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CITYOF TIGARD BUILDING PERMIT
PERMIT#: BUF 2002-0Q280
DEVE! OPMENT SERVICES DATE ISSUED: 01 002
13125 SW Hail Blvd.. Tigard, OR 97223 (503) 639-4171 PARCEL: 2S116AD-05100
SITE ADDRESS: 16555 SW MONACO LN
SUBDIVISION: KING CITY NO. 11 ZONING:
BLOCK: 13 �1
� ,�.S -7 S LOT: 114 JURISDICTION: KIN
REISSUE: _ FLOOR AREAS EXTERIOR_WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E -W:
TYPE OF USE: MF SECOND: sf PROJECT O_PEN:NGS?
TYPE OF CONST: sf N: S_ ^ E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
B5MT?: MEZZ?: _ RFQ_D_SETBACKS _ _ REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: —
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
EEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 32,000.00
Remarks: Reroot entire building, tear-off and replace.
Owner: Contractor:
MITCHELL, LOIS F BOB CARLSON INC
16555 SW MONACO LN PO BOX 63
PING CITY, OR 97224 HILLSBORO,OR 97123
Phone: Phone: 640-3623
Reg #: LIC 5113
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Dryrot After Tear-Off Insp
PRMT CTR _ 7/17/02 $62.50 27200200000 Final Inspection
5PCT CTR 7/17/02 $5.00 27200200000
Total $67.50
This permit is issued subject to the regulations contained in the Tigard Municipal Gode, 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 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 952-001-1987. You may obtain a copy of these rules or direct questions to(?UNC by
calling (503) 246-6699 or 1 800-332-2344.
Permittee
Signature: .,r,�.�..� t ►�-� �(��- `-
r1
Issued Bk.. -----
Call 639-4175 by 7 p.m. for an inspection the next business day
Re-hoofer fi
Building Permit Application
City of Tigard Date received: 7Ia ��• Pertnitn�.
Address: 13125 SW Hall Blvd,Tigard,OR 97223Pro1��appl.no.: re date:
City of Tigard phone: (503) 639-4171 Date issued: �,ki Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: �Q,� P�_ //b r 0 1&2 family:Simple Complex:
rAM
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteralion/replacement U Tenant improvement U Fire sprinkler/alarm U Odter:
JOB SITE INFORMATION
Jolt addles:;: 1 AW_ st'3 ! ' • -'�'+ _ - _ Bldg.no.: Suite no.:
Lot: I Block: -I Subdivision`- Tax map/tax lot/account no.:
Project name: -OA.
Description and 1 ation of work on premise special conditions: _ _ ° _lSI�lN I e-
OWNE111 FOR SPECIAI,INFORAJATJON,
Name: �� ,p t t ,
27�Mailing add s: f &2 family dnclling:
City: - Nato: 0Valuation of work......................................
Phone: Fax: 1.-mail: No.of bedrooms/baths................................ —
Owner's representative: — Total number of floors.................. ..
Phone: Fax f mail: New dwelling area(sq.ft.) ................... .... .
Garage/carport area(sq.ft.) --
Nar.lc: L3 Covered porch area(sq.ft.) .........................
Mailing address: Deck arca(sq.ft.)........................................
-_-- Othcr structure area(sq. ft.).. _
City: _ State:0 LII' ,Z
Phtmr:`gyp_ S��, l;,x:�,�p-�/�yD F mail Commerciallindustrial/multi-family:
+ t Valuation of work..................................... ..
Business Warne: (p ��s.,,` `„E;.ri,y� Existing bldg.area(sq.ft.) ..........................
--- — --- New bldg.area(sq.ft.) ................................
-
Address: / p (�
City: _ 10 � State: ZIP: } Number of stories........................................
Phone: •(O- i6 J 3 lax: p-y fqE-mall: Type of construction.................................... —
- --+� - ---- — - Occupancygroup(s): Existing:
�Y'B no.: SII S New:
ity/mctm lie,no.: l q 3 Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
� f provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed.If the applicant is
nadress: 14C; .SS ��— -- �`�` `a-20`�
Cit S atr:p exempt from licensing,the following reason applies:
Y:
Contact person:S{eve t flan no.:
i'Itonc210- Fax:tt5-rTiolp
Not Ml 11'
Name: Contact person: Fees due upon application ...........................
Address: Date rrceived:
Citi': State: ZIP: Amount received ......................................... $
Phone: I E-mail: Please refer to fee schedule. --_
I hereby certify l have read and examined this application and the Not tit iudst icUm accept credit cords,please cell jutiuliction Ix mote intomtation
attached :hecklist. All provisions of laws and ordinances governing this Ovse 0MaaterCard
work will be complied ith w t cified herein or not Credit cud number — -- -- [--L--
�� tiepiree
Authorized signature: - D3tr"
�. z- 0Z. Name of cordholder es shown on credit card --
-
Print name: 1oy�..^vyNe o►�_v� —__—_ c,tdnd aRnutar— — Miwtat
Notice:This permit application expires if it p:rmit is not obtained within 190 days after it has hecn aazpi-:. as c inkplete,
RE-ROOFING PERMIT CHECK LIST
RESIDENTIAL ONLY - Class of Work: Alteration
❑ REPAIR (MAJOR) (plan review r(.yulred 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 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 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
S(EP 1:
`.a1 RE-ROOF (circle A, B or C):
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. Peview shall bear the seal (or stamp)of the
architect or engineer licensed in Oregon.
C. )Asphalt or wood shingle/shake, (PROCEED TO STEP 2) _
CO MEACIAL ONLY - Class of Work: Repair
STEP 2: NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix 15)
Please fill out applicable section and altauh copy of roofing specifications.
Listed Assembly Circle and complete A, B or C):
A. —Specification#, e
2. Manufacturer.
3a. UL Classification: _
Listed UL Building Materials Directory Page#::Sii —cg �+e Sir 4 41arL1.e
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page#:
`COPY OF ASSEMBLY REQUIRED _
B. ICBO Research#:E-S3o0 —
_ Dated: _
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
_ tReview re uiq red byplans examiner.
VALUATION OF PROJECT: $
sq. ft. of roof area _
Permit Fee based on valuation: $
see Building Permit Fees chart
8% State Surcharge: $
65% Plan Revie-1 Fee: III $
(Required for major repairs of Residential or
Assembly iters "C"above.
TOTAL: $
i:dsts\forms\roofchedciist.doc 10/05/00