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CITYO F T I G.A R.D BUILDING PERMIT
PERMIT#: BUP2001-0023L'
DF` ELOPMENT SERVICES DATE ISSUED: 6/25/01
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S110CA-80051
SITE ADDRESS: 1 1535 SW CROWN DR
SUBDIVISION: KING CITY CONGO. BLDG. #81 1 ZONING:
BLOCK: L OT: 001 JURISDICTION: KIN
REISSUE: FLOOR AREAS _ EXTERIOR WALL_CONSTRUCTION_
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SFA SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 000 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 RrHT: ft FIR SPKL: SMOK DET-
DWELLING UNITS: FRNT• ft REAR: ft F:!R AL.RM : HNDICP AC(::
BEDRMS: BATHS: Ilv,, SURFACE: PRO CORR: PARKING:
VALUE: $ 15,300.00
Remarks: (2)owners project to be done under(1) permit. Other address is 11575 SW Crown dr. Porject be done under the
address of 11535 SW Crown. per Gary Lampella.
Owner: Contracioi:
PAGAN, MARIA H UNITED ROOFING + CONSTRUCTION
11535 SW CROWN CT 7276 SW BEAVERTON-HILLSDALE HW
KING CITY, OR 97224 STTpERR199
Phone: PPhone ND, OR 97225
Reg #: LIC 00091955
FEES I A REQUIRED INSPECTIONS
Type By Date Amount Receipt Roof Nailing Insp
PRMT CTR 6/25;01 Y $196.90 27200100000 Dryrot After Tear-Off Insp
5PCT CTR 6/25/01 $15.75 27200100000 Final Inspection
Total $212.65
This permit is issued subjact to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other aprlicable A!'work will be done in accordance with approved plans. This permit w1:I 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 L)y the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-19,97. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246-6699 or 1-800-332) 231.4
Pe nn ittee
Signature: jylhr �e
Issued By:
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application
City of Tigard In
ate.eccivet Permit (�
CiryajT.teard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Project/appl.no.: Expire date:
Phone: (503) 639-1171 Date issued: 152 Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land otic' approval- 1&2 family:Simple Complex:
1
L I&2 family dwelling or accessory U Com icrcial/industrial U Multi-family U New construction 0 Demolition
U Addition/aheration!replacenient U Tenant improvement U Fire sprinkler/alarm ❑Other:
1 { SITE INtORAIATION
I Is
tub address. _ i Bldg.no.: Suite no.:
Lot: 13iock: S ivision: Tax map/tax lodaccount no.:
Project name:
Description and location of work on premises/zpecial conditions: "T - ;is -
OWNER FOR SPECIAL INFORSIATION,
it 't C I► a 01 f f I►l INsolar,
Mailing address: 1 &2 family dwelling:
City: State: ZIP: Valuation of work...................
T �r
Phone: Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq. fl.)
Garage/carport area(sq.ft.)......................... _ _-
Name: Covered porch area(sq.ft.) .........................
Mailing address: Deck area(sq.ft.)........................................
City: Y State: ZIP: Jther structure arca(sq. ft.)........................
Phone: I • E-mail rommerciat/industr•ial/multi-family:
1KillValuation of work........................................ $--
r ,
Existing bldg.area(sq.ft.) ..........................
Business name: ____---
Address: , + , New bldg.area(sq.ft.) ............................... _ ----
- -=�-- - Number of stories..................
City: ,; State �(� ZIP: - ----
Phone;L_ Faith+ ;v, �E-mail: Type of-instruction etion.................................... ----
(kcupancy group(s): Existing:
CCB no. ---
-�--'"-' New.
City/metro lie.no Notice:All contractors and subcontractors are required to be
I licensed with she 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 die applicant is
-
City: State: 1!I I_---- - exempt fro..i licensing,the fallowing reason applies:
_
Contact person: Plan no.: _ --- - -- -
Phone: Fax: - F-mai L• --
Name: _ _ ontact person: _ Fees due upon application ...........................
Address: - Date received:
City: State: ZIP: Amount received ......................................... $- _--.--
Phone: -� Fax: E-mail: -V Please refer to fee schedule.
