Permit 44 CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP1999 -00339
I
DEVELOPMENT SERVICES DATE ISSUED: 8/3/99
- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 641'1
SITE ADDRESS: 16775 SW QUEEN MARY AVE ! G I N A L PARCEL: 2S115BC -17100
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: 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: $ 6,179.00
Remarks: Tear off existing roofing material. Replace with Class 'A' composition shingles and new sheathing.
Owner: Contractor:
RAY REUCK BOB CARLSON INC
16775 SW QUEEN MARY 560 SW MAPLE
KING CITY, OR 97224 HILLSBORO, OR 97123
Phone: Phone: 640 -3623
Reg #: LIC 005113
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Dryrot After Tear -Off Insp
5PCT GEO 8/3/99 $6.74 99- 317368 Final Inspection
PRMT GEO 8/3/99 $96.25 99- 317368
Total $102.99
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 - ,_. 2 ).z._e_, i
Signature:
Issued By: 76
� � 47(---4—
Call 63' -4175 by 7 p.m. for an inspection the next business day
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:
Commercial and Residential Date to DST:
F 503 - 598 - 1960 Permit #: &&//(999 "a
Incomplete or illegible applications will not be accepted Called:
Name of evelopment/Business • : :<:::.
'�P. �.... NENVROElNG
E.. . ....ftt#
zt..a
S 1ri N Queen Mary Ste # Please fill out applicable section and attach copy of roofing
Job Site specifications.
Bldg # City/State Zip >::1 sted::Assem:bl. >?: >::::Cfrcle::&::Gom:.. ete A :: H:: olr::: G:: »: >:::<::::::: >: >:::: >:::: »: >
Tigard 97224 A.
Name 1. Specification #: Timberline Composition Shingles
P GAF
Applicant Mailing Address - 2. Manufacturer:
!62775 '.i„ /. l tvea*-, t-11..- y •
City /State Zip Phone *3a UL Classification: A
Roofing Name Listed UL Building Materials Directory Page #: 3
Contractor Bob Carlson, Inc. (OR)
(Prior to issuance Mailing Address *3b Warnock Hersey :
applicant must P.O. Box 63
provide a copy of City/State Zip Listed Wamock Hersey Directory Page #:
all contractor Hillsboro OR 97123 *COPY OF ASSEMBLY REQUIRED
licenses if Phone # Fax # -
expired in COT 640 -3623 640 -4840 B. ICBO Research #: •
database) State Constr.Contr. Board # Exp. Date
DATED:
P PURPOSE : ..tCsOltg� SPECIAL P
>. 833 .: ' ::: ��.. (�_ Q�:.::.:.;:.;:..;:.;;:.;:.;; .;:.;;;: �;:.;:;:.;:.; >.:.;.;:...:.:.:. : >:: >:::: :::<;:: :> ROOFING: WOOD SHAKES
Builng --• Of Use: (circle one) (review required by plans examiner)
SF SFA COM MF
Buil me of Construction: VALUATION U TION OF PROJECT $
Wood Frame sq. ft. 1•5 of roof area 6,179.00
Existing Deck Type: 7 Permit fee based on valuation*
Combustible Non - Combustible ( ) * see chart on back $ 106.25
L....... CkII
: : : . tlff
:::::.:.::..: .:::::::.:::::.::::.::.:::::::: :::.::::.:::.. ..... c;< tic.. Alte0 :::::.::.:CI :;use on .:;:. > <: . .:..:
❑ EPAIR MAJOR (review re uired by plans examiner
( ) ( q P ;.: BUILD ; >`::::::: >;;
Permit required ONLY when spaced sheathing is covered by 5.31
solid sheathing. Changes to roof line require Building Permit 5% State Surcharge $
Application.
C ity ;;
SUBMIT
TWO
LANS S PECIFYIN
G.
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 $ 72.52
space. Vents shall located eo .:::,,• ...
is s be orated m the upper 1/3 of the roof.
P PP C1 ;useonl .<�: > : :: >�: > < ::: :;WAC.O�::: =:' :;;;< � °:::: > > >:;::::;:'_>": : <.:::: > °.::<:;::: >; >;::::> :: >�::: ><.
