Permit CITY OF TIGARD MASTER PERMIT
,
, I A DEVELOPMENT SERVI DERM o E/0 -0226 -4171
PARCEL: DS110CC -17000
SITE ADDRESS...: 1 `461 SW KING GEORGE
SUBDIVISION -KING CITY ZONING: ?
BLOCK.......... LOT.... ...... JURISDICTION: KIN
Remarks: Reroof existing single family dwelling. Tear off and replace.
__ ---- _ - -_ -- BUILDING --- __--r_ - --_r - -_ - -_ --- ______—
REISSUE: STORIES • 0 FLOOR AREAS --- - -- BASEMENT...: 0 sf REQUIRED SETBACKS - -- REQUIRED- -
CLASS OF WORK.: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 FINBSMENT: 0 sf RIGHT : 0
OCCUPANCY GRP.:R3 BORN: 0 BATH: 0 TOTAL- 0 sf VALUE..$: 5000 REAR : 0
PLUMBING _________________________________ _ __w - - -- _ - --
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 INP.: 0 BTU FLOOR FURNACES: 0 VENTS : 0 WOODSTOVES • 0 GAS OUTLETS...: 0
---------------- ELECTRIC.. ----------------------------------------------
- RESIDENTIAL UNIT— -- SERVICE /FEEDER - -- —TEMP SRVC /FEEDERS — —BRANCH CIRCUITS - -- ---MISCELLANEOUS--- - -ADD'L INSPECTIONS -
1m SF OR LESS: 0 0 - amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 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 - amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1000 amp.: 0 601 +amps- 1m v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 -------- --- - -- PLAN REVIEW SECTION --------------- - --
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 6Y V NOMINAL: CLS AREA /SPC OCC:
- --
-------------------------------- - ELECTRICAL - RESTRICTED ENERGY - -- ------ - - - - --
A. SF RESIDENTIAL- -- - - -- -------- B. COMMERCIAL - -- ________________ _ _ _--- _________ — _— _ -__ --
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: DTH: •• BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: ..
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL B SYSTEMS: 0
Owner: - - --- ------- -- _r_ - -- _Contractor: - - -- TOTAL FEES:$ 85.86
MRS ELSNER GREG'S QUALITY ROOFING This permit is subject to the regulations contained in the
12461 SW KING GEORGE DR 11170 SW TORLAND ST Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone B: 684 -1203 Phone #: 590 -6148 not started within 180 days of issuance, or if the work is
Reg B..: m958 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 -001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
- - -- - ---- -- -------- - - - - -- REQUIRED INSPECTIONS - - -- --- - - - - -- - - - --
Misc. Inspection
Final inspection
Issued P :Aimi Al „,' Per°mittee Si:gnatur�- �'
+ + + + + + +: + +"' ” + + ++•'+ + + + + ++ + +a- ++• + + ++ + +• r + ++•i- + ++ - :- +: +• + ++ °' + + + + + + + + + + +•r
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
CITY OF TIGARD Plan Check #:
13125 SW HALL BLVD. Rec'd By:
TIGARD OR 97223 E- ROOFING PERMIT APPLICATION Date Recd:
V- 503 - 639 -4171 X304 Date to PE:
C ommerc i a l and Residential Date to DST:
F 503 - 598 - 1960 Permit #: /7/57
Incomplete or illegible applications will not be accepted Called:
ame of Develop ment/Busi ess
'€4 �....tllAail'I�gE�tI�IG'.' .Sg
/.G '4 av Ail, 4-. 1'-1. N C N� � I t�. 4 Eif# 1$t�ti�F�.- �100 �O}.:;.,..... ; .:.. :; <: ;;;;;;;;; :::
Street Address '/ /1 Ste # Please fill out applicable section and attach copy of roofing
Job Site ( 1 .--q& I .5.4.,) 4N ( -°o , specifications.
Bldg # C ty /State Zip.
:€ sI:: Assetitbly>«:::: rls:: . &..<omplete::AtBar- : }::<:::i >: ::: > :::'::: >«;: >::>
_�► C A.
