Permit CITY OF T MASTER PERMIT
• DEVELOPMENT SERVICES PERMIT # • MST97 -0372
1J.., 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 09/09/97
PARCEL: 25115BB -01300
SITE ADDRESS...:1654O SW ROYALTY PKWY
SUBDIVISION • ZONING:
BLOCK LOT • JURISDICTION: KIN
Remarks: Remove cedar shakes, replace deck, add 17 sq feet venting, re -roof
BUILDING
REISSUE: STORIES : 0 FLOOR AREAS BASEMENT...: 8 sf REQUIRED SETBACKS -- REQUIRED- -
CLASS OF WORK.:ALT HEIGHT • 0 FIRST • 8 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT : 8 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 8
OCCUPANCY 6RP.:R3 BDRM: 0 BATH: 0 TOTAL 0 sf VALUE.. 1: 5758 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..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 8 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 8
MECHANICAL
FUEL TYPES FURN ( 189K ..: 8 BOIL /CMP ( 3HP: 0 VENT FANS • 8 CLOTHES DRYERS: 0
FURN ) =108( ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX IMP.: 0 BTU FLOOR FURNACES: 0 VENTS : 0 WOODSTOVES • 8 GAS OUTLETS...: 0
ELECTRICAL
— RESIDENTIAL UNIT— -- SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— —BRANCH CIRCUITS— — MISCELLANEOUS— - -ADD'L INSPECTIONS—
SF OR LESS: 0 0 - 200 asp..: 0 0 - 200 alp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 281 - 400 asp..: 0 201 - 408 asp..: 0 1st W/O SVC /FDR: 0 SIGN /CXIT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 asp..: 0 401 - 608 asp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLANT • 0
MAW HM /SVC /FDR: 0 681 - 1099 asp.: 0 681 +asps- 1' v: 0 MINOR LABEL -18: 0
1000+ asp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 688 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..: DTH: •• BOILER HVAC L /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: ..
HVAC DATA /TELE COMM.: NURSE CALLS....: TOTAL N) SYSTEMS: 0
Owner: Contractor: TOTAL FEES:$ 59.33
NINA MILLIGAN HERMAN ROYBAL This permit is subject to the regulations contained in the
16540 SW ROYALTY PKWY 1982 NE HYDE ST Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 HILLSBORO OR 97124 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 8: 684 -6741 Phone 8: 681 -8933 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 - 001-0910 through OAR 952- 001 -0880. You may obtain copies of these rules or
direct questions to OUNC by calling (593)246 -1987.
REQUIRED INSPECTIONS
Exterior Sheathi
Building Final
Issued By: yg)• d/[ A 4 _._ Permittee Signature:
+ + + + + + + + + + ++ ++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++ ' + -+ + + + ++
Call 639 -4 5 by 6:00 p. m. for an inspection �fieed.e. t ne, bu in- s day
CITY Of TIGARD Recd By:
13125 SW HALL BLVD. Date Recd: G1 q
TfGARD 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 x: S1_ =P)31 Y
Called:
N . of Oevelopme r ness STEP 2._. NEW ROOFING ASSEMBLY::: :: > ::::. :`.," ',.
r r • . . - - — Material Documentation ( ,. ' `x£ ,,,; `
treat Address / Ste s Please fill out applicable section and attach copy of roofing
Job Site /6 59O S. l�J, r / �. specifications.
Bag 5 - Ci State - ' Zip • Listed Assembly ( Circle &.Complete A. B orC).::.: :. i.s.. > :' :.;:.:::: : : :, : :.:::
y , . ^ y2ZZ A.
Name , 1. Specification*:
M, 4, 7// 47-4- C2/\
Owner Mailing Address 2. Manufacturer.
City /State I , ? .) P e 3a UL Classification:
�J % 3 ( y - 6 7Y/
L UL Building Materials Directory Page #:
/i2 - IJ /61 C, /fee. (OR)
Roofing Mailing Address 3b Wamock Hersey : +
Contractor /%t2 z ___)9v J 1/ (Prior to issuance /S p Listed Warnock Hersey Directory Page #:
applicant must /7,∎,6 � 9 2/ 2 - 5 ` (PROVIDE COPY OF ASSEMBLY)
provide a copy of Ph n C _, Fax e
all contractor 4)-/-- 8-1 ////// B. ICBO Research #:
licenses if State Constr.Contr. Board* Ex . Da✓
expired in COT /13 00 f i z 6 DATED:
database) COT Bus. Tax or Metro Licit .Date (PROVIDE COPY OF ASSEMBLY)
SU.PAWINFORMAVAlt C. SPECIAL PURPOSE ROOFING: WOOD SHAKES'
3Of Use: (circle one)
MF e review required by plans examiner)
3uilding SF
SFA COM
3uilding ype of Construction: N V ALUATION OF PROJECT $ • -
5 5 76 -,--
Existing Deck Type: - Permit fee based on valuation*
Combustible ( ) Non - Combustible )( • see chart on back S
:.<i.IN !OE[ EEAE . ,.:_ t '-: <: .:. >:a1: : : : :a k;:� Ci use on
.. ...�.`'s�tia \vah \�;::..: �♦ a•:♦ wa�a:., t„ v... a.:. a.,. t..,•: �a tiv«:.::a,:::::w::::; >.;:�:�:::.M tY IY: i WACO: -
REPAIR (MAJOR) (BUILD) , (UBUILD) .
