16855 SW 126TH AVENUE-1 16855 SW 126"' Avenue
CITY OFTlGARD BUILDING PERMIT _
PERMIT#: BUP2003-002.55
DEVELOPMENT SERVICES DATE ISSUED: 5/9/03
13'125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S116AL1 Ofi800
SITE ADDRESS: 16855 SW 126TH AVE
SUBDIVISION: KING CITY NO. 12 ZONING:
BLOCK: 17 _ LOT: 031 JURISDICTION: KIN T
F REISSUE: _ FLOOR AREAS_ _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W
T"/PE OF USE: MF SECOND: sf PROJECT OPENINGS? _
TYPE OF CONST: sf W S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: READ SETBACKS _ _ _ REQUIRED__ _
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: �SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR AL.RM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 55,286.00
Remarks: Reroof entire building (install new plywood over spaced sheathing).
(6)units: 16855, 16875, 16885, 16895, 16905 & 16915.
Owner: Contractor:
TAYLOR, MERLE F + LOUISE G BOB CARLSON INC
706 AUGUSTA CT NW PO BOX 63
ALBANY, OR 97321 HILL.SBORO, OR 97123
Phone:
Phone: 503-640-3623
Reg#: LIC 0W N5111p3gg�3
FEES MFTREQUIRSPECTIONS
Description Date Amount Dryrot after tear-off
lil 111.1)] Pennit Fee 5/9/03 $503.62 Final Inspection
1 \XIS State Tax 5/9/03 $40.29
Total $543.91
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 wot k 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
requi e-Wu to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9521001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions to OUNC by
Cal ng (503)246-6699 or 1-800-332-2344.
Issued t3y:
Pe nn ittee
Signature:
Call 639-417.51 by 7 p,m. for an inspection the next business day
Building Perrreit A �lieation Reeei�ed Building
PennalloaBll��4U3
DateB : SG �� Other
Planning Approval
DateI Permit No
City of Tigard Plan Review Other
13125 SW Hall Blvd. Date/B : Pernit No.: __—
Tigard,Oregon 97223 Pnst-Review Land Use
DateiBV: Case No.
Phone: 503-639-4171 Fax: 503-598-1960 — - risa--
Internet:
Sec Pagc 2 for
www.ci.tigard.or.us Contact > lemental information
24-hour Inspection Request: 503-639-4175
Nam./Method -�
TYFF.OF WORK REQUIRED DATA:
_ Demolition 1-&2 FAMILY DWELLING
New construction _
_ Addition/alteration/re lacement ❑ Other:
CATEGORY OF CONSTRUCCION Note: Permit fees'are based on the total value of the work performed. Indicate
dustrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
BSc Commercial/In
1 2-Family dwellin overhead and profit for the work indicated on this application.
Accesso Buildin Multi-Family
Valuation.........................................................
Master Builder Other: No.of bedrooms: No.of baths:
JOB SITEsINFORMATION and LOCATION — Total number of floors...................................... _ — —
Job site address: New dwelling area(sq.ft.)..........•••••.......•••••... --
Suite#: Bid ./A t.#: _ Garage/carpoti area(sq.ft.).........................
—
Covered porch area(sq.ft.)............................
Pro'cct Name: V I Deck area( ft.). .......................•..................
Cros street/Directions to job site: Other structwe area(sq.ft.).................... -- -
// �< S//GlJG-O�faO /fiefs DOf/cr0 __.
(� (0?7!r QDGao 16 9iS o03°a -- REQUIRED DATA:
/6IfY5 Dnscr c) /h.7�� ooh COMMERCIAL-list,,
Subdivision: Note: Permit fees*are based on the total value of the work performed. Indicate
Tax map/parcel #: _ — the value(rounded to the nearest dollar)of all equipment,materials,labor,
Drs RIPTION F\'VOT_R1C r,-4 overhead and prof t for the work indicated on this applications/
---_ - r-, ti� _ !�
o -
r I � "�-- Existing building area(sq.ft.)......................... - _New building area(sq.ft.)...............................
Number of stories............................................