I hereby certify I have read and examined this application and the Na all Jurisdictions accept credt cards,pease call Jurisdiction for more information
attached checklist. All provisions of laws and oniinanres governing this U Visa U Mastercard
work. 'I be,c:ompli tth,whethe sp cified herein or not. Credit card number:_____. — —1
i /
mr
Auth< store. Date: 11� N. or cardbolder u.bow„on credit Cara er
Print Haar -_--- _-i_, �_�Cardbotder si`rutwe - _ Amount
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 4404613(6AX1&X M)
RE-ROOFING PERMIT CHECK LIST
RESIDENTIAL ONLY - Class of Work: Alteration _
L7 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.
SUBMIT TWO(2)SETS OF PLANS SPECIFYING:
A. Roof area and nearest street.
B. Attic vents: Provide 1 sq. ft. for eaci 150 sq. ft. of aitic space. Vents shall be located in
the upper 1/3 of the roof. Provide 'i 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
COMMERCIAL ONLY - Class of Work: Repair
STEP 1:
LJ I -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
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. 13 or C): _
A. 1. Specification#:
2. Manufacturer:
3a. UL Classification:
Listed UL Builuing Materials Directory Page#: _
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page#:
_ "COPY OF ASSEMBLY REQUIRED__
3. ICBO Research#:
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
Review required by plans examiner.) _
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 or
Assembly item"C"above.
TOTAL: $
I:dsts\brmslroofchedd l9t.doc 10/05/00
KING CITY
15J00:-W 116101 Axenin F,:ng City,Oregon 9i'="4 .16,93
Phone:003)6394033- 1AX,'503)iM9.377,1
Notice To Contractors N Vorking In Kina City
Due to an intercoyernmental agreement with the Cite of Ti-ard. mane building related permits
for projects in king Cite are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW. simple complete the
appropriate application legibl.,• and submit it to the King City staff. The King Citi staff will
collect all fees and fa:,- the application ;o the City of Tigard. City of Tigard staff v:ill 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 :nailed %%ithout an- noti:lcation. Any incomplete or ille-ible
application will be returned to Kinc Cin staff for correction and no processing will occur until a
complete. legible application is received.
If your permit application DOFS REQUIRE PLAN REVIEW. this form must be signed by a
King Cit.: staff person. King Cite stat:= .:;I1 simple sign this form indicatinj land use approval.
Take this signed form to the City of Tigard Development Sen-ices Counter located at 13125 SVC'
Hall Blvd. Tigard to submit applications and plans. Development Sen ices Technicians are
available at 639-4171 Ext. 304 should you have am questions concerning submittal
requirements. All permit gees will be assessed and collected at the City of Tigard.
The Cit% of K;ng City hereby authorizes applicant to pursue permits at the Cite of Tigard
Building Department for the following project: c,
located at: 1 I Sri J 1 165!:j Zxjr) L
G'7Q_^\,I)CAj
King CitN Representame i�- -2-5*61
! DSif S1 in:.
/11135
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspectic—i Line: 639.4175 Business Line: 631-4171
�J BUP
_ Date Re::quested! / ' 3 --AM----PM — BLD
Location�/ Suite MEC
Contact Person Ph ?!_M -
Contractor Ph _ SWR _
BUILDING Tenant/Owier - _- _ - ELC
Retaining Wall ELR
Footing Access: FPS
Foundation
Ftg Drain --- SGN
Crawl Drain Inspection Notes' - -.- .--_-._-_
Slab -___._� _-_-_� SIT
Post&Beam _ --------- -------- -
Ext Sheath/Shear
Int Sheath/Shear _
Framing vey.T� S- 4- 5--------- - - - ------ - -------- -- ---
Insulation
Drywall Nailing
Firewall ---
Fire Sprinkler -- -
Fire Alarm
S 'Piling
15G:
-ilial^ -
ASS PART FAIL_ ----- ----- -------- -- _ -- --
PLUMBING_
Post&Beam -- ---- ..-. ----- -
Under Slab _
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL _
Post RBeam --- ----- - - --------
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 ( J Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: - [ )Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sidewalk3_ �/ Inspector r
Other
Dete < - _ _ _Ext --_
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.