( Name {- 1. Specification #: 7 S `- 1
Ye-4 ci,,,A,,,` - // /►, ►Ln / N` ) , I N L ,
Applicant Mailing Address , 2. Manufacturer: QW � J N 1 Y ' C
11)7C 4w !Df1A -N9 St
J
._City /State Zip . Phone *3a UL Classification: 1) L I 0
II£ p 5 7 2 z3 S //g ,
Roofing Na e , Listed UL Building Materials Directory Page #:
Contractor LA Y - O l S Q w) 1N G (OR)
(Prior to issuance Mailing dress '" ((°� *3b Warnock Hersey :
applicant must I 1 1 cW (' or I f *'9 S ,
provide a copy of City /State di Listed Wamock Hersey Directory Page #: '
all contractor
1 � �D � — M *COPY OF ASSEMBLY REQUIRED
-
licenses if Phone # Fax # -
expired in COT c - (r 1 L(g B. ICBO Research #:
database) State onstr.Contr. Board # j Exp e
11 $ o I q DATED:
:::B01Li]INi:iNFt7i iiii# 3N:::::> :::::::<:>< ><; »::::<:::<:::> »; > :: : ::>:: » >:: C. SPECIAL PURPOSE ROOFING. WOOD SHAKES
B uildi n . - - Of Use: (circle one) (review required by plans examiner)
SFA COM MF
Bui ing - ype of Con ction: VALUATION OF PROJECT $
�- f � V F sq. ft. 2400 of roof area �DO D
xisting Deck Type: ,,/ Permit fee based on valuation*
Combustible ( ) Non - Combustible ( ) * see chart on back $ 5 6 g)
::. ESID E NTIAL: >:: >:::: >:;ONVO::Cla s >:Work:: . - .::;::, : • < ,: ; >.
: :::::...:..:::::..:.... ............................... std of.:............: Atter�) ran::::> ::< >:: >: >:::<::::: > :: » ::::: ; ; CI : ....,::::; :: :;;::::;; '2":"
:,. .; :::<:; :::::::. :::<.::::. :.:. :.:..�. . ty,use.only,:,:..- >;:: ::: <: WAC .O..... .......:..........................................................
lii REPAIR MAJOR review re uired b lans examiner)
(MAJOR) (review q by P ) : . :. ' :•..(BUILD :� . �.: (UBUILD} �-�-::. -' :
Permit required ONLY when spaced sheathing is covered by
solid sheathing. Changes to roof line require Building Permit 5% State Surcharge $ ,v `.2` .3
Application. Ci s .=':::: ` : W :' : : :-:': :::,:':':� >:.
SUBMIT TWO (2) SETS OF PLANS SPECIFYING. :>> ::.::::::; >.;y u: (. e..on ,,> A -
,:.::.: (.. TAX} = � ' ' �> � < "s : ' '; < :; < '(.UTAX)?� <;< : = . ''''.:';-::-;:•
A. Roof area &, nearest street. , *Required for major repairs of Residential c
B. Attic vents - Provide 1 sq. ft. for each 150 sq. ft. of attic or "C" above * 65% Plan Review $ 7Z 3
space. Vents shall be located in the upper'1 /3 of the roof. City use: only ; >; ;: : :.;: :WACO ::..; %:: ; > :; :; -. ,;:,, -.., ::
Provide 1 sq. ft. for each 300 sq. ft. when eave & attic (BUPPLN) - >':`,(UBUPLN) =5
venting is provided.
TOTAL $ � =" r
:::STEP:;'i >: >: »` > : CO
1VfmEk3Gt; 4p[ ON4Y::::»;:::;:::>:::>:<:><:;::<: : >::< >:: >:: »<::::::::::: >:::
1-acknowledge that I have read this application and that the
A;agS. o -
information given is correct that I am the owner or authorized
Describe work :: ;
to be done: (check appropria box) ::: . agent of the owner, and that the plans (if applicable) are in
0 RE - ROOF (circle A ,B or C) compliance with Oregon State law.
A. Existing built -up roof covering to be REMOVED and deck
repaired - Signatur of Owner /Agent Date
B. Existing built -up roof covering to REMAIN: note applicant i
must submit an engineer's review of the roof structural 6.--- q-- / / elements. Review shall bear the seal (or stamp) of the -
architect or engineer licensed in Oregon. Contact Perso ame Telephone
C. Asphalt or wood shingle /shake"" - / Le`e 3/ G; 3 3Z
(PROCEED TO STEP 2) (,6 VC-- / (/J
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
12,001- 13,000 98.50 64.03 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
I:ROOF1.DOC (dsts) REV 5/1/98
,,
KING CITY
IllAki
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: °J C. 4` - ' / ii■ _
located at: li ? / \icJ 71
./ee7 c-e._.i Q Oa
King City Representative
I- DSTS \KGINST:DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST ��_ CZ 2 2
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM . BLD
Location a v MEC
EC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING., °� °� Tenant/Owner ELC
Retaining Wall ELR
Footing Access: �p �
Foundation I l �v \ FPS
Ftg Drain SGN
Slab Slab
Crawl Drain Inspe i Not Requested
Post & Beam I F ound During Research SIT
Ext Sheath /Shear ` cNo Insnection(sl 1n File
Int Sheath /Shear -
Framing °
Insulation
Drywall Nailing 2(- /OGL7Z I?
Firewall
Fire Sprinkler
Fire Alarm
S . •'d Ceiling
- oof
isc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Rost & 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
SITE
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 Inspector = Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.