Permit •
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00062
; x r DEVELOPMENT SERVICES DATE ISSUED: 2/14/01
r�I II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11992 SW ROYALTY CT 3 PARCEL: 2S1156A -90203
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: E 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: $ 13,150.00
Remarks: Recover ceftwith 25 year Class 1 Fiberglass Architectural shingles.
Boor
Owner: Contractor:
WAYNE MARTIN INTERSTATE ROOFING
11992 SW ROYALTY CT #11 15065 SW 74TH AVE
KING CITY, OR 97224 TIGARD, OR 97223
Phone: Phone: 684 -5611
Reg #: LIC 55485
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
PRMT CTR 2/14/01 $177.70 27200100000 Pre - roofing inspection
5PCT CTR 2/14/01 $14.22 27200100000
Total $191.92
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 /
Q
Signature .40 _�,_,._
Issued y: i / _ 4 i "�
P
Call 9-4175 by 7 p.m. for an inspection the next business day
Z 0 cl 096T 26S 20S :1•101:1.3 ONI30013 S.LV.LSHR.LNI :O.L L0:60 T0— t7T -30
41), . Building Permit Application
Daten:ceived: ///D Permitno.:8I l )D(pa
�' `{��'�yi° City of Tigard 1
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Pro)ecdappl.no.: F�tpi redate :
City of Tigard Date B Recei [ao.:
Phone: (503) 639 - 4171 y p
Fax: (503) 598 - 1960 Casefileno.: Payment type:
Land use approval: 1 &2 family:Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial Multi- family ❑ New construction ❑ Demolition
Addition/alteration/replacement O Tenant improvement O ire sprinkler /alarm ❑ Other.
JOB SITE INFORMATIO,
Job address: / / 'fZ .s Ai R0 yea riy eye /kvt &/ BBldg.no.: 3 Suite no.:
Lot: Block: 'Subdivision: /7 z.. z'/ / 'Tax map /tax lot/account no.: a 5//54i4'Sb,So�
Project name: O>'rf?L ca-.Dew- e on/D Q
Description and location of work on premises/special conditions: Iee - t=.rll/ie-e rotes kV i 0
, S .era- r'Jase / Fti. ' /ass 4,€ i ie fuQ/ , r
OWNER FOR . PECIAL INFORMATION, USE CHECKLIST
Name: idaufL � 1 /�j ( Floodplain ,septiccapacity,solar,etc.)
Mailing addr : / . / , zf t o`// 1 & 2 family dwelling;
City: ,k e , 4 . IState: I ZrP:9972yy Valuation of work..._ $
Phone: 6 - . pt/ (Fax: I E-mail: No. of be irooms/baths
Owner's representative: 5Ce4ttar...- Total nuniber of floors
Phone: Fax: E -mail: New dwe.ling area (sq. ft.)
APPLICANT Garage/c:rport area (sq. ft.)
Name: Covered irorch area (sq. ft.)
Mailing address: Deck ace`. (sq. ft.)
City: I State: I ZIP^ Other stn cture area (sq. ft.)
Comdten lal/mdttstrial/mniti- family: 2 /
Phone: Fax: E-mail: : Valuation of work $ /� /51) .CONTRACTOR
Business name: �,4/ck4� - • ' " f� w G Existing bldg. anew (sq. ft.)
G / New bldg. area (sq. ft.)
