Permit •1 .
a
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00388
fl�, DEVELOPMENT SERVICES DATE ISSUED: 6/23/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S134BD 07202
SITE ADDRESS: 10900 SW 121ST AVE
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR 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: 4 BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: _5
Remarks: Re -roof
Owner: Contractor:
TRINITY CHURCH OF THE COLUMBIA CONSTRUCTION SERVICE
EVANGELICAL CHURCH OF NORTH 28395 SW BOBERG RD
AMERICA WILSONVILL, OR 97070 -6769
TIGARD, OR 97223
Phone:
Phone: 503 - 684 -9123
Reg #: LIC 116607
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
Pre - roofing inspection
Total
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.
Issued By:
S n ittee f� SLR ex l/
Signature: f � � _ ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
06/17/2003 15:18 FAX ,5035981960 CITY OF TIGARD Ii1002
Re -Roof
Building Permit Application FOR OFFICE, i - SE ONLY
:inkling
r '' r I II I PermitNo.: ,_„,, a• • 5 X03
CitY of Tigard Planning Approval Other
b Betels Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/13_y: Permit No.:
Phone: 503 - 639 -4171 Fax: 503-598-1960 •. i "i111Jst D t Re Cane No.
Internet www.ci.tigard.or.us Contact Juris•: ® See Page 2 for
24 Inspection Request: 503 - 639 -4175 Name/Method: Supplemental Information
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�l New construction ■Demolition r , ;w I ' ';;i p v • , ' , m r t r : r 4 • . . • , , :,
Addition/alteration/ � - Other: ' 6)&0 �� , ,I , "' l'
$ - :1~ 1 1.55 "1: ' m s m •i F -'• (o, . 'G,�'i; kP :? ; ` Note: Permit fees' are based on the total value of the work performed. Indicate
1 & 2- Family dwelling Q Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application,
Accessory Building ❑ Multi- Family
Master Builder Other: valuation. $
. :I' "1 :i r: r� o :t c e b;m i:.'" r , r sir'; i'j' `'.,i:> No of bedrooms: No of baths:
Job site address: I C' IC C' c: 121 , 1 G Bab Total number of floors
Suite #: Bldg./Apt #: New dwelling area (sq. ft.)
C)arage/carport area (sq. !L)
Project Name: TRt N IrY EvANeEL-IC ct+u2cil Covered porch area (sq.R) •
Cross street/Directions to job site: Deck area ( $ ft
5�e -A 1 � � ; r n A Other structure area (sq. it) _
rr; r�-", ;•••:: ; : 3 I ,'..7Z-;:=';1'W i . I r 1 (1,1 (111A1;{.; 1
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Subdivision: Lot # ^ ^ It r ti e . A:. ..
Tax ma / arse] #: Note: Permit fees' arc based on the total value of the work performed. Indicate
vc[yp{ ii
-qua ! , A .' cl
c , :Ire e +' r �� 1ro �„; i . ,F, .�a " 17 the value (rorarded to the nearest dollar) of all oquipn 0 1, materials, labor,
'•
overhead and profit for the work indicated on tltis application.
Re - m'--( — 5 a ii VA Ac- c-r)
..4 C7 r= l.L. es. 4-1L Valuation $ G _ ___coo
Existing building area (sq. R) "7 Sct s r
. New building area (sq. ft) 2
�^
I Number of stories.,,„
.:.• 5, I : f l . �,. ;. j �.I'r r -,- Firi_c �:� . I IKI,v� =:kid '' 1,;;I: .i Type of construction. CDr , . t ,t45L(Cit L
Name: - T r t n; i- y E Var,o i cal CAA ccupancy Y group(s) N �
Address: i 09 00 �ww 121
City /State/Zip: - i - ; o arm 0 l •
Phone: 503 -(020 - (D 1 '+D Fax: (0.›) L2C7 - NOTICE: All contactors and subcontractors are required to be
� r „ licensed with the Oregon Construction Contractors Board under
'' I _ 3 r 7 ' '. '^ 'a 1 '�" - ° 212: ';A' ' t I' l provisions of ORS 701 and may be required to be licensed in the
Business Name Lit-') ;yn Ps+ ,{ ' � u cr Sr1tz7 I jurisdiction where work is being performed. If the applicant is exempt
Contact Name: - f'( QL `3 ' CZ g-f1- 4 l _ from licensing, the following reason applies:
Address: 2g% SW. P h — 0 13 '
City / State/Zip: i Leavi L 970 30
Phone~;so3) a4 -91 e I Fax:(5) C4 ! 4srd, :1 ,: ::, �:,.,; --1 .. pT 'wit : k J'' �
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Business Name :Cot umb,c, kcz, 4Shee# Me-40-1 Fees due upon application $ ,
Address: 2 239 S Sup lobes- "Rd 3
Ci /Sta : A . Is() r'v' Ile O2 c17.)7) Amount received. S
Phone: 5Q . -tJA - Fax: L-t - i ti S is Date received: -
CCB Lie. : L[l _127 7 - '
Authorized I
� �'r�' N ot i ce: Thi p e rmit been application ex if a permit is not obtained within
Signature: ; I • e • -_- Date: ilki 23 U 180 days after it has been accepted as complete.
R ‘i - -' / ''Fee methodology set by Trl -County Building Industry Service Board. f
. (Please print name)
is \ Lists \permit ForrneBldgPcrmitApp.doc 01/03 t /.5/\- .
r
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171 BUP J
-3 g
Received 0 " Date Requested (' / AM PM BUP
Location /0 ' o e /2- - c› 1- Suite MEC
Contact Person \d Ph ( 7 ) geA 3/ 16 PLM
Contractor r 4 Ph ( ) SWR
L 1 Tenant/Owner 7r/t/ 7 /1.14/ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Nailing c .„ ( Z "V.
Firewall /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
..."-V 0 Other:
4erM.►
e" `; PART FAIL
• MBING
/ I / Ce
( .7
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: "
Final -/'
PASS PART FAIL
MECHANICAL di
Post &Beam
R
1 2
ough -In
7
Gas Line
Smoke Dampers f
Final i t V
PASS PART FAIL CO ,C 0 ELECTRICAL
Service
Rough -In ( ,,�
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ re. • . - ore next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date 0 r� 6 Inspector U
/ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING • • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3 8 1
Received Date Requested 7 r O AM PM BUP
Location 6 D a - - ' u MEC
Contact Person Ph ( ) 13 ` OOH f PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner V✓) ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing �C
Fire wall Q (1-e/i- ( 7 Y 5y s % `'� V <`
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
7 C yitQ rze /fie (c
Other:
Final
PART FAIL
- ING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line IS(4-sZ)
ADA 7 / v ! v 3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
. City of Tigard Building Department
13125 SW Hall Blvd., Tigard, OR 97223 Phone: (503) 63g -4171
if � h
Re -Roof Pre - inspection Report'torm ,L �
Requested by W r l).--vvv,Lj vim- 1 24 D C Telephone f 9V 3) (084— q 1 2 3
Job Address 1 0 g 0 0 ' Z k. S � Permit #: , v 1 -.Q' Zd O 3- 0 0 O G d C
Roof Access Location f' L./V1 1J . C.
Date Requested 1.//7- / 3 Time Requested C
Type of Existing Roof 3 Y4 f Z )3 4-4 s io-c,e C€ 461p
1. Slope of roof deck
2. Roof /Penetrations /General Conditions it ❑ Poor .
3. Are there blisters? ❑ Yes No
4. Are there cracks? ❑ Yes V No
5. Is there evidence of water ponding? ❑ Y No
6. Is moisture present under roofing (leak)? Yes ❑ No
7. Is roof insulation existing? El" Ye ❑ No
8. Is roof insulation wet? es ❑ No
9. Property line setbacks on all sides > 10 feet — ❑ No
10. Building size 3000 sq. ft. ❑ < 6000 sq. ft b Ers 6000 sq. ft.
11. Building height 40s-2- Stories ❑ > 2 Stories
12. Class of roof required ❑ Non -rated K. 5?-13. ❑ C.
13. Type roof deck mb
oustible , ❑ Non-Combustible
14. Roof drains eirgided ❑ Required ❑ Adequate
15. Overflow drains r l 0 MI Provided El Required ❑ Adequate
16. Attic ventilation ovided ❑ Required ❑ Adequate
17. Roof listing
•
rovided ❑ Required
18. Installation Instructions tarrovided ❑ Required
To re -roof this structure the following conditions must be met:
7. d Cam' I B S ✓ b r /0 ,' 4 .
? Se 0 r5 Std c5 Aoi cli„.--
The re -roof proposal is ❑ Approved for permit issuance if the conditions listed above are met. After obtaining your permit you must contact the
Building Division for an inspection when the roof deck is ready for the first inspection. The first inspection for a complete tear off is the deck
inspection. For a built -up roofing system (overlay), the first inspection is at the start of the job. After the re -roof is complete, a final inspection is
required.
Inspector 1 Ext. 2 .7/1 Date 6(1-4/ 6
q�uoo(Pr�pedon Report Form
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175
•
INSPECTION DIVISION. • Business Line: (503) 639 -4171 MST
a BUP 3 — &
—
•
Received Date Requested Y AM PM ; ` • BUP
Location / d g Db / a ( '" -v` _-- Suite p U MEC
Contact Person Ph ( ) a 1 — ' / ° 3 PLM
Contractor (o } Pte Ph ( ) Co R - 6 I y0 SWR
BUILDING Tenant/Owner vi ...L ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
(///
Final
PASS PART FAIL
PL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA / £ / (�
Approach/Sidewalk Date ( /r Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL