12461 SW KING GEORGE DRIVE I
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12461 SW KING GEORGE DR �-
CITY OF TIGARD BUILDING INSPECTION DIVISION MST `s Z Z�
2.4-Flour Inspection line: 639-4175 Business Line: 639-4171 -
BLIP
Cate Reque7 d _ AM �PM BLD
Location �.1 c j" �' quite _ MEC — ---
Contact Person Ph PLM
Contractor _ — Ph _ SWR
6UILDING Tenant/Owner ELG
Retaining Wall - ELR
Fooling --
Access: (-10
/
Fojndadon I�fW FPS
Ftg Drain 7 -
Crawl Drain Inspec y,4 RSGN
Requested Slab -...___ Found D!riring Research — SIT
Post,1 Beam --- ----_--- -- -
Ext Sheath/Shear Vn Insnec•tiou(sl in Fila
Int Sheath/Shear ---- -�----._�-_---- ---
Framing
Insulation
Drywall Nailing Ltit/+'L[=T�/� --------- _
Firewall —_-_..-
Firo Sprinkler
Fire Alarm
S 'd Ceiling
00
79TISC: --- ----------—- ��
Final
PASS PART FAIL
PLUMBING
Post r 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 —
e '
Service
Rough In ----
UG/Slab --- ----- - — — -
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Gracing -- `" - --- '—
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$—_ —reouired before next inspection. Pay at City Hall, 13125 SW Hell Blvd
Catch Basin
Fire Supply Line [ j Please call for reinspection RF:--_ — _ ( ]Unable to inspect-no access
ADA
Approach/Sidewalk
Other
Date inspector, �^ Ext
Final
,_PASS _ PART FAIL DO NOT REMOVE, this inspection rP::ord froin the job site.
CITY OF T11ASTE R PIERIrI I T
DEVELOPMENT SERViCES PERMIT #. . . . . . . . MST98— 26
13125 SW Nall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 06/04/98
PARCEL., DS 1 10CC--1 7000
SITE ADDRESS 12461 SW KII\IG GLGRGL
SUBDIVISION. . . . :KINCI CITY ZONING: ?
BI_.n(-,K. . . . . . . . . . I_.OT. . . . . . . . . . . . . .I ,T;.J R I SD I CT I ON: K11\1
Remarks: Reroof existing s.ngle family dwelling. Tear off and replace.
------------------------- ---------------------------------------- BUILDING ------------------------------------------------------—-----------
RE I SSUE;
-------------- ---
REISSUE: STORIES.......: 0 FLOOR AREAS---------- BASEMENT...: 0 sf REDUIRED SETBACKS----- REPUIRED------------•-
CLASS OF WOW,:ALT HEIGHT.,......: 0 FIRST..,. : 0 sf GARAGE.....: 0 sf LEFT..........: 0 SW',E DETECTRS:
TYPE OF USE...:5F FLOOR LOAD....: 0 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0
TYPF OF CONST, :SN DWELLIIIG UNITS: 0 FINBSMENT: 0 sf RIGHT,........: 0
OC( ,)ANCY GRP.-R3, BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE-1: 5000 REAR..........: 0
--------------------------------- ---------- --- - PLUMPING -------------------- -- ----- -- --------------------
SINKS.........: 0 WATER CLOSETS.: E WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.... ....: 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRt"US..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS—: P
TUB!5HOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WiITFR LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS—: 0
OTHER FIXTURES: 0
- ----------------------------------- _____ __--------- MECHANICAL
rUEL TYPES----------- FURN ( 180K ,.: 0 BOIL/CMP ( 3HP: 0 BENT FANS.-... : 0 CLr-TIES DRYERS: 0
FUEN )=IABP ' UNIT HEATERS., : 0 HOODS.........: 0 0*HER UNITS...: 0
MAX INF,: 0 PTU FLOOR FURNACI VENTS....,....: 0 WOOD5TOVES....; 0 GAL OUTLETS.,.: 0
-- -------------------------------------------------------- ELECTRICAL ---------------------------------------------------------------
--RESIDENTIAL UNIT-- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANETXIS---- --ADD'L INSPECTIONS—
ION SF OR LE55: 8 8 200 asp..: 0 0 200 asp..: 0 W/SVC OR FDR... : 0 PUMP/IRRIGATION: 1 PER INSPECTION: 0
EA ADD'I 5005F. : 0 El11 - 400 alp.,: 0 ?01 - 400 alp..: 0 1st W10 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......:
LIMITED ENERGY,: 0 401 600 asp.. : 0 401 - 600 amp..: 0 EA ADM BR LIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: b
MANE ;#/SVC/FDR: 0 601 - 1000 asp.: 0 601+asps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp-volt.: 0 ----------------------------------- PLAN REVIEW SECTION --------------------------------
Reconnect only.: 0 )=4 RES UNITS..: S�VFDR)=2?_5 A.: ) 600 V NOMINAL; CLS AREA/SPC OCC:
----------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -
A. SF RESIDE 171AL--------------------------- P. COMMERCIAL--------------------------------------------------------------------------------
AUDIO b STEPCO,: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALAR►' ..... INTERCOM41GING: OUTDOOR LNDSC LT:
BURGLAR ALARM., : 0TH: ;; BOILER,,,.,.,,,: HVAC............ LANDSCAPE_/Ih9IG: PROTECTIVE 51GN1 :
GARAGE OPENER_: CLOCK.,........: INSTRUMENTATION: MEDICAL..: ...... OTHR:
HVAC.....,.....: DATA/TELE COMM,: NURSE CALLS.... : T)TAL I SYSTEMS: 0
Owner: --- - -_ _.----._._Contras+.or ---------- ---- _---- TOTAL FEESA 85.86
MRS ELSNER GREG'S DUALITY ROOFING Thii permit is subject to the regulat!ons contaiied in t'op
12461 9W KING GEORGE DP ',1170 5W TORLAND 5T tigar� i'a�isipa] Code, State of Ore. Specialty Codes ai,d all
KING CITY OR TIGARD CR 97223 other aopl:^abla laws. All work will be done in accordance
with approved plans. This permit will expire if Mork is
Phone N: 684-1203 Phone M: 590-6148 not started within 180 d.ys of issuance, or if the work i,
Reg N...,;* 58 suspended for more than 180 days. ATTENTION: Oreqnn law
----------------------------------------------------- ---------- requires y:u to follow rules adc,,ted by the Oregon Utility
Notification Center. Those rules are forth in BAR 952401--0010 through OAR 952-08'.-8880. You may nbtain copies of these rules or
direct questions to OUNC by calling (503)2x,'-1987.
_- REDUIRED INSPECTIONS --------------------- --------------------------------
Misc. Inspection
"incl inspection _
lssi.ted ES _ �- _._ Flermittee Signat -i
+++++++ ++ + + + ;. +4++++4-+++-+A +•++++++++-4•+4 +++ : i -`- ++++ ++-+++-++++++ +
Call 639-14175 by 7:00 p. m. for an inspection needed the next bi.:siness day
C11 Y OF TIGARD Plan Check#:
13125 S`N,HALL BLVD. Rec'd By:
TIGARD OR 97223 OZE-ROOFING PERMIT APPLICATION Date Recd:
V 503-639-4171 X3()4 Date to PE:
Commercial and Residential Date to DST:
F-503-598-1960 Permit#: 111= Ci C7_';i,T (p
Incomplete or illegible applications will not be accepted Called:
Name of Developrnent/Busin�ss STEP 2. NEW ROOFING ASSEMBLY
_1j c „r '. ..(.i Iry N< Material Documer0tion( 9C Appendix A _
Street AddressSte# Please rill out applicable section and attach copy of roofing
Job Site 7 y(! 5w' s ecifications.
Bldg# Cfity/State Zip Listed Asoembly L'311rcle&Complete A,9 or C)
_ k--,r. (.c. A.
ame / ( 1. Specification#:
Applicant Mallind Ac dress 2. Manufacturer: �� .h1` C C'7 ti v-�) C __
City!State Zip - Phone '3a UL Classification: _U L-
( ichQV G� � 7Z�
Roofing — Naj a Listed UL Building Materia's 'irectory Page#:
Contractor l_Iya '� a, L nv•I (OR)
(Prior to issuance Mailing diess r_� _ •3b Warnock Hersey
applicant must 1 II w Dr r,�J 9 fi
provide a copy of City/State 7 Listed Warnock Hersey Directory Page#
all contractorr.,�� `>� "/ l 2 3 'COPY OF ASSEMBLY REQUIRED
licenses if Phone# Fax#
expired in COT C•�_ B. ICBO Research#:
data base) Stateor .str.Contr.Board# Exp e
r C1 b ? U — �j ---DATED:---
BUILDING INFORMATION SPECIAL PURPOSE ROOFING: WOOD SHAKES
Buildinq- Type Of Use: (circle one) (review required by plans e):aminer)
Fes, SFA COM MF _ _ __
duilc(ino Type of Con truction: VALUATION C' PROJECT $
sq. ft. 2-100 of roof area!y��
Existing Deck Type: Permit fee based on valuation*
Combustible ( ) Non-Combustible ( ) _ ' see chart on back $
RESIl5 NTIAL ONLY-Class of Work: Alteration City use only WACO:
U REFAIP. (MAJOR) (review required by plans examiner) _ (BUILD) (L)BUILD)
Permit required ONLY when spaced sheathing is covered by
solio sheathing. Changes to roof line require Building Permit 5% State_Su_ rch_argp $
Applir,ation. City use only: WACO:
SUBMIT TWO (2) SI=TS OF PLANS SPECIFYING (TAX) I (UTAX)
A. Roof area&nearest street. 'Required for major repairs of Residential
F3. Attic vents- Provide 1 sq. ft. for each 150 sq ft. of attic or"C" above ` 65% Plan Review $ a_ 1
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 �(SUPPLN) _ (UHUPLN)
venting is provided
_ _ __ TOTAL $�7 =
STEP 1. COMMERCIAL ONLY V 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(it applicable) are In
❑ RE-ROOF (circle A ,B or C) compliance with Oregon State law.
