Permit •
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP1999 -00147
*A. DEVELOPMENT SERVICES DATE ISSUED: 4/20/99
„� ! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12535 SW PRINCE ALBERT CT PARCEL: 2S109DD -01700
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN •
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 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: $ 5,000.00
Remarks: Tear off existing roof sheathing and replace, Owens Coring 25 yr dimensional compoistion roofing material.
Owner: Contractor:
WILLIS, GLENN R FREEDOM REFINISHING SERVICE
12535 SW PRINCE ALBERT ST HERMAN ROYBAL
KING CITY, OR 97224 6288 SW SEVILLE AVE
Phone: L OS1l 97035
Reg #: LIC 123001
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Dryrot after tear -off insp
PRMT GEO 4/20/99 $50.50 99- 314698 Final Inspection
5PCT GEO 4/20/99 $2.54 99- 314698
Total $53.04
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
i
Signature: atuitur e: ("--------- ' !
ignr � �
Issued By: � 4 � /%
Call 639 -4175 by 7 p.m. for an inspection the next business day
err OE TIGARD . Rec'd By:
13125 SW HALL BLVD. Date Rec'd:
. TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date to PE:
V- 503 - 639 -4171 X304 Date to DST:
Incomplete or illegible applications will not be accepted permit #04P /$¢9'a5/17-
F- 503 - 598 -1960 Called:
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Na a fDevelopment/ Business ST� � �NRO! EtINCS` ASSEM�x;€'< :< :.:::::::::::: :: ..::::::: :.::::::::::..� :::.:
7 :" :.l atetle . 4e !# tiQe . :.... 11 . . :..... ... ..:::i:::::::::::MON::::.:i::i1::::
Street Address Ste � -T ease fill out applicable section and attach copy of roofing
Job Site ZS' .3 5 5 la krice Ste �[ IV specifications.
Bldg # State Zip > .d::AkSe011�k yf::s'::>.::C rc1e::: :. mp1et Ar.::B:: :I ):::::>:::::::<:>::::>: ' >:::: »::: >:: >:: >:::::: >::<::
4 :
6 (I r` � f 7z21 A.
N yl N /,,, / 1. Specification #:
Owner Mailing Address (4 2. Manufacturer ,1" , l 1 ! e i ,
City/State Zip I P 3a UL Classification: G .7.9 -Pmfgwr 77- i
/< y( Gi r�l 1 -zl 6 , yz
R..ofing N l `` a Listed UL Building Materials Directory Page #:
Contractor 4 , / Pi // i t f ///�(, s is e. (OR)
(Prior to issuance Nailing Address 3b Wamock Hersey :
applicant must nZJsf s, h 5' / LL,t ,1/,
provide a copy of City/State Zip Listed Wamock Hersey Directory Page #:
all contractor L l�ri= Cs y/ #_6r0 IA 970 3s" (PROVIDE COPY OF ASSEMBLY -
licenses if Phone # Fax #
expired in COT 4 ?7 -( f/ & . ICBO Research #:
database) State Constr.Contr. Board # . Date
a300( - DATED:
SHAKES'
'`� C. SPECIAL PURP RO FIN :WOOD SH
PURPOSE ROOFING:
Building - Ty a Of Use: (circle one) (* review required by plans examiner)
SF SFA COM MF
Building - Tyke of Construction: VALUATION OF PROJECT $ edr---_
Existing Deck Type: Permit fee based on valuation* 1
Combustible ( ) Non - Combustible ( ) * see chart on back $
.. :4:
SIQI» :: :: >; ;t�Nf,.Y1wiaSes� >... »::>:: »:: >::; >:: >:<::::. » >::;::. :::....::::.
II�'#�4l» ... • . .: 1Afa�. Atte�aot3 .... .................... . � : - ; :.::.:: : ::>; >;::. : ,
:::;.. >:::<: » >:: >>: > ; >: <: » >:: » >: ;::»: : » >:<::<:: >:: :::.;:.. - .: >:: >:: >::::: <:: >:;::>
0 REPAIR A R
Permit required ONLY when spaced sheathing is covered by
solid sheathing. 5% State Surcharge $
only: i.-
SUB
OF R E (3) SETS 0 LAN SPECIFYING.
MIT TH E S S
A. Roof area & nearest street.
65% Plan Review $
B. Attic - vid 1 sq. ft. for v is Pro e s o each 1 0 sq. vents 5 ft of attic q q : use. :. - :. <:> . ;;? WA.::::.::: - < :: : ::::.: ;:.... :. ;; :.:. :. :.; :::. . ; >
space & vents shall be located in the upper 1/3 of the roof. ,.
Provide 1 sq. ft. for each 300 sq. ft_ when eaves & attic
TOTAL $ 53- c
: : :i::fi:::::i:i::ii
5'..1 ::.: :::::: ::.;:...:: �! �.::. �:: t�t4::::::::. �!.. �.:::::::»:.;:.;:< .::: .:.::.::.;
::::.; ;:.;;;;:.:. .::.,:.:::<.::
:.: I acknowledge that I have read this application and that the
:<:Cla >:
.. :::::: .::::::::::.::::;:.::::::::::::::;:.;:;.:.:.;:.;:.;:.;:.;;:::.;;:.;:.;:.;:;:<.:.;:.;:.;:. ;:.;:.;:.;:.;:.;:.::.;;:;:.;:.: information given is correct, that I am the owner or authonzed
De nbe work to be done: (check appropriate box) agent of the owner, and that the plans (if applicabel) are in
F - OF (circle A ,B or C) compliance with Oregon State law.
rP sting built -up roof covering to be REMOVED and deck
- repaired - Signature o •, genes Date
B. Existing built -up roof covering to REMAIN: note applicant
must submit an engineer's review of the roof structural / r /2o/rf
. elements. Review shall bear the seal (or stamp) of the
architect or engineer licensed in Oregon. Co - - e - , ame Telephone
C. Asphalt or wood shingle /shake
11 \
(PROCEED TO STEP 2) h Z . i OWRiL 9 to t/b
I:ROOF1.DOC (dsts)
. . .
KING CITY
410
15300 SW. 116th Avenue, King City, Oregon 97224 -2693
Phone: (503) 639-4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: k2- 3\-
located at: k OS 3S '7 1- .■ - A / i-
King City — resentative
I:'DSTSKC[NST.DOC
5/17/99 Activities for Case #: BUP1999 -00147
9:05:42 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPA005 Application received 4/20/99 4/20/99 No Hold GEO 4/20/99
BUPA008 Permit created 4/20/99 GEO No Hold GEO 4/20/99
BUPA830 Dryrot after tear -off insp 4/20/99 4/20/99 No Hold GEO 4/20/99
BUPA870 Final Inspection 4/20/99 4/20/99 4/26/99 RC PASS No Hold AKJ 4/26/99
BUPA085 (F) Issue building permit 4/20/99 GEO DONE No Hold GEO 4/20/99
BUPA950 Case Finaled 4/26/99 AKJ DONE No Hold AKJ 4/26/99
•
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171 BUP /g� - N y7
Date Requested -99 AM )( PM BLD
Location I - S 3 S Pn►?t;. y1 lavLi Suite MEC
Contact Person (' 'f\ 2 R-CX 3 k2etQ Ph (pg - C04' / PLM
Contractor _ ✓J Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
ic•
PASS PART FAIL
BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other Date ° � Inspector C / — Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.