Permit ''� ,� CITY OF TIGARD MASTER PERMIT
�� t,, DEVELOPMENT SERVICES PERMIT # • MST9e -0018
NIPM6 DATE ISSUED: 01/29/98
_ _.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 -
PARCEL: ES115PC -04000
SITE ADDRESS...:16650 SW KING CHARLES AVE
SUBDIVISION ZONING:
BLOCK LOT JURISDICTION: KIN
Remarks: Re -roof
_ -- _ _____ ------------- - -- BUILDING - -- - ---- -- _ _ —_ —_ —
REISSUE: STORIES : 0 FLOOR AREAS- - - - --- BASEMENT...: 0 sf REQUIRED SETBACKS - -- REQUIRED-------- --
CLASS OF WO K.:ALT HEIGHT • 0 FIRST • 0 sf GARAGE • 0 sf LEFT : 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT : 0 PARKING SPACES: 0
TYPE OF CONST. :5N DWELLING UNITS: 0 FINB5MENT: 0 sf RIGHT : 0
OCCUPANCY GRP.:R3 BORN: 0 BATH: 0 TOTAL 0 sf VALUE..$: 4151 REAR : 0
---
--------------------------PLUMBING----------------- — ______ --------
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
— --------- MECHANICAL ---------
FUEL TYPES ----- FURN ( 100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX IMP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
- -------------------- -------- _ ELECTRICAL ----- ------------- ----------
--RESIDENTIAL UNIT— — SERVICE /FEEDER -- —TEMP SRVC /FEEDERS -- --- BRANCH CIRCUITS -- ---- MISCELLANEOUS --- - -ADD'L INSPECTIONS —
i'«,, SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FOR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 4% amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MRNF HlI /SVC /FDR: 0 601 - amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 -------------- -- - ----- PLAN REVIEW SECTION -- _ -------------- -
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR > =225 A.: > . V NOMINAL: CLS AREA /SPC Off:
- -- - - ----- ELECTRICAL - RESTRICTED ENERGY - -- -------- �
A. SF RESIDENTIAL ---- B. COMMERCIAL— -------------- -- _-- -- - - -- ---- --
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: .. BOILER HVAC • LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK : INSTRUMENTATION: MEDICAL.........: OTHR:
HVAC • DATA /TILE COMM.: NURSE CALLS • TOTAL O SYSTEMS: 0
Owner: ---------------------------- Contractor: - --- — TOTAL FEES:$ 53.03
GREG HICKMAN INTERSTATE ROOFING This permit is subject to the regulations contained in the
16650 SW KING CHARLES 15065 SW 74TH AVE Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone O: 639 -0546 Phone O: 684 -5611 not started within 180 days of issuance, or if the work is
Reg 0..: 000554 suspended for more than 180 days. ATTENTION: Oregon law
---------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952- 001 -0010 through.OAR 952- %1 -0O80. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
- ---------- - — ----- -- ---- REQUIRED INSPECTIONS -------------- -- ------ ------
Roof Nailing
Building Final
Issued By: "------ - - Permittee- Signature: //� ��-� - --
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
A.
CITY OF TIGARD Rec'd By: /i
13125.SW HALL BLVD. Date Recd: a 2% - 'j
TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date to PE:
V- 503 639 - 4171 X304 Incomplete or illegible applications will not be accepted Date to 0 T:
F- 503 -684 -7297 Permit ar
Called:
Na of Dev lop enuBusiness STEP 2.;. NEW Roo FING'A9SEMBt Y: >3 : :: :: :> ?`:: >: :: > ? > ?:> i::::: :::::: > :i : >.: i.
L to K-n-►G Material :Documentation:(UBC::Appe zdix1'S s ;.:» :;; 4:i: '< <: < >:
Stree dress / Ste # Please fill out applicable section and attach copy of roofing
Job Site /6I , d �L✓, 4 et, ,rf specifications.
