Permit I
Ali i BUILDING PERMIT
CITY O I TIGARD PERMIT #: BUP2004 -00016 SSUED: 1/20/04
�,�AI,j DEVELOPMENT H O BMENT r SERVICES � 639 -4171 DATE I
SITE ADDRESS: 12930 SW SCHOLLS FERRY RD PARCEL: 1S133AD -02200
SUBDIVISION: ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: A2 TOTAL AREA: 0 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: $ 63,000.00
Remarks: Re -roof.
Owner: Contractor:
WESTGATE BAPTIST CHURCH MCDONALD + WETLE
12930 SW SCHOLLS FERRY RD 2020 NE 194TH
TIGARD, OR 97223 PORTLAND, OR 97230
Phone:
Phone: 667 -0175
Reg #: MET 4 000 0 011996
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Insulation Insp
[BUILD] Permit Fee 1/20/04 $541.91 Final Inspection
[TAX] 8% State Surchart 1/20/04 $43.35
Total $585.26
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: s e . r r�A • �i
Pe mi ittee '
Signature: • � . = / (I
Call 639 -4175 by 7 p.m. for an inspection the next business day
F P Re -Roof
Building Permit Application • FOR OFFICE USE ONLY
/
City of Tigard Received Date/By: / Permit No.: - n , )r (T --LW I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �'N
Phone: 503.639.4171 Fax: 503.598.1960 � � ^ Date/By: Other Permit:
Inspection Line: 503.639.4175 -ice• P Date Ready/By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: -7 Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
ew construction El Demolition Permit fees* are based on the value of the work performed.
// Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONS UCTION work indicated on this application.
Valuation: $
El 1- and 2- family dwelling Co mmercial/industrial
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB 'SITE INFORMATION AND LOCATION Total number of floors:
Job site address: t Z S 0 s‘,..s '5GI'toLGS ge1 . zv e‘, New dwelling area: square feet
City/State/ZIP: erl ( t is, i O a . 9 ? 223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: ( ecm 6 c ( S c Covered porch area: square feet
Cross street/directions to job site: N Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
R ,G-to Fe+t l I INS _ A +r Sc L Valuation: $ j (JQp
Q iN e0-01-- Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: („... eS ,rGA-rty' 6 farQ C r,ST C RI 10 G 144 Type of construction:
Address: cc5 3c , 5W -5 cm-DLLs FldrzQy ex Occupancy groups:
City/State/ZIP: Ti t�iCl2.-D d K Cr Existing:
Phone: ( 503) S 2 y - 3 C da Fax: ( ) New:
• El APPLICANT ❑ CONTACT PERSON NOTICE •
Business name: 4..) (s c Gk s ' fret- A r C An 2G l+ All contractors and subcontractors are required to be
Contact name: t XN b v r� licensed with the Oregon Construction Contractors Board fq
under ORS 701 and may be required to be licensed in the
Address: (-ill a St-1 5 (MOLLS F (SRrt v 1k t. jurisdiction in which work is being performed. If the
/ State/ZIP: ^ s Z Z 3 applicant is exempt from licensing, the following reasons
Ci
�' 1 1, /t," L t2t 9 7 7 apply:
Phone: (So 3) $' Z ? 3I, Z Fax:: ( )
E -mail:
CONTRACTOR
Business name: A Co 01,1 rct.0 Z L3 i3 mu. BUILDING PERMIT FEES*
Address: j 2-c9 AlE /9i17W
Please refer to fee schedule
City/ State/ZIP: )ph
/� Fees due upon application
Phone: (03 ) &6::7 7 -0/ 73 I Fax: ( )
Amount received
CCB lic.: 4,iv& Date received:
Authorized signature: This permit application expires if a permit is not obtained
4,_,, ei within 180 days after it has been accepted as complete.
Print name: ' Date: / — Zd -a j * Fee methodology set by Tri -County Building Industry
��,' r , Se rvice Board.
i:\BuildingTemtils \ROOF -Pe mitApp.doc 12/03 440-4613T(I1 /02/COM/WEB)
RE- ROOFING PERMIT CHECK LIST
RESIDENTIAL (One- & Two -Family Dwelling)
❑ REPAIR (major) plan review required by plans examiner:
Building permit is required when structural changes are made or the space sheathing
is removed or replaced.