Permit required ONLY when spaced sheathing is covered by
solid sheathing. SJ1 ekt 1 f9 I Ilnat 5% State Surcharge $
City use only: .:. I , WACO: •. .
SUBMIT THREE (3) SETS OF PLANS SPECIFYING., (TAX) -• ' • I (UTAX)
A. - Roof area & nearest street. I,t/� PO m
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 • 56.512 ) 5( /L
"I 5 • 2 83 TOTAL $ 57 3 /
. tii:iii"
fit:::: ': i;:.i;.v;ii: ?4:iv. aK.. : :( '..: {::: .,.v
STEP.:5�...:,,.,.: _n i s. : 9044lERCIAL. OHL :' <«<::::`:: n: :: : : :; :::; :
t..:.::: ,:..;: <: I acknowledge
,,. t♦.. kw ,z, >:.fit.;:::.:.::. >.,:::., >.. , t.,, �;;.: ;.;;::;:.,;: : that I have read this application and that the
Describe work to be done: (che appropriate box) information given is correct that I am the owner or authorized
J RE -ROOF (circle A .3 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 - Signature of OwneriAgent Date
B. Existing built -up roof covering to REMAIN: note applicant / /// 977 � must submit an engineer's review of the roof structural /� "--
elements: Review shall bear the seal (or stamp) of the .i /�
architect or engineer licensed in Oregon. • .., ame Telephone
C. Asphalt or wood shingle/shake STEP 2) ) / � 400 / yo /9z 4P/ 5_
(PROCEED TO STEP
I:ROOF1.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
4,001 -5,000 50.50 20.20 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 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
I: ROOF1.DOC (dsts)
•
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: elf o' 4 - TTY -
located at: Z / _ �i ,z. _ t
/ dOCeJ ICJ
King City Representativ
1: DSTS' KCINST. DOC
lbg
q2
CITY OF I ARD B
T G UILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: — ?'' — 9 7 n A.M. P.M. MST: 0.3 70---
Location: l .5eb0 C S60 ,,ef T d2 X cP rr BUP:
Tenant: o
Suite: Bldg: MEC:
Contractor: p 4J7I aJ'(./ Phone: 9 7- e?3 / 9 PLM:
Owner: Phone: ELC:
ELR:
SIT:
BUILDING : LD PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing ' oof UndFl/Slab Rough -In Ceiling Water Line
Slab ranting 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 • .. , Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk .... !Ft ... ed Not Approved Not Approved Not Approved Not Approved
A FINAL FINAL FINAL FINAL
r
•
O Call for reinspec on O Reinspection fee of $ required before ne nexxtt inspection O Unable to inspect
Inspector: / Date: 772 / J Page of
D `"_-✓/
• CITY OF TIGARD BUILDING IINSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 9/-l A.M. P.M. MST: q-7 d 3 7
Location: f 6 S ,/ eQ_eG� � ilk , si. BUP:
•
Tenant: Suite: Bldg: MEC:
Contractor: Phone: 6 7 - R 3 C) PLM:
Owner: Phone: ELC:
ELR:
SIT:
BUILDING LDG on't) PLUMBING MECHANICAL ELECTRICAL SITE
Site ' . ter,; • : Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing - op UndFl/Slab Rough -In Ceiling Water Line
Slab ., g 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
pprovv Approved Approved Approved Approved
Appr /Sdwlk roved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
'I 00 144 iY\
. Lr
J
��� � O (-0-6.p � `/1� t t111�
c -e (..)0_ ,.€ -e 'J L r. T t vx "1-
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. Cs
_ . . . _ _ _ _ . 1 2 7 - 6 . _ _ _ _ _ . _ 1 / 1 - KY- 6P
4 •
4 I • all for reinspection Cl Reinspection fee of $ required before next inspection Cl Unable to inspect
Inspector: Date: 9A 1 --(q Page of