Bldg # City/State \l Zip 'ListetAssem Iete. tit. C : ::::m: »:? s: <! : : : :: <:
Al (? y Or. q» -J-e-/ A. btx: ( Circle•B p
A :6.:
�' i / , 1. Specification #:
(, /L / / ') G g/ c,11
Owner Maiii ddress /9 J 2. Manufacturer. C7we/1S (_c,erl t fc
/6 6 0. sw kil /� e40.(GS �J
City/State Zip \/ Phone 3a UL Classification:
(JJ7 9 7 z2L/ X3 /
e n ! Listed UL Building Materials Directory Page #:
cr 0..e cam/ (OR)
Roofing Mailing Address 3b Warnock Hersey : •
Contractor h56 6,S ,s IA," 79
i Prior to issuance Cj4y /sjattp / � p Listed Warnock Hersey Directory Page #: .
applicant must r1 an O ?.:3 (PROVIDE COPY OF ASSEMBLY)
srovide a copy of Pone # #
all contractor � 5 ' 6 ' (1 (LI, 331 ��G 3OS6 S. ICBO Research #: licenses if State Con trontr. Brd At Exp. Date
expired in COT q c ,�' DATED: -. .
database) • COT Bus. Tax or Metro Uc # Exp. ate (PROVIDE COPY OF ASSEMBLY) - '
-
``: \iC \: <f5fi ?;ii:i>::: ?: i ai:iiiii:iii:i::i:::i ; ii,::;..
BUILDING tNFORJfltRT1 31!lE \ :, : ;:,s:<: ;<::;e<� .. ; > :;<:;<:: � >:: >:,: »:<:::<;<�:iT . - C. SPECIAL PURPOSE ROOFING: WOOD SHAKES . .. _ .
Building - pe Of Use: (circle one) (' review required by plans examiner)
CS`E, SFA COM MF
3uilding - Type of Construction: VALUATION OF PROJECT $
1+� - - x• . ' 1 51
Existing Deck Type: Permit fee based on valuation* _ . ..
Combustible ( ) Non- Combustible ( ) ' see chart on back S
RES ;_ON .
Ei�E�l L
..... .,....,................. City use on WACQ:
REPAIR (MAJOR) (BUILD) • • ; (UBUILD)
Permit required ONLY when spaced sheathing is covered by n � Y n
solid sheathing. -- 5% State Surcharge $ 6-D �J )-
City use only:. ; . ; WACO: -- - .. - -
SUBMIT THREE (3) SETS OF PLANS SPECIFYING. (TAX) -::, l - ' ..: "' ''' "''`z -S
A. Roof area & nearest street.
65% Plan Review $
B.-Attic vents - Providel sq. ft. for each 150 sq. ft of attic City use only: f WACO:. . -
space & vents shall be located in the upper 1/3 of the roof. - (BUPPLN) (UBUPLN)
Provide 1 sq. ft. for each 300 sq. ft. when eaves & attic
TOTAL $ 5.--
........... .............................................. ...............................
Mi=RCiA .....:.. EY§:.::::i.,.._ ... ......:..:.......: :::..: ::... :. I acknowledge that I have read this application and that the
Describe work to be done: (check appropriate box) information given is correct; that I am the owner or authorized
D RE - ROOF (circle A .B or C) agent of the owner, and that the plans (if applicable) are in
