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CITYOF TIGARD _ BUILDING PERMIT
PERMIT#: BUP2004-00115
DEVELOPMENT SERVICES DATF ISSUED: 3/22/04
13125 SW Hall Blvd., Tioard, OR 97223 (503) 6.19-4171 PARCEL: 2S111CC-21600
SITE ADDRESS: 10280 SW GREENLEAF TERR
SUBDIVISION: SUMMERF IELD NO.5 ZONING: R-12
BLOCK: L07: '274 JURISDICTION: TIG
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
' CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF 11SF SFA SECOND: sf PROJECT OPENINGS?
TYPE_ OF: CONST: sf N: S: E: W _
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: ARE RET?
OCCUPANCY LOAD: BASEMENT: s; AREA SFP. RATED:
:,TOR: HT: ft GARAGE: sf OCCU SEP. RATED:
B;'MT?: MEZZ?: REUD SE i BACKS _ REQUIRED _
FLOOR LOAD: psf LEFTY ft RGI-IT: ft —FI_R_S__PKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
B!EDRMS: BATHS: IMP SURFACE=.: PRO CORR: PARKING:
VALUE: $ 25,957.00 1✓:43
Remarks: Rero%f Building#4, 10280, 10290, 10300, 10310, 103210,10330'
1 33,E 7'
Owner: Contractor:
WALLER, MILDRED Z TRUSTEE JDC ROOFING
WATKINS, VIONA J TRUSTEE 12155 SW GRANT AVE STE C
10260 SW GREENLEAF TERRACE TIGARD, OR 97223
TIGARD, OR 97223
Phone:
Phone: 503-9r.8-1235
Reg #: LIC 98255
_ FEES" REQUIF:ED INSPECTIONS
Description Uate Amount Final Inspection 1
[BUILD1 I'rrntit I rr 3/22/04 – –Y~$139.30
[TA X1 R°,,Stag Surrharl 3/22/04 $11.14
Total $150.44
his permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes
and al!c hu applicable law All work will be done in accordance with approved plans This permit will expire if work is
riot 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 -,et forth in OAR
962-001-0010 through OAR 952-001-0100 You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1-800332-2344
Issued By:
Permittee
Signature:
Call 6�9-4175 by 7 p.m. for an inspection the next business day
Re-Roof
Buildin , Permit App kation VICE I.J9E ONLY
Cit of Tigard HEC .� Deceives
Y � L..V��--++ ���///"""""' Date/19 ;
13125 SW Hall Blvd.,'figard,OR 97223 Plau Review 1 Other Pernk
Phone: 503.639.4171 Fax: 503,598.1960 Date/By.
inspection Line: 503,639.4175 MAR f t Date heady/By Juris 0 See Page 2 for
Internet: www,c1,tigard.or_,s Notified/Method Supplementallnfotmotion
TYP§LqEtVMI0IV1S10N REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑ m
Demolition rPermit fees'are based nn the value of the work perfol ed.
Indicate the value(rout,ded to the nearest dollar)of all
Addition/ulteration,replacement ❑Other: equipment,materials,labor,overhead,an,l the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
--• —
❑ 1-and 7.-family dwelling ❑Commercial/industrial Valuation: $--
i Number of bedrooms:
❑Accessory building ❑Multi-family -
❑Master builder Other: eNA)140 Ll56s Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:/0 �j 33t+ l,(' �fIP_ee A&i-= New dwelling area: �quare fret
City/Stale/ZIP: , R M. e '7Garage/carport area: square feet
Suite/bldg./apt.no.: Project nume• U—MeA�E ,e /G Covered porch area: square feet
Cross street/directions to job site: i \ '��p<9+ Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCI41-USE CHECKLIST
Subdivision: Lot no.: Permit fees'are based an the value oCthe wor!.performed.
-' - Indicate the value(rounded to the nearest doliar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ �
L M 0 tl� ?—�-�4Y�2 5 0"41tri ,c�,1 �G E�T i�4p
W 0&%J �..eY �'A P6. 3B` Existing building area: square feet
!e^/ �C. � -- , C?pII?7? J#r�lh4_�,� New building area: —square feet
PROPERTY OWNER _` ❑ TENANT Number of stories: -
Name: W 4l'e'C TI'ts(k, t1 S SA tI[-7 t661ese r l A-.—6e/-v t,p prype of construction:
� io
Address: /0T /07-p0� . Occupancy groups:
City/State/Zip: [' ` Existing:
Phone:( ) Fax:( ) -- New:
❑ APPLICANT CONT)►f'T PERSON NOTICE
Business natuc: v _ All contractors and subcontractors are required to be
Contact name: G S cA/ - licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If th-.
applicant is exempt from licensing,the fnllowing rehsons
City/State/ZIP: apply:
Phone: or" --b ;Oc,- Fax: :
E-mail:
-�CONTRACTOR
Aa,
Business name: t / / _ BUILDING PERMIT FEES*
Please refer tofee schedule.
CI,:,State/ZIP: 4C-'7 ?eR- -�1�3 Fees due upon application
Phon,:(_ ".-� y Fax:( ) --
_— � Amount received
CCB lic,: _
Date received.
Authorized signa � �9,fL ye,�, f Thi,permit application expires It a permit Is not obtained
Ithin 180 days after it has been accepted as complete.
Print name: Date: 3 / ' OV( �eh methodology set by I'ri-County Building Industry
Service Board.
itBuildifilTermHetRaaF-PemitAppdoc ILOI "G-4613T(Ito:/C'aM/WE01
RE-RVZPFING PERMITCHECK LIST
RESIDENUAL(One-&Two-Family Dwelling) —
(J� 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 l sq. ft. for each 130 sq. ft. of attic spat;;. Vents shall be
located in the upper 1/3 of the roof. provide 1 sq. ft. for each 300 sq. ft. when
cave and attic venting is provided.
Note: No �ermit is required for resider'ial re-roof if not more hal; two (2) layers of
roofing will exist upon completion o"the re-roofing.
COMMERCIAL(includes multi-family and cond(miniums)
RE-ROOF: Pre-inspection is required for all roofs sloped 2.12 and less. Please
make an a ointment by calling the inspection line at 503) 639-4175.
El PLAN REVIEW:
Note: Depending on the cond«;ons noted at the pre-inspection, plans may be
required to address any non-conforming items.
VALUATION OF PROJECT: S
of roof aic2
Permit Fee based on vale .ttion: $
- - - - -`---(see Building Permit Fee- start
8% State Surchar e. $
65% Plan Review Fee: $
(Required for major repairs of residential and
sk ciao ose roofing commercialr�ojects.
TOTAL: $
i\Ruin img\Forms\Rc-RnoiT'hccklist.doc 12/24/03