Permit .. CITY OF T D MASTER PERMIT
ii� �rmdi 1 DEVELOPMENT SERVICES PERMIT # - MST97 -0386
h"0i1'j DATE ISSUED: 09/19/97
'� — 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: E9110CC -09000
SITE ADDRESS...:15730 SW QUEEN VICTORIA PL
SUBDIVISION -KING CITY NO. 3 ZONING:
BLOCK LOT •064 JURISDICTION: KIN
Remarks: Major Re -roof
BUILDING
REISSUE: STORIES : 0 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS --- REQUIRED
CLASS OF WORK.:ALT HEIGHT • 0 FIRST • 0 sf GARAGE • 0 sf LEFT : 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD : 0 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0
TYPE OF COdST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL 0 sf VALUE-0: 4500 REAR : 0
PLUMBING ----
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAIN..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASIN..: 0
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
,MECHANICAL
FUEL TYPES - FURN ( 108K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN )=108K ..: 0 UNIT HEATERS..: 8 HOODS • 0 OTHER UNITS...: 0
MAX IMP.: 0 BTU FLOOR FURNACES: 0 VENTS • 8 WOODSTOVES • 0 GAS OUTLETS...: 0
ELECTRICAL -
- RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS --- ----MISCELLANEOUS---- —ADD'L INSPECTIONS —
1' SF OR LESS: 0 0 - 200 amp..: 8 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5.: 0 201 - 480 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - amp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HM /SVC /FDR: 0 601 - 1'.v amp.: 0 601 +amps- 1' v: 0 MINOR LABEL -10: 0
1080+ amp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 1=4 RES UNITS..: SVC /FDR) =225 A.: 1 V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COOERCIAL
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: .. BOILER HVAC L /IRRIG: PROTECTIVE SIGN:
GARAGE OPENER—: CLOCK INSTRUMENTATION: bEDICAL • OTHR: ..
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL 0 SYSTEMS: 0
Owner: Contractor: TOTAL FEES:$ 53.83
BETTY STRICKLER GREG'S QUALITY ROOFING This permit is subject to the regulations contained in the
15730 SW QUEEN VICTORIA PL. 12245 SW PIONEER LN Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 0 D-119 . other applicable laws. All work will be done in accordance
BEAVERTON OR 97'.x'.: with approved plans. This permit will expire if work is
Phone 0: Phone 0: 590 -6148 not started within 1:' days of issuance, or if the work is
Reg 0..: 000958 suspended for more than 1:' days. ATTENTION: Oregon law
- .requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001-0810 through OAR 952 -001 -0080. You may obtain copies of these rules or
direct questions to OJNC by calling (583)246 -1987.
REQUIRED INSPECTIONS -
Roof Nailing
Building Final
Issued By: /( ad Alf
Permittee Signature: fri a0
+ + + + + + + + + ++ +++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++►+ + + + + + + + + + ++
Call 639— 175 by 6:00 p.m. for an inspection needed the next business day
f
CITY OF TIGARD Rec'd By: 0
13125 SW HALL BLVD. Date Rec'd: r F WE
TIGA RD OR 97223 RE- ROOFING PERMIT APPLICATION Date to PE:
V- 503 - 639 -4171 X304 • Incomplete or illegible applications will not be accepted Date to DST:
F-503-684-7297 Permit # - '3W1::,
Called:
me of DevelopmenuBusiness STEP 2.:. NEW ROOFING AS$EMBt.Y... :>
Mme
Al 5 Qv� , , o.,, Material Documentation (UBC "Appendix:•1 1 : :. ' , ;i:> .
Street Address (jor ' Ste • I Please fill out applicable section and attach copy of roofing
,,v I
Job Site 1C-1W �'
� i �p�„ � specifications.
Bldg # City /State Zip Listed Assembly .:::( Circle &Complete A, B or C) - :. >' > 5 ::<:i <> : •: >-::
CA cti — A.
am rs i-r t v� l� 1. Specification #
Owner Mailing Address r . 2. Manufacturer.
15 Sw (a F1 (1G�2�J \i,C�W _ i.
K.% qty/StN Zip Phone 3a UL Classification:
N e Listed UL Building Materials Directory Page #:
Y�>j .f (OR)
Roofing Mailing Add ss 3b Wamock Hersey :
Contractor 11 / 70 5 r.) 7 -r Bari ,Sf -
(Prior to issuance City/State Zip Listed Wamock Hersey Directory Page #:
applicant must r ,4 A) gF (PROVIDE COPY OF ASSEMBLY)
provide a copy of Phon # Fax #
all contractor SLO - (p ('f Y B. ICBO Research #:
licenses if State Constr.Contr. Board # Ex . Date
expired in COT �1 cs-cl (J 3 g r DATED:
database) COT Bus. Tax or Metro Lic # .Date (PROVIDE COPY OF ASSEMBLY) •
ElUILDING :INFORM 4):K \ "` `KIZN"' `':< `> '> ° gge C. SPECIAL PURPOSE ROOFING: WOOD SHAKES'
Building - Type Of Use: (circle one)
r review required by plans examiner) •
SF SFA COM MF
3uilding - Type of Construction: VALUATION OF PROJECT $
: xisting Deck Type: Permit fee based on valuation*
Combustible ( ) Non - Combustible ( ) • see chart on back S 3
. ;; : ::.. � »� :»:;: > City use only: WACO:
Vii: \:`i:- ::v. . vi::� \.% \Wiv .v niA `\ \ \V +.: • "I � I - • � . • t RE (MAJOR) (BUILD) , (UBUILD) .
