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Permit CITY OF T IGA R D MASTER PERMIT , . , . .0, , , , ^... 1)PPolil DEVELOPMENT SERVICES PERMIT SSLJFD a 8� 1MST97- 3 4 ' I PARCEL: 2S 1,1'513'C- -060001 SITE ADDRESS. ,..: 16735 SW QUEEN ANNE AVE SUBDIVISION....: ZONING: BLOCK.......... LOT...........e.: JURISDICTION: KIN ,Reparks: Reroof peroit. ' REISSUE: - -I , STORIES...'....: I. FLOOR' AREAS BUILDING BASEMENT...: 0 sf REQUIRED SETBACKS--- REQUIRED------- - -- CLASS OF WORK.:r;i 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 CON'ST. :5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT : 0 ., OCCUPANCY GRP.:R3 BORM: 0 BATH: 0 TOTAL--= - -: 0 sf VALUE.. S: ' 4200 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 DRAINS..: 0 SEWER LINE ft: 0 ' S RAIN DRAINS: 0 CATCH BASIN'S..: '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 Fi1RN (100K ..: 0 BOIL /CKP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0 . FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS : 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS : 0 WOODSTOVES • 0 GAS OUTLETS..,: 0 . - -- - - - -- ELECTRICAL - - -- ----- ---- -- RESIDiNTI UNI; _...•.. _ -T SRVC FEEDERS R_ C ___. A :E OU S_ is -- _ urn. -. —_; _ � -- INSPECTIONS—. _ — `IVL�Ii[/Zltl il•ii:-7iiz 3'1-- - ""�CiCV 1l.LYrCCLC(1' - -'T —IGI$' J1lYL />•CCUCRJ " - -BR�� G1 RI:U117 - -- '--- i9171.CLLMVCUUJ - - -- --F1UU L,11�1.•Si'ClrllUrirJ - -' - 1000 SF OR LESS: 0 0 - 200 app..: 0 ' 0 • - 200 app..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION :, '0 ' EA ADDL 500SF.: 0 201 - 400 app..: 0 201 - 400. asp..: 0. 1st W/0 SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR . 0 LIMITED ENERGY.: 0 401 - 600 asp..: 0 401 - 600,a©p..:'0 . EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLAIT.......: 0 ' MANF HM/SVC /FDR: 0 - 601 - 1000 app.: 0 601 +asps -1000 v: 0. ' - • ' MINOR LABEL -10: 0 1000+ aeip /volt.: 0 — - , — PLAN REVIEW SECTION ------ ; -- - - . Reconnect 'only.: 0' ) =4 RES.UNITS..: 'SVC /FDR }=225 A.: ) 600 V NOMINAL: . CLS AREA /SP OCC: -- - - -- ELECTRICAL - RESTRICTED ENERGY - - --• ' A. SF RESIDENTIAL -------- - - - - -- B. CONMERC1RL-- -- ---- ------ - - - - -- ------------ AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDEC LT: BURGLAR ALARM..: 0TH: .. BOILER HVAC . LANDSCAPE /IRRIG; PROTECTIVE SIGNI.: . GARAGE' OPENER..: ' CLOCK ' • INSTRUMENTATION: MEDICAL ' ' : ' 'OTHR: .. HVAC ' DATA /TELE COMM.: • - NURSE CALLS • ' - TOTAL R SYSTEMS: 0 Owner: --- - - - - -- -- Contractor: - --------- - - - - -- TOTAL FEES :5 85.86 RON DAVIS CORNICK CONSTRUCTION INC This peroit is subject ,to the regulations contained in the 16735 5W QUEEN ANNE 6327 SW CAPITOL'HWY #214 ' ' Tigard Municipal Code,'State of Ore. Specialty'Codes „and all ' KING CITY OR 97224 PORTLAND OR 97201 - ' - ' other applicable laws. All' work will be done in'accordance with'approved plans. This peroit will expire if work is Phone B: 774-7703 Phone D: 299 -4750 not started within 180 days of issuance, or if the work is Reg 21..: 035254 - suspended for sore than 180 days. - ATTENTION :.Oregon.law -- ---- - - - - - -- - - -- - .-- - - - - -- ,. requires you to 'follow rules'adopted by the "Oregon Utility Notification Center. . Those rules are set forth 'in 952=001 -0010 thr'ough OAR952- 001 - 0 You'day;'obtain copies of these rifles or ,, direct questions to IOU;NC'by Calling (503)246 -1987. - ---- ' REQUIRED INSPECTIONS -- - , - --- - -- Misc. Inspection ' ' Building Final ' ' . ' ' Issued B :, - . . /' 1 ,A , Permittee Signature: — O • +•F + ++- : -4-1- '• "'1--1- +-:- •'1-- 1..,1- -y'.. x...,1--1..'.1- +- 1 -a..