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Permit CITY OF TIGARD PERMIT PERMIT #: BUP2001 -00241 , ';� I i � DEVELOPMENT H B So R9 2 C 'E S ) 639 -4171 D ATE ISSUED: 6/28/01 SITE ADDRESS: 12421 SW PRINCE ALBERT ST PARCEL: 2S110CC -16000 SUBDIVISION: KING CITY NO. 5 ZONING: BLOCK: LOT: 040 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: : sf N: S: E: W: OCCUPANCY GRP: R3 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: g 77 , DD Remarks: Rerliove shake roof and cover spaced sheathing with solid sheathing and fiberglass shingles. Owner: Contractor: NELSON, NILS S + ANNA E PEOPLES QUALITY PLUS ROOFING 12421 SW PRINCE ALBERT CT 1120 PARKWAY DR NW KING CITY, OR 97223 SALEM, OR 97304 Phone: Phone: 503 - 581 -3113 Reg #: LIC 109054 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Dryrot After Tear -Off Insp 'of IJA/z- /Via, PRMT CTR 6/28/01 $91.30 27200100000 Final Inspection 5PCT CTR 6/28/01 $7.30 27200100000 Total $98.60 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 -6699 or 1- 800 - 332 -2344. Permittee i 1 / Signatur=. ._'d - _� w / 4/arfA Issue. By: . -.�A_ / 1 /!1 %diag / Call 639 -4175 by 7 p.m. for an inspection the next business day • - • . Building Permit Application r Datereceived: ®Ag O/ Permit no.: taieey -,0 1// �'� =-'^/ City of Tigard �,1- y�` Project/appl.no.: Expire date: City ajTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: By:. I Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: l &2 family: Simple Complex: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: /a/ f 2.1 s k. l'r l � « fl koz rt. �. CA t QC Q. Bldg. no.: Suite no.: Lot: I Block: ,Subdivision: I 1 Tax map /tax lot/account no.: Project name: Description and location of work on premises/special conditions: OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: /vies r , P 1 Co ✓1 1 (Floodplain, septic capacity, solar, etc.) Mailing address: / 2, ( $W PY! Prl tN ri' 1 & 2 family dwelling: City:.< C_A-3 I State: o . 1 ZIP: ' T 2 Valuation of work $ 7 77 Phone:qi,o .-13 S 'Fax: 1E-mail: No. of bedrooms/baths Owner's representative: • h / ltr f i Total number of floors • Phone:449.o- ' SZ(o Fax: E-mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: � ,Q0� , f • • ,(,.g Covered porch area (sq. ft.) Mailing address: Q . %ox 5b5G Deck area (sq. ft.) City: 59 k W, I State: oc i ZIP g 770 t Other structure area (sq. ft.) Phone:r 51/ -3/) • Fax: E- mail: Commerciall'mdustriallmulti- family: CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: ; Qp �s D 4 Address: // go a✓LAI Op I IN1 New bldg. area (sq. ft.) W Y 54 1'e l� 1 . O [ 9, : Number of stories City: State: � [ZIP: � Phone: - ax: 341- 622.4 E -mail: Type of construction Occupancy group(s): Existing: CCB no.: � p g D S rf New: City/metro lic. no.: Mkt-,,, j,) c.< . Notice: All contractors and subcontractors are required to be ARCHITECT/DESIGNER 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: State: ZIP: exempt from licensing, the following reason applies: Contact person: I Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: 9 City: State: ZIP:. Amount received $ / ' Phone: 'Fax: 1E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. . attached checklist. All provisions of laws and ordinances governing this CI Visa CI MasterCard work will be complied •tlt, whether pec`+ed he i or not. Credit card number / / t Expires Authorized Si i . I - 1 /: a r Zg O I Name of cardholder as shown on credit card $ Print name: r � ,��� Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440613 (6100/00M) RE- ROOFING PERMIT CHECK LIST RESIDENTIAL 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). COMMERCIAL ONLY - Class of Work: Repair STEP 1: ❑ RE -ROOF (circle A, B or C): A. Existing built -up 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 #: 2. Manufacturer: 3a. UL Classification: Listed UL Building Materials Directory Page #: 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 PROJECT: $ L/ sq. ft. of roof area // 7 7. Permit Fee based on valuation: $ � (see Building Permit Fees chart) � 3 8% State Surcharge: $ 7 65% Plan Review Fee: $ (Required for major repairs of Residential or • Assembly item "C" above. TOTAL: $ / O c, &C) • i:dsts\forms\roofchecklistdoc 10/05/00 06/28/2001 10:05 5036393771 CITY OF KING CITY PAGE 01/01 .T . . • . KIl\1G- .CITY . 7 IA/ 15300 SW: 116th Avenue, King City, Oregon 97229.4693 IIMMIIIIIIIIIIIMIN Phone: (503) 639 90$2 • FAX (503) 639.37 71 • • • 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 v. 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 Cite of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: 1 ." - , - • • located at: Id 411 ,/kuticv 4 -i-1 / -"" / 4 • • • /GDS King City Representati 6-,2,- oI . I DSTSTCINST DOC 431-7 )140.4 ad QJQS 09/62 S51 4 e-Q 1 A4 9 01 — les Lak C115 SS "IP H ,A i41 i \)-/j-5 ‘4(1 / 1,-) p erfirrtal j v a tto L1.- 3 5Q )1'i \A-#5T ''Ic5c31‘ '1 Po P9 1 rvt`O leo) a I w4.13 r • sx AO • 1015 - Dv9l) , ){ "bi 11111r ) C,‘ ,61 11(1' > .hk 5• Q 11- L ‘ A ? ))-)2 - 0,-L N-frf-cj " 0 qPi\I C.zv • ' CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP 2v / -09 zyl Date Requested Z — Z AM PM BLD Location / 2 tf Z / S w 'Y -1 , = , u AZ/6e J Ike• Suite MEC Contact Person / fi e 41 Ph 77 3 7 PLM Contractor Ph SWR �UILQJDICr� 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 /I1G7 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Ceiling Roof Final PASS PART 4 0 1 • PLUMBING Post & Beam Under Slab Top Out Water Service G Sanitary Sewer Rain Drains 1 1 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 Date 7 — -- d/ Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • /,c. V CITY.OF TIGARD BUILDING INSPECTION DIVISION MST • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP 'OP/ —6 v.2-c/( Date Requested 7- / AM PM BLD Location / Z i Z- I Sw firs c // r 4-el Suite MEC p� Contact Person f Ph 3 Z U d') 7 PLM Contractor Ph SWR UIL 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 Sus I'd Ceiling �toof c: -- 45 a:1W PART FAIL ' = ING 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 7 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 3.,,°f CITY•OF TIGARD BUILDING INSPECTION DIVISION MST . 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �( BUP �.t�t—/U 2 / Date Requested 7 -3 AM PM BLD Location ( Z ' Z ( 54-+- Orir U /6 1 <G Suite MEC Contact Person 1-t J v� Ph '92 '92 0937 PLM Contractor Ph SWR ILDI Tenant/Owner ELC Rtaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear �> Framing � � a _ 2, 2a. S, zzl,Z i.c� �� st • - 7 . : , rvLr , , ./e /7,Z Insulation Drywall Nailing ../r:.vT4,47ZaN Firewall Fire Sprinkler Fire Alarm S� Ceiling isc: Final PASS PART FAIL PLUMBIN — 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 Dat 7 —3 -5/ Inspecto E x t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.