Permit h-
CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP1999 -00252 •
41 DEVELOPMENT SERVICES DATE ISSUED: 6/22/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16535 SW QUEEN MARY AVE PARCEL: 2S1156B -03200
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: $ 2,624.00
Remarks: Reroof existing dwelling w/25 yr comp. Tear off existing and replace sheathing.
Owner: Contractor:
PLAYER, DORIS C TRAIN ROOFING INC
16535 SW QUEEN MARY AVE 12990 SW PACIFIC HWY
KING CITY, OR 97224 TIGARD, OR 97223
Phone: Phone: 620 -0260
Reg #: LIC 126008
•
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
PRMT GEO 6/22/99 $38.50 99- 316321
5PCT GEO 6/22/99 $1.93 99- 316321
Total $40.43 ORGNAL
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: / 1./
Issued B /
Y /I Ate____
all 639 -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 Recd:
V- 503 - 639 -4171 X304 Commercial and Residential Date to PE:
F- 503 - 598 -1960 Date to DST:
Permit #441/04" 6d ,25R
Incomplete or illegible applications will not be accepted Called:
Name of Development/Business
A r
�F
t rr �. Inc. t�rsaf fait:{ �sQ A � i 5} .:: : .::::>:>>:::::;;:<:< . >: : > > : : : >: : >: : <
................ ...
Street Address Ste Please fill out applicable section and attach copy of roofing
Job Site ! 3 S St,0 Cauea specifications.
Bldg # City/State Zip is e d m
P ; ::�rsfe>` Assei�rbi'': ?<' ?GiF :' ; : ;., :.:.. � :.:::::..: :.. . .....
cis. &.mom Iefe::A ► >8a�C �; > <' > <s`;;;;<:;:: > . • : > <;>
Name — 1. Specificati #: �G L_ j— , — -r .
re,& e ctakc ? l ye,- I
Applicant Mailing Address 2. Manufacturer: Ce I(� , j y( j�,`.u2.ksIrcQ
/6v � � SO a 'n. vi .K
City/Stato Zip Pfione *3a UL Classification:
1 I., 6 . O
Roofing Na Listed UL Building Materials Directory Page #:
Contractor ,,r 44 (OR)
(Prior to issuance Mailing Address
applicant must d' *3b Wamock Hersey
"�
provide a copy of City/State Zip Listed Wamock Hersey Directory Page #:
all contractor b( ; ,a7 ' *COPY OF ASSEMBLY REQUIRED
licenses if • ,. ne # Fa #
...360 /
expired in COT C� 0.24 B. ICBO Research #:
database) State Constr.Contr. Board # Exp. Date
d �/ 30 DATED:
BUILD €NYG u''FQ1.011.4F1lt'rl >:::<::<>:>::;::> :: >:: >:: >:;:: »:: » :::<:::;:;;::> >;:.;:.:.;:.; -<::: : ::i::::> C. SPECIAL PURPOSE ROOFING. WOOD SHAKES
....: :::::::::.:;.:;.::.:;;:.: ;:.;:::.;:.;; >; »:.;;; >;:;.;
..... .......... ....
Building - Tvo Of Use: (circle one) (review required by plans examiner) .
SFA COM MF
Building - Type of Construction: VALUATION OF PROJECT $ se
7 3 sq. ft. of roof area
Existing Deck Type: Permit fee based on valuation* •
Combustible ( ) Non - Combustible
( ) see chart on back $
;KE ![3E�T)/�I_ : > <? <'; Giw�!1:iG1ass . . . . . . . . . . .. . . . : 4
... .
Gd" REPAIR (MAJOR) r ... . . ...T:::::----1.1::::..:::;::: .. W . ,..
( JOR) ( eview required by plans examiner) :`::' ''., ::(B :, :: »»' ( :?
Permit required ONLY when spaced sheathing is covered by
solid sheathing. Changes to roof line require Building Permit 5% State Surcharge $ C f
Application.
C ity a aseon:ly ' ; _: > W ACC3 : ,: ': < .:
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 $
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.
STE <:.:::: : > : : :i : "; .
TOTAL $ V - `./3
P9
.........COM1V[ERG#FiiL`::> < < <: ; > >:: >:: >:: >:<::: »:::: >::: >::> :>::> :: >< >:::<: >::::::::::: >: < ::
acknowledge that I have read this application and that the
of Y1f
orfc.
... information given is correct; that I am the owner or authorized w
9
work to be done: (check appropriate box) agent of the owner, and that the plans (if applicable) a 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 - Si, nature of Ownerl t Date
B: Existing built -up roof covering to REMAIN: note applicant ' /, f,- //--- ,y + j
must submit an engineer's review of the roof structural (,, - 2. ''
elements. Review shall bear the seal (or stamp) of the /�-----
architect or engineer licensed in Oregon. gontact Person Name Telephone
C. Asphalt or wood shingle /shake ��a c)
(PROCEED TO STEP 2)' -----r'/2'
I: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- 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 r
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 5/1198
6
_ a 73 .r Q 0
ti
is 4
.")
,.
Vigt KING 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 form 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: \ .
O
located at: /& 535'5'(.1) eit en
P---he \?i.
King City Representative
k DOC