Permit CITY OF TIGARD REROOF PERMIT
• COMMUNITY DEVELOPMENT Permit#: RER2020-00007
Tf GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2020
Parcel: 1 S126CD00100
Jurisdiction: Tigard
Site address: 9925 SW GREENBURG RD
Project: Crescent Grove Cemetery Subdivision: None Lot: None
Project Description: Remove existing roof on mausoleum down to concrete. Install 135 mil fleece back Versico TOP fully adhered to
concrete with Versico Dash.
Contractor: JIM FISHER ROOFING& CONST INC Owner: CRESCENT GROVE CEMETERY ASS
13580 SW GALBREATH DR CRESCENT GROVE CEMETERY
SHERWOOD, OR 97140 9925 SW GREENBURG ROAD
TIGARD, OR 97223
PHONE: 503-625-2586 PHONE:
FAX:
FEES
Description Date Amount
Permit Fee 05/01/2020 $880.05
Specifics: 12%State Surcharge-Building 05/01/2020 $105.61
Tigard CET- Non-Residential-Admin 05/01/2020 $27.85
Type of Use: COM Tigard CET-Non-Residential-AH 05/01/2020 $668.34
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
Project Valuation: $69,619.00
General Information
Building Area: 0
Re-Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $1,681.85
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 OA 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1Yy
Issued By: 7 PermitteeSignature: r ?- o , ( /-7C/L
/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Re-Roof RECEIVE® FOR OFFICE t Sr UA 1.1
City of Tigard q q q Recosed // �}�
;�i • 13125 SW Hall Blvd.,Tigard,OR 97223A P R 2 2 2020 Dazai ly:�/ „`(s� PCON7�'e/V`flo�'riGt''O/
Phone: 503.7I8?439 Fax: 503.598.1960 Plan Reciew
Inspection DatdBy: Other Permit:
r 1:1; pee on Line: 503.639 4175 CITY OF TIGARD Date Reedy/[iy ,a e
Internet: www ii d-or.gov I S See Paget for
� BUILDING DIVISION Notified/Method. Supplemental lnformatiao
TYPE OF WORK p REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees`arc based on the value of the work performed.
❑Addition alteration/replacement Other: K Indicate the value(rounded to the nearest dollar)of all
P ao I. equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling 14,Commercial/industrkal Valuation: S
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 99j a'j 5 t.�. �,,,,,Q7j 110 p`1, e,C,/ New dwelling area: square feet
City/State/ZIP: Gr� �� /
-I f�-a 3 Garage/carport area: square feet
Suite/bldg./apt.no.: J Project name: 6,4,/L04_Jil- G�pr p (F y, ir,r,.y. Covered porch area: square feet
Cross street/directions to job site:
Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision_ Lot no.: Permit foes"are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
y!kepn � / Valuation: $ t(� / 1%019. od
i/lye ost[n )2oDY DC,t/ /-16)0 'i/eG �-t;/�,1�-ram lclapr,-, /
rur„ rlti uh>✓�/( t 3 5 NI/ F/Pe(P ire eir" Ve-5.c- 2 Existing building area: .7,100, square feet
T1v rG ifr .pike-e l/y (o ti('ro d W,/ ve•h'CG t�R S`j New building area square feet
PROPERTY OWNER
El TENANT Number of stories:
Name: C/,,•4(-OI✓,L ,..eve l r• e
/' C 1���Q r� Type of construction: rout,e e'I`C
Address: 9/25 4 lT.PP4l6, /y
/y1 Occupancy groups:
City/State/ZIP: -,y e,,eyc CI.- ��a 3
J Existing:
Phone:( ) Fax:( )
New:
,APPLICANT 0 CONTACT PERSON
� NOTICE
Business name. t P. G?7Y-t All contractors and subcontractors are required to be
Contact name: ii2bti�� licensed with the Oregon Construction Contractors Board
p,,� I / under ORS 701 and may be required to be licensed in the
Address:
3'5W 1 cc�/Jr>t 74 �. jurisdiction in which work is being performed.If the
City/State/ZIP: 4.%,,,l.�oo// or 97/Yet applicant is exempt from licensing,the following reasons
apppply:
Phone:( )�.27—'/-7 GGG 4,KP '3 Fax::( )
F-mail: 050,h (') //s'/FZ.- ✓U fO t. trod
CONTRACTOR
Business name: F,..5/ ..
vr. jeal.A g/ -,I- BUILDING PERMIT FEES*
Address: i 3 3i/y, .c __ /4,/4,er'`j L- tP/wee rejremlr<schedrle1
City/State/ZIP: 7./ / Gl. 1 7/!/yO Structural plan review fee(or deposit):
Phone:(;03) ?2-7_ 766 3 Fax:( ) FLS plan review fee(if applicable):
CCB lie.: q 59 70 Total foes due upon application:
Authorized signature: -c—
Amount received:
�'"�� This permit application expires kf a permit is snit obtained
Print name: /� �p within ISO days after it has been accepted as complete.
✓/ ��G"( Date: 471_7e ZQ70 • Fee methodology set byTri-County Building Industry
Service Board. �r , p-
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