Permit A- - CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2000 -00415
'A
' DEVELOPMENT SERVICES DATE ISSUED: 10/4/00
'�" 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S109DD -05400
SITE ADDRESS: 12650 SW PRINCE ALBERT CT
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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: 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: $ 4,275.00
Remarks: Existing built -up roof to be removed and spaced sheathing to be covered by solid sheathing.
Owner: Contractor:
ANNA CARLSON SCOTT HAMMER
12650 SW PRINCE ALBERT 591 OAKDALE AVE
KING CITY, OR 97224 SPRINGFIELD, OR 97477 -7592
Phone: 503 - 639 -3497 Phone: 541 - 744 -1906 •
Reg #: LIC 140452
FEES REQUIRED INSPECTIONS
Type By . Date Amount Receipt Dryrot After Tear -Off Insp
PRMT CTR 10/4/00 $97.18 27200000000 Final Inspection __.
5PCT CTR 10/4/00 $7.77 27200000000 •
Total $104.95
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.
Permitee -
Signature:
Issued B 1 ! / _ C1-(1)12/i __
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application
Date received: /0-1-00 Permit no.: A P -6O y
�...ty�,plr City of Tigard
^:_ Project/appl. no.: -- Ex ire date: •
Ciry ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: !O - 4/-60 Receipt no.: /�
Fax: (503) 598 -1960 Case file no.: Payment type: �
. Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
.: & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other: I f
JOB SITE INFORMATION
Job address: ., . r . 0 Y' 1 tiff t e Ki r� Bldg. no.: Suite no.:
Lot: I Block: 'Subdivision: OR q - 7g? 1 a x map /tax lot/account no.:
q Project name:
� r Description and location work on p - ises/special conditions. 9P4 g., / r c.,165 FS
r . e •fi( - `.,.. -e �� ).r S.
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
n f=i,^, (Floodplain ,septiccapacity,solar,etc.)
Mailing address: \ , "'f` CO v-; C e 4 Ib 1 & 2 family dwelling: CU
Cit K ; ,,, c State: G R1 ZIP: q 2 / Valuation of work $ 449 75'
Phone: � 3'? -`- !W , Fax: I E -mail: No. of bedrooms/baths
Owner's representative: a _ R ✓ Total number of floors
• Phone: 41 / -7'-)N •-)906 �• E -mail: • 40;0 ew dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial /multi- family:
CONTRACTOR Valuation of work $
)) /� Existing bldg. area (sq. ft.)
Business name: ,„ 5 , ,,
� , ,,,,,,,,,,- (-AW #,t g,FYy6tic f New bldg. area (sq. ft.)
Address: 5 Qp kj c A-�-e Number of stories
City Q -1 State:pf- ZIPT N "1 `1 Type of construction
Phone: 7 j LA — ) Q(, I f - 1 I0 E-mail: 14. .. �er,r -Y Occupancy group(s): on Existing:
no.: /lolls „L. Ca CS -6,M New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /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: 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: ZIP: 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 cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with, whether ified herein or not. Credit card number: / /
Expires
Authorized signature: _ Date: /d�7 0 Name of cardholder as shown on credit card
N Print name: 5 _ $
__ • r� V.A. .. w� �- Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6N0/COM)
CITY OF TIGARD Plan Check #:
13125 SW HALL BLVD. Rec'd By:
TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date Rec'd:
V- 503 - 639 -4171 X304 Date to PE:
Date to DST:
F- 503 - 598 -1960 Permit #:
Incomplete or illegible applications will not be accepted Called:
Name of Development/Business STEP 2. NEW ROOFING ASSEMBLY — C! 44--,401. 4 t / {
Material Documentation (UBC Appendix 15)
Street Address Ste Please fill out applicable section and attach copy of roofing
• • Site specifications.
Bldg # City /State Zip Listed Assembly ( Circle & Complete A, B or C)
. A.
Name 1. Specification #:
Applicant Ma • g Address 2. Manufacturer: (S >t i /(/ ( ((Fof �ilf &J
City /State ,Zi• Phone *3a UL Classification: /
Roofing Name Listed UL Building Materials Directory Page #:
Contractor (OR)
(Prior to issuance Maili , • Address *3b Wamock Hersey :
applicant must
provide a copy of ► qty /State Zip Listed Wamock Hersey Directory Page #:
all contractor *COPY OF ASSEMBLY REQUIRED
licenses if Phone # Fax #
expired in C • B. ICBO Research #:
databa - State Constr.Contr. Board # Exp. Date
DATED:
BUILp NG INFORMATION C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
Building - e Of Use: (circle one) (review required by plans examiner)
SF,I SFA COM MF
Buil g - Type ofQnstructicU : VALUATION OF PROJECT $
( \-e � -- 0. . t sq. ft. of roof area y a , 7 :
Existing D k Type: Permit fee based on valuation*
Combustible ( ) Non - Combustible * see Chart on back $ �' / 7
RESIDENTIAL ONLY - Class of Work: Alteration City use only: WACO:
0 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 8% State Surcharge $ 7. 7 7
Application. City use only: WACO:
SUBMIT TWO (2) SETS OF PLANS SPECIFYING. (TAX) (UTAX)
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 $ I
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. /O / / 7 s
. TOTAL $ 7
STEP 1. COMMERCIAL ONLY I acknowledge that I have read this application and that the I
Class of Work: Repair _ information given is correct; that I am the owner or authorized
Describe work to be done: (check appropriate box) agent of the owner, and that the plans (if applicable) are in
❑ - E -ROOF (circle A ,B or C) - • compliance with Oregon State law.
