Permit CITY OF TIGARD MASTER PERMIT
- 4111 , ��� „ DEVELOPMENT SERVICES PERMIT PERMIT
• MST97 -0397
s'��I �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 09 / 19/ 97
lit PARCEL: 2S115BC -10500
SITE ADDRESS...:16555 SW ROYALTY PKWY
SUBDIVISION • ZONING:
BLOCK LOT • N/�TURISDICTION: KIN
Remarks: re -roof existing single family dwelling. remove sheating and replace. NO
JURISDICTION:
REISSUE: STORIES : 0 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS -- REQUIRED
CLASS OF WORK.:REP HEIGHT • 8 FIRST • 0 sf GARAGE • 8 sf LEFT • 8 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT : 8 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT : 0
OCCUPANCY 6RP.:R3 BDRM: 0 BATH: 0 TOTAL 0 sf VALIJE..$: REAR : 0
PLUMBING
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 8 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 8 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 8
MECHANICAL
FUEL TYPES FURN (108K ..: 0 BOIL /CMP ( 3HP: 8 VENT FANS • 0 CLOTHES DRYERS: 8
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES....: 8 GAS OUTLETS...: 0
ELECTRICAL
— RESIDENTIAL UNIT— -- SERVICE /FEEDER -- --TEMP SRVC /FEEDERS— — BRAND( CIRCUITS— — MISCELLAMEOUS— - -ADD'L INSPECTIONS —
1'RE' SF OR LESS: 0 0 - 200 amp..: 0 8 - 208 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR : 8
LIMITED ENERGY.: 0 401 - 600 amp..: 0 481 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 8 681 - 1'. ;' amp.: 0 601 +amps -1080 v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 608 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER HVAC L. /IRRIB: PROTECTIVE SI6NL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: ::
HVAC • DATA /TELE COMM.: NURSE CALLS TOTAL 0 SYSTEMS: 0
Owner: — Contractor: TOTAL FEES:$ 53.03
HACHINSEN. MR & MRS GHESS QUALITY REMODEL SERVICE This permit is subject to the regulations contained in the
16555 SW. ROYALTY PARKWAY 12245 SW. PIONEER LANE Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 MITE D119 other applicable laws. All work will be done in accordance
BEAVERTON OR 97'.''-: with approved plans. This permit will expire if work is
Phone 8: Phone 8: 598 -6148 not started within 180 days of issuance, or if the work is
Reg B..: 089589 suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952-881-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (583)246 -1987.
REQUIRED INSPECTIONS
Building Final
Issued By: /1 // ". Permittee Signature:
+ + + + + + + ++ + + ++ +++++++++-/+++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
CITY OF TIGARD 3/2 8- S &- Recd By:
13125 SW HALL BLVD. Date Rec'd: 'IILIN
TIGARD OR 97223 RE-ROOFING PERMIT APPLICATION Date to PE:
V- 503-639-4171
F-503-6847297 X304 • Incomplete or illegible applications will not be accepted Date to OST i i timco!tt 6
- Permit rt
Called: ' /7/ c- _03,.
/ Name of Development/Business _., STEP .--,
. - ai AA t4-1 i' MateifelOadUrnerititfoii(UBC .: -;
Street Address .....) st Please fill out applicable section and attach copy of roofing
Job Site I (,,9 5S5cAo ikcie.,-, 6-.Pki., Ste specifications.
Bldg * ,gity/Statsl, / Zip • LietedAssembly .,( Circle. &Complete Ail3OrC).:•:i
(A54-11 A.
Name 1. Specification it:
Mr , VIrs -IL ,,k-f o ciz_i..:.)
Owner &lading Address 2. Manufacturer
uowc-si, ifea - ? - c 1 -1
a ty/Set 1 if ate I Zip I Phone 3a UL Classification:
Nape Listed UL Building Materials Directory Page it
C:-/ e/C Le e- (OR) -
Roofing malting Address 3b Warnock Hersey :
Contractor 1 1 / 70 S&L) 77) _SI
'nor to issuance SA/State Listed Warnock Hersey Directory Page ft
:
applicant must / brit-r) i 0 (4— R
/2-23 _ (PROVIDE COPY OF ASSEMBLY)
rovide a copy of Phan * ' Fax *
all contractor 5(,) - Ciii-f X B. ICBO Research #:
licenses if Ste Constr.Contr. Board* Exp. Date
expired in COT I --- S-- -- 9 b 319( DATED:
database) COT Bus. Tax or Metro tic* Exp.Date (PROVIDE COPY OF ASSEMBLY)
3.UILDING4NFOFUWATPft,V.Agn•r:4Meaigi:lata C. SPECIAL PURPOSE ROOFING: WOOD SHAKES'.
3uilding - Type Of Use: (circle one) . (*review required by plans examiner)
SF SFA COM MF
_Wilding - Type of Construction: VALUATION OF PROJECT $ r - '
b; 60
xisting Deck Type: Permit fee based on valuation' __,,
Combustible ( ) Non-Combustible ( ) • see chart on back S ._ C) - ----\ )
•••••::::•k--?']e624 _..-.1.g49)kEW;28P14!t:Q::41;;SEV.:::::::::::ki: City use only : : : WACO:
• . . . .
24 REPAIR (MAJOR) (BUILD) , (UBUILD)
Permit required ONLY when spaced sheathing is covered by
solid sheathing. 5% State Surcharge S
City use only: -. .•.. ; WACO:- • • :.. . . - - - -
SUBMIT THREE (3 ) SETS OF PLANS SPECIFYING. (TAX) - - - ! • • .`: (UTAX)
A. Roof area & nearest street
65% Plan Review S
B. Attic vents - Providel sq. ft. for each 150 sq. ft of attic City use only: WACO:
space & vents shall be located in the upper 1/3 of the roof. • (BUPPLN) (UBUPLN) .
