Permit (15) CITY OF TIGARD REROOF PERMIT
COMMUNITY DEVELOPMENT Permit#: RER2019-00002
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/21/2019
T 1 C.;k r.L= g Parcel: 25111 BCO2603
Jurisdiction: Tigard
Site address: 10310 SW CANTERBURY LN
Project: WCCCA Canterbury Subdivision: TIGARDVILLE HEIGHTS Lot: 7
Project Description: Re-roof existing equipment shelter.
Contractor: DAY WIRELESS SYSTEMS Owner: TIGARD, CITY OF
4700 SE INTERNATIONAL WAY 13125 SW HALL BLVD
MILWAUKIE, OR 97222 TIGARD, OR 97223
PHONE: 503-780-5524 PHONE: 503-718-2591
FAX:
FEES
Description Date Amount
Permit Fee 01/30/2019 $87.17
Specifics: 12%State Surcharge-Building 01/30/2019 $10.46
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
Project Valuation: $1,500.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $97.63
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 5. 232.1987 or 1.800.332.2344.
is
Issued By:
,�,� ` .4Permittee Signature: �Il ,
Call 503.639.4175 by 7:00 a.m.for the next available inspectionte.
cornThis permit card shall be kept in a conspicuous place on the job site until co . -tion of the project.
Approved plans are required on the job site at the time of each inspection.
wilding Permit Application
Re-Roof FOIR()HACE USF O'Sl.v
RecDate/By:eived
I � W
City of Tigard $.w,. eL� / ] �� P ��7 �'g
II 4 13125 hnS50 Hall Tigard,OR 98223.19 JAN 2 2 2019 Plan Review �/
® Phone: 503.718.2439 Fax: 503.598.1960 Date/By: S.-
-I-I(;
-I-1(;A R p Inspection Line: 503.639.4175 ( Date ReadyBy: . furls: H See Page 2 for
Internet: www.tigard-or.gov Bui:: ,-. i ,,4 �//�N ethod� `jy w w Supplemental Information
i,
,. , Or; ;, @ > >i# ' ,I� � ,
®New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
„ 4 * ' , 7work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
o13 E�'+ "ll?IQ � C TIUI y Total number of floors:
Job site address:10310 SW Canterbury Lane New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:WCCCA Canterbury Covered porch area: square feet
Cross street/directions to job site:From Tigard City Hall:Head south on SW Deck area: square feet
Hall Blvd.Turn right onto SW McDonald St.Turn left onto SW 103rd Ave.Turn Other structure area: square feet
right onto SW Canterbury Lane.Destination will be on the left. '''''40,14.0t4 , * (1 04 , tA1 C 1 t E W
Subdivision: Lot no.:02600 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:2S111BC Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
Re-roof existing equipment shelter. Valuation: $$1,500.00
Existing building area: 231 square feet
New building area: square feet
... 0 1'” W1RTY O R Vx , . . t 1 ;n a.., , . Number of stories: 1
Name:City of Tigard Public Works Type of construction:
Address:8777 SW Burnham Street Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing:
Phone:(503)718-2591 Fax:( ) New:
a F.A.'" OI T O1 R
Business name:Washington County Consolidated Communications Agen All contractors and subcontractors are required to be
Contact name:Don Forsberg licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:17911 NW Evergreen Place jurisdiction in which work is being performed.If the
City/State/ZIP:Beaverton,OR 97006 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)267-1947 Fax::( )
E-mail:donforsberg45@gmail.com
Business name:Day Management Corp.
4700 SE International Way - •- 1 �+� . .
J r
Structural plan review fee(or deposit):
City/State/ZIP:Milwaukie,OR 97222
FLS plan review fee(if applicable):
Phone:(503)659-1240 Fax:( )
CCB lie.:64950 Total fees due upon application:
Amount received:
Authorized signature: :).1\.,/
-hi
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Don Forsberg Date:1-22-19 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\ROOF-PermitApp.doc 10/01/09 440-4613T(11/02/COM/WEB)
.a
City of Tigard: Re-Roofing Permit Checklist
Page 2-Supplemental Information
RESIDENT (One-&Two-Fa r► Dweiiin� .. . .,
❑ 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.
+C�VIi rclAt(40,„eludes multi-familyand condonunm s)
® RE-ROOF: Pre-inspection is required for all roofs sloped 2:12 and less. Please make
an appointment by calling the Building Division at 503.718.2439.
❑ 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: $ 1,500
sq.ft.231 of roof area
Permit Fee based on valuation: $ 87.17
(see Building Permit Fees chart)
12% State Surcharge: $ 10.46
65% Plan Review Fee: $ 56.66
(Required for major repairs of residential and
special purpose roofing of commercial projects.)
TOTAL: $ 154.29
C:\Users\Don\Desktop\C800\Canterbury Square W-2\BP\WCCCA CanterbuP'-Roof Application.doc