Permit ,CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00239
COMMUNITY DEVELOPMENT DATE ISSUED: 7/21/2008
TIGARD
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 112 D D - 002 00
SITE ADDRESS: 15618 SW 72ND AVE ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: SHARPS
Project Description: Rerooflrg existing building.
REISSUE: O\e- FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: )e FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 67,700.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES PACIFIC ROOFING COMPANY INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 1728
PORTLAND, OR 97224 BEAVERTON, OR 97075
Phone: Contact #: PRI 503 - 647 - 2894
FAX 503 -647 -7415
Reg #: LIC 41571
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/21/2008 $453.10
[BUPPLN] Pln Rv 7/21/2008 $294.52
[TAX] 12% State Surch 7/21/2008 $54.37
Total $801.99
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 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 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ' --
41 1/16
Issued B �� � _ _ - - rm S J� (CX�
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.
/5 Su 7.2 Yt - j2
Building Permit Application
Gom nerCial FOR OFFICE USE ONLY
g
City of Tigard ® Received
q
Date : — 7 �' Permit No.: �/
Phone: 503. 639.4171 Fax: 503. 598.1960
II
1 3 125 SW Hall Blvd -, Tigard, OR 97223 Plan Review ri�]l PM Date : _ m /QI ] r l�
�� Other Permit:
T I G A R D Inspection Line: 503. 639.4175 O �� Q 1 . to Ready . H 65 See Page 2 for
Internet: www.tigard- or.gov ��" = � •' f / / i / f Supplemental Information
TYPE OF WORK n Q1� Per•mitffees* are . d on the value of the work performed.
‘,..4"\
Indicate the valu - ounded to the nearest dollar) of all
❑ New construction ❑ Demol equipment, materials, labor, overhead, and the profit for the
❑ Addition/alteration/replacement Q Other: r t- work indicated on this application.
CATEGORY OF CONSTRU ON Valuation: $
❑ 1- and 2- family dwelling 15J Commercial/industrial Number of bedrooms:
❑ Accessory building ❑ Multi - family Number of bathrooms:
❑ Master builder ❑ Other: Total number of floors:
JOB SITE INFORMATION AND LOCATION New dwelling area: square feet
Job site address: `S (9 I p 0 . 5 ( J 1 �7 a 1 `� H ,I Q. Garage /carport area: square feet
City /State /ZIP: 1- 0 ` Covered porch area: square feet
Suite/bldg./apt. no.: Project name:
J s RA ( S Deck area: square feet
Cross street/directions to job site: 0 v C � ). n A u
h �N. - Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
1 Permit fees* are based on the value of the work performed.
Subdivision: I Lot no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
Tax map /parcel no.: work indicated on this application.
pp DESCRIPTION OF WORK Valuation: $ 4/ 1100 e-
ILr 6'cic e. S t s A", CO J,� Existing building area: a j 1 square feet
New building area: (j- square feet
Number of stories:
51 PROPERTY OWNER I ❑ TENANT Type of construction:
Name: ? c, L ; i` q\ A-t ? S5 G C t c.a e ) Occupancy groups:
Address: )S Sc..) 3 e g v O Ic, Q -.u) '#3Qc) Existing:
City/State /ZIP: eoc-A \c, -.. Gc Q »y
New:
Phone: (5b ) ( , a y- (,300 Fax: ( )
NOTICE
APPLICANT ❑ CONTACT PERSON All contractors and subcontractors are required to be
Business name: pc„s t - Qc .. „, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Contact name: (., u A. :\ Qe \fit jurisdiction in which work is being performed. If the
Address: 00 6c.y \ - ) k applicant is exempt from licensing, the following reasons
City /State /ZIP: C v '-r, A. Q ( c -•Z6 1 S-
apply:
Phone: (56 ) ( . ` t . - t -)-84 `t I Fax:: ( ) ( 74 IS
E-mail: f c C(16 Z j - , 6I'Ll
CONTRACTOR
BUILDING PERMIT FEES*
Business name: Nc._. ,- {' (Please refer to fee schedule '7 6 3 ■ (
Address: Q a (SQ. k 1•-,- b Structural plan review fee (or deposit): ACI4,
City/State /ZIP: Vr-r No ”. 6 C QZ 6 S enew fee (if applicable): 't 3
Phone: ('5& ) ) ( - D y q I Fax: (s 3 ) ( 1 L(( Total fees due upon application: 041?
CCB lic.: X11 C7 \ Amount received: ---
Authorized signature: �4-t (i!- This permit application expires if a permit is not obtained
Print name: 6u e_ Lk I Date: 1- / (j --(1 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri County Building Industry
REQUIRED DATA: 1 AND 2 FAMILY DWELLING I Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB)