Permit 1
- CITY OF T'IGARD ,
BUILDING PERMIT
/ „ �,� n / DEVELOPMENT SERVICES PERMIT #.......: BUP9B -0355
L'� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/04/98
PARCEL: ES 109DD- 02800
SITE ADDRESS...: 12365 SW KING GEORGE DR
SUBDIVISION....: ZONING:
BLOCK........... LOT .............. JURISDICTION:KIN
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:OTR FIRST....: 0 sf N: S: E: W:
TYPE OF USE...:SF SECOND...: 0 sf PROTECT OPENINGS?---- -
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP.:R3 TOTAL . 0 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: ' 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD - 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET.. :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:'
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 3917
Remarks: RE-roof
• Owner: FEES
CHARLIE GAY type amount by date recpt
12365 SW KING GEORGE DR PRMT $ 44.50 B 09/04/98 98- 308879
KING CITY OR 97224 5PCT $ 2.23 B 09/04/98 98- 308879
Phone #: 524 -7550
Contractor: ---
INTERSTATE ROOFING
15065 SW 74TH AVE
TIGARD OR 97223
Phone #: 684 -5611 $ 46.73 TOTAL
Reg #..: 000554 •
.
-- REQUIRED ACTIONS or INSPECTIONS----
This permit is issued subject to the regulations contained in the . L°- 6041. ; Y\ WAWA
Tigard Municipal Code, State of Ore. Specialty Codes and all other OPOSIMAg . ,
applicable laws. All work will be done in accordance with �� �W ` (0v \
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- 00H410 through OAR 952- 00101987.
You many obtain a copy of these rules or direct questions to OUNC _-__
by calling (503)246 -1987.
R • Permittee Signature: �v �Gp By: 6(
�
+ ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+ + + +-F + + + + + + + + + + + + + + + + + + + + + + + + + ++ +-- i-+++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
CITY OF TIGARD Plan Check • :
13125 SW HALL BLVD. Rec'd By: - �
TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date Rec'd: gn;
V- 503 - 639 -4171 X304 Date to PE:
Commercial and Residential
F -503- 598 -1960 Date to D
•
. Permit #: •S .---
• Incomplete or illegible applications will not be accepted Called:
Name of Development/Business
< >::Ntate Lrt:OCut#ltentatjOrtiii . BGiApperndiiaila.: :: ?:: ::;::;:;: :: >: >:; >:: >:;:: <: ::: <<::: >:
Street Address Ste # Please fill out applicable section and attach copy of roofing
�,34
Job Site � E!ji/ 4,10, J specifications.
Bldg #
9
City/Stale
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Arse; ii�"<', �ircl$ :SiOtirii'.:.t..::;...,> : ,:;;.; � .«?<?<:<�« ;x< : >:: >;:
y.....>` pate. A B. or.. f�} ....... .:
..............:: :.:<...:.
ed Cie A
Name . Specification #: V.. c15:
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c h Adore et- 11
Applicant �i►aiiing Addres 2. Manufacturer: i .� .(
• . � a1 \o5 (-)Ira � t Q.r O ki e ,
City /.tate Zip Phone *3a UL Classification:
•i 1, o2 9 0 ga 3 .il - 3
Roofing N- e Listed UL Building Materials Directory Page #:
Contractor `X\, ' I • , r j Jl (OR)
(Prior to issuance Mailing Address *3b Wamock Hersey :
applicant must \SOWS ,SL ) Ak ,
provide a copy of ►r / to 1 Listed Wamock Hersey Directory Page #:
all contractor , (! �.t O)/� `/ 2 t `I *COPY OF ASSEMBLY REQUIRED
licenses if Phone # Fax #
expired in COT i _9_p N 1039 _ 'J B. ICBO Research #:
database) State Constr.Contr. Board # Ex D to
5�t >3 1 ct co DATED:
?`H0.141 ICNN :INFOl ATIO N:::: :>::;:;:> ::>::: >:: » >:: >::.: >:: > :: »:: ::: >: >: .C. SPECIAL PURPOSE ... ..... >::>:: >: ................................ ............................... ROOFING: WOOD SHAKES
Building y e Of Use: (circle one) (review required by plans examiner)
F SFA COM MF
Building - Type of Cons: VALUATION OF PROJECT $ I
A ,t� sq. ft. of roof area
Existing Deck Type: Permit fee based on valuation* /I
Combustible (X/) Non - Combustible ( ) * see chart on back $ "��•�
ICE II ENTI « : > :: <.. ; . ' »" 77 s , ,:: ork ... : ::..: _:,. : :. :< :7 777 >;< :< > ; : » » : : : : : : : : : : : : : :> ity u .... 7......77.7 > : : . .