Provide 1 sq. ft. for each 300 sq. ft. when eaves & attic
TOTAL S . ° 3
rEgxigarropahwAc*PMMPAAVW0=:]iiiiiii:::::inS.A.4 I acknowledge that I have read this application and that the
'escribe work to be done: (check appropriate box) information given is correct; that I am the owner or authorized
J RE-ROOF (circle A ,B or C) agent of the owner, and that the plans (if applicable) are in
A. Existing built-up roof covering to be REMOVED and deck compliance with Oregon State law.
repaired - Slgnatu of OvmedAge t Date
B. Existing built-up roof covering to REMAIN: note applicant
must submit an engineer's review of the roof structural lig-lei . 7--
elements. Review shall bear the seal (or stamp) of the
architect or engineer licensed in Oregon. Contact Pers n Name Telephone
C. Asphalt or wood shingle/shake ,
vi- e_ ; —6 /I'r
(PROCEED TO STEP 2) _ ii- i
I:ROOF1.DOC (dsts)
CITY OF TIGARD
BUILDING PERMIT FEES .
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT F.L.S. REVIEW TAX PERMIT
PROJECT FEES (40 %) • (65 %) (5 %) FEES
1 -1500 25.00 10.00 - 16.25 1.25 52.50
1,501 -1600 26.50 10.60 17.23 1.33 55.66
1,601 -1,700 28.00 11.20 18.20 1.40 58.80
1,701 -1,800 29.50 11.80 19.18 1.48 61.96
1,801 -1,900 31.00 12.40 20.15 1.55 65.10
1,901 -2,000 32.50 13.00 21.13 1.63 68.26
2,001-3,000 38.50 15.40 25.03 1.93 80.86
3,001 - 4,000 44.50 17.80 28.93 2.23 93.46
4,001 - 5,000 50.50_ 20.20 32.83 ?5 -.--- , 106.06 3, O_3'
5,001 -6,000 56.50 22.60 36.73 2.83 118.66
6,001 -7,000 62.50 25.00 40.63 3.13 131.25
7,001 -8,000 68.50 27.40 44.53 3.43 143.86
8,001 -9,000 74.50 29.80 48.43 3.73 156.46
9,001- 10,000 80.50 32.20 52.33 4.03 169.06
10,001 - 11,000 86.50 34.60 56.23 4.33 181.66
11,001- 12,000 92.50 37.00 60.13 4.63 194.26 •
12,001 - 13,000 98.50 39.40 64.03 _ , 4.93 . 206.86 . _ . . .
13,001 - 14,000 104.50 41.80 67.93 5.23 219.46
14,001- 15,000 110.50 44.20 71.83 5.53 232.06
15,001- 16,000 116.50 46.60 75.73 5.83 . 244.66
16,001 - 17,000 122.50 49.00 79.63 6.13 257.26
17,001 - 18,000 128.50 51.40 83.53 6.43 269.86
18,001 - 19,000 134.50 53.80 87.43 6.73 282.46
19,001- 20,000 140.50 56.20 91.33 7.03 295.06
20,001- 21,000 146.50 58.60 95.23 7.33 307.66
21,001- 22,000 152.50 61.00 99.13 7.63 320.26
- 22,001- 23,000 158.50 63.40 103.03 7.93 332.86
23,001- 24,000 164.50 65.80 106.93 8.23 345.46
24,001- 25,000 170.50 68.20 110.83 8.53 358.06
25,001- 26,000 175.00 70.00 113.75 8.75 367.50
26,001- 27,000 179.50 71.80 116.68 8.98 376.96
27,001 - 28,000 184.00 73.60 119.60 9.20 386.40
28,001- 29,000 188.50 75.40 122.53 9.43 395.86
29,001- 30,000 193.00 77.20 125.45 9.65 405.30
30,001- 31,000 197.50 79.00 128.38 9.88 414.76
31,001- 32,000 202.00 80.80 131.30 10.10 424.20
32,001- 33,000 206.50 82.60 134.23 10.33 433.66
33,001 - 34,000 211.00 84.40 137.15 10.55 443.10
34,001- 35,000 215.50 86.20 140.08 10.78 452.56
35,001- 36,000 220.00 88.00 143.00 11.00 462.00
36,001- 37,000 224.50 89.80 145.93 11.23 471.46
37,001- 38,000 229.00 91.60 148.85 11.45 480.90
I:ROOF1.DOC (dsts)
, ..
41„t KING CITY
15300 SW. 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: �Q , ,, ii
i
• located at: .653 _ i
)eiekic_e_..‘
King City Representative
I:`DSTS \KCrNST.DOC
6/13/00 Activities for Case #: MST97 -00387
2:26:17 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA005 Application received 9/19/97 GEO RECD DST 9/19/97
MSTA008 Permit Created 9/19/97 GEO PASS DST 9/19/97
MSTA799 Building Final DST 9/19/97
MSTA757 Roof Nailing 9/19/97 9/19/97 DST 9/19/97
MSTA092 (F) Issue combination permit 9/19/97 GEO PASS DST 9/19/97
MSTA945 Request inspection research 5/22/00 ST DONE No Hold ST 5/22/00
MSTA153 Expired by limitation 6/4/00 HAP DONE No Hold AKJ 6/4/00
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