+ i..q...r- ]• -°h -1- 4••1-•1 - 1- 1- 1••1 --1 -.1• d-•+- I--{-'-- 1 F- 1- .L 1- .. �� . _1 -- f .. q...r ., {- .i• -r- -1. 1•- L..1--I-,r ' ball G�,S --41 75 by 6 :00 p.m.: for an iri'sp.ect i'on. needed the next bus -i Hess day CITY OF TIGARD Rec'd By: _ 13125 SW ^HALL BLVD. Date Recd: ir /4 f / / T IGARD OR 97223 RE- ROOFING PERMIT APPLICATION Date to PE: V- 503 684..7 '171 X304 Incomplete or illegible applications will not be accepted Date to DST: I 3 � F- 503 - 684 -7297 Permit � #: S'�'�l 7 -1� Called: e f Dev ment/Business a ,, •°• > .: :,: .:::, <•> . P ' NE tING<ASSEdlBI� > ::: .�::; , �, .: �:�r:' ::::.::::. . r. ic - 9 �i t (� �� : .•: \::: •,C'tvo,. <a y , . �s. u �;.r,,,:. > "•::'a2: '•x: Y�� u$i:$• 3 : ^;25:.:c• °.t 'f'`:'4a : ;: �:ti `� . tul 1 04 �Q�ARA !J k :Mate ta:Docwneritatio u tic- ppet►ditli5) '::�x�?s;;•x,v ,:::.'.' <;.,.'Y > Street Address Ste # Please fill out applicable section and attach copy of roofing Job Site 1.4, 3s lid .9•46111411 specifications. g # c� ls� tG it , h zip NAfstis�� �%?tcT��.B,�Ca w- � �pte:€ rarxCj _s ':<:�.� :� �; :�:s <� f.�_ ; led / V 1. Specification #: I o 4..5 3 Ai n OSAt 1)4 / i, S Owner ailing Address 2. Manufacturer. n ( 6Als — -() f A) /iI4 /‘7"."RSM plAt d /IAN /State Zip I Phone 3a UL Classification: A Ij p h i 7.?' 1�7 7o� Name nn I Listed UL Building Materials Directory Page #: ) O CoRAl) tile- Cb/�.� `t JLj (OR) Roofing ailing Address 1 3b Warnock Hersey : Contractor 6 7 s, 14 , C Apf16L ki i ou (Prior to issuance / tate Listed Warnock Hersey Directory Page #: applicant must fora- - /#0,1 O I (PROVIDE COPY OF ASSEMBLY) provide a copy of Phone # Fax # . all contractor a q 0) r 17 B. ICBO Research #: licenses if Stale Constr.Contr. Board # Exp. Date expired in COT S' oa it . `7ia, 9$ DATED: database) COT Bus. T or'Met Lic # L p.Da e • (PROVIDE COPY OF ASSEMBLY) • .BttWLDINGJN ORMA ' ; *.:.Y''-••` `:y`x'iosk —A : C. SPECIAL PURPOSE ROOFING: WOOD SHAKES* Building - , pe Of Use: (circle one) (' review required by plans examiner) SF SFA COM MF Building - TType Construction: VALUATION OF PROJECT $ 0 CO Existing Deck Type: . Permit fee based on valuation" Combustible (X) Non Combustible ( ) ' see chart on back $ RESIDE,N '1AE : ONLY _ . ' L s'tivot' gjAt_teUoni City use only: i WACO: . A R EPAIR (MAJO (BUILD) i (UBUILD) Permit required ONLY when spaced sheathing is covered by solid sheathing. 5% State Surcharge $ . s3 City use only: ' WACO: - .. : .. SUBMIT THREE (3) SETS OF PLANS SPECIFYING. (TAX) . I (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: j. WACO: 4 • . . i space & vents shall be located in the upper 1/3 of the roof. (BUPPLN) 1 (UBUPLN) ... - • • Provide 1 sq. ft. for each 300 sq. ft. when eaves & attic e 3 „.. 4 / TOTAL $ (OO 3TERI :: `rCOMMR ECi 4 L ONL ° ': ::, >:<, ` , =t <:= '> v. ;:,� . ., ;.;Ytf.:..,., •'� � �. Y :. �.- -: - ..- ' ,.,,:,: - �.,�._ r: . � >.. K: . I acknowledge that I have read this application and that the Class < V �s i Ci! iy = .•,'�: J i'S.n+`2a \:^::'. : .:., •'�:.:' L.•Q •� Wi t :. /ViG a .„ - - ,;- :. . a: :: - - -- { :: :: is . Describe work to be done: (check appropriate box) information given is correct; that I am the owner or authorized 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 - Signature of Owner /Agent Date B. Existing built -up roof covering to REMAIN: note applicant rr g must submit an engineer's review of the roof structural ` - ` / / y _ f elements. Review shall bear the seal (or stamp) of the I architect or engineer licensed in Oregon. Contact P* on me Telephone C. Asphalt or wood shingle /shake g"k.1' Name e a )bi , c2-99 s Li 7 ROOF1.DOC (dsts) I (PROCEED TO STEP 2) I I I 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) 01 (A C 0 CITY OF TIGARD BUIL ING I CTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 1 1— 1$ -q1 A.M. P.M. MST: " Q 33 Location: I0 7 3 5 Su) l u Nit C(AML' - K-C. BUP: Tenant: Suite: Bldg: MEC: Contractor: &A. Phone: 539 — G ( 1 . 