Permit ` . - BUILDING PERMIT
lig II C ITY OF TIGARD PERMIT #: BUP2007 -00266
COMMUNITY DEVELOPMENT DATE ISSUED: 5/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AC - 01704
SITE ADDRESS: 12720 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD DENTAL
Project Description: Reroof - tear -off, install fire barrier, install PUC membrane.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 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: $ 19,480.00
Owner: Contractor:
RCIK BRAEM MAIER ROOFING
12720 SW PACIFIC HWY PO BOX 623
TIGARD, OR 97223 ALBANY, OR 97321
Contact #: PRI 541- 928 -8253
Phone: FAX 541 - 924 -9825
Reg #: LIC 32989
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/16/2007 $235.30
[TAX] 8% State Surcharl 5/16/2007 $18.82
Total $254.12
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 -0 01 -0100. You may obtain a copy of these rules or direct questions
to OUNC b ing .246 • : or 1.800.332.2344.
Issu d By: I / �' 1 i / Permittee Sig ure: i i ' A / 1 W' ( , r
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall 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.
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Buiidin Perm Applica
' Re -Roof FOIL OI FICL: LisE o I
City of Tigard rni e�� A irmirm Permit No.: ° ,007�60 i
. ° 13125 SW Hall Blvd., Tigar. 0 • GEV Plan Review
Phone: 503.639.4171 Fax: s�'!s' Date/B . Other Permit:
T I G A K D Inspection Line: 503.639.417 ' U u Date Ready/By. '� 1 �r�®See Page 2 for
Internet: www.tigard or.gov MAY 1 6 i? Notified/Method: I� Supplemental Information
.t V 1S
ON
TYPE ∎ o, , REQUIRED DATA: 1- AND 2- FAMILY DWELLING
Ii
' ❑ New construction B Demolition 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.
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ 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: / 7 V .5 4, /1 SC New dwelling area: square feet
City /State/ZIP: Tlc i ,,, ? p if 9 ) . 2 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 774.47/1 «�,( a o e ft / 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: I Lot no.: Permit fees' are based on the value of the work performed.
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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.
/ g s a
/� // / (-:.) A ,,,z.x[/) Valuation: $ / / 18 ° • -''--
Existing building area: square feet
-- • // / ✓/l l✓ ,e, ire erA64,q.,,.s-
New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: /7/c it thf A ,i Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: MI contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City / State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail:
CONTRACTOR
Business name: # 7 / /IA ? itIo /smi BUILDING PERMIT FEES*
Address: "e• A 09( 6, 23 (Please refer to fee schedule)
City /State /ZIP: 44/3A4.4/ D/r 973,4 Structural plan review fee (or deposit): �3
FLS plan review fee (if applicable):
Phone: (S-y//) , J' oZ S..... Er2 r 3 I F ' 1) 12,/,_ 5 s.Z S ,?2.. CCB lic.: „ ..3.9 . 8 1 6119 Total fees due upon application: f 6
Amount received: p��
Authorized signature: e�c.,.,f This permit application expires if a permit is not o tamed
" within 180 days after it has been accepted as complete.
S,
Print name: �e,' A fy0 / �/ S Date: ,•` fG - or ? • Fee methodology set by Tri-County Building Industry
Service Board.
I:V 3uilding \ Permits \ROOF- PenniiApp.doc 06/26/06 440.4613T(11/021COM/WEB)
r
City of Tigard: Re- Roofing Permit Checklist
Page 2 - Supplemental Information
RESIDENTIAL (One- & Two - Family Dwelling)
0 REPAIR (major) plan review required by plans examiner:
building permit is required when structural changes are made or the space sheathing is
removed or replaced.
SUBMIT TWO (2) SETS OF PLANS SPECIFYING:
A. Roof area and nearest street.
B. Attic vents: Provide 1 sq. ft. for each 150 sq. ft. of attic space. Vents shall be
located in the upper 1/3 of the roof. Provide 1 sq. ft. for each 300 sq. ft. when
eave and attic venting is provided.
Note: No permit is required for residential re -roof if not more than two (2) layers of
roofing will exist upon completion of the re- roofmg.
COMMERCIAL (includes multi- family and condominiums)
❑ RE -ROOF: Pre - inspection is required for all roofs sloped 2:12 and less. Please make
an appointment by calling the Building Division at (503) 718 -2433.