A. • ing built -up roof covering to be REM i • and deck
repaire • - Signature of Owner /Agent Date
B. Existing built -up roo • • • ' • REMAIN: note applicant
must submit an engine- ' review • • e roof structural -
• . 0/00
elements. Revie : all bear the seal (or tamp) of the
architect ore • : neer licensed in Oregon. Contact Pe • n Nam Telephone
C. Asphalt • wood shingle /shake pay
.% `ROCEED TO STEP 2) ' - l ail / S�` 7 y� - / ( ` �
1:dsts \forms\roof res. doc
8/26/99
4
Valuation of Project Permit fee Review Tax 8%
65%
1 - 2,000 62.50 40.63 5.00
2,001 - 3,000 74.06 48.14 5.92
3,001 - 4,000 85.62 55.65 6.85
4,001 - 5,000 97.18 63.17 7.77
5,001 - 6,000 108.74 70.68 8.70
6,001 - 7,000 120.30 78.20 9.62
7,001 - 8,000 131.86 85.71 10.55
8,001 - 9,000 143.42 93.22 11.47
9,001 - 10,000 154.98 100.74 12.40
10,001 - 11,000 166.54 108.25 13.32
11,001 - 12,000 178.10 115.77 14.25
12,001 - 13,000 189.66 123.28 15.17
13,001 - 14,000 201.22 130.79 16.10
14,001 - 15,000 _ 212.78 138.31 17.02
15,001 - 16,000 224.34 145.82 17.95
16,001 - 17,000 235.90 153.34 18.87
17,001 - 18,000 247.46 160.85 19.80
18,001 - 19,000 259.02 168.36 20.72
19,001 - 20,000 270.58 175.88 21.65
20,001 - 21,000 282.14 183.39 22.57
21,001 - 22,000 293.70 190.91 23.50
22,001 - 23,000 305.26 198.42 24.42
23,001 - 24,000 316.82 205.93 25.35
24,001 - 25,000 328.38 213.45 26.27
25,001 - 26,000 336.82 218.93 26.95
26,001 - 27,000 345.26 224.42 27.62
27,001 - 28,000 353.70 229.91 28.30
28,001 - 29,000 362.14 235.39 28.97
29,001 - 30,000 370.58 240.88 29.65
30,001 - 31,000 379.02 246.36 30.32
31,001 - 32,000 387.46 251.85 31.00
32,001 - 33,000 395.90 257.34 31.67
33,001 - 34,000 404.34 262.82 32.35
34,001 - 35,000 412.78 268.31 33.02
35,001 - 36,000 421.22 273.79 33.70
36,001 - 37,000 429.66 279.28 34.37
37,001 - 38,000 438.10 284.77 35.05
38,001 - 39,000 446.54 290.25 35.72
39,001 - 40,000 454.98 295.74 36.40
40,001 - 41,000 463.42 301.22 37.07
41,001 - 42,000 471.86 306.71 37.75
42,001 - 43,000 480.30 312.20 38.42
43,001 - 44,000 488.74 317.68 39.10
44,001 - 45,000 497.18 323.17 39.77
For valuations over $45,000, please contact a Permit Technician for fees.
I:dsts\forms\roof.res.doc
8/26/99
•
a. KING C
. . _••••_::i. 15300 SW. 116th Avenue, King City. Oregon 97224 -2693
EIMERIMEMIIME 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 SIN
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: \\' /`-2 )e,rof
located at: //4 oS-Le) 61-4/
( ?CP y CO
Radia0.6
King City Representativ M C
I JsT-`.Kr;\:T Dec
-II g �P.S
� I
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP f ifTh — 49,9 4t
Date Requested !'D I. (r AM BLD
Location 1245b S4i / i 4z &/ Suite MEC
Contact Person • Ph PLM
Contractor • Ph SWR
BUILDING Tenant/Owner 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 _D
Framing O 01541-4.- / talio6l44A-JC� v "P ?,�i*
Insulation V
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Sus 'd Ceiling n 1
of t�crt—
Misc:
Fin
PART FAIL
PLUMBING
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 'l
Otheoach /Sidewalk Date /O `7 ` Inspector 42/4 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.