Permit � CITY OF TIGARD REROOF PERMIT
• t - COMMUNITY DEVELOPMENT
Permit #: RER2011 -00019
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
... Parcel: 2S102BD01503
Jurisdiction: Tigard
Site address: 12750 SW PACIFIC HWY
Project: Village Square Offices Subdivision: FREWING'S ORCHARD TRACTS Lot: 1
Project Description: Reroof, tear -off and replace.
Contractor: J VAUGHAN INC Owner: GOSPODINOVIC, ROSE MARY
2092 NW ALOCLECK DR #512 REVOCABLE TRUST
HILLSBORO, OR 97124 12770 SW PACIFIC HWY
TIGARD, OR 97223
PHONE: 503 - 690 -1807 PHONE:
FAX: 503- 690 -9905
FEES
Description Date Amount
Permit Fee 11/30/2011 $940.29
Specifics: 12% State Surcharge - Building 11/30/2011 $112.83
Type of Use: COM
Class of Work: OTR Type of Const:
Occupancy Load:
Stories: 2 Height: 0 ft
Project Valuation: $77,500.00
General Information
Building Area: 0
Re - Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $1,053.12
Required Items and Reports (Conditions)
i
This permit is ed subje • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in - ccordance with app •.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 ENTION: Oregon law r= •uires you to follow the rules adopted by the Oregon Utility Notification Cente Those rules ar- set forth in OAR
952 -00 -0010 t ,ough OAR 952 - 001 -00•s. 'o m- tain a copy of the rules or direct questions to OUNC by calling 503.232. =87 0 1.800.332.234.
Iss ed By: /, �j / / , Permittee Signature:
At/
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 completio of the project.
Approved plans are required on the job site at the time of each inspection.
Builtling Permit Application
•
Re-Roof , -iitin:OF*icE4100.Ntivf',...-,„.
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'• L :''' ' '' '''' ' : P 7 City of Tigard Perorrt NO.: kide;C/A-CM1
13 SW Ilan Blvd.. Tilqard, OR 9722.
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'Phone 501718.2439 Fax: 503.598.1960 I Dme li!, O errrat
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'.,:,.:,'' In trction 1 ine- SW 519 41 ! DWI: Reir...1\ trio.. Kin: 1 53 See Page '1 for
Internet: TTG:Altu.., 5. L -: ' '); - .
v, 1 NotitiMAtaitted: 1 Supplemental Information
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TYPE 01:' wOkK „ - ' 1 .11EQ01kEt6AI4 i 1 .AND. 2:FA ',.t1 i.-Y l) \ V}1 :1,ING.
New construction I 0 Demolition l, Penult fees* are based on the \able of the work performetri
Indicate the value 4 rounded to the neareFt dollar) of all
1 VA i
/
Additionnt:era l
' frepaceme
0 Other: I i equipment. materials. labor. merhead. and the profit Mr the
O , , . I work indicated on this application.
f CONSiRt lel IO N , .:
I I Valuation: S -- .4 111: f44 - • ---- 1
0 I- and 2-family dwelling I tA-Commercial -
1 1 umber of bedrooms:
, 0 Accesso bu
ry ildin g I 0 Multi-family ...,
1 Number of bathrooms: ..,
:
0 Master builder 0 Other: ;
JOB, st i t IN:FORMA flON AND LOCATION : — I •: 'Iota' number of' -
11 '-'urs-/
x
Job site address: 2. 7 o
New dwelling area/
I I 5 sp.) po. , c. ; f t - e- bloolf -
-r--- I New feet .1
....--
Cit /
StateiZIP: 1" i 0 0_ c 7 2,7 3 1 Garage"carporKirea:
square feet
1 Suitehldglept. no.: 1 Project name: 1,4 Oa., . 5. ,,,.„,i 6 Ff 3 i i Covered ptIt area: square feet
1
i
Cross
I C streetidirections to job Site: xr .. ' ' c. k c, z ; ( t. I- . ' .7 Deek at:ea: square feet
I l Other structure area: square feet
liE4`,W.tRf.VDATACCi7,;18:1tRClA11.„0.S E:C14 EC k.11:ISTZ- : J
Subdivision: ' Lot no.: Permit fees are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
It Tax man(parcel no.:
equipment. materials, labor. overhead. and the profit E the 't
i ,:•YOR,K''' r .., . ,-•;_: ! '-I-: ;' '.: .::' :::::-, :I work indicated on this application. I
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11 fa...) r,,,,, ,,,t- 015 ' 4 —1/ V a l uat i on: --, i I auation: s - 7 7 5 -4) 0
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,_ _ . 1 F.xistine build* area: 2 /,, ,ro square feet: Roof;
..
i Nev. building area: _.------ square fect
i:j4liOkitiikON :-, ::, . ::.: -- . :,,,b:-tikANi:.': ,: : ''. Number of stories:
I Name-. l Type of construetion: I
Name:.
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Address: I Occupancy groups: ,i A
1 City!StatcqIP: I
Existing:
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Phone:( ) i i
Fax'. ( ) I
i New;
0 APP1IC.A1NT': h : '-:: '...'.,:.`., '.:1 t!.0.NTitrl".:PER.SoiN•
Rosiness name: 4 4.43 1 1 A ., , -2., , i All contractors and subcotttractors are. required to be
Contact name
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e-, I licensed itith the Oregon Construction Contractors Board
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. „_..) 4.54- V d $.4 311 a ,....
under (IRS 701 and mat be required to be licensed in the
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I -Addr 5',.5 tf,....ert:..4 i jurisdiction in which work is being performed. If the.
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City/StatelZIP applicant is exempt from licensing... the follOwing reasons
: C. t , :
I apply:
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' Phone: (5 )) 3/ 2, .r3 I Fax: : ( i I I
1 E-mail: ' et340-1 • V a ( ',... " 1 -'‘.› .
CONTRi( TOR'
Bus iness name li ‘4.5 e.
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,:111i1L,MING 11T1011f
Address: 2- & iti ir A /0 C /E CV. I 57 2-: l L. ' - alease refer Mfee si-heihrie:t
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— i Structural plan review fee for deposit): 1 I
CityiStatert_IP: )4.,-if b 0 , 0 0 a ' 7/ 1- '''.
Phone: (4.03) (O ix:13, t 9D - e,e, 0- ,
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Fl S plan rc..view fee fir applicable): I
CCB tic.: ? ? Y ) t :34/ i !
i Foud fees due upon application: I
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Amount receit en: ! 1
Authorized sil2nature. , ' 5 , 611/ This permit application expires if a permit k not obtained
----7 within ISO days after it has been accepted as complete.
Print name: 1
--, elk..10'" 411 jt.L., L 4 el .1
I Date: II 2 7 t' 1
* roc nvihodoloay set to 'Fri-County Building Industry