❑ PLAN REVIEW:
• Note: Depending on the conditions noted at the pre - inspection, plans may be required
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to address any non - conforming items.
VALUATION OF PROJECT: $
sq. ft. of roof area
Permit Fee based on valuation: $
(see Building Permit Fees chart)
8% State Surcharge: $
65% Plan Review Fee: $
(Required for major repairs of residential and
special purpose roofing of commercial projects.)
TOTAL: $
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I:\Building\Permits\ROOF- PermitApp.doc 2
City of Tigard Building Department u
13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639 -4171 • ∎ —
Re -Roof Pre- Inspection Report Form :TI GARO
Requested by V� \� �� �v� Telephone j `7 / ) C2 - I �-4 'j '
Job Address I ` 4-!....-Z — r ` l 1 s — 0.3 3 r
Roof Access Location
Date Requested S/ t 7 (0 lime Requested �—
Type of Existing Roof
1. Slope of roof deck I foot (ratio) ( %
2. Roof /Penetrations/General Conditions Fair ❑ Poor
3. Are there blisters? Yes ❑ No
4. Are there cracks? es ❑ No ,
5. Is there evidence of water ponding? Yes ❑ No
6. Is moisture present under roofing (leak)? Yes ❑ No
7. Is roof insulation existing? ❑ Yes ❑ No tvtAkinnfr1.477%.1
8. Is roof insulation wet? ❑ Yes ❑ No Lt'VVI bVVl/1N'n
9. Property line setbacks on all sides > 10 feet ❑ Yes o
10. Roof Area ■' < 6000 sq. ft ❑> 6000 sq. ft.
11. Building height :1 < 2 Stories ❑ > 2 Stories
12. Class of roof required ❑ Non -rated ❑ A. ❑ B. C.
13. Type roof deck - 12(Combustible ❑ Non - Combustible / nn
i), 14. Roof drains t) g 6 e-4 1,- � LI Provided ❑ Required ❑ Adequate 4 t Ae u..J.e
15. Overflow drains . 31' moo, Provided ❑ Required ELAdequate
P41 4A 16. Attic ventilation ❑ Provided ❑ Required ❑ Adequate IAA& kAh PI
17. Roof listing ,4 b Provided ❑ Required
18. Scope of work ❑ Tear off ❑ Overlay \,
To re-roof this structure the following ` s _ �tlons must be m ` n �
k/� /� ( e_N / !J2_ \.
vu - 1i1 -' '0.(e___ S C , .
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The re -roof proposal ' roved for permit issuance if the conditions listed above are met. After obtaining your permit you must contact the
Building Division for an inspection when the roof deck is ready for the first inspection. The first inspection for a complete tear off is the deck
inspection. For a built -up roofing system (overlay), the first inspection is at the start of the job. After the re -roof is complete, a final inspection is
required.
Inspector VC• c - ' i 7 I ' Ext.Z ( Date — / ( 7 A 7
PBuadmplReroof Piei,specton Report Form
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2001-00266
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2712007
Phone: (503) 639 -4171 � ' I
Inspection Requests (24 Hrs.): (503) 639 -4175 NV it
INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 12720 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD DENTAL
DESCRIPTION: Reroof - teal-off, install fire barrier, install PUG membrane.
OWNER: BRAEM, RCIK PHONE #:
CONTRACTOR: MAIER ROOFING PHONE #: 541- 978 -8253
Inspection Request Scheduled For: Date: 6/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me •e .71
Roof
260 oof neifirrg 049927 -01 541 -928 -8253 . /0 ' A \
Corrections /Comments /Instructions:
ill Fi/k/il . f
dgC*
ICI PASS "PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL M LL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: A ■ - Date: 6 4 07 Phone #: (503) 718- l-0
VF 4111.
CITY OF TIGARD !l n /
BUILDING DIVISION PERMIT #:9.6b7_DV.0 om/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: }
Phone: (503) 639-4171 .typ F i�lle,
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'!...-1.-
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION:
Lq LOT #: TYPE OF USE:
PROJECT NAME: �- `�J
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: l PHONE #:
----yA.A-LeA, 8...6-e--_,Al
Inspection Request Scheduled For: ((JJ Date: 5 — 1 - 7 — 01 Pour Time:
Code # Inspection Description Confirm # Contact # ∎ , - - ge
l --,A.46-6--r 4 ' , • SY/ 6 /9 P -4 1
Corrections /Comments/ Instructions:
--LP —eY) —
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-