Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00521
A . k DEVELOPMENT SERVICES DATE ISSUED: 12/10/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115BA-01500
SITE ADDRESS: 11925 SW KING JAMES PL
SUBDIVISION: R/ ZONING:
BLOCK: LOT: ��� JURISDICTION: KIN
REISSUE: FLOOR AREAS XTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR • FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 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: na7C)
Remarks: Re(oof permit, remove existing roofing material and replace with new.
Owner: Contractor:
OPOCENSKY, EDWARD JR+ OWNER
DOROTHY L OWNER RESPONS FORM SIGNED
11925 SW KING JAMES PL
Kl oCITY, OR 97224 Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
PRMT DEB 12/10/99 $59.25 99- 320348
5PCT DEB 12/10/99 $4.74 99- 320348
Total $63.99
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1987. You
may obtain a copy of these rules or direct questions to NC by calling (503) 246 -1987.
Permitee
, ( .
Signs e:
Issue .5y: ,• /, A ' / ./ (
Call 639 -4 5 by 7 p.m. for an inspection the next business day
1. •
•
CITY OF TIGARD Plan C t_
13125 SW HALL BLVD. Rec'd B 7 ' '
. TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date Recd: /a - /o s
V- 503 - 639 -4171 X304 Date to PE: —
F- 503 - 598 -1960 Date to DST:
Permit #:,,e3, S�
Incomplete or illegible applications will not be accepted Called:
Name of Development/Business STEP 2 = "NE s:PtRO FINE ASSBMBl* 5 °- : "
*, teinal, on (UBC- Appendix 15 },._, , . -:',
Street Address L ---,' Ste # j Please fill out applicable section and attach copy of roofing
Job Site i / 92$ r" ' /Pi d —0 .4 I specifications.
Bldg # City /State Zip listed Assemti, - C rcle1&Corri� `tete A 6 C' '� °" itrn - T"
, i�, ak4pv A.
Nalrie G��>� 1. Specification #:
Appl icant
etvoill ing Addr s 2. Manufacturer:
/1% t� /f` ✓ ,
City/State Zip Pho
3 , ' � p1Z *3a UL Classification: •
Roofing Name (G� Listed UL Building Materials Directory Page #: • Contractor U' , W"i" • (OR)
(Prior to issuance Mailing Address *3b Wamock Hersey :
applicant must
provide a copy of City /State Zip Listed Warnook Hersey Directory Page #:
all contractor *COPY OF ASSEMBLY REQUIRED
licenses if Phone # Fax #
•
expired in COT B. ICBO Research #: •
database) State Constr.Contr. Board # Exp. Date
DATED:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
ry i y : -'
IByl>31N�G�INrQRIIfIATtL7N : �. t . - � j _.
Buildin - e Of Use: (circle one) SF
(review required by plans examiner)
,SFA COM MF
Building - e of Construction: VALUATION OF PROJECT $
sq. ft.4 roof area �, O r�
Existing Deck Type: • Permit fee based on valuation* -- 9 P. S""
Combustible ( ) Non - Combustible ( ) * see chart on back $ r
RSIDEN�1°Ii4L ON �" y' � . / " �� !
LY' lass �ifrk:Alferahor% Ci m;;;use I ,4
U REPAIR (MAJOR) (review required by plans examiner) . y,,., *:i3tJtLD= 44:J , ",,,, ,,,,,,, , „., .,..a e..
• Permit required ONLY when spaced sheathing is covered by
I/ solid sheathing. Changes,to roof'line require Building Permit \ 8% State Surcharge $ `f ' 7
"Ci , ruse o nl ° 1NAE0. y° : ';
1 Application. : tY., n,,� � Y,�; °-;�� �..,., ;
�, tr
SPECIFYING. -� „ "s„ . . ,.:m,, y , T
. SUBMIT TWO (2) SETS OF PLANS S TAX �.- U SAX .. . , ., z ;,�� � :I CA
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 $
shall be located in the upper 1 /3 of the roof. `'Ct :.use,only..,„ : WACCO;., „�:' :':?.”
space. Vents sh �e.:
PP . tY< ,m.,Y, :` , A, „y �>
P`,N'
t r�3'°
Provide 1 sq. ft. for each 300 sq. ft. when eave &attic , ;3 1` h (.BUPPLN:)r :, ,,,,, (•,,,,,,,- ,,....,. o ,., }�.� E, , c�i� =:;:��w•�� ° °- �„ _.
\\ venting is provided. LPd 22 , 99
TOTAL $
STER,,,Ii � ''COMMERG.IAt; _ +DNLY ` `, I acknowledge that I have read this application and that the
Klass of Work Repair- ,,
.� M. _ ^ � ",�fir -� y , �y ', information given is co /r - ct; th m the owner or authorized
Describe work to be done: (check appropriate box) agent of the owner, - d tha a ans (if applicable) are in
❑ RE - ROOF (circle A ,B or C) compliance wit regon ate w.
• A. Existing built -up roof covering to be REMOVED and deck �D
repaired - Signature of Ow er7 gent / Date
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. Contact Person Name Telephone
- C: Asphalt or /shake
(PROCEED TO STEP 2)
I:dsts \forms\roof.res.doc ! - • .. ( X•d- / � C a
8/26/99 / f✓
4:0 et 3-4.4".a /2 i0 -9
{ iiri 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: - Re, ece-r
located at: /[ & ' r .! ...0 _■
�!
£t„.44
• King City Ripresentative )a- - /O —Cf
I_DSTS'1<CINS.T_DOC - - - - - - - - - -- - ---
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line_639- 4171.
.� 2 UP l 9 q - q , ao sz
Date Requested / AM - BLD
Location I l I iS Suit MEC
Contact Person COCIAAlc Ph CP 3 ! Lp 9 , PLM
Contractor Ph SWR
ILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
•
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Sus 'd Ceiling
Misc: J (/
Fin
S PART FAIL
L 1NG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
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
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
Approach /Sidewalk , 15-6
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.