Permit q CITY OF TIGARD REROOF PERMIT
COMMUNITY DEVELOPMENT Permit#: RER2013-00035
T I G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2013
Parcel: 2S110DC00700
Jurisdiction: Tigard
Site address: 11205 SW SUMMERFIELD DR
Project: SUMMERFIELD CLUBHOUSE Subdivision: WILLOW-BROOK-FARM Lot: 17
Project Description: Tearing off existing roofing and installing new Versico 60 Mil PVC roof system.
Contractor: PACIFIC WEST ROOFING LLC Owner: TIGARD RETIREMENT RESIDENCE LLC
9360 SW TUALATIN-SHERWOOD RD PO BOX 847
TUALATIN, OR 97062 CARLSBAD, CA 92018
PHONE: 503-635-8706 PHONE:
FAX: 503-691-2249
FEES
Description Date Amount
Permit Fee 10/16/2013 $2,706.55
Specifics: 12%State Surcharge-Building 10/16/2013 $324.79
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
Project Valuation: $364,120.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class:
Tear Off: Yes
Overlay:
Existing Roof Layers:
Parapets:
Total $3,031.34
Required Items and Reports(Conditions)
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 the 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �i? ,rmittee Signature: / /(G//4� J•� A
� ►75 by 7:00 a.m.for the next available inspection date.
permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application
Re-Roof FOR OFFICE USE°NL1"
City of Tigard } `-1 �I � Received !�� w�
• ����� ;1� Date/B � iJI Permit No.: �,��( �+d 35�
13125 SW Hall Blvd.,Tigard,OR 972ri Plan Review
II Phone: 503.718.2439 Fax: 503.598.1 6 3 Other Permit:
j
Inspection Line: 503.639.4175 OC I 2�� Date/B Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: M Supplemental Information
;6 p)
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# :r. (, I (` ` D ` - FAIL '
❑New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
a
)77 CTI
CATEGORIt.01&-VONSTRU+' O X9:4
❑ 1-and 2-family dwelling ® m
Comercial/industrial Valuation: $
El Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
VTotal number of floors:
Job site address: 11205 SW Summerfield Drive New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: I Project name: Covered porch area: square feet
Cross street/directions to job site:Next to Sumemrfield golf course on Deck area: square feet
north side of street.Pacific Highway and Durham. Other structure area: square feet
.--
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK ' work indicated on this application.
Tear off existing roofing and install new Versico 60 MIL PVC roof system per Valuation: $$364,120.00
fire code and manufacture guide lines. Existing building area: 47000 square feet
(Manufacturer Inspected Job) New building area: SAME square feet
RROPERTY O 1 Number of stories: 2/1
Name:Tigard Retirement Residence,LLC Type of construction: RE ROOF
Address: 11205 SW Summerfield Drive Occupancy groups:
City/State/ZIP:Tigard,OR 97224 Existing: SAME
Phone:(309)267-4490 Fax:( ) New:
11404#1i )�.APPLICANTI , • ) , 1:8j CONTAcr PRSON,. c
Business name:Pacific West Roofing,LLC All contractors and subcontractors are required to be
Contact name:Malt Krill licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9360 SW Tualatin-Sherwood Road jurisdiction in which work is being performed.If the
City/State/ZIP:Tualatin,OR 97062 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)635-8706 Fax::(503)691-2249
E-mail:matt @pacificwestroofing.com
Business name:Pacific West Roofing r • • - BUILDING PIf,BNITT= � r
nil?Address:9360 SW Tualatin-Sherwood Road ( (I�oabJiK
City/State/ZIP:Tualatin,OR 97062 Structural plan review fee(or deposit): -
Phone:(503)635-8706 Fax:(503)691-2249 FLS plan review fee(if applicable):
CCB lic.:169414
Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Matt Krill Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\ROOF•PermitApp.doc 10/01/09 440-46131(11/02/COM/WEB)