0 6 PLM: Owner f f , ,/ ,fL4' Phone: 43 — ciY Y" ELC: ' 1 1— LAS t (�)Ve P- PA TI // ELR: C.O 0112ACTO/25 PHOtJE 01S CArJ40 &T PC CusTo 440 BUILDING BLDG (con't) , PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam fUndFI/Slab rm ost/Beam Post/Beam Cover /Service Sewer /Sto Footing / oof Rough -In Ceiling Water Line Slab 'i r g op 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 GAEproved �, Approved Approved Approved Approved Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved - FINAL FINAL FINAL FINAL O Call for rein ctio O Reinspection fee of $ required before next inspection O Unable to inspect Inspector: Date: /7—,b 7 Page of C CJ CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: - 76-' � 03 A.M. P.M. MST: 7^ v Location: /6 735 (A ) 0 C( 0J4't i BUP: Tenant: Suite: ' Bldg: /' Bldg: MEC: Contractor: _ ` �J Phone: J , 6 PLM: Owner: :� /. _, 1 4 Phone: ELC: ELR: SIT: BUILDING a> .),n't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam . d Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof , UndFl/Slab Rough -In Ceiling Water Line Slab F 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 Appr ved Approved Approved Approved Approved Appr /Sdwlk of Approv Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL _ ' s _I - / _ /� / 1 4 ..� _ - � L _a '.-+." / L9'Call for reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to ins t P� Inspector: V Date: / 6 - / 0 - 2 7 Page of ib CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: a- /S. 77 0t/ P.M. MST: 7-633V 3 Location: /(, 7 S(,{) (.(,C p.r i1 — � C UP. Tenant: Suite: Bldg: MEC: Contractor: 6P/) t 7 Phone: 5 3 (, / 6 PLM: nn Owner: /� 4)1 Phone: ELC: ELR: SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE Site ost/Beam , Post/Beam Post/Beam Cover /Service Sewer /Storm Footing ' ( (Roof ndFl/Slab Rough -In Ceiling Water Line Slab Framing /ttl4..t 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 Not Approved Not Approved Not Approved Not Approved Not Approved � FINAL FINAL FINAL FINAL FINAL a , Ai _ _., _ sii .s.d! , c. /'.0 S a. _ L ?2z-! --doh _ 1. CJ Pe_.c " f O d-T70 ii/. 0 F d t) g P'rT 54. 04Lc_ ,7 IL o'" e.- / Sor2 4-'C, a 4.----,4 0• , O Call for reinspect' n 0 Reinspection fee of $ required before next inspection 0 Unable to inspect Inspector: Date: 8 /5 9' 7 Page of CITY OF TIGARD BUILDING INSPECTION DIVISION /t--.);57 I 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: – 1 – , A ,, P,M. MST: 3 CO Location: l ( 7.3.5 Ili V D d l � - .. i` a. BUP: Tenant: .dowir T Bl MEC. r Contractor: f _iI JI .. t R - it al.,' i< I. Phone: 53q 6 4 PLM: Owner: 1 I Phone: Pl i1/l SL ft LC: ELR: SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE Site PostBeam i Post/Beam Cover /Service Sewer /Storm Footing ' oof �, ndFUSlab Rough -In Ceiling Water Line Slab g aming Gas Line Rough -In UG Sprinkler Foundation Insulation � o p O ut er Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Maso Ceiling Rain Drain A/C UG Slab Shear Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Appr /Sdwlk Not A Not Approved Not Approved Not Approved Not Approved FIN - FINAL FINAL FINAL FINAL ( 7 AgeiZ- i?Ui $"-r -a g�.g6- /.2 ` 3 ( 4 -ti - i er, l 4escr2 - SO /.cI3 LC., `';rC'i \' C C • c7 #J Q7 ff , 4� 0" -- S us,- –7---_NA ..,— Call for reinspect' .n % O Reinspection fee of $ required before next inspection O Unable to inspect Inspector: A Date: / Page of