A Existing built-up roof coverinc to he REMOVED and deck
repaired - 3lgnatur of OwnertAgent Ds!e
B. Existing built-up roof covering to REi,4AIN note applicant
must submit an engineer's review of the roof structural
elements. Review shall bear the seal (or stamp)of the _
architect or engineer licensed in Oregon. Contact Pemo ame Telephone
C Asphalt or wood shingle/shake /�j' 7
(PROCEED TO STEP 2)
I:ROOF 1 DOC(dsts)REQ/5/1/98
CITY OF TIGARD
BUILDING PERMIT FEES
TOTAL
PLAN STATE BUILDING
VALUATION OF PERMIT REVIEW TAX PERMIT
PROJECT FEES (65%j (5%) FEES
1-15001 25.00 16.25 1.25 42.50
1,501-1600 26.50 17.23 1.33 45.06
1,601-1,700 28.00 18.20 1.40 47.60
1,701-1,80C., 29.50 19.18 1.48 ;,0.16
,801-1,900 31.00 20.15 1.55 52.70
1,901-2,000 32.50 21.13 1.63 55.26
2,001-3,000 38.50 25.03 1.93 65.46
3,001-4,000 44.50 28.93 2.2' 75.36
4,001-5,000 5050 2.53 85.86
5,001-6,000 56.50 2.83 96.06
6,001-7,000 62.50 40 b,) 3.13 106.25
7,001-8,000 68.50 44.53 3.43 116.46
8,001-9,000 74.50 48.43 3.73 126.66
9,001-10,000 80.50 52.33 4.03 136.86
10,001-11,000 86.50 56.23 4.33 147.06
11,001--12,000 92.50 60.13 4.63 157.26
12,001-13,000 98.50 64.03 4.93 167.46
13,001-14,000 1t.j4.50 67.93 5.23 177.66
14,001-15,000 110.50 71.83 5.53 187.86
15,001-16,000 116.50 75.73 5.83 198.06
16,001-17,000 122.5C 79.63 6.13 208.25
17,001 18,000 128.50 83.53 6.43 218.46
18,001-19,000 134.50 87.43 6.73 228.66
19,001.20,000 140.50 91.33 7.03 238.86
2.0,001-21,000 146.50 95.23 7.33 249.06
21,001-22,000 152.50 99.13 7.63 259.26
22,001-23,000 158.50 103.03 7.93 269.46
2.3,001-24,000 164.50 106.93 8.23 279.66
24,001-25,000 170.50 110 83 8.53 289.86
25,001-26,000 175.00 113. 5 8.75 297.50
26,001-27,000 179.50 '116.68 8.98 305.16
27,001-28,000 184.00 119.60 9.20 312.80
28,001-29,000 188.50 122.53 9.43 320.46
29,001-30,000 193.00 125.45 9.65 328.10
30,001-31,000 197.50 128.38 9.88 335.76
31,001-32,000 202.00 131.30 10.10 343.40
32,001-33,000 206.50 134.23 10.33 351.06
33,001-34,000 211.00 137.15 10.55 358.70
34,001-35,000 215.50 140.08 10.78 366.36
35,001-36,000 220.00 143.00 11.00 374.00
36,001-37,000 22450 145.93 11.23 381 66
37,001-38,000 229.00 148.85 11.45 389.30
1 ROOF 1 DOC(dsts)REV 511199
KING CITY
1 6300 S.W. 116th Avenue,King CitV,Oregon 97124.2693
�I Phone:(603)6139.4082•FAX 003)CM-3771
r'
Notice To Contractors Working In King Cite
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 p-n.1it 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 tees 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 fer 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 Cite staff person. King City staff will simply sign this form indicating land use approval.
Take this si�tned form to the City of Tigard Development Services Cc;unter 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'1"igard.
The City of King City h;.;eby authorizes applicant to pursue permits at the City of Tigard
-t
Building Department for the following project: dV,J ,t ,
located at: (f�
/A- '.1 c v RC1 Cl
King City Repre3entative
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