A. Existing built -up roof covering to be REMOVED and deck compliance with Oregon State law.
repaired - Signature of Owner /Agent Date
B. Existing built-up roof covering to REMAIN: note applicant
must submit an engineers review of the roof structural �� _ elements. Review shall bear the seal (or stamp) of the / - 3 - 9 l
architect or engineer licensed in Oregon. Contact Person Name Telephone
C. Asphalt or wood shingle/shake
TO STEP 2) —7 `' g ?(( -S6 / f
l : ROOFI.DOC (dsts)
CITY OF TIGARD
BUILDING PERMIT FEES
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT F.L.S. REVIEW TAX PERMIT
PROJECT FEES (40 %) - (65 %) (5 %) FEES
1 -1500 25.00 - 10.00 16.25 1.25 52.50
1,501 -1600 26.50 10.60 17.23 1.33 55.66
1,601 -1,700 , 28.00 11.20 18.20 1.40 58.80
1,701 -1,800 29.50 11.80 19.18 1.48 61.96
1,801 -1,900 31.00 12.40 20.15 1.55 65.10
1,901 -2,000 32.50 13.00 21.13 1.63 68.26
2,001 -3,000 38.50 15.40 25.03 1.93 80.86
3,001- 4,000 44.50 17.80 28.93 2.23 93.46
4,001 -5,000 50.50 20.20 32.83 2.53 106.06
5,001 -6,000 56.50 22.60 36.73 2.83 118.66
6,001 -7,000 62.50 25.00 40.63 3.13 131.25
7,001 -8,000 68.50 27.40 44.53 3.43 143.86
8,001 -9,000 74.50 29.80 - . 48.43 3.73 156.46
9,001- 10,000 80.50 32.20 52.33 4.03 169.06
10,001- 11,000 86.50 34.60 56.23 4.33 181.66
11,001 - 12,000 92.50 . 37.00 60.13 4.63 194.26 ,..
12,001- 13,000 98.50 . 39.40 64.03 _ . ... 4.93 _._ 206.86. ,_ ..... .
13,001- 14,000 104.50 41.80 67.93 5.23 219.46
14,001- 15,000 110.50 44.20 71.83 5.53 232.06 - _
15,001- 16,000 116.50 46.60 75.73 5.83 - - ` 244.66
16,001- 17,000 122.50 49.00 79.63 _ 6.13 - 257.26 _ _ _ _
17,001 - 18,000 128.50 51.40 83.53 6.43 269.86
18,001 - 19,000 134.50 .53.80 87.43 6.73 282.46
19,001- 20,000 140.50 56.20 91.33 7.03 295.06
20,001- 21,000 146.50 58.60 95.23 7.33 307.66 .
21,001 - 22,000 152.50 61.00 99.13 7.63 320.26
"22,001- 23,000 158.50 - 63.40 103.03 7.93 332.86
23,001- 24,000 164.50 _ 65.80 106.93 8.23 - - 345.46
24,001- 25,000 170.50 68.20 110.83 8.53 358.06
25,001- 26,000 175.00, 70.00 113.75 8.75 367.50
26,001- 27,000 179.50 71.80 116.68 8.98 376.96
27,001- 28,000 184.00 73.60 119.60 9.20 386.40
28,001- 29,000 188.50 75.40 122.53 9.43 395.86
29,001- 30,000 193.00 77.20 125.45 9.65 405.30
30,001- 31,000 197.50 79.00 128.38 9.88 414.76
31,001- 32,000 202.00 80.80 131.30 10.10 424.20
32,001- 33,000 206.50 82.60 134.23 10.33 433.66
33,001- 34,000 211.00 84.40 137.15 10.55 443.10
34,001 - 35,000 215.50 86.20 140.08 10.78 452.56
35,001- 36,000 220.00 88.00 143.00 11.00 462.00
36,001- 37,000 224.50 89.80 145.93 11.23 471.46
37,001- 38,000 229.00 91.60 148.85 11.45 480.90
I:ROOF1_DOC (dsts)
, _
liged 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 perform 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: L ( 4 • "el/
located at: 1'49/ g_5 > 7 rit fx,f. es ,
L King_ City Representat
I DSTS'KCNST-DOC - - - - - -- - - --
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cC INTERSTATE ROOFING
• CITY OF TIGARD BUILDING INSPECTION DIVISION MST mar
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /t'(' Suite MEC
Contact Person v LY' �x� - �w—Ph Q' 5 - 69 5 PLM
1 C�
Contractor r,.. •
Ph � 4 sj?j/ SWR
:BULDIN Tenant/Owner ELC
te -
Retaining Wall ELR
Footing Access: I ( p �
Foundation Q t t� J y ., FPS
Ftg Drain /� SGN
Crawl Drain Inspection Notes: t
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Mis :
Ark
PART FAIL
PL I.! BIIdG 4
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains a
Final
PASS PART FAIL
•
MECHANI-CAL::
Post & Beam
Rough In
Gas Line •
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL N' `'m °4 a'
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 --
Otheoach /Sidewalk Date " 1 Inspector r , r E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.