Permit ,.
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00512
' ' DEVELOPMENT SERVICES DATE ISSUED: 8/26/03
�° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11850 SW GREENBURG RD PARCEL: 1S135DD 04300
SUBDIVISION: ZONING: R -
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: R1 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:
Remarks: Reroof of tri - plex, remove old roof covering and replace with new.
Owner: Contractor:
PATHFINDERS HOMES INC ALLSTATE ROOFING & CONSTRUCTION
20055 SW PACIFIC HWY STE 105 190 NW GIESE AVE
SHERWOOD, OR 97140 GRESHAM, OR 97030
Phone: 503 - 625 -9151
Phone: 503 - 661 -3586
Reg #: LIC 149289
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 8/26/03 $100.90
[TAX] 8% State Tax 8/26/03 $8.07
Total $108.97
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
requi es ot..rollOvv, he rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through • i R 952 -001 -I 00. You may obtain a copy of these rules or direct questions to OUNC by
. Iling (503) 246 -6699 or 800 -33 #
I . ued By: ' .i4 r / .i �. /'
Perm' -.
Signature: I.'"
Call 639 -4175 by 7 p.m. for an inspection the next business day
Re -Roof .
FO OFFICE ONLY.
Bui tiling Permit Application
Date/By: / � � - Building /,1 d r0-e5057.2 a5
�1 l Permit No. f�
City f Tigard Planning Approval Other
y DatDate/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 / �na"MiiIt i ( i i " Post- Review Land Use
Internet: www.ci.tigard.or.us ' Date/By: Case No.
g Contact J ' ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: J Supplemental Information
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New construction El Demolition a: 41 1 D�I I� —i �v
g Addition /alteration/replacement • ❑ Other:
g = .n 0I '` OVIIMO SMOVI ONE ' _ ` ,,.= I Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application. '
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
r`�"'� Pr F� , No. of bedrooms: No. of baths:
�,��:*� �'OB S1�EE k '_ x 0 '��21VIATf_SN.�anc1��O��:T;i0�1 �� :
Job site address: Total number of floors
(� S SO Sias c v e Pra h u r_, /' V New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: Covered porch area (sq. ft.)
Cross street/Directions to job site: / 6/ pc , 0c. Deck area (sq. ft.)
Other structure area (sq. ft.)
Hoot elvo
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Subdivision: Lot #: ow 's�.`y"d��:§"��. w�.�t.�`f., ��° a� s�. sris�� '�?"��;.'�"w.�"k::'R�ii�:� wa
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
`" t. •` =g s WV:t, "' 7,,a the value (rounded to the nearest dollar) of all equipment ,materists;'labor•,
overhead and profit for the work indicated on this application.
Valuation ( $ 6
Existing building area (sq. ft.) /
New building area (sq. ft.) �/
Number of stories
g Bo � fR®` 'RM R" iti i 1 E .T "' ' ' � Type Y�(QVE!1V�`�_;i�;€ .€ �.� LAN:: � ��..�,.� _ .�€� YP e of construction
Name: Occupancy group(s): Existing:
New:
Address:
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
P t C - °' `= � '' " "' ' ' provisions of ORS 701 and may be required to be licensed in the
Business Name: 4 0 s f 4 e K ()ra f., ii A c h jurisdiction where work is being performed. If the applicant is exempt
Contact Name: if ; J from licensing, the following reason applies:
Address: / 90 fw (1'e S -e 411
City /State /Zip: GY,sh,, n L t2R q7o3o
Phone: (So 3) ((, /- .?,5 9(o Fax: (So3) x(74- yi3 Ir,...,A - - ,:itsw w `v4440: ��
E -mail: ,, ,,, ittI G4TEI M>[ E S* , . 4
�� �� �
_ le ase ` e r4to feeVentdu e_ x
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Business Name: ,416c-{ c oc,c-:fly ri 01,1 rot) 4 f Fees due upon application $
Address: /90 ,vw Gese Av a
City/State/Zip: ? '70 3 O Amount received $
Y P� G re sh � r r � 01
Phone:(So 3) 6 6!- 3ss-, Fax: (5o3) 6 6 y - yi3 9 Date received:
CCB Lic. #: / 4 9 ?