Address: LS-46 .S s 74/7.1-1, Number c f stories
City: .ems I Star I ZIP: 479"4/ Phone: 4 ty -,SG // I Fax: I °'mail: Type of canstrtrction
Occupancy group(s): Existing:
CCB no.: SSS/,,f New:
City/metro lic. no.: c) 00 0 / c/7 6 Notice: /11 contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provision; of ORS 701 and may be required to be licensed in the
Address: jurisdictiun where work is being performed. If the applicant is
City I State: I ZIP: exempt fi om licensing, the following reason applies:
Contact person: ( Plan no.:
Phone: Fax: E -mail:
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZWP:. Amount received $
Phone: (Fax: 1E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the ' xm air p risdictions accept crecfir raids, please call iarisdicdon for more mformotioo.
attached checklist. All provisions of laws and ordinances governing this ❑visa O Mastercard
work will be complied wi j wheth cif j herein or not / ' Credit ca a nnmnv
Expires
Authorized signature: f ... Date: 0 -/ 4 _ / !lame of cardholder as shown on credit card
•
Print name: / 7 ,// # � Cider s b Amount
Notice: 'this permit applicatio - xpires if a permit is not obtained within 180 days after it has been accepted as complete. a 13 (4AO/Con)
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•
.14V KING CITY
4aa. rr�r
15300 S.W. 116th Avenue, rung City. Oregon 97224 -2693
CrigiESSEINEEMESI Phone: (503) 639-40S2 • FAX (503) 6.39-3771
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
whet er 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: 1 — .x; 0 • i_
d,do
located at: /MIA .& J >ec..Q
Kin City Representative o2 ./ Q /
I DSTS\KCI \ST COC:
CITY OF TIGARD BUILDING INSPECTIO ► . DIVISION MST
24-Hour Inspection Line: 639-4175 Busin - �. Line: 639 171 41:23, _ o � 4
• Date Requeste 3/0 ( �u P BLD
Location l (1- C-T 'Lite MEC
Contact Person Ph v 0 / E PLM
Contractor /: -Q /0.a.)& Ph G l- £/ Q9 SWR
UILDIN Tenant/Owner S fa ELC
raining Wall 7 ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab • SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear /1 1
Framing [\ ' 7(9 Se�ug i`kp�1x4e -; c m1G -->!6S /-f pL06iN 0064_
Insulation //]►
Drywall Nailing CAM I BS7z.J� iNS fhc-r 01011‘1-6<-
Firewall UU
Fire Sprinkler
Fire Alarm ,, f r� I �
Sus.'d Ceiling 21 U i-& , o �S , 6 A- V 1 be gCto
oof
'i
PART FAIL
BING
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
I 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/ 1 � JO 1 Inspector &C/41 EXt�� VC.
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTIO
24 -Hour Inspection Line: 639 -4175 Business Line: 639-41/ ;,
• BUP � GUd So Z
Date Requested ' " al AM PM BLD
Location //,f . Rtr i /7 &- Suite MEC
Contact Person / Ph 414 57. ( o( PLM
Contractor - 241 kZ / G' c SWR
3UILQLN Tenant/0 er /21,4 !'� . i • ELC
Retaining Wall h ✓{ [.G cam- G,. 514 • ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear " �� �'
Framing Alb A1 4li: ��� `� t-1/'\/1
Insulation tn
Drywall Nailing ` 1 �C-∎ ( x , \ /)
Firewall
Fire Sprinkler
Fire Alarm r,f/'`f � / � 7 - t tru)
Suu'd Ceiling G.:1.1e/ct
Roof
isc
Final SL
PASS PART �b ��
PLUMBING c��IU V"ex viA t/Ly.
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 �7
Approach /Sidewalk Date 7/S76 I. Inspector
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION . .
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -41 •i
�, J � e)i -- cant eon
Date Requested " - vi AM PM BLD
Location // sio / ,1. (',.G nsuite 3 MEC
Contact Person Ph 2 (2-14 PLM
Contractor a" / Ph SWR
BUILDING Tenant/Owner "T- S' i irc 1,��T 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 Ib
Insulation 1
Drywall Nailing tin _
Firewall
Fire Sprinkler
Fire Alarm
Susp' Ceilyg
c ' ; ) s c 4 .S7{ /') gittr
Final
PASS PART FAI
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
A p pr oach /Sidewalk ` Z / G / Ins pector 7 Ext
G R I E x
D ! I
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.