__— - Type of construction................................•......
,ROP.ER'TY�OWNER TENAN'I�_ Existing: --
V.,
Occupancy group(s):
Name - y -- --- New: _
Address, --
Ot /State/Zi r • OR -- NOTICE: All contractors and subcontractors are required to be
—y- --__�' ---
Phone: Fax: _ licensed with the Oregon Construction ontractors Board under
C
AFFI,ICAN7_!_ COH7•ACI'PERSON provisions of OR5 701 and may be required to be licensed in the
C jurisdiction w
Business Name: 13m� — here work is being performed. if the applicant is exempt
from licensing,the following reason applies:
Contact Name:iC__n�__*3__ �•-- - -
Address_ 5 Pro.. 3�� G - - -- -
Cit /State/Zi
Phone:503 IOyv-3CO3 IFax: G'W"I"46 BUILDING PERMIT FEES'
E-mail:— � �— Cor', J I'Iease refer to fee schedule.
CONTRACTOR ---
�b ----
Fees due upon application ........................
Business Namc: y-- -
Address: _�w Amount received............ .... .....•..................... --
City/State/Zi : ld;I- tom C*
Phone: f5ih� el W Ar-2 x:3 Fa � � b Date received: J
CCB Lic. #_
Authorized Notice: This permit application expires if■permit Is not obtained within
Date: '80 days after it has been accepted as complete.
Signature:
6 Fee methodoln�•set by Tri-CountN Building Industry Service hoard.
(Please print name)
`Dsu\Permit FommislBiditPerinitApp.doc 01103
04/28/2003 08:21 5036393771 CITY OF KING CITY PAGE 02/02
. 0, KING CITY
15300 3.tiV, 116th Avenue.King City,Oregon 97224.2692
Phone!(503)639-4082•FAX(503)639.3771
Notice To Contractors Working In King City
Due to an intergovernmental aereemerr, with the City of Tigard, many bu Iding related permits
fc, )rojects in King City are issued and inspected by the Ciry of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, sir�lply complete the
appropriate application legibly and submit it to the King City staff. The King Circ staff will
collect all fees and fax the application to the City of Tigard. City of Tigar 9 staff«-ill then create
the permit, issue the permit, and perform inspection --ise indicate on the pennit application
whether you would like the Tigard staff to call you he permit is readv for issuance or
«hether you prefer it to be mailed without any notific;Llon. Any incomplete- or illegible
application will be retumed to King City staff for correction and no proces sing v ill occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this forth 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 Servire5 Technicians are
available at 639-4171 Ext. 504 should you have an% questions concerning s abntittal
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 follo«-in? project:
located at: 'OyLLh".
King City Representative
I DSTtKCIvfT00C
Malarkey Roofing -272 Legacy SBS Modified Laminated Shingle Page I of 2
TECHNICAL PRODUCT DATA SHEET
#272 LEGACY"
SBS MODIFIED LAMINATED SHINGLES
WITH POLYGLASS"'MAT
PBQpDD—�?��Ps'19N
Product Use:0272 Legacy SBS modified Laminated shingles are used whenever increased flexibility,architectural design,tensile strength and
tear resistant shingles are desired.These SBS rubber modified asphaR shingles are designed for a 5 5/8'exposure
Precautions:0272 Legacy SBS modified laminated shingles require dry storage or plastic-covered storage and protection from the weather until
applied.Do not use on roofs where the slope is lest:than 2'. For slopes 2"to 4',additional deck protection is recommended l?72 legacy SBS
modified laminated shingles have a factory applied self-sealing stip that activates In warm weather. When appliod in cold weather or windy
location,hand-sealing is recommended but nut required If sealant activates. In high wind areas,six nails aro required Contact Malarko7 for further
conditions and Instructions
Composition and Materials: #272 Legacy SBS modified laminated shingles are mineral-surfaced and self-sealing, made with SBS rubber
inodified asphalt coating and fire-retardant fillers on a Malarkey poyglass fiber mat,and featuro the exclusive design of'The Zone"'"
TECHNICAL DATA
1272 Legacy are available in 9 standard colors,with other colors available upon request with a 300 square minimum
Typical Average Properties
Approximate Weight 275 lbs.(124.74 kg)per square
Dimensions 1374'x 40'(t 1/8'.)