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 not more than two (2) layers of
roofing will exist upon completion of the re- roofing.
CO I I RCIAL (includes multi -family and condominiums)
N RE -ROOF: Pre - inspection is required for all roofs sloped 2:12 and less. Please
_ make an appointment by calling the inspection line at (503) 639 -4175.
❑ PLAN REVIEW:
Note: Depending on the conditions noted at the pre - inspection, plans may be
required to address any non - conforming items.
VALUATION OF PROJECT: $
sq. ft. of roof area
Permit Fee based on valuation: $
(see Building Permit Fees chart)
8% State Surcharge: $
65% Plan Review Fee: $
(Required for major repairs of residential and
special purpose roofing of commercial projects.)
TOTAL: $
i:\ Building \Forms\Re- RoofChecklist.doc 12/24/03
t _
City of Tigard Building Department
13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 639 -4171
Re -Roof Pre - Inspection. Report Form .. t 1!I
c r quested by /� %,(. Telephone j ✓' ) 'Silo , — 7 2
b Address / Z, /) 5 %% A g � / Permit #:
oof Access Location 4 V.' - , ,G,ii/, A - .// it ./.A ^ � /..
Date Requested /— /� f7 9 lime Requested �� 1 --
Type of Existing Roof , ,,,,,,a„, /',4'( A .
1. Slope of roof deck Ad_ L „ � l / °"9 )
2. Roof /Penetrations/General Conditions Fair ❑ Poo r f
3. Are there blisters? ❑ Yes WO
4. Are there cracks? ❑ Yes 126
5. Is there evidence of water ponding? ❑ Yes Rio
6. Is moisture present under roofing (leak)? ❑ Yes (moo
7. Is roof insulation existing? 0 Yes e1
8. Is roof insulation wet? ❑ Yes 0 No (,k j N,�
9. Property line setbacks on all sides > 10 feet s ❑ No
10. Building size ❑ < 3000 sq. ft ❑ < 6000 sq. ft > 6000 sq. ft
11. Building height < 2 Stories 0 > 2 Stories
12. Class of roof required ❑ Non -rated ❑ A. tali. E C.
13. Type roof deck L ‘mbustible ❑ Non - Combustible
14. Roof drains 0 Provided ❑ Required. [uate
15. Overflow drains ❑ Provided ❑ Required dequate
i
16. Attic ventilation ❑ P9vided U uired ❑ Adequate •
17. .Roof listing giProvided ❑ Required
18. Installation Instructions ' vided ❑ Required
To re -roof this structure the following conditions must be met:
The re -roof proposal is A pproved for permit issuance if the conditions listed above are met After obtaining your permit you must contact the
Building Division for an inspection when the roof deck is ready for the first inspection. The first inspection for a complete tear off is the deck
inspection. For a built -up roo em (overlay), the first inspection is at the start of the job. After the re -roof is complete, a final inspection is
required. \-
Inspector "" Date V S70 `-( i I. 1 v Pt''
Pr
•
CITY OF TIGARD 24 -Hour Irir-
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 cM
`'t
B UP — OC°66
Received Date Requested y -( AM PM , R }IP
Location / �Gj.3n JI4fL f "1 Suite MEC
Contact Person Ph s 7a — 735 a— PLM
Co tai Ph ( ) SWR
U ILD1t� Tenant/Owner L / ■ ; �, ' • ELC
raining ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear r S i
Framing ■ i ∎ �� LL • - !�__
D Drywall 11 I N ailing S �� ,
ryll N - __ _ - -=
Firewall
Fire Sprinkler
Fire Alarm
Sus•'d Ceiling
Other:
•• PART FAIL
PL MBING
Post & Beam
Under Slab
Rough -In
Water Service e
Sanitary Sewer
Rain Drains Oi ligi7i ir alib
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
/
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -tn
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line { G/ j / , /)
ADA 7 cl D '« ;
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL