Permit CITY OF TIGAR P BUILDING PERMIT
PERMIT #: BUP2002 -00151
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DEVELOPMENT SERVICES DATE ISSUED: 4/29/02
1,L R--- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11505 SW PACIFIC HWY A PARCEL: 1S136AD -04000
SUBDIVISION: VILLA RIDGE ZONING: C -G
BLOCK: LOT: 007 JURISDICTION: TIG
REISSUE: 0- FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: 9L1 FIRST: sf N: S: E: W:
' TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 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: .4Z2- cif
Remarks: RE ROOF
Owner: Contractor:
SMITH, EDITA M SNYDER ROOFING OF OREGON LLC
833 NW 170TH DR PO BOX 23819
BEAVERTON, OR 97006 TIGARD, OR 97281
Phone: Phone: 620 -5252
Reg #: LIC 135987
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
PRMT CTR 4/29/02 $264.10 27200200000
5PCT CTR 4/29/02 $21.13 27200200000
Total $285.23
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you t. ollow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010' thr• . • h OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 66• • or 1 -810- 332 -2344.
Pe rm ittee
Signature: ' ' ;-11. '
Issued By: /4j 4.0
Call 639 -4175 by 7 p.m. for an inspection the next business day
r
t - Building Permit Application
Date received: 4}/ / ( a,., Permit no.W() Pa —6,0/
^,iii i City of Tigard Pro ect/appl, no.: Expire date:
Ci a Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
ty f 8 Phone: (503) 639 -4171 Date issued: By:. I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory u Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: VAIIIMtaGIARIIM Bldg. no.: ' Suite no.:
Lot: Block: Subdivision: - A Tax map /tax lot/account no.:
Project name: (,��Ei( ($ ` A
i
Desc • 'don and 1. of work premises/special ... t ion ork on premisl condi • ins: . II , :0 - 1 i. S vi
ak i wt
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Moms o 4 L> (Floodplain, septic capacity, solar, etc.)
Mailing address: 520 (j i ki1E CAI le 400 1 & 2 family d • 1 g: _ Z GO
City: I State: 01� IZ1P: lag Valuation of work $ ' ;
Phone: 1,11 _ 7 Fax: 1E-mail: No. of bedrooms/baths .
_Owners representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) _
Garage/carport area (sq.
Name: %, V Coveted porch . : sq. ft.)
Mailing address: D Deck • . q. ft.)
City: �(� I State: 4/-1 Zip; Pr) Other structure area (sq. ft.)
Phone: Fax: 3 i E -mail: Commercial/indust l /multi - family:
CONTRACTOR : . Valuation of wo $ ' h- — 5
Business name: "JIB► % 1 1' v' , CF ca. «-C, Existing bldg. area (sq. ft.)
� New bldg. area (sq. ft.)
Address: iZ `� Liv Pl Number of stories
City: 'f (i� State: ( ZIP: 1 I ��.5 Type of construction
Phone: (p'pt - 57,0_ I Fax: (41.-1,101E-mail:
CCB no.: 1'75 f r;� ex p.: 7 H 0� Occupancy group(s): Existing:
no.: H New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI I ITECT/DESI GN ER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: Ste (gyp; exempt from licensing, the following reason applies:
Contact person:
Phone: Fax: E -mail:
Name: INA RA f f Contact person: i M Ri Fees due upon application $ •
Address: 1070 6 (2 sQ ti lOb Date received:
City: I1fi,r(> Lou? IS State:" 1 ' IZIP:. 1 Amount received $
Phone: 1,0 - vioo I Fax: q°i? 7O()E -mail: Please refer to fee schedule.
I hereby certify I hay: • . an' xamined this application and the Not all jurisdictions apt credit cards, please call jurisdiction for more information.
attached checklist All p • vi ens of laws and ordinances gov min this o Visa U MasterCard
work will be complied ''' er specified herein or not t card n umb / /
Authorized signature: ` Date: 1 �� 0 v Name of cardholder as shown on credit card
$
Print name: :4.1 -• _i k. _/* Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepter n jjt tr 440613 ( t`) IRED
.
RE- ROOFING PERMIT CHECK LIST j''
RESIDENTI4L ONLY - Class of Work: Alteration
❑ REPAIR (MAJOR) (plan review required by plans examiner)
Building permit is required when spaced sheathing is covered by solid sheathing and /or
changes are made to roof line.
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, (1) not more than three layers of
roofing will exist upon completion of the re- roofing or, (2) sheathing is not being applied over
spaced sheathing (spaced sheathing usually exists when wood shingles were initially
applied).
C MMERCIAL ONLY - Class of Work: Repair
S EP 1:
RE -ROOF (circl= or C):
A. Existing built -• • roof covering to be REMOVED and deck repaired.
B. Existing built -up roof covering to REMAIN. Note: Applicant must submit an engineer's
review of the roof structural elements. Review shall bear the seal (or stamp) of the
architect or engineer licensed in Oregon.
C. Asphalt or wood shingle /shake. (PROCEED TO STEP 2)
COMMERCIAL ONLY - Class of Work: Repair
STEP 2: NEW ROOFING ASSEMBLY
Material Documentation (UBC Appendix 15)
Please fill out applicable section and attach copy of roofing specifications.
Listed Assembly (Circle and complete A, B or C):
A. 1. Specification #: CNN
2. Manufacturer: ,1 McktiVILAE
3a. UL Classification:
Listed UL Building Materials Directory Page #: __ s g :��iL 4Q ...
OR
3b. Warnock Hersey:
Listed Warnock Hersey Directory Page #:
*COPY OF ASSEMBLY REQUIRED
B. ICBO Research #:
Dated:
C. SPECIAL PURPOSE ROOFING: WOOD SHAKES
(Review required by plans examiner.)
VALUATION OF o a $ Z1 oh 1
s
Permit Fee based on valuation: $
(see Building Permit Fees chart)
8% State Surcharge: $
65% Plan Review Fee: $
(Required for major repairs of Residential or
Assembly item "C" above.
TOTAL: $
i:dsts \forms\roofcheddist.doc 10/05/00
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175 MST
INSPECTION D,,aIISION Business Line: (503) 639 -4171 BUP CC) / -7
Received 4 � Date Requested ( AM PM BUP f
Location I / 57 5 C��l�tr�, c ite " ! ► MEC
Contact Person Ph ( ) 9 3' /t PLM
Contractor Ph ( ) SWR
Tenant/Owner ELC
Foundation ELC
Access: 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
Su Ceiling
00
Other:
F in
ART FAIL
PLUMBING
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: El Unable to inspect — no access
Fire Supply Line
ADA ( .) Approach/Sidewalk Date f " ��Spector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL