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BUILDING PERMIT
CITY OF TIGARD
PERMIT M BUP2001-00229
DEVELOPMENT SERVICES DATE ISSUED: 6/12/01
13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S11513C-05500
SITE ADDRESS: 16605 SW KING CHARLES AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICI'ION: KIN
RFI"SUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: sf N. S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
UCCUPA14CY 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: B QTHS: IMP S"IRFACE: PRO CORR: PARKING:
VALUE: (p 0 0C? . 00
Remarks: Re-roof and replacement of sheathing.
Ow,rer: Contractor:
BAXTER, GEORGE C AND ARROW ROOFING
MARY A P.J. BOX 55097
16605 SW KING CHARLES PORTLAND, OR 97238
KtI�PhQ CITY. OP, 97224
one: Phone: 503-460-2767
Reg #: LIC 115153
_FEES PE:wUIRED INSPECTIONS
Type By Date Amount Receipt Dryrot After Tear-Off Insp
PRMT CTR 6/12/01 $100.90 27200100000 Final Inspection
FPCT CTR 6/12/01 $8 07 272001000n0
Total $108.97
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 lard
requires you to follow the rules adopted by the Oregon Utility Nofification Cents:r. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
c�.;ling (50)246-6699:41- 1-800-332-2344.
Permittee
Signature: �— ----
Issued By:
�'s� Cali 639-4175 by 7 p.rn. for an inspection the next business day
litulding Permit Application
-- Date rcceived:r" � Permit no.:
City of Tigard ProjccUappl.no.: Expircdatc:
Ciryr�jTi�arA Address: 13125 SW Hall Blv-i,Tigard,OR 97223 - —
Phone: (503) 639-4171 Date issues ,
By J`J/ Recriptno.:
Fax: (503) 599.1900 Case file nc.: Paymernt type:
land use approval: _--__--_ 1&2 family:.:implc Complex:
TYPE Or- PERMIT
W I &2 family dwelling or accessory U Comniercial/industrial �J Multi-family U New constniction U Demolition
U Add itiordalteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: L
JOB SITE INFORMATION
Jvb a_ddress: l F' i `. Il!dg.no.: _ Suite no.: -
Lot: Block: Subdivision: -- — Tax map/tax lot account no.: - -
Project name: iE7!t���)��=. -- -- — --
Description and location of work on prcmises/slhecial conditions:
0117�111 FOR SPECIAL INFORMATION,
Name: �� ! ��X '.
Mailing address: " I&2 family dwelling:
Cit State: ZIP 7 Valuation of work.......................... ... ......... $�0
y �- r-�-
Phone: Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: Q Total number of floors................................. -
Plume: Fax: E-mail: New dwelling area(sq.ft.) .......................... _-
Garagelcarport area(sq.ft.)......................... --
Name: Covered porch area(sq.ft.).........................
__ _. ---- - - ----- -- Deck area ft.
Mailing address: .........................Y......... --
�_._..� _ -_-- --- Otter structure area(s ft. _
City: state TZIP: q. -Ls la
-`� (:ommerciaUindatitrfaUmulti-famil
!'hone: Fax:
E-mail:
Valuation of work........................................ $_ --
Existing bldg.area(sq.ft.) .
Business name: ��-; j fif/, /,�Jf'—`.
_ New bldg.cess(sq.ft.) ................................ _
Address: Number of stories
City: State'✓% ZIP: Type of construction.................................... __—
Phonc: Fax: E-mail: _- Occupancy group(s): Existing:
New: _
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Nance: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed.If the applicant is
City: State: ZIP: exempt from licensing,Ute following reason applies:
Contact person: Plan no.: - -` ---- —� —�-
Phone: --�— Fax: E-mail: - -- ---- _
Name: Contact person: Fees due upon application ........................... $
Address: — v Date received:
City: State: ZIP: Amount received ......................................... $____....._____
Phone: Fax: Email: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all Jwisdictiom secq+r eredh cu&,please cal Jurisdiction for nine information.
attached checklist.All Provisions of laws and ordinances governing this ❑visa U Mastetcand
work will be complied hetbrlr s rr herein or not. Credit card number: - _---
P yvU�.vy i?y sed �, r xp R'
Authorized signature: X f'~`�=�— Date:, r / Name of ardholdr�r a.t,mn,on ceteil -
s
Print name:� .4,! L' - E: 1.:� --_ cranoiee�at"fure -- Amount
Notice:This permit application expires if a permit is not obtained within I days fler it hasbeen acceppted/as complete. "04613 OWrt'oM)
i�
RE-ROOFING PERMIT CHECK LIST
RESIDEN'T'IAL ONLY - Class of W(1:i" A.itf;ratiun
I REPAIR (MAJOR) (Ilan review me fired by plans examiner)
Building permit is required when spaced sheathing is covcrPd by solid sheathing and/or
changes are made to roof line
SUBMIT TWO (2) S,- ,S OF PLANS SPECIFYING:
A. Roof area and nearest street.
$. .,ttic vonts: 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 sqft, when eave and attic
venting is provided.
4
Note: No permit is required for residential re-roof if, (1) not more than three layers of
roofing will exist upon completion of the roofing or, (2)sheathing is not being applied over
spaced sheathirq (spaced sheathing usually exists when wood shingles were initially
-
COMMERCIAL ONLY - Class of Work: Repair
STEP 1: ---- - -- --- -- -------
❑ RE-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 thf, roof structural elements. Review shall bear the seal (or stamp)of the
I architect or engineer licensed in Oregon.
J C. Anhalt or wood shin le/g shake�(PROCEED TO STEP ?;
COMMERCIAL ONLY - Class of Work: Repair -
STEP 2: NEW ROOFING ASSEMBLY
Material DocumentationUBC Appendix 1)__
Please fill out applicable section and attach copy of roofing specifications._
Listed Assembly _Circle and^complete A, B or C):
A. 1 Specification #: 12 S f1k,
2. Manufacturer:_�_fZ�.i�i]
3a. UL Classification: EJListed UL UL Building Materials Directory Page#:
OR
3b. Warnock Hersey:____
Listed Warnock Hersey Directory Page
'COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:—_,_
_ Dated:
C_ SPECIAL PURPOSE ROOFING: WOOD SHAKES
Review required by plans examiner.
VALUATION OF PROJECT: $
_sq. ft. ,�of roof area C?
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\forms\roofcheckIIst doc 10/05/00
n T, KING CITY
15.'.;#0 AV.116th Avenue,King City.Oregon 9-,'—"'4'693
Phone:(503)639.4082•FAX(003)639-3771
Notice To Contractors Working In Mina City
Due to an mter,overnn:c:ra:.i a_grecrnent with the Cite of Tigard. many building related permits
for projects in King Cir: are issued and inspected by,the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW. simple complete the
appropriate application legibly and submit it to the King City staff. The Kine City staff vvill
collect all fees and fax the application to the City of Tigard. City of Tigard staff v.ill then, create
the permit, i;=:ue the permit. and perform inspections. Please indicate on the permit application
wl' ether you would like the Tigard staff to call you when thepermit is ready for issuance or
whether you prefer it to be mailed \yithout anv notification. Arty incomplete or illegible
application a.ill be returned to Kim: City staff for correction and n:1 processing vyill occur until a
complete. legible application is reWved.
If your permit application DOES REQUIRE PLAN REVIEW, this form must 11C signe d by a
)'ling City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the Cite of Tigard Development Services Counter located at 1312-5 SVS'
Hall Blvd. Tieard. to submit applic,tions and plans. Deyeleptnent Services Technicians, are
available at 6.39-4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the Cite of Tigard.
The City of King CitN hereby authorizes applicant to pursue permits at the City of Tigard
Building D,!partment for the following project: ky ��11
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located
King City City Represen
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST y
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- � - —
j BUP U 2Z
Date Requested Z �--—_PM _- BLD
Location /4/D S�54L ��r � � &Cc: Lite — MEC
Contact Person _— _ Ph "Z Z— 3 PLM _—
Contractor _ Ph — SWR _ - ---
-- Tenant/Owner — 4 F.LC
Retaining Wall ELR
Footing Acces
Foundation FPS —_— --_
Fig Drain SGN
Crawl Drain Inspection Noter: --- —
Slab __----_-- ----- — SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear /
Framing 4 _—_--
Insulation
Drywall Nailing -___y'/) ITS fXT r-'7 o--- r
Firewall
Fire Sprinkler
Fire Alarm
d Ceiling -- —��
Roo
Fina —
�ASS PAR r FAIL. ---- --------
PLUMBING �yi
Post& Beam �— —_— -- — -- l
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beam - -- ----- . -- — --
Rough In
Gas Line - ------- _.. - --- -
Smoke Dampers
Final ------ ----- _ - --- —
PASS PART FAIL
ELECTRICAL
Service —
Service
Rough In
UG/Slab - - - --- --- ------- --
Low Voltage
Fire Alarm — —
Final
PASS PART FAILSITE
Backiiil/Grading a ----
Sanitary Newer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd
Catch Basin
Fire Supply!_ine [ J Please call for reinspection RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk !
Other Date _ Inspector _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.