Permit A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2000 -00437
, , o , DEVELOPMENT SERVICES DATE ISSUED: 10/25/00
„Ai '�f �! 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16080 SW ROYALTY PKWY PARCEL: 2S110CC -01300
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 022 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: sid � 7 7
Remarks: R ential re- robf
Owner: Contractor:
COUNTRYMAN, MARIE + PEOPLES QUALITY PLUS ROOFING
COUNTRYMAN, DERAL 1120 PARKWAY DR NW
16080 SW ROYALTY PKWY SALEM, OR 97304
KloneTY, OR 97224 Phone: 503 - 581 -3113
Reg #: LIC 109054
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Roof Nailing lnsp
PRMT CTR 10/25/00 $91.30 27200000000 Final Inspection
5PCT CTR 10/25/00 $7.30 27200000000
Total $98.60 •
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.
•
Pe mi itee
Signature: • Ef
� 1
Issued By: ,cAr% 7 _
Call 639 -4175 by 7 p.m. for an inspection the next business day
Ai
Building Permit Application
At, d� Datereceived: /6/25/4 Permit rm.:QliP2mo 5 37
1yl City of Tigard
- . Project/appl.no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By:. I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New onstructioA ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm Other: 1Ge r o -o k-
JOB SITE INFORMATION
Job address: /(p0)0 $ Inl Q q i 1 C C..r ',je K:•� JI, Bldg. no.: Suite no.:
Lot: I Block: 'Subdivision/ 1 I Tax tap /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: OIYiz_ Cara..,., %i - nun-- ( Floodplain ,septic capacity, solar,etc.)
Mailing address: s'A rv.r I 1 & 2 family dwelling:
City: , C :4- IState: OR,I ZIP: q �ZZt- f Valuation of work $
Phone: (14 333.41 (Fax: E -mail: No. of bedrooms/baths
Owner's representative: P P o IRS bZ0 o 4- ,k Total number of floors
Phone: Z, ) -3) Fax:; ' .- 6220 E -mail: ` New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: 5.21 MI_
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: Commerelallmdustrlallmulti- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: 1 E o O , ,tom 1
Address: New bldg. area (sq. ft.)
1IZO Ar me � , Number of stories
City: 5 k,", I S tate:O g,,I ZIP: ?1-3.o Y Type of construction
Phone: /--3 13 Fax :3 7- /-( E-mail: Occu group(s): Existing:
CCB no.: ' O � a S's New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECT /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: I 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: 1E-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 ❑ Visa o MasterCard
work will be complied t ith, whe ; r s .` fled , erein or not. l credit card numbs. Exp'r res
Aut signatu 41 t' - • .. A . _ tit ) • ate: / 0/ L 0 4 Name of cardholder as shown on credit card
Print name: 63'i Cardholder signature 0.r p! . ! / o eAf. gnature 3 Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (doonc:OM)
4
• I `
t RE- ROOFING PERMIT CHECK LIST
F SIDENTIAL ONLY - Class of Work: Alteration
REPAIR (MAJOR) (plan review required by plans examiner)
Building permit is required when spaced sheathing is covered by solid sheathing and /or
changes are made to roof line.
1 SUBMIT TWO (2) SETS OF PLANS SPECIFYING:
A. Roof area and nearest street.
B. Attic vents: Provide 1 sq. ft. for each 150 sq. ft. of attic space. Vents shall be located in
the upper 1/3 of the roof. Provide 1 sq. ft. for each 300 sq. ft. when eave and attic
venting is provided.
Note: No permit is required for residential re -roof if, (1) not more than three layers of
roofing will exist upon completion of the re- roofing or, (2) sheathing is not being applied over
spaced sheathing (spaced sheathing usually exists when wood shingles were initially
applied).
COMMERCIAL ONLY - Class of Work: Repair .
STEP 1:
❑ RE -ROOF (circle A, B or C):
A. Existing built -up roof covering to be REMOVED and deck repaired.
B. Existing built -up roof covering to REMAIN. Note: Applicant must submit an engineer's
review of the roof structural elements. Review shall bear the seal (or stamp) of the
architect or engineer licensed in Oregon.
C. Asphalt or wood shingle /shake. (PROCEED TO STEP 2)
COMMERCIAL ONLY - Class of Work: Repair
STEP 2: NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix 15)
Please fill out applicable section and attach copy of roofing specifications.
Listed Assembly (Circle and complete A, B or C):
A. 1. Specification #:
2. Manufacturer:
3a. UL Classification: •
Listed UL Building Materials Directory Page #:
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page #:
*COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
(Review required by plans examiner.)
VALUATION OF PROJECT: $ y�
sq. ft. of roof area
Permit Fee based on valuation:
(see Building Permit Fees chart) 9/, 3
8% State Surcharge: $ 7, 3 0
65% Plan Review Fee: $
(Required for major repairs of Residential or
Assembly item "C" above. 4//9 , 2.Q.. '
TOTAL: $ W G U
i:dsts \forms\roofchecklist.doc 10/05/00
1
Building Permit Fee Chart
v
Project Valuation Permit Fee Review Tax
65% 8% Total
1 2,000 62.50 40.63 5.00 108.13
2,001 3,000 72.10 . 46.87 5.77 124.73
3,001 4,000 81.70 53.11 6.54. 141.34
4,001 5,000 91.30 59.35 7.30 157.95
5,001 6,000 100.90 65.59 8.07 174.56
6,001 7,000 110.50 • 71.83 8.84 191.17
7,001 8,000 120.10 78.07 9.61 207.77
8,001 9,000 129.70 84.31 10.38 224.38
9,001 10,000 139.30 90.55 11.14 240.99
10,001 11,000 148.90 96.79 11.91 257.60
11,001 12,000 158.50 103.03 12.68 274.21
12,001 13,000 168.10 109.27 13.45 290.81
13,001 14,000 177.70 115.51 14.22 307.42
14,001 15,000 187.30 121.75 14.98 324.03
15,001 16,000 196.90 .127.99 15.75 340.64
16,001 17,000 206.50 134.23 16.52 357.25
17,001 18,000 216.10 .140.47 17.29 373.85
18,001 19,000 225.70 146.71 18.06 390.46
19,001 20,000 235.30 152.95 18.82 407.07
20,001 21,000 244.90 159.19 19.59 423.68
21,001 22,000 254.50 165.43 20.36 440.29
22,001 23,000 264.10 171.67 21.13 456.89
23,001 24,000 273.70 177.91 21.90 473.50 _
24,001 25,000 283.30 184.15 22.66 490.11
25,001 26,000 290.80 189.02 23.26 503.08
26,001 27,000 298.30 193.90 23.86 516.06
27,001 28,000 305.80 198.77 24.46 529.03
28,001 29,000 313.30 203.65 25.06 542.01
29,001 30,000 320.80 208.52 25.66 554.98
_ 30,001 31,000 328.30 213.40 26.26 567.96
31,001 32,000 335.80 218.27 26.86 580.93
32,001 33,000 343.30 223.15 27.46 593.91
33,001 34,000 350.80 228.02 28.06 606.88
34,001 35,000 358.30 232.90 28.66 619.86
35,001 36,000 365.80 237.77 29.26 632.83
36,001 37,000 .373.30 242.65 29.86 645.81
37,001 38,000 380.80 247.52 30.46 658.78
38,001 39,000 388.30 252.40 31.06 671.76
39,001 40,000 395.80 257.27 31.66 684.73
40,001 41,000 403.30 262.15 32.26 697.71
41,001 42,000 410.80 267.02 32.86 710.68
42,001 43,000 418.30 271.90 33.46 723.66
43,001 44,000 425.80 276.77 34.06 736.63
44,001 45,000 433.30 281.65 34.66 . 749.61
45,001 46,000 440.80 286.52 35.26 762.58
46,001 47,000 . 448.30 291.40 35.86 775.56
47,001 48,000 455.80 296.27 36.46 788.53
48,001 49,000 463.30 301.15 37.06 801.51
49,001 50,000 470.80 306.02 _ 37.66 _ 814.48
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I: \dsts \forms\feechart.xls 10/01/00 1
, • •
KING CITY
15300 S.W. 116th Avenue, Bing City, Oregon 97224.2693
miannorassim .d., 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: \I.P lx c- O,y - 4
located at: S.70 e . : _ [/ / I/
<U — 25-400
King City Representative
1 DSTS4:CINST DOC
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
241Iourtspection Line: 639 -4175 Business Line: 639 -4171
BUP 2,650— 00 4 ?7
Date Requested //-' I AM PM BLD
Location /Gd PU 5441 RG7 L,f lee Suite MEC
Contact Person Ph 5 9 7Z-- Di/37 PLM
Contractor Ph(6/3 33 SWR
(BUILT Tenant/Owner /.,// 503 - 2 3( eoO ELC
Retains' r g all ELR
Footing Access
Foundation f / pile cG / �� ��� � / of FPS
Ftg Drain �G � -/ !/ SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
s 'd Ceiling
Roof
isc:
0 1110 PART FAIL
MBING
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 ,/ 7- ed Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CIT" OP TiGARD BUILDING INSPECTION DIVISION
MST
24-lournspection Line: 639 -4175 Business Line: 639 - 417.1
BUP "s.e4v -vv z13 7
Date Requested / d' 3 I AM PM BLD
Location /G a Pr a 5 ytil P K (. y Suite MEC
Contact Person / / Ph ,Ir3 y 3 Z G 3 7 PLM
Contractor Ph 5D3 Z3 L 9°ci, SWR
BUILDING Tenant/Owner • ELC
Retaining Wall ELR
Footing Access �� / /
Foundation C-G.Gt ! c FPS
Ftg Drain R. ? �G '
Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing / ,VSj c 7 iv
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Sus a'. Ceiling
woof dlgeli
T isc:
Final
AR FAIL
P UM 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 id — 3,0-0a Inspector . Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.