:..:.. S 77...7.7.....:. t-:: ONL`� Cfa v W e rk Attt~ CI :.use on .: <... . : ; ; > a : . ;:: .r:.: " : >�,. :...
❑ REPAIR (MAJOR) (review required by plans examiner)
.::.:.....:...: ::..:::.:..::...:.. :; ...... :::::. : : : : > : : : : : : : : : : :..fY: 7.7. :...... : .. ACO._:.......... . :.. . ..............: :.........
;; :B.UILD ":::>: : :
7..777
_ >:::> .. ( ) ..7.7...7.7 ;7777:: (lJ B U I L D).< < :: >> : : :.:i. <`; : : > : : : : :; ; ::: ;:.: :
Permit required ONLY when spaced sheathing is covered by
solid sheathing. Changes to roof line require Building Permit 5% State Surcharge $ c ). 023
Application. ���/
PP
"Ci 'use: n �< <:
SUBMIT TWO (2) SETS OF PLANS SPECIFYING. : .. :; : : . .. >.. . : :. 4747 .::: : :....7.:.7:._74... ;. : : : . :0 : >
O G ,.T�.
... AX :, : : : : : : :: : >: > : : > : : . : : :; : :; :.: :; : :; :<> 777 . 7 : > : > :< >_ : : :� > : :; : : :. : :.: _ : : < : : : : > : : : > : : : : : : : : =: .. :
7;;;47 : > , ... E.... � ..- . >. :. :....�....._. :.....tIJ _ ... )......:::..:::: : : : ..._ :. : :. :.,- : : . .,..
A. Roof area & nearest street. *Required for major repairs of Residential
B. Attic vents - Provide 1 sq. ft. for each 150 sq. ft. of attic or "C" above * 65% Plan Review $
space. Vents ac e s hall
t shall be located i
t in upper er1/ ft
P 1/3 the roof. eo
C _ use l n ° :_ >_;< : :< < >V 1lA � : : »` ::;:a" < :' >; . : : : <« > << » :<;: <;;< : >< < : : : : :� : :.
PP . �Y.. :. :.. :. �:. X. > ;, : : > : : > :. :. : :; :- . CQ- 747 > > : : :. :. : :.. : ::
Provide 1 s
ov
sq. for
each 300 s
ft. when
sq. eave a attic tt
is
q g > p ._ :' : :< : : : :< : >< : : : : .,; :.; .. : : ` 7 ; >' < - ' > > : : >' : < :''::::•::'.-..::..-.'::'...-
Pr
44
4( U , PLN):
.:.::.....:: UBUf? LrM...:: :. : : :. : : : > : :. : :;; > : : . :. ..
venting is provided.
STP :> :4 .: : < « » 47 4;
TOTAL $ 462,23
... .ERG "777 : >< : :< > : :: ;..;;:. :. > :. :; :. : :.; :.; : .; ; ; :. :;. :.;:
;:E
:::: : : : : : : : : : :. : : : : : : : : : : : : : :,. _.. f�.. :. :.... I».: .::: OA€ ��:;:>::::_»::::::»::> : : : : > : : :< : >< : : :;; :; : » > : : >; : > : >. I acknowledge that I have read this application ; ;4;74; : >: 9 t PPllcatlon and that the
::C : o€:
lass. .
information given is correct; that I am the owner or authorized
< Descri be u v ;.:: r ;::<:
9
o k to be 'done: (check appropriate box) agent of the owner, and that the plans (if applicable) are in .
❑ RE - ROOF (circle A ,B or C) compliance with Oregon State law.
A. Existing built -up roof covering to be REMOVED and deck _
repaired - Signa - re of Owner /Agent Date
B. .Existing built -up roof covering to REMAIN: note applicant
must submit an engineer's review of the roofstructural / /V: elements. Review shall bear the seal (or stamp) of the . % / / /
architect or engineer licensed in Oregon. on • ct erson Name / Telephone
C. Asphalt or wood shingle /shake
(PROCEED TO STEP 2) ` -- - - -- �l �� , toRV- 6Z0 /7 � -
•
I:ROOF1.DOC (dsts) REV 5/1/98
CITY OF TIGARD - -
BUILDING PERMIT FEES - ,
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT REVIEW TAX PERMIT
PROJECT FEES (65 %) (5 %) FEES
1 -1500 25.00 16.25 1.25 42.50
1,501 -1600 26.50 17.23 1.33 45.06
1,601 -1,700 28.00 18.20 1.40 47.60
1,701 -1,800 29.50 19.18 1.48 50.16
1,801 -1,900 31.00 _ 20.15 1.55 52.70
1,901 -2,000 32.50 21.13 1.63 55.26
2,001 -3,000 38.50 25.03 1.93 65.46
3,001 -4,000 44.50 28.93 2.23 75.66
4,001 -5,000 50.50 32.83 2.53 85.86
5,001 -6,000 56.50 36.73 2.83 96.06
6,001 -7,000 62.50 40.63 3.13 106.25
7,001 -8,000 68.50 44.53 3.43 116.46
8,001 -9,000 74.50 48.43 3.73 126.66
9,001- 10,000 80.50 52.33 4.03 136.86
10,001- 11,000 86.50 56.23 4.33 147.06
11,001- 12,000 92.50 60.13 4.63 157.26 •
r,001-13,000 98.50 GA nn
U�+.va 4.93 167.46
13,001- 14,000 104.50 67.93 - 5.23 177.66
14,001-15,000 110.50 71.83 5.53 187.86
15,001-16,000 116.50 75.73 5.83 198.06
16,001- 17,000 122.50 79.63 6.13 208.26
17,001- 18,000 128.50 83.53 6.43 218.46
18,001- 19,000 134.50 87.43 6.73 228.66
19,001- 20,000 140.50 91.33 7.03 238.86
20,001- 21,000 146.50 95.23 7.33 249.06
21,001- 22,000 152.50 99.13 7.63 259.26
22,001-23,000 158.50 103.03 7.93 269.46
23,001- 24,000 164.50 106.93 8.23 279.66
24,001- 25,000 170.50 110.83 8.53 289.86
25,001- 26,000 175.00 113.75 8.75 297.50
26,001- 27,000 179.50 116.68 8.98 305.16
27,001- 28,000 184.00 119.60 9.20 312.80 -
28,001 29,000 188.50 122.53 9.43 320.46
29,001- 30,000 193.00 125.45 9.65 328.10
30,001- 31,000 197.50 128.38 9.88 335.76
31,001-32,000 202.00 131.30 10.10 343.40
32,001-33,000 206.50 134.23 10.33 351.06
33,001- 34,000 211.00 137.15 10.55 358.70
34,001-35,000 215.50 140.08 10.78 366.36
35,001- 36,000 220.00 143.00 11.00 374.00
36,001- 37,000 224.50 145.93 11.23 381.66
37,001- 38,000 229.00 148.85 11.45 389.30
1:ROOF1.DOC (dsts) REV 5/1/98
,„
.,
liat KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224-2693
Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perfolin inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: ��1. - 3 / , . ,+• 4�
1
located at: 49.,3 ' ) A ' 7i
ell U.) \l'eLy .
King City Representative
1:'DSTS \KCM`ST DOC r
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Page No. 1 CASE HISTORY FOR CASE NO.: BUP98 -0355
CHARLIE GAY
12365 SW KING GEORGE DR
10/26/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
BUPA005 Application received / / / / 09/04/98 RECD B 09/04/98 DST
BUPA010 Permit created / / / / 09/04/98 DONE B 09/04/98 DST
BUPA085 (F) Issue building permit / / , / / 09/04/98 PASS B 09/04/98 DST
BUPA810 Roof Nailing inspection 09/04/98 / / 09/09/98 PASS RC 09/11/98 J *H
BUPA815 Pre- roofing inspection 09/04/98 / / / / 09/04/98 DST
BUPA870 Final Inspection / / / / 09/11/98 PASS RC 09/11/98 J *H
BUPA950 Case Finaled / / / / 09/11/98 PASS RC 09/11/98 J *H
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour ouur Inspectio i Line: 639 -4175 I Busi Line: 639 -4171
° 3 1 q / q AM. )( PM BUP
1
``' e a ue �` (� !!\ BLD
L cation .. 08 22i Vk/ 1t�&_ Suite. MEC
Contact Person I/ ...I - MI - 27)C__ )C_ Ph 2-09`035 PLM
Contractor 41J > 'i I ; - Ph SWR
Tenant/Owner ' ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing ... .
Insulation -
Drywall Nailing
Firewall •
Fire Sprinkler
Fire Alarm
Su _•', eiling
Roof
4N
S S PART FAIL
II . BING
•
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL " "' "';q`: =.o
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL?
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA — — —
Approach /Sidewalk (�
Other Date / l ' Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.