Permit •
• d y � � • BUILDING PERMIT
OF T I G " ` ' R1D PERMIT #: BUP2005 -00392
T�l� DEVELOPMENT SERVICES DATE ISSUED: 8/11/2005
Aj. ` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104AA -90191
SITE ADDRESS: 12654 SW KAREN ST 19 ZONING: R -12
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUMS LOT: 019 JURISDICTION: TIG
Project Description: 2nd layer roofing shingles.
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: UNK : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 4,000.00
Owner: Contractor:
MOZINSKI, STEVEN P RELIABLE HOME IMPROVEMENT, INC.
ZAKOCS, EDWARD JR PO BOX 13692 •
PO BOX 189 PORTLAND, OR 97213
YAMHILL, OR 97148
Phone: 503 - 662 -3010 Phone: 503 - 481 -0240
Reg #: LIC . 00048637
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 8/11/2005 $6.54
[BUILD] Permit Fee 8/11/2005 $81.70
Total $88.24
•
•
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 By: . fL/ . 71C> Permittee Signature: s
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.
Re -Roof
" Building P AP.plication t° ~ma FOR OFFICE USE ONLY
City of Tigard Received _ I---D //)2,__ Permit No
13125 SW Hall Blvd., Tigard, OR 97223 : 't Plan Review � 1 � � � 3 ,
Phone: 503.639.4171 Fax: 503.598.196UV'J 1_ - 2005 //Hiar:llhp� ! it1' I+- Date/By. Other Permit:
Inspection Line: 503.639.4175 * -'! 1� Date ReadyBy: ® See Page 2 for •
Internet: www.ci.tigard.or.us CITY OF rIGPIRD Notified/Method: Supplemental Information
r,r nl n_ iNG DIVISION
y TYPE. OF WORK . REQUIRED DATA: 1- AND'2- FAMILY DWELLING ,-
❑ New construction 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El m
1- and 2- family dwelling ❑ Comercial /industrial Valuation: $
1:1 Accessory building 8- Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
° - JOB - SITE,, INFORMATION AND LOCATION , Total number of floors:
Job site address: A (2s1.1 Ski A,- )4 2 4 ::_ rY _ New dwelling area: square feet
City /State /ZIP: ,• i 7 g O 12 c 7 Garage /carport area: square feet
Suite/bldg. /apt. no.: l Z(. y Project name: d e 4. ✓ ,,, r Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
r
/072,5 Z / S ,e fir/ - Other structure area: square feet
REQUIREDHATA: COMMERCIAL -USE CH ECKLIST
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.
p �d - n Valuation: $ (- "' g )
` Existing building area: square feet
New building area: square feet
° "-,�. PROPERTY, .OWNER . , _ ` - - ❑- TENANT Number of stories:
. Name: G` n 7 4 rc, • Type of construction:
Address: /) • U • /3 (k Occupancy groups:
City /State /ZIP: )f 0._L[, o (2 , Existing:
Phone: (.so)) (P 4p-3 o!D Fax: ( ) New:
❑ APPLICANT . B- CONTACT PERSON NOTICE
Business name: g E L ; q 0h. ,L/O»t.e � �aALentc.� All contractors and subcontractors are required to be
Contact name: �°� ��/t/ licensed with the Oregon Construction Contractors Board
/ under ORS 701 and may be required to be licensed in the
Address: p , d . 13 / 3 1-J? jurisdiction in which work is being performed. If the
City /State /ZIP: poja ('- 4-N f") 1 2_ applicant is exempt from licensing, the following reasons .
apply:
. Phone: (j' 3) ' f 3 ' ( - d?. f a Fax:: ( )
E -mail:
CONTRACTOR
Business name: r f eJ 63 LF /jaw s -4iti► D R��, i J y JNv BUILDING PERMIT FEES*
Address: / , u , 43 o ) 4 - i3(.;
P /ease refer to fee schedule.
City /State /ZIP: /, p f Z_ / -- 1h 0 G
/ Fees due upon application
Phone: (> a 2 ) cti. 0./ -- a a l Li Fax: ( ) Amount received
. • CCB lic.: 1 77 63 7 , P., v ` 29 6 W -
Date received:
Authorized signature: This permit application expires if a permit is not obtained
, within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building Wermits\ROOF- PermitApp.doc 12/03 440- 4613T(11/02/COM/WEB)
City of Tigard: Re- Roofing Permit Checklist '
Page 2 - Supplemental Information
RESIDENTIAL (One- & Two - Family Dwelling)
❑ REPAIR (major) plan review required by plans examiner:
building permit is required when structural changes are made or the space sheathing is
removed or replaced.
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 not more than two (2) layers of
roofing will exist upon completion of the re- roofmg.
COMMERCIAL (includes multi- family and condominiums)
❑ RE -ROOF: Pre - inspection is required for all roofs sloped 2:12 and less. Please make
an appointment by calling the inspection line at (503) 639 -4175.
E PLAN REVIEW:
Note: Depending on the conditions noted at the pre- inspection, plans may be required
to address any non - conforming items.
VALUATION OF PROJECT: $
sq. ft. 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 and
special purpose roofing of commercial projects.)
• TOTAL: $
I:\ Building \Permits\ROOF - PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200S-00392
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: a/1 1/2005
Phone: (503) 639 -4171 A illtiii j �*
Inspection Requests (24 Hrs.): (503) 639 -4175 .' `'' �..
INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7:07AM PAGE: 71
SITE ADDRESS: 12654 SW KAREN ST 19 CLASS OF WORK:
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUM; LOT #: 0.19 TYPE OF USE:
PROJECT NAME: BELLWOOD TERRACE CONDO
DESCRIPTION: 2nd layer roofing shingles.
OWNER: 1v1OZINSKI, STEVEN P, PHONE #: 50x,.562 -3010
CONTRACTOR: RELIABLE HOME IMPROVEMENT, INC. PHONE #: 503 -481 -0240
Inspection Request Scheduled For: Date: 9/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014861 -01 503 -401 -0240 Y
Corrections /Comments /Instructions: Mk?'
tr,310
•
SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FO)INSPECTION ❑ ADDITI• AL • EES ASSESSED s" Inspector: Date: / Phone #: (503) 718-