Permit CITY OF TIGARD REROOF PERMIT
2 • • COMMUNITY DEVELOPMENT Permit #: RER2012 -00004
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/06!2012
Parcel: 2S102AA03301
Jurisdiction: Tigard
Site address: 12345 SW HALL BLVD 22
Project: Tigard Terrace Apartments Subdivision: TIGARD HIGHWAY TRACTS Lot: 24
Project Description: Reroof - remove and replace.
Contractor: ABC ROOFING CO Owner: BLUESTONE AND HOCKLEY
10123 SE BRITTANY CT 9320 SW BARBER BLVD SUITE 300
CLACKAMAS, OR 97015 PORTLAND, OR 97219
PHONE: 503 - 786 -0616 PHONE: 503 - 222 -3800
FAX: 503 - 786 -0642
FEES
Description Date Amount
Permit Fee 03/06/2012 $180.17
Specifics: 12% State Surcharge - Building 03/06/2012 $21.62
Hourly 12% State Surcharge 03/06/2012 $10.80
Type of Use: MF Hourly Building Rate 03/06/2012 $90.00
Class of Work: ALT Type of Const: Info Process /Archiving - Sm $0.50 (up to 03/06/2012 $19.50
Occupancy Load: 11x17)
Stories: Height: 0 ft
Project Valuation: $6,594.00
General Information
Building Area: 0
Re -Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $322.09
Required Items and Reports (Conditions)
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 the 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ` Permittee Signature: A
C 5 by 7:00 a.m. for the next available Inspection date.
This permit cards a 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.
Building Permit Application
Re -Roof FOIZ c)FFIci.: USE ONLY
City of Tigard ‹,0 Received
: , a ��� Permit No.: y •
1114 •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.19 ( Yy b. 1 DateB Other Permit:
T WARD
Inspection Line: 503.639.4175 0 , Date Ready /By ® See Page 2 for
Internet: www.tigard- or.gov ttP G,, �,.tified/Method: /` Supplemental Information
t c
TYPE OF WORK ,,,�C l�C REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Dem�'lhbn 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.
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial/industrial
❑ Accessory building ® Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12345 SE Hall Blvd. New dwelling area: square feet
City/ State/ZIP: Tigard/OR/97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: #22 Project name: Tigard Terrace Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: L Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Remove existing BUR roofing to wood structure and install a class A single ply Valuation: $$6,594.00
roofing system. Existing building area: 900 square feet
New building area: N/A square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 2
Name: Bluestone and Hockley Type of construction: Re -Roof
Address: 1,1,3 2,0 5i4/ Berb.Pir M 3 300 Occupancy groups:
City/State/ZIP: Po rtIA, r 0 K/'1 72( Existing:
Phone: 603) 2ZL. $0C) Fax: (Sa3) 222 - L 9 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: ABC Roofing Company, Inc. All contractors and subcontractors are required to be
Contact name: Matthew Lines licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 10123 SE Brittany Ct jurisdiction in which work is being performed. If the
City/ State/ZIP: Clackamas /OR/97015 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 786 -0616 I Fax: : (503) 786-0642
E -mail: matthew@abcroofingco.com
CONTRACTOR
Business name: SAME AS ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/ State/ZIP:
' FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
Total fees due upon application: ` q 1
CCB lic.: #00427 �I31 I ) ` Q ��
Amount received:
Authorized signature: / r/ 1
/ IMP' ° /(, /(, L This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Matthew Lines Date: 3/6/12 • Fee methodology set by Tri -County Building Industry
Service Board.
1:1 Building \PennitslROOF- PermitApp.doc 10/01/09 440.46137(11 /02/COM/WEB)