Provide
l f r
s for 30
ft each s wh
300 . ft. en eave 4
attic
venting is provided.
TOTAL $ 194.08
:STEP:7::: >i<:: >: € i::::::: CO NIERCIAL : >[ : >`
acknowledge that I have read this application, and that the
Class of lilt' `:::
n is correct; information 1ve i that I am the owner t t o or uth ri
:: Describe . wo rk t nform (c
9
o a o zed
work t � be one. (. heck appropriate x) agent of the owner, and that the plans (if applicable) are in
❑ RE -ROOF (circle ' B or C) compliance with Oregon State law.
A. Existing built -up r• 4 coverin. -to be REMOVED and deck
repaired - Signature of Owner /Agent Date
B. Existing built -up ro• ov- • g to REMAIN: note applicant
must submit a - gineer's re • of the roof structural v /�_ �/ �y /
elements. - -view shall bear the s or stamp) of the C
ntact P ers o
architect •r engineer licensed in Oregon. Co ame Telephone
C. Aspha or wood shingle /shake / 040 3& 3
PROCEED TO STEP 2) Zc03-
1:ROOF1.DOC (dsts) REV 5/1/98
CITY OF TIGARD
BUILDING PERMIT FEES
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT REVIEW TAX PERMIT
PROJECT FEES (65 %) (5 %) FEES
1 -1500 25.00 16.25 1.25 42.50
1,501-1600 26.50 17.23 1.33 45.06
1,601 -1,700 28.00 18.20 1.40 47.60
1,701 -1,800 29.50 19.18 1.48 50.16
1,801 -1,900 31.00 20.15 1.55 52.70 -
1,901-2,000 32.50 21.13 1.63 55.26
2,001 -3,000 38.50 25.03 1.93 65.46
3,001 -4,000 44.50 28.93 2.23 75.66
4,001 -5,000 50.50 32.83 2.53 85.86
5,001 -6,000 56.50 36.73 2.83 96.06
6,001 -7,000 62.50 40.63 3.13 106.25
7,001 -8,000 68.50 44.53 3.43 116.46
8,001 -9,000 74.50 48.43 3.73 126.66
9,001- 10,000 80.50 52.33 4.03 136.86
10,001 - 11,000 86.50 56.23 4.33 147.06
11,001-12,000 92.50 60.13 4.63 157.26
12,001- 13,000 98.50 64.03 4.93 167.46
13,001- 14,000 104.50 67.93 - 5.23 177.66
14,001-15,000 110.50 71.83 5.53 187.86
15,001-16,000 116.50 75.73 5.83 198.06
16,001 - 17,000 122.50 79.63 6.13 208.26
17,001- 18,000 128.50 83.53 6.43 218.46
18,001- 19,000 134.50 87.43 6.73 228.66
19,001- 20,000 140.50 91.33 7.03 238.86
20,001 - 21,000 146.50 95.23 7.33 249.06
21,001-22,000 152.50 99.13 7.63 259.26
22,001-23,000 , 158.50 103.03 7.93 269.46
23,001- 24,000 164.50 106.93 8.23 279.66
24,001- 25,000 170.50 110.83 8.53 289.86
25,001- 26,000 175.00 113.75 8.75 297.50
26,001- 27,000 179.50 116.68 8.98 305.16
27,001- 28,000 184.00 119.60 9.20 312.80 •
28,001- 29,000 188.50 122.53 9.43 320.46
29,001- 30,000 193.00 125.45 9.65 328.10
30,001- 31,000 197.50 128.38 9.88 335.76
31,001-32,000 202.00 131.30 10.10 343.40
32,001- 33,000 206.50 134.23 10.33 351.06
33,001-34,000 211.00 137.15 10.55 358.70
34,001-35,000 215.50 140.08 10.78 366.36
35,001-36,000 220.00 143.00 11.00 374.00
36,001-37,000 224.50 145.93 11.23 381.66
37,001-38,000 229.00 148.85 11.45 389.30
I:ROOF1.DOC (dsts) REV 5/1/98
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Natitie K ING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224-2693
® 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 foam indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
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: ■. — 4i--
located at: /iO1 ataii OA
U
King City Representati 'e
1'DSTS KCINST.DOC