Permit (31) CITY OF TIGARD REROOF PERMIT
111 — iii
II ' COMMUNITY DEVELOPMENT Permit#: RER2016-00015
Date Issued: 05/10/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 DA00105
Jurisdiction: Tigard
Site address: 13009 SW 68TH PKWY C
Project: Extended Stay America Subdivision: VARNS ACRES Lot: 9
Project Description: Reroof-remove and replace.
Contractor: FIKE INDUSTRIAL CONSTRUCTION LLC Owner: BRE/HV PROPERTIES LLC
P.O. BOX 873607 TAX DEPTARTMENT
WASILLA,AK 99687 EXTENDED STAY HOTELS
OP BOX 49550
CHARLOTTE, NC 28277
PHONE: 503-357-6003 PHONE:
FAX:
FEES
Description Date Amount
Permit Fee 05/10/2016 $509.05
Specifics: 12%State Surcharge-Building 05/10/2016 $61.09
Type of Use: COM
Class of Work: OTR Type of Const: VA
Occupancy Load:
Stories: 2 Height: 0 ft
Project Valuation: $30,000.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class: A
Tear Off: Yes
Overlay: No
Existing Roof Layers:
Parapets: No
Total $570.14
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.
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Issued By: Permittee Signature: ...Zw.....,_
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Call . 9.4175 by 7:00 a.m.for the next available inspec ion date.
This 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 ONLY
Cityof Tigard and Receid
Date/By:
S / Permit No.: /!J„�.1.'/
a 131SW Hall lvd.,Tigard, 97223 y
g Plan Review I
111 IC Phone: 503.718.2439 Fax: 503.598.1960 late/B t 4C, cher Permit.
r
Inspection Line: 503.639.4175 1 to Ready/By: /�j rods ® See Page 2 for
TIGARD Internet: www.tigard-or.gov RECEIVE� �tified/Method: S/ f�(� Supplemental Information
TYPE OF WORK MAY 0 9 2n16 REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition r u Permit fees*are based on the value of the work performed.
p 0 [ 'rl1�£, 1IGAKI) Indicate the value(romded to the nearest dollar)of all
❑Addition/alteration/re lacementektt��1c 1 V equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSIg kIMANG DIVISION work indicated on this application.
CI1-and 2-family dwelling 0 Commercial/industrial Valuation: $
❑Accessory building ID Multi-family Number of bedrooms:
❑Master builder 1=1Other: Number of bathrooms:
JOB SITE INFORMATION ANDB�LOCATION Total number of floors:
Job site address: /300t 5W (Dp k /ft / New dwelling area: square feet
0
City/State/ZIP: h�fjCttb 0,e— Garage/carport area: square feet
dg./
Suit lt.no.: �/ Project name: J Covered porch area square feet
Cross street/directions to job site: 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.
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.
D�` Valuation: $ �j apC.-DO
/� Existing building area square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( )
New:
APPLICANT CONTACT PERSON NOTICE
Business name: // fiat/5Tf2.-/A- 1 Co437p_G(L770-it-(iX. All contractors and subcontractors are required to be
Contact name: IM�ei�cc� ���¢ S licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: SIM e q s /3e /0 i " jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:(570 3)a70 3'4 3(9 Fax::( ) /�
E-mail: ,�,/'/n�JCrly ..._70/ /i?dG�$Tie/i4/ 41.(T000r�•C1fX/(
CONTRACTOR
Business name: ,E /, s ' —/712,' -/ CarS7i—G(Cl/5ln. L--(-C • BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
��3�0 Structural plan review fee(or deposit):
City/State/ZIP: u.)45 J//A- 7-ke.../0, fk 96,8 -7 - 36 6-7
Phone:(56'3) , '5 7 666 3 Fax:( ) FLS plan review fee(if applicable):
CCB lic.: 0 / Total fees due upon application: 4 5 70.1,/
I Amount received:
Authorized signatu .� \ This permit application expires if a permit is not obtained
ig within 180 days after it has been accepted as complete.
Print nanfe: ; 1/4����It r�j • Date: 5 1 I(l * Fee methodology set by Tri-County Building Industry
Service Board.
I.\Building\Permits\ROOF-PermitApp.doc 10/01/09 440-46131(1 I/02/COM/WEB)