Authorized v Notice: This permit application expires if a permit is not obtained within
Signature: �/. Date: x'4 643 180 days after it has been accepted as complete.
� --
,---1 e2 —s li/ i /Gf *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms\B1dgPermitApp.doc 01/03
RE- ROOFING PERMIT CHECK LIST
RESIDENTIAL ON14 ,Class of Work_, Alteration::- 0 x,... _'. ,_ . , _
❑ 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
I applied).
CO MEWAS ,O LY�� s'Clas ,k. R'A,,,,,,,,;; =
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❑ 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)
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-;S,TE . 2 V- YAROO,F NG ASS,MBLIY l �0 a , § >;:.. ,: .s:
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ate is D,oeurnenfationl;ll3 A e "radix' + 5 ' ��- `,-._� ...., . <y. . taI :. A_ '` . -:;
Please fill out applicable section and attach copy of roofing specifications.
*.,*,. :,`mom `�� � ^r. = "�:'7, - - �.: ;�' � F,; " �b.. t#'�rrd'v:k' ' ° "4..�" --� - rr'°tfl;r °".' =ap 2F.'pf ° - ^;�^ ,c^3,,"z�._• ��.
�
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) , (C rc e �a mplete,'A �. ).. .�, �.� „v - . .. ,.F�. .�,.�;, , �<,� _. � :�.,z �..�. •� _ _� . � t,_t�S..d..- -.,. .. _...: ... -,,.. aL.h.fx ,. _,.3 •b' =:o�- ,,.a? cil ' ° "�`?�,
A. 1. Specification #:
2. Manufacturer: 0, s Croon n,
3a. UL Classification:
Listed UL Building Materials Directory Page #:
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page #:
*COPY OF ASSEMBLY REQUIRED
B. ICBO Research #: F5 Eie ..59
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
(Review required by plans examiner.)
.'.'':,c„vi ,f .AS s; $ * � ..�4 u. 3. ''�`. �'' +E. i^au,',.`:�' ':. „°.,�, *rr .wsx..: >,: .�-. off;
'_ _s�,;-:,.3.,� 3v. � ss`°�ws�:�`�,.., ":w- ... -'• f.;m"��`Y�.»,�'s�� -„ _.�.� -. .� ,.��.. _.': "55'_x.,., _ _.K.�. �.. '� s;,�u..a_.. m�.. >.,,:ura°�:� ,us'.�a4�.- '°saw.
VALUATION OF PROJECT:
sq. ft. of roof area
Permit Fee based on valuation: $ 0� 1
(see Building Permit Fees chart) l
8% State Surcharge: $ U p
- o 7
65% Plan Review Fee:
(Required for major repairs of Residential or
Assembly item "C" above.
TOTAL: $ / 0 • 2. 7
i:dsts \forms \roofchecklist.doc 10/05/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (5 3) f 9 -4175
MST
INSPECTION DIVISION =Business Line: (5 39 -4171 y 3 -OD 6 7 a
Received 4l) 12 33 Date Requested 3/i (/ 4 AM PM 42120 - Or) '9 9
Location //S 5 6 5--'' Suite MEC
Contact Person Pf'i ( . 3 3 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain U I1(1, c ELR
Crawl Drain
Slab Inspection Notes: i 1 % � C , � SIT
/
Post & Beam l C/
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear 6 _ 3e c V _ 7'd,) 4) — d Insulation
Framing `� ( J
[['
Drywall Nailing
Firewall /� 7ieJd — O
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
� - ��
'ART FAIL
P BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer < •
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
4-/
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date Sj\ \/ Inspector \J� �° ® - Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
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