Permit required ONLY when spaced sheathing is covered by
solid sheathing. - 5% State Surcharge $ 02, 5
• City use only ; WACO: , • -
SUBMIT THREE pi SETS OF PLANS SPECIFYING. (TAX) - r ' (UTAX) •
A. • Roof area & nearest street.
65% Plan Review $
B. Attic vents - Providel sq. ft. for each 150 sq. ft of attic City use only: WACO: .
space & vents shall be located in the upper 1/3 of the roof. - (BUPPLN) (UBUPLN)
Provide 1 sq. ft. for each 300 sq. ft. when eaves & attic
TOTAL $ 7 3 -�
STEPI.40, ai,cofi!lMERCt ,. ONll::::::<::<!:!:! : ::: >: ><:-::: >:: > ::; >:: >:::> g.: : :: :.::: I acknowledge . :..:. :::: . . �::::::::::::::;;; �._._.:::... �.>:.:: � ....> .:. h.::.. �.:::::::.:::::::-.: �.,,-.::>.,.::, .:::::.::;.�:� »::...:. :.;:v. o edge that I have read this application and that the
Describe work to be done: (check appropriate box) information given is correct; that I am the owner or authorized
- 3 RE -ROOF (circle A ,B or C) agent of the owner, and that the plans (if applicable) are in
A. Existing built -up roof covering to be REMOVED and deck compliance with Oregon State law.
repaired - Signatu if Owner/Agent Date
B. Existing built -up roof covering to REMAIN: note applicant
must submit an engineer's review of the roof structural c7/" q/6/
elements. Review shall bear the seal (or stamp) of the /"
architect or engineer licensed in Oregon. Contact Perso ' ame Telephone
C. Asphalt or wood shingle/shake
(PROCEED TO STEP 2)
I:ROOFI.DOC (dsts)
CITY OF TIGARD
BUILDING PERMIT FEES .,
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT F.L.S. REVIEW TAX PERMIT
PROJECT FEES (40 %) (65 %) (5 %) FEES
1 -1500 25.00 . 10.00 16.25 . 1.25 . 52.50
1,501 -1600 26.50 10.60 17.23 1.33. 55.66
1,601 -1,700 28.00 11.20 18.20 1.40 58.80 .
1,701 -1,800 29.50 11.80 19.18 1.48 61.96
1,801 -1,900 31.00 12.40 20.15 1.55 65.10
1,901 -2,000 32.50 13.00 21.13 1.63 68.26
2,001 -3,000 38.50 15.40 25.03 1.93 80.86
3,001 - 4,000 44.50 17.80 28.93 2.23 93.46 5 3, 0 _ 3
4,001 -5,000 50.50 32 83 2 53 106 06
5,001 -6,000 56.50 22.60 36.73 2.83 118.66
6,001-7,000 62.50 25.00 40.63 3.13 131.25
7,001 -8,000 68.50 27.40 44.53 3.43 143.86
8,001-9,000 74.50 29.80 - 48.43 3.73 156.46
9,001- 10,000 80.50 32.20 52.33 4.03 169.06
10,001- 11,000 86.50 34.60 56.23 4.33 181.66 -
11,001 - 12,000 92.50 37.00 60.13 4.63 194.26
12,001 - 13,000 98.50 39.40 64.03 _ . 4.93 . 206.86.. - . ._.. ,_
13,001- 14,000 104.50 41.80 67.93 5.23 219.46
14,001- 15,000 110.50 44.20 71.83 5.53 232.06 - - . ._
15,001- 16,000 116.50 46.60 - 75.73 5.83 " - 244.66
16,001- 17,000 122.50 49.00 s 79.63 6.13 - 257.26 .. __
17,001 - 18,000 = 128.50 51.40 83.53 6.43 269.86
18,001- 19,000 134.50 53.80 87.43 6.73 282.46
19,001- 20,000 140.50 56.20 91.33 7.03 295.06
20,001 - 21,000 146.50 58.60 95.23 7.33 307.66
21,001- 22,000 152.50 61.00 99.13 7.63 320.26
- 22,001- 23,000 158.50 63.40 103.03 7.93 332.86
23,001- 24,000 164.50 65.80 106.93 8.23 - 345.46
24,001- 25,000 170.50 68.20 110.83 8.53 358.06
25,001- 26,000 175.00 70.00 113.75 8.75 367.50
26,001- 27,000 179.50 71.80 116.68 8.98 376.96
27,001- 28,000 184.00 73.60 119.60 9.20 386.40
28,001- 29,000 188.50 75.40 122.53 9.43 395.86
29,001- 30,000 193.00 77.20 125.45 9.65 405.30 .
30,001- 31,000 197.50 79.00 128.38 9.88 414.76
31,001- 32,000 202.00 80.80 131.30 10.10 424.20
32,001- 33,000 206.50 82.60 134.23 10.33 433.66
33,001- 34,000 211.00 84.40 137.15 10.55 443.10
34,001- 35,000 215.50 86.20 140.08 10.78 452.56
35,001- 36,000 220.00 88.00 143.00 11.00 462.00
36,001- 37,000 224.50 89.80 145.93 11.23 471.46
37,001-38,000 229.00 91.60 148.85 11.45 480.90
t:ROOF1.DOC (dsts)
_ . ,..
lAir KING CITY
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: `
located at: I O30 S&) L)ve...e._.,
King City Represent ive
I :'DSTS \KCINST.DOC