Permit A: z CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00085
_ 1i4c DEVELOPMENT SERVICES DATE ISSUED: 3/1/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103DD -01201
SITE ADDRESS: 13900 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP 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: 0.00 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 33, 5( 3
Remarks: Tear off and reroof existing building.
Owner: , Contractor:
MILLER, PRUDENCE M GRIFFITH ROOFING
4220 SW GREENLEAF DRIVE 6815 SW 111TH AVE
PORTLAND, OR 97221 BEAVERTON, OR 97005
Phone: Phone: 643 -1596
Reg #: LAC 00000925
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Dryrot after tear -off
PRMT CTR 3/1/01 $350.80 27200100000 Final Inspection
5PCT CTR 3/1/01 $28.06 27200100000
Total $378.86
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 rule 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 OUNC by
calling (503) 246 -1987.
Pe nnitee
Signature: _ _ / ,
Issued By: /� 41 / ��'
ssued B J i�
y . �` 7
Call 63 1 by 7 p.m. for an inspection the next business day
t
Building Permit Application
•
I Datereceived: d / O / Permit no. f"90/ 000 es
- ,4- , -;::61 . ' City of Tigard
Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By:. I Receipt no.:
Fax: (503) 598 -1960 Case file no.: • Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory l'• Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: / 3y 00 s"1.4...) a 4 i l w r Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: / I Tax map /tax lot/account no.:
Project name: 2 i bode r /r eSS
Description and locatioy of work on premises/special conditions: reel o a ■ : _ i'oo . '/ a
S -' , ecI/'r'C cc /ibri
OWNTR FOR SPECIAL INFORMATION, USE CHECKLIST '
Name: r ate s1(.e (11 t 11 e r (Floodplain, septic capacity, solar, etc.)
Mailing address: 1/2 2.0 S t.4.) 6 r t e4 I ect ( D r - 1 & 2 family dwelling:
City: PO r) - k kt cl I State:0 r, I ZIP: 4 7 2.7.1 Valuation of work $
Phone:, 0 - 227 70701Fax: I E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
• Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: I' /h q eo G q S/iev� Covered porch area (sq. ft.)
Mailing address: g WS — SWj)/ 4-1 /,vim Deck
Other we (sq.
structure area (sq. f
tore at)
City: g,.. mo t /io if
I State2J,, Imp: St 7
Phone: G Y3 4 Fax:'/q-/52 E-mail: Commerciallmdustrlal /multi - family: �
CONTRACTOR Valuation of work $ 3 3 S 63
/ y Existing bldg. area (sq. ft.) O9Qfl
Business name: G, . j ri, ,r v /ran�. ea
Address: 6 g'i',15 .5'1 .5'1 /lick 4 u1T New bldg. area (sq. f )
Number of stories /
City: •ncr t.r-r 4 A O I State;Or 'ZIP: l 7Oar Type of construction
Phone:d y3 -/s56 ( Fax: 6 fy /S2,f I E -mail:
CCB no.: 5,0 Q 2 Occupancy group(s): Existing:
New:
City etro' 'c. no.: 6 Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: I State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP:. Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit car, please call jurisdiction for more information.
attached checklist. All provisions of laws . d ordinances governing this 0 Visa ❑ MasterCard
work will be complied wi whether s • . f :<• • • in or not. Credit c ard numb /
Expires
Authorized sign n ature:. 1 • - L_ Date: 3'/ 0 / Name of cardholder as shown oo credit card
Print name: l� i ry S .f p $
Cardholder a Amount
Notice: This permit ap lication expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (600/COM)
RE- ROOFING PERMIT CHECK LIST • ,
RESIDENTIAL ONLY - Class of Work: Alteration
❑ REPAIR (MAJOR) (plan review required by plans examiner)
Building permit is required when spaced sheathing is covered by solid sheathing and /or
changes are made to roof line.
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, (1) not more than three layers of
roofing will exist upon completion of the re- roofing or, (2) sheathing is not being applied over
spaced sheathing (spaced sheathing usually exists when wood shingles were initially
applied).
COMMERCIAL ONLY - Class of Work: Repair
,STEP 1:
RE -ROOF (circle A, B or C):
® Existing built -up roof covering to be REMOVED and deck repaired.
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.
C. Asphalt or wood shingle /shake. (PROCEED TO STEP 2)
COMMERCIAL ONLY - Class of Work: Repair
STEP 2: NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix 15)
Please fill out applicable section and attach copy of roofing specifications.
Listed Assembly (Circle and complete A, B or C):
A. 1. Specification #: M N - fS 1+ A-
• 2. Manufacturer: MAIar Vey
3a. UL Classification: 4
Listed UL Building Materials Directory Page #:
OR
3b. Warnock Hersey: / 9 9 7
Listed Warnock Hersey Directory Page #: (a S(,
*COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:
Dated: •
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
(Review required by plans examiner.)
VALUATION OF PROJECT:
sq. ft. Z0906 of roof area 33 � 3.
Permit Fee based on valuation: $
(see Building Permit Fees chart) 2�Q.
8% State Surcharge: $
65% Plan Review Fee:
•
(Required for major repairs of Residential or
Assembly item "C" above.
TOTAL: $ %(
i:dsts\forms\roofchecklist.doc 10/05/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
34 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP 2c ,t, = L u k
Date Requested .' 1 3 AM PM BLD , 1ra
Location /3y6U > c✓ f GC'i ' rc. ML' 7 Suite MEC 'W
Contact Person Ph 6 -/ S 9 PLM
Contractor Ph SWR
DI Tenant/Owner ELC
e aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler � /C%���
Fire Alarm
p'd C ' 'n /kJ& ./�- y L/ QL�e 2
Roof �� cJ/ /c/ '9�E/L Lam✓ %�� L. Gi s7;vf i
� 4 •ART FAIL
• MBING
Post & Beam
Under Slab Out
Water v / , �� � �
Water Service I
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
C
Post & Beam C� Sr� rh.l
Q/
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 Date 3 // i� ` Inspecor
Other t Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.