /` / 6P „1 L =L . �S 5 b3 _- 8� _ A ye. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7i/ 4 vg„ jurisdiction in which work is being performed. If the
/ 7 `/ applicant is exempt from licensing, the following reasons
City / State/ZIP:
f OR ILA, ,0 C? / 7 apply:
Phone: (563) &3'4 5-61/1 Fax: : (563 6 3 Y-- 3t, 5f ` y s; o/
E-mail:
. . CONTRACTOR
Business name: i - -- i . Al
Address: l5
`�Tl� Please 5 l./” 7 (� ease refer to fee schedule.
City /State/ZIP: , , — L-A,J !� .2. L�'
,/ / / t ? 6 Fees due upon application
Phone: 1563 C, 8 Y' a b L j Fax: (ej w (c; 3 2'— 3 C;.S (cam
CCB lic.: 5 S" 1 �S Amount received
t
Date received:
Authorized signature:��1 ' ��. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: k L i...5 £5 ,t,j E L Date: * Fee methodology set by Tri- County Building Industry
Service Board.
1: \BuildingWermits \ROOF- PermitApp dec 12/03 440- 4613T(1 I )02 /COM/WEB)
i
CITY OF TIGARD
BUILDING- O`NVISION PERMIT #: BUP2008- 00125
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4 /16/200E
Phone: (503) 639 -4171 " �Ip u�ii � '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/4 /2008 TIME: 7:01AM PAGE: 55
SITE ADDRESS: 09500 SW BRENTWOOD PL CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.9 LOT #: 500 TYPE OF USE:
PROJECT NAME: SUMMERFIELD
DESCRIPTION: Reroof, remove and replace. This permit is for addresses 9500, 9510, 9520, 9530 & 940 SW
Brentwood PI.
OWNER: ARCHIBALD, BESSIE W TR, PHONE #:
CONTRACTOR: INTERSTATE ROOFING PHONE #: 503 - 684 -5511
Inspection Request Scheduled For: Date: 6M/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 070777 -01 503-481-8256 N
Corrections /Comments /Instructions:
/ ((:________
•
•
pkPASS — PARTIAL APPROVAL El CANCEL — NO ACCESS
FAIL ❑ CALL FOR NSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ' Date: 007 Phone #: (503) 718-