Permit •
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00386
4 �� DEVELOPMENT SERVICES DATE ISSUED: 09/02/1999
' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06721 SW PINE ST PARCEL: 1S136AD -04400
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS . EXTERIOR 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: $ 3,220.00
Remarks: Re -roof
Owner: Contractor:
CORNISH, MARY D OWNER
6721 SW PINE ST SIGNED RESPONSIBILITY FORM
PORTLAND, OR 97223 IN FILE
Phone: Zc.(4, Phone:
Reg #:
FEES REQUIRED INSPECTIONS
•
Type By Date Amount Receipt Roof Nailing Insp
PRMT BON 09/02/199C. $68.50 99- 318077 Final Inspection
5PCT BON 09/02/199C, $4.80 99- 318077
Total $73.30 ORIGINAL
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 OUNC by calling (503) 246 -1987.
Pennitee 1
Signature: L �L L��1�
Issued By: (VIM // ,..._
Call 639 -4175 by 7 p.m. for an inspection the next business day
,• I
• CITY OF TIGARD Plan Che ,
13125 SW TIGARD OR 23 Date VD RE- ROOFING PERMIT APPLICATION Date Rec ' • . : ' 'il
V- 503 - 639 -4171 X304 Date to PE:
RESIDENTIAL Date to DS :
F- 503 - 598 -1960 Permit #: ' ' .4 W' —
Incomplete or illegible applications will not be accepted Called:
Name of Development/Business STEP_2. NEW ROOFING ASSEMBLY ;.,;,,,„4 Material Documentation (UBC Appendizl5) " " ; : ' - , '
Street Address • Ste # Please fill out applicable section and attach copy of roofing
Job Site (,^/7-= I %, Lj,) (i Y 2 , a specifications.
Bldg # ,City /State ` / Listed Assembly ( Circle & Complete A; B or C) "
Fr v'" yi ' ,- �: A. .i
Nar �y 1. Specification #: 15 il
Applioont Mailing Ad ress 2. Manufacturer: i
City/ State Zip - z Phone *3a UL Classification:
sill ' i� -�f( 2.7
Roofing Name ✓ Listed UL Building Materials �ctory Page #:
Contractor D J� ,�" (OR)
(Prior to issuance Mailing Address *3b Wamock Hersey :
applicant must
provide a copy of City/State Zip Listed Warnock 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:
-
BUILDING NFORMATION . ;
Buildin. •
SFA COM MF
- Of Use: (circle one) ` %
_ . _. (review required by plans examiner)
Buildin. ype of Construction: VALUATION OF PROJECT $
:1- 1 sq. ft. 2- _ ') of roof area ' � )0
Existing Deck Type: Permit fee based on valuation* '
Combustible ( ) Non - Combustible ( ) * see chart on back $
RESIDENTIAL ONLY Class of Work: Alteration w� „ *; - r ; City use only: WACO: ',
' ❑" REPAIR (MAJOR) (review required by plans examiner) (BUILD) (UBUILD)
Permit required ONLY when spaced sheathing is covered by
solid sheathing. Changes to roof line require Building Permit 7p% State Surcharge
Application. City use only: WACO:
SUBMIT TWO (2) SETS OF PLANS SPECIFYING. f
(TAX) (UTAX) � -
C
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 $
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)
\\\ venting is provided.
TOTAL $ •V
STEP 1. COMMERCIAL ONLY I acknowledge that I have read this application and that the
Class of Work: Repair " information given is correct that I am the owner or authorized
Describe work to be done: (chec appropriate box) agent of the owner, and that the plans (if applicable) are in
❑ RE - ROOF (circle A ,B or C) compliance with Oregon State law.
A. Existing built -up roof covering to be REMOVED and deck
repaired - Signature of Owner /Agent Datte
B. Existing built -up roof covering to REMAIN: note applicant
must submit an engineer's review of the roof structural Lab ( / t/f' `�/ -Y7
elements. Review shall bear the seal (or stamp) of the on � F-13 architect or engineer licensed in Oregon. C ct Per // �' n Nam Telephone
C. Asphalt or wood shingle /shake I
(PROCEED TO STEP 2) !� ll�� Z��� ((/�Z q
I :dsts \forms\roof.res.doc
CITY OF TIGARD R
RESIDENTIAL BUILDING PERMIT FEES
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT REVIEW TAX PERMIT
PROJECT FEES (65 %) (7 %) . FEES
1 -2,000 50.00 32.50 3.50 86.00
2,001 -3,000 57.00 37.05 3.99 98.04
3,001 -4,000 66.25 43.06 4.64 113.95
4,001 -5,000 75.50 49.08 5.29 129.87
5,001 -6,000 84.80 55.10 5.92 149.42
6,001 -7,000 94.00 61.10 6.58 161.68
7,001-8,000 103.25 67.11 7.23 177.59
8,001-9,000 112.50 73.13 7.88 193.51
9,001- 10,000 121.75 79.14 8.52 209.41
10,001- 11,000 131.00 85.15 9.17 225.32
11,001- 12,000 140.25 91.16 9.82 241.23
12,001-13,000 149.50 97.18 10.47 257.15
13,001-14,000 158.75 103.19 11.11 273.05
14,001 - 15,000 . 168.00 109.20 11.76 288.96
15,001-16,000 177.25 115.21 12.41 304.87
16,001-17,000 186.50 121.23 13.06 320.79
17,001-18,000 195.75 127.24 13.70 336.69
18,001- 19,000 205.00 133.25 14.35 352.60
19,001-20,000 214.25 139.26 15.00 368.51
20,001-21,000 223.50 145.28 15.65 384.43
21,001-22,000 232.75 151.29 16.29 400.33
22,001-23,000 242.00 157.30 16.94 416.24
23,001-24,000 251.25 163.31 17.59 432.15
24,001-25,000 260.50 169.33 18.24 448.07
25,001- 26,000 268.00 174.20 18.76 460.96
26,001- 27,000 274.75 178.59 19.23 472.57
27,001-28,000 281.50 182.98 19.71 484.19
28,001- 29,000 288.25 187.36 20.18 495.79
29,001- 30,000 295.00 191.75 20.65 507.40
30,001- 31,000 301.75 196.14 21.12 519.01
31,001- 32,000 308.50 200.53 21.60 530.63
32,001- 33,000 315.25 204.91 22.07 542.23
33,001- 34,000 322.00 209.30 22.54 553.84
34,001- 35,000 328.75 213.69 23.01 565.45
35,001- 36,000 335.50 218.08 23.49 577.07
36,001- 37,000 342.25 224.46 23.96 590.67
37,001- 38,000 349.00 226.85 24.43 600.28
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP ) q9 63 84,0
Date Requested ` D--I. I AM PM BLD
�� t
Dp
Location w 7 2-1 r fL ...4,2),„ Suite MEC
Contact Person Ph Ra.7 PLM
Contractor Ph SWR
BUILDING Tenant/ e� ^ - ELC
Retaining 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
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PASS ART FAIL
NG
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
ADA
Approach /Sidewalk
Other Date // l F9 Inspector / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.