(.33 m x 1.02 m)
Exposure 5 5/8'(142.9 mm)
Shingles per square 64 shingles(J bundles/square)
Granule Adhesion 0 5 gram loss
Fire Rating Class A
Warranty 50-year Limited Warranty
110 m p.h Limited Wind Warranty
The Legacy meets or exceeds UL 2218 Class 4 Impact Resistance,ASTM D 3462,ASTM D 3018-90 Type 1,ASTM D 3161.97 Type I.ASTM E
108-91 Class A and CAN/CSA A 123 51998,ICBO ER-5300 The Legacy limited Wind Warranty may have conditions attached to it Please
contact Malarkey Roofing for further details
APpUCST1QNPM_QJD4IAE All shingles should be applied over undarlaymsnt,Malarkey Right Start UDL o+an approved substitute.Shingles
should be attached to decking by approved fasteners,comply with bundle printed Instructions and meet industry standards contained in NRCA or
ARMA manuals Malarkey recommends the use of nails for fastening.For specific instalintlon instructions,consult Malarkey Roofing Company
VVAp,P,AN . 0272 Legacy SBS modified laminated shingles carry a 50-year limited warranty and a 110 m.p.h limited wind warrant) D.icumerts
littp://www.malarkey-tfg.com/Teclinical/272.h2m 6/27/2002
Page 1 of I
,t't.WL.R4299 - Prepared Roof Covering Wterials
romi On- lilne Certifications: Di-re0ofy
Prepared Roof Covering Materials
Previous Page
Page Bono Qum i w-
Prepared Roof Covering Materials
G d.e IWfftm-ation
HERBERT MALARKEY ROOFING CO
84299
3131 N COLUMBIA BLVD
KENTON STATION
PO BOX 17217
PoitT7,AND, OR 97217 USA
Asphalt glass fiber mat shingles, for installation as Class A prepared roof coverings.
Asphalt glass liber mat shingles. For installation as wind resistant roof coverings.
A sphalt glass fiber stat sheet roofing, fen installation as Class C prepared roof coverings.
Modified asphalt glass fiber mat shingles, for installation as Class A prepared roof coverings for
installat1On ()11 i)lM 15/12 in thick plywood decks.
Page-TQPTree ofD-WA tt " QVI timij — Previous Page
IJ ;111 _ t la �fied II��t_ecag"Ured Frost_um-cerd13t
�'roducfts C4111ponentrls W-Cmada
This pate and III w)nlents arc Copyright A 2002 by Underwriters Laboratories Inc.0
i
'llrc appearance of a uornpany's name or product in this database&wq not in itself assure that pn)ducts so identified have been i
manufactured under I.IL's Follow-tJp Service. Only those products bearing the I it,Mark should be considered to be Listed
and covered under UL's Follow-Up Service. Always look l'ot the Mark on the product.
http://datab,tse.ul.com/cgi-bin/XYV/template/LISEXT/1FR"L/showpage.html?nanie '1'. . 6/27/2002
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 , �
UO
Received Date Requested_ v/Z AM _ FM_.—___- BUP
Location — _— �` G� �r^ ���-,—� Suite ? MEC _--
G�l7 — P� � =�J PLM — --- --
Contact Person _______ ( )
Contractor __—. _ Ph(—) SWR
"WILD I TenanUOwner _ — ELC —�—_-- —
Footing -- --- - ELC - -- --
Foundation Access:
Ftg Drain ELR —_--- -__--
Crawl Drain - SIT -
Slab Inspection Notes - - —
Post&Beam - --- - - ------ -
Shear Anchors
Ext Sheath/Shear ---- --- —
Int Sheath/Shear
Framing --
Insulation
-----------------
Drywall Nailing
Firewall ------_-—-- — --
Fire Sprinkler ----
Fire Alarm ----
Su 'd Ceiling
0
Ot r:
ina _
ASJ PART FAIL
PLUMBING --- - ----
Post& Beam
Under Slab ------ -- - -- -- -
Rough-In
Water Service --- -
Sanitary Sewer -
Rain Drains -- ---- --
Catch Basin/Manhole _
Storm Drain -—
Shower Pan —
Other: --- _-- --
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
Finai Reinspection fee of$_- required befo�u next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS _PART FAIL
SITE Please call for reinspection RE: -_ U linable to inspect no access
Fire Supply Line e-
ADA 0#A* ��� 03 Inspector - �6 Ext
Approach/Sidewalk _
Other:
Final - - DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL