Permit "r CITY OF TIGARD
i „,>,: D DEVELOPMENT SERVICES MASTER PERMIT
M1l'li PERMIT # • MST98 -0162
AJ- 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 04/23/98
PARCEL: 29110CD -04500
SITE ADDRESS...:15565 SW ROYALTY PKWY
SUBDIVISION -KING CITY NO. 2 ZONING:
BLOCK LOT •028 JURISDICTION: KIN
Remarks: Residential 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 • 8 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 8 sf FRONT • 0 PARKINS SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 8 FINBSMENT: 0 sf RIGHT • 8
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL 0 sf VALUE..$: 5879 REAR : 0
PLUMBING
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 8 DISHWASHERS...: 0 FLOOR DRAINS..: 8 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 8 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN (108K ..: 0 BOIL /CMP ( 3HP: 8 VENT FANS • 8 CLOTHES DRYERS: 0
FURN ) =100)( ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 8 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOYES....: @ GAS OUTLETS...: 0
ELECTRICAL
-- RESIDENTIAL UNIT— - -SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — — MISCELLANEOUS— --ADD'L INSPECTIONS- -
1' SF OR LESS: 0 0 - 200 alp..: 0 0 - 280 alp..: 0 W /SVC OR FOR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5 .: 0 201 - 400 alp..: 8 201 - 408 alp..: 0 1st W/O SYC/FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 8
MANF HM /SVC /FDR: 0 601 - 1'.lw. amp.: 0 601 +amps- 1' v: 0 MINOR LABEL -10: 0
100+ amp /volt.: 0 PLAN REVIEW SECTION -
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) .sr, V NOMINAL: CLS AREA /SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER • HVAC • LANDSCAPE /IRRI6: PROTECTIVE SIB:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL OTHR: ..
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL It SYSTEMS: 8
Owner: Contractor: — TOTAL FEES:$ 96.06
JERRY WARRINGTON HERMAN ROYBAL This permit is subject to the regulations contained in the
15565 SW ROYALTY PKWY 6288 SW SEVILLE AVE Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 LAKE OSWEGO OR 97035 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 8: 639 -7033 Phone 8: 697 -6916 not started within 180 days of issuance, or if the work is
Reg 8..: 123001 suspended for more than 188 days. ATTENTION: Oregon law
— requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 001-0210 through OAR 952 801 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
REQUIRED INSPECTIONS
Roof Nailing
Dry -rot after to
Building Final
/r
Issued By: r 1.--- Permittee Si /� i / //�
++++++++++++++++++++++ + + + + ++ + + + + + + + + + + + + + + + + + + + + + + + ++ + + +-,•, + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed w ' e b es day
,DIV QF TIGARD Rec'd By:
13125 .,W HALL BLVD. Date Recd: -
TIGARD 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 - 598 -1960 Permit #: teZ
Called:
Name of Development/Business Na a De elo menUBus ess
>'STgRiNgllt :ROOFING ::.° . S O: Bilf>::>'<'`:M: >:` >. > > > >`E< >< >? <<': »_< >' > "s
`:::> . .:t l'::Docume .. .
11 >Nr� Gib ............................. ... tU...... PP000.......0......... ..............................
Street Address Ste # Please fill out applicable section and attach copy of roofing
Job Site /S (,S . W /(, � L..7 / f, j& ) specifications.
Bldg # City/State Zip :::li d:: elithig : >:::(:: latO om3 �.AF B[Q)f:`:erii<::> :iiiii gili::> : > ? >:: > :: > > :'
b G,ri 9722 A.
N me 1. Specification #:
Owner Mailing dress 2. Manufacturer: 0tvgAS - Colj ///N C
City /State . ' �� ( Phone 3a UL Classification:
63?
Roofing Name '5 ��,7 / / ' Listed UL Building Materials Directory Page #:
Contractor ,, , ar, 0 I,. ,,_ . ,. (OR)
(Prior to issuance Mailing Address 3b Wamock Hersey :
applicant must 4 1 * 5 ' , k el,, ! ., /4-0
provide a copy of City/State ,,, Listed Warnock Hersey Directory Page #:
all contractor �,4x SIU CCU g7p3,5 (PROVIDE COPY OF ASSEMBLY) _
licenses if Phone # Fax #
expired in COT a12- 6.97,6, B. ICBO Research #:
database) State Constr.Contr. Board # Exp Dat
/2,340 ,,'20fy DATED:
1 0). VI :: 'if`lOI iiiii :: >:: >:: >:;:::>iiiii :»::>::>::>::>:: >:: > ::;:: >:: >:<: >::<:::::iiii : : >:::: >:<: >:::: >:::: >:::: >:::<: iiiii::: C. SPECIAL PURPOSE ROOFING. WOOD SHAKES*
Building pe Of Use: (circle one) (• review required by plans examiner)
SF SFA COM MF
Building - Type of Construction: VALUATION OF PROJECT $ r D7/ -
Existing Deck Type: Permit fee based on valuation* �
Combustible ( ) Non - Combustible ( ) ` see chart on back $
} :: :
A,N......M ./yiyb� �(' may! � .. . .......:.... .:.. ...... ...... :......:. .. ... ... ....... .. ...
WRiM7::1✓�:'I:ili:�illiF
...... I ::. eon •: <::;<>::::>::<<:::><::<::::>:::::::::>::>::>:<<:>: ::::::::< <:: >> >:: >::: <::<::
❑ REPAIR ........ ..........
;:::> : :fir! ..... .
R MAJOR <: >:: >:::::: >:;::::.. »'»: > »:<:.::: > > > :<:::; :; ; :»:: :::
(MAJOR) ;: >:. :.:.:( BUILD):::::>::;;:»> �:. (.UBU.Itt?):: <;.: »:;:;;: ;;::>;::>:: ::.:: :::<:.
Permit required ONLY when spaced sheathing is covered by
solid sheathing. 5% State Surcharge $
n
>Ci ;raise o ;< >:WAGO= :' > » > » > :> > > >:<::;.;;: : > >
SUBMIT (3) S
B THREE SETS OF PLANS SPECIFYING.
' . ."'-:
'
ET S ECIFYIN '; : ::.:: ::i
G
( > >< : : : :< :< : » : : : :<;: TAX ;. > : : > : :< : »< : : : : : : :<; :< : : >: UTAX :; :' :< : : > -> .::., : :... :. : : :..... :.. :. : :
A. Roof area & nearest street.
65% Plan Review $
B. Attic vents - Provid 1 ft. for e is e sq. ft o each 150
sq. ft of attic
'Ci ;:use o >; : : :WACO<< p >: <_ > << ` `; > > < :, < : > :<
space & vents shall be located in h
the upper 1/3 of the roof. ;
Provide 1 sq. ft. for each 300 sq. ft. when eaves & attic �j/ ,�+
TOTAL $ I (0 .00O
AMR.10 .; : :.; .: �. :: �!. : :: I : : : : : : : .: �3..: i. �::::::::::::,.:.:;.:.;; :. :.; : :;. :.; :. : :_ :.; :.; :.;: I acknowledge that I have read this application and that the
Class >: r » > : :> iiii< : » : : > : :< : :< :::: :::: li!i: °:? >:iiiiis : : >< : : : : > : : :iniii ::::::::: ::::, .
•..:...:...:':::::.:::;.;.:;::::::::::::.:::::.:::::::::::::: : : : . : : : : : : : : : : : : : : : : : : : : : : :; :: 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 applicabel) 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 Owne 4 � Date B. Existing built -up roof covering to REMAIN: note applicant V 2 2 re
must submit an engineer's review the roof structural '� �//
elemm enn ts. . R Review shall ll bear the seal (or stamp) o of the
architect or engineer licensed in Oregon. •n t Pte' ame / Telephone
C. Asphalt or wood shingle /shake /� �I� 6>/z54z- 697-r/ �
(PROCEED TO STEP 2) l�j
I:ROOF1.DOC (dsts)
. „
4/ KING CITY
15300 S.W. 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: \-10--A-L1 Off — 6— - key
located at: /- - • _, . • ,_ AL_
P -4:JCL.l '
King City Representati
I:'DSTS XCINST.DOC
/G17 � � ; 6 ,-
CITY OF TIGARD BUILDI G INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 5- I - q(?" )( P.M. MST: 6 k-(J / 2
Location: /5565 ) 4,( A ) fed-alt:;-(e_. t e: BUP:
Tenant: Bldg: MEC:
Contractor: _J _'e. ! -1 -.II s _ _ Phone: R 7 - 6p 9/6 PLM:
C
Owner: 9e, / 0,4 _ /i � 1-.` J� _ Phone: 61 , j 7O3 , ELC:
0 ELR:
SIT:
BUILDING ,- ' P Ve ftI con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site am Post/Beam Post/Beam Cover /Service Sewer /Storm
' Footing • oo .s "- UndFl/Slab Rough -In Ceiling Water Line
Slab :r - irg Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
,Approved Approved Approved Approved Approved
Appr /Sdwlk pproved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
't tf ,
O Call for reinspection O Reinspection fee of $ required before next inspection CI Unable to inspect
Inspector: l/ Date: F-1-$53 Page of
5--5- K-11.) 4 Gary
/e/ ( -J 6
ti10 1-1 CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: 5 - 47OP A.M. P.M. MST: cia
Location: / S-c() 66p-eug, PoluArud--- BUP:
Tenant: Suite: Bldg: WC:
Contractor: Phone: (6' q7-6974. PLM:
Owner: Phone: ELC:
(-11.0 otAC-J ...-- ELR:
SIT:
BUILDING I(* ...D con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Po :eam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing ' oof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer - Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire S •klr/Ahn Crawl/Found Dr Heat Pump Low Volt
A, • oved Approved Approved Approved Approved
Appr/Sdwlk • . • u. oved Not Approved Not Approved Not Approved Not Approved
- &hip FINAL FINAL FINAL FINAL
C4
1:3 Call for re ■ s 6 t D Reinspection fee of $
'I required before next inspection 0 Unable to inspect
Inspector: , . Date: 5 /6(7e Page of
_......._____