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Permit CITY OF TIGARD PERMIT PERMIT #: BUP2000 00068 ,0� DEVELOPMENT SERVICES DATE ISSUED: 03/01/2000 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15790 SW QUEEN VICTORIA PL PARCEL: 2S110CC -08700 SUBDIVISION: KING CITY NO. 3 ZONING: BLOCK: LOT: 061 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: $ 3,800 Remarks: Re -roof Owner: Contractor: COOK, LUTHER MARBLE AND J VAUGHAN ROOFING INC PHYLLIS E, TRUSTEE 2373 NW 185TH AVE 15790 SW QUEEN VICTORIA HILLSBORO, OR 97124 KrnoneTY, OR 97224 Phone: 503 - 645 -8923 Reg #: LIC 88412 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Roof Nailing Insp PRMT BON 03/01/200C $68.50 0000355 Final Inspection 5PCT BON 03/01/200C $5.48 0000355 Total $73.98 OR1GNA L 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. Permitee Signature: CO P tk (J"Y\ Issued By: f • ( t& JA _. Call 639 -4175 by 7 p.m. for an inspection the next business day CITY OF TIGARD Plan Chec : A 13125 SW HALL BLVD. Rec'd By: TIGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date Rec'd: 3- t - 2cIPP V- 503 - 639 -4171 X304 Date to PE: Date to DST: F- 503 - 598 -1960 Permit #: ar Incomplete or illegible applications will not be accepted Called: Name of Development/Business STEP 2. NEW ROOFING ASSEMBLY Material Documentation (UBC Appendix 15) . St5eet Address 4i, / 41 Ste # Please fill out applicable section and attach copy of roofing Job Site 15. 790 S W 4a., .,•1. PI. specifications. Bldg # City /State Zip Listed Assembly ( Circle & Complete A, B or C) A. Name n ) i /° 1. Specification #: Y y i ss 6 L Applicant Mailing Address 2. Manufacturer: a ve. p o T ra nia r 2.c- 5 fart i; bfic is 3.) i 6 790 5" Q Age.. L2 J '1 P / .9ty /State Zip Phone *3a UL Classification: 1C G/ G1 Roofing Na r ./ Listed UL Building Materials Directory Page #: Contractor J. 1/clM.y 1 .l RooF,••5 , i2 c. (OR) (Prior to issuance M lin Addl�ss *3b Wamock Hersey : applicant must 7- 5. 3 A/ i%) / ' S � � L Air . provide a copy of City /State Zip Listed Warnock Hersey Directory Page #: all contractor 14 ,' 6 r,.J o 9Q 97/z Y *COPY OF ASSEMBLY REQUIRED licenses if Phone # Fax # expired in COT (p °/ 0 - l ?D 7 r, Vi 6 - 1 2 3 B. ICBO Research #: • database) State Constr.Contr. Board # Exp. Date gg t/l 2 r-2 /- 0 DATED: BUILDING INFORMATION C. SPECIAL PURPOSE ROOFING: WOOD SHAKES Building Of Use: (circle one) (review required by plans examiner) F SFA COM MF Building - Type of Construction: / .- 7 . 7 OF PROJECT $ t)) sq. ft. 2 »a of roof area `. ' O - Existing Deck Type: Permit fee based on valuation* Combustible ( ) Non - Combustible ( ) * see chart on back $ eRESSD 11AL T`ONCY = Class o n• _ _ City use only: WACO: 16 ❑ REPAIR (MAJOR) (review required by plans examiner) (BUILD) (UBUILD) Permit required ONLY when spaced sheathing is covered by solid sheathing. Changes to roof line require Building Permit 8% State Surcharge $ Application. ity use only WACO: SUBMIT TWO (2) SETS OF PLANS SPECIFYING. , (TAX) (UTAX) 6 • A. Roof area & nearest street. r *Required for major repairs of / Residential B. Attic vents - Provide 1 sq. ft. for each 150 sq. ft. of attic or "C" above * 65% Plan Review $ space. Vents shall be located in the upper 1/3 of the roof City use only: WACO: Provide 1 sq. ft. for each 300 sq. ft. when eave & attic (BUPPLN) _ (UBUPLN) venting is provided. TOTAL $7 ; [ STEP 1. COMMERCIAL ONLY [ I acknowledge that I have read this application and that the Class of Work: Repair • information given is correct; that I am the owner or authorized Describe work to be done: (check appropriate box) agent of the owner, and that the plans (if applicable) are in ❑ RE - ROOF (circle A ,B or C) compliance with Oregon State law. • A. Existing built -up roof covering to be REMOVED and deck repaired - Signature of Owner /Agent Date B. Existing built -up roof covering to REMAIN: note applicant must submit an engineer's review of the roof structural - o elements. Review shall bear the seal (or stamp) of the architect or engineer licensed in Oregon. Contact rson Name Telephone C. Asphalt or wood shingle /shake . P- 6g - /8b7 (PROCEED TO STEP 2) ,.Joi s on a H ol I, 4 t :dsts\forms\roof. res. doc 8/26/99 - -- . . • Vie KING CITY 15300 S.W. 116th Avenue, King City, Oregon 97224 -2693 IIMMINEMMINIII Phone: (503) 639-4082 • FAX (503) 639 -3771 Notice To Contractors Workin 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: ‘..1-e.,024.-/ v located at: /5791 iLt. c ,l g,i LI & M ie .-„,_-_,'Ag_i_.._ King City Represent v e 1:'DSTS\KCINST.DOC x Z(o 3 0 150 103 0 ) t.9 3 S pA c ¢ ?a N I5 5 0J (u¢¢n i V' 1. ,Ci'rt (�a41 ' = /401 3,4 � a 0 v , I I6i _› CITY OF TIGARD BUILDING INSPECTION DIVISION Ms 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 Date Requested 3 - 7 AM PM BLD Location /5 Q .Q,1 ifisiccasuite MEC Contact Person c&JOY) Ph g r v( - 21 3 PLM Contractor Ph SWR ILDI 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 Roof Misc: i PART FAIL NG 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 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 (-018. Date QOO C Date Requested / . AM PM BLD Location �] q ({� 1 V 1 c �U n Suite MEC Contact Person 6 /kciA.../ Ph 3 / Z_/ 33 PLM Contractor Ph SWR UILDI enant/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 I tai Nee '•/ i A 770.1) Dd / iL/ - e ' !� Insulation ,,// Drywall Nailing f /e- Firewall Fire Sprinkler '■./ C4 /i� 4 L - 7A_l S / 0 Fire Alarm Susp'd Ce''u • Rs.q i Misc: Final PASS PART FAIL PLUMB! 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 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.