Permit (60) CITY OF TIGARD REROOF PERMIT
COMMUNITY DEVELOPMENT Permit#: RER2017 00037
Date Issued: 08/22/2017
T EG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136DD03800
Jurisdiction: Tigard
Site address: 11675 SW 66TH AVE
Project: City County Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: 4-8&27
Project Description: Reroof-remove and replace.
Contractor: DIVERSIFIED ROOFING&CONSTRUCTION LLC Owner: CITY COUNTY INSURANCE SERVICES
16509 NW SELLERS RD 1212 COURT ST NE
BANKS, OR 97106 SALEM, OR 97301
PHONE:
PHONE: 503-828-4644
FAX:
FEES
Description Date Amount
Permit Fee 08/22/2017 $2,313.95
Specifics: 12%State Surcharge-Building 08/22/2017 $277.67
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
Project Valuation: $300,000.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class:
Tear Off: Yes
Overlay:
Existing Roof Layers:
Parapets:
Total $2,591.62
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. . •87 or 1.800.332. 344.
Issued By: " Permittee Signature: v
Call 503.639.4175 by 7:00 a.m.for the next available inspection•ate.
This permit card shall be kept in a conspicuous place on the job site until c• pletion of e project.
Approved plans are required on the job site at the time of e.: inspection.
Building Permit Application
Re-Roof FOR OFFICE LSE ONE)'
FiCtAIN s 1� Receivedpermit No.: /^iCity of Tigard Date/B : s1/ -
g 13125 SW Hall Blvd.,Tigard,OR 97Plan Review
111 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: .1-., r_1 i 7— g
Inspection Line: 503.639.4175 of I r d L� Date Ready/By: ifffl ® See Page 2 for
T I G A R D p AUG !t Notified/Method: Supplemental Information
Internet: www.tigard-or.gov
OF TIGARD
TYPE OF � C i REQUIRED DATA:1-AND2-FAMILY DWELLING
PJ' oiitton ? Permit fees*are based on the value of the work performed.
❑New construction Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration la ellta Other: PQ .F- ' equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY OF CONS ON
Valuation: $
❑ 1-and 2-family dwelling Commercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
Number of bathrooms:
❑Master builder 0 Other:
JOB SITE INFORMATION AND LOCATIONTotal number of floors:
ry s
Job site address: /V& 76 5Lt) co�.y ptV C_ New dwelling area: square feet
City/State/ZIP: 6 j. c r 0/1 C 7 , 3 _ �(,4i� Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: 6, ��r�t, j/�scw-aCovered porch area: square feet
Cross street/directions to job site: 6 V.4s- ` -- y/0 f- Deck area: square feet
-r lle d /30-vA /or -1= 6
f'L Other structure area: square feet
(\ T' — 5 REQUIRED DATA:COMMERCIAL-USE CRECKLOTI.
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicatethe value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
g .. DESwRIPTION rOv F WORK t _ k � f
_work indicated
ated on this application.
d� r� 3 ,sLt, � 4,epJ J7iF'�n. VValuation:
$�r1 0 6c--3
Existing building area: /E.I. square feet
New building area: square feet
EIATEgANt Number of stories:
Name: 4'$7 °I ,er Type of construction: RY r-o6
Address: `i 7s 5`'.j' v-L-- Occupancy groups: cit4O
City/State/ZIP: -7-";? e!` Existing:
Phone:( ) e„...-'t Fax ( ) New:
APPLICA '
� a CONTACT PERSON _: �=� . .., � $4
Business name: r✓� 1 i y et)Lc- -i�'a.t,,t,c' .. Sc?g-k-I t (Q S All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: apply:
Phone:( ) Fax::( )
E-mail:
CONTRACTOR 4
`� t `
Business name: 2)'� .,- 1,`�,ed c>='-/;._ t �",r�G ,L7,� .�s.r
_ , "BUILDING PERMIT FEES* -
j lt� >V C /L
(Please Yefertofee schedule ,'
Address: ,ill (�i ' e Structural plan review fee(or deposit):
City/State/ZIP: 2e,"..// , C//'- 1 7/0
0
{ FLS plan review fee(if applicable):
Phone:(55C-32) "76 5/c�' Fax:
Total fees due upon application: i )1 'j/.4
CCB lic.: / yc, y C
J Amount received:
Authorized signatu e: 'V/`� This permit application expires if a permit is not obtained
f ) within 180 days after it has been accepted as complete.
Print name: 3 C,'C- ' 1",, L Date: K--....:- ..2 7 * Fee methodology set by TriCounty Building Industry
Service Board.
I:\Building\Permits\ROOF-PermitApp.doc 10/01/9 440-4613T(ii/02/COM/WEB)
City of Tigard: Re-Roofing Permit Checklist
Page 2-Supplemental Information
RESIDENTIAL(One-& Two-Family Dwelling)
❑ 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 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 not more than two (2) layers of
roofing will exist upon completion of the re-roofing.
COMMERCIAL'(m iu es` uu i-fa y and con onumums) °
❑ RE-ROOF: Pre-inspection is required for all roofs sloped 2:12 and less. Call
503.639.4175, for code 295 Miscellaneous inspection after permit is issued.
❑ PLAN REVIEW:
Note: Depending on the conditions noted at the pre-inspection,plans may be required
to address any non-conforming items.
VALUATION OF PROJECT: $
sq.ft. of roof area
Permit Fee based on valuation: $
(see Building Permit Fees chart)
12% State Surcharge: $
65% Plan Review Fee: $
(Required for major repairs of residential and
special purpose roofing of commercial projects.)
TOTAL: $
I:\Building\Permits\ROOF_PermitApp.doc 2