Permit CITY OF TIGARD REROOF PERMIT
0. COMMUNITY DEVELOPMENT Permit #: RER2010 00019
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 25101 DD00500
Jurisdiction: Tigard
Site address: 6755 SW SANDBURG ST
Subdivision: Lot: 0
Project: Coiltron
Project Description: Reroof - remove and replace.
Owner: FEES
FRENCH, WILLIAM P Description Date Amount
6755 SW SANDBURG ST Permit Fee 10/08/2010 $564.15
TIGARD, OR 97223 12% State Surcharge - Building 10/08/2010 $67.70
PHONE: 503 - 936 -8311
Contractor:
INTERSTATE ROOFING INC
15065 SW 74TH AVE
PORTLAND, OR 97224
PHONE: 503 - 684 -5611
FAX: 503 - 639 -3056
Specifics:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Load:
Stories: Height: 0 ft
1/ / R - 1,uA -1701k)' l eg SGT'
General Information
Building Area: 0
Re -Roof Area: 0
Roof Class:
Tear Off:
Overlay:
Existing Roof Layers:
Parapets:
Total $631.85
Required Items and Reports (Conditions)
This permit is - • • -, to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do = accordance with app • d plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da . ATTENTION: Oregon law requ • • o follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
• 2- 001 -0010 through OAR 952 -• • s • •ou may obtain a copy of the rules or direct questions to OUNC by calling 503. 46.6699 or 1.800.332.2344.
Issued By: Permittee Signature: x
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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
1 Conlmercial RECE N3D 1.0R 0141(1': (J I : ()NI.)
City of Tigard Received C Permit No.: ��D
• 13125 SW Hall Blvd., Tigard, OR 97223 n Date/B : / / D ��a
O/U
'� P hone: 503.639.4171 Fax: 503.598.1960 O T 7 U o Plan Review
Date /B Other Permit:
I
i _ , ` RI)
Inspection Line: 503.639.4175 CITY OF TIGARD Date Read /B �"� RI See Page 2 for
Internet: www.tigard- or.gov No tified/Method: ISM Sapplemental
BUILDING DIVISION
TYPE OF WORK REQItIR D DA'I At I- ANb Z y ll ,
❑ New construction ❑ 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 Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTIOJy work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ 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: 475 s I 5- AA' 04 (� a c New dwelling area: square feet
City/State/ZIP: •77 G AA 6 / 0 A . ( 17 a y Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Z:' 0 /4 TA 0 A/ /3,6 ,. 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 fees* 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.
Valuation: $ 3g / 5 4 5
Existing building area: square feet
New building area: square feet
PROPERTY OWNER 1 0 TENANT Number of stories:
. L, �,�L►
Name: 4 e.-C� Type of construction:
Address: .55,E e 6 41L,VeiC C 77 Occupancy groups:
City/State /ZIP: h1// sr-66,2d G le.,. ?W g 3 Existing:
Phone: (C43 )7g 4n. 4934 / Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: mirth- o < 5, - R — 69A . All contractors and subcontractors are required to be
Contact name: Cdr fit! A S licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
/
Address: ! ` g , 5 ..y "d..■ 717;17 "d/t_, . jurisdiction in which work is being performed. If the
City /State /ZIP: /' R .4 Al O e �. C 7- 2,
applicant is exempt from licensing, the following reasons
apply:
Phone: ( 5 2 ) 3) 6 , siv' 5 l v l l Fax:: (, D 3) C 39— 30 5
E -mail:
CONTRACTOR .
Business name: / A/ r1 -� ASTA . 7-6 „ R T�j "c,f 6 BUILDING PERMIT FEES*
!, / 77.1 (Please refer to fee schedu /e)
Address: i 4 5 mil.` _, 4 7 � e ,1 1 - (�P.� - St 6-6,e/. `5
City/State /ZIP: "0/Z 7 ZA ii./ ,0 ®,/E . 97a a, y
Phone: (� 6 g� 5 // Fax: Fax: ( ) ): 7. •7 —
CCB lic.: 5 5 f e1/11 �r Total fees due upon application: 63/ , g 5 ,
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
• within 180 days after it has been accepted as complete.
Print name: 4,6 LA..... (5 O ra., / tie L. .4 3 Date: f,e) — / p * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits \BUP -COM PermitApp.doc 10/01/09 440 -4613T(11 /02 /COM/WEB)