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12386 SW MAIN STREET i N W W C) U) 3 Ti H z rii ti Ma H I M'323',S NTVW MS 98i7T F CITU OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Linc: 6394175 Business Phone: 6394171 Date Rquested: _ _ — A.M. — I'.M. _ _— MST: Location: --_— BUR Tenant: --- _— ,Suite:_ --131dg: — — -� MEC:_ Contractor: _%_ — Phone _ — —_� PLM: (honer: -- --- -- --- - Phone --- -----—— ELC:_ —__— — — ELR:_�_ SIT: _ BUILDING BLDG(con't) PLUMBING — MECHANICAL Y ELECTRICAL SITE Site Po."eam Post/Beam Post/Bealn Cover/Service Sewer/Storm Footing Roof UndFI/Slab Rough-In Ceiling Water Line Slab Framing Top Out Gas line Rough-In UG Sprinkler Foundation Insulation Sewer I food/Duct Rmonnect Vault Bsmt Damp I"ll Storm Furnace Temp Service MISC. Masonry Ceiling Rain Thain A/C I IG 31ab Shear/Sheath Fire Spklr/Alm Crawl/l ound Ih Ileat Pump Low Volt Approved Approved Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved Nut Approved Not Approved FINAL FINAL FINAL FINAL FINAL 0 Call for reinspection 17 Reinspection fee o'S_ required before next inspection C1 Unable to inspect Inspector:—� ' l i_ r'I cn` el � Date: e `%� �_7_1 rage--- 1 of—�_ CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES PERMIT #: E:LC97 -0388 13125 5W Hall Blvd., Tigard,OR 97223 (.503)639.4171 DATE ISSUED: 06/1 /97 PARCEL: L1S 1 O2AB--04.000 SITE-. ADDRESS. . . SW MAIN 51- SUBDIVISION. . . . - ZONING:C;BD BLOCK. . . . . . . . . . . L.0T. . . . . . . . . . . . . JURISDICTION: TIC; Project De scar i pt ion : instl 1 branch circuit // job 4 72225 -- RESIDEPJTIAI_ UNIT-----W- -----TEMP SRVC/FEEDERS----•- -------MISCELLANEOUS----.-.. 1000 SF OR LESS. . . . : 0 0 -- EOO amp. . . . . . . : 0 FIUMP/T.RRIGATION. . . . : 0 EACH ADD' L 500SF. . . : 0 ;=O1 - 400 amp. . . . . . . : 0 SINN/OUT LINE I-TG. . : 0 LIMITED E=NrRGY. . . . . : 0 401 -- 600 amp. . . . . . . .. 0 SIGNAL../PANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR I-ABEL ( 10) . . . : 0 ---._..SERVICE/FEEDER__.__— ------BRANCH CIRCUITS------ --- ADA' L. INSPECTIONS--- -- 0 - C:00 amp. . . . . . 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 201 -- 400 amp. . . . . . : 0 I st W/O SRVC OR FDR. : 1. PER HOUR. . . . . . . . . . . : 0 401. 600 amp. . . . . . N EA ADD' L BRNCH CIRC;: 0 IN PLANT. . . . . . . . . . . : 0 601. - 1000 amp. . . . . . 0 ____...-___.____._ _..._- PLAN REVIEW SECT 1ON-.-__._.-_.__._____._ 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . : Rec.onnec_t only. . . . . : 0 SVC/FDR ) = ELS AMPS. . : CLASS AREA/SPEC OCC. : Owner: _._.._ ___.___.__________._.____---_-_---.--- -------._-_ ___.____.____.__-- FEES - CAFE ALLEGRO type amoi.rnt by date recpt 1.238(*j SW MAIN PRMT $ :?`.'i. 00 TAT 06/19/97 97--x'9619:5 TIGARD-OR 97223 5PCT $ 1. 75 TAT 266/1.9/97 97--296195 Phone #: Contractor,: OREGON ELECT CONS)TRCTN/GRI' INC $ 36. 75 TOTAL. 1010 SE 11711 ---- -- REQUIRED INSPECTIONS --- PORTLAND OR 97214 Fl.ect' 1 Service Wall. Cover~ Phone #: 234--9900 Ceiling Cover F 1 er_t' I Sery i cr Reg fl. . . 0316359 This pewit is issued subject to the r?gOations contained in the Tigard Municipal Code, State of Oregon Specialty Codas and all other applicable laws. All work will be done in .ccordance with approved plans. This pewit will expire if work is not started within 180 days of issuance, or if work is suspended for rare than 180 days. ATTENTION: Oregon law requires you to follow the rules aJopted by the Oregon Utility Nutifica:•i:, Lenter. Those rules are set forth in OAR 952-9191-001@ throuqh OAR 952-981-1987. You aay obtain a copy of these rules or direct questions to OUI C by calling t )246-1987. P r r m i,t t e e S i g n a t ur•a:: .c�!� .__ __-....._._-._ I s s r.r e d B I NSTAL.LAT I OIJ -rile installation is being made on property T own which is not intended for, sale, lease, or, r^ent. OWNER' S SIGNATURE: _ _ __ DATE:: --------------------------CONTRACTOR INSTALLATION ONLY- SIGNATURE OF SUPR. ELEC' N: &-k—) ct?—Z w DATES ~ � LICENSE NO: 0` o 7/ s ++4+•} •f444+-F+4....+.-F++4+++++-F++.•+•+++++•F+t 1i.+-# +++.++.+i•++.....+++++i•+++++....+i•+ ,- Cal 1 639--4177, by 6:00 p. m. for an inspection needed the next bi-rsiness da.,- ............................ ........I.........4..............4 a•,.....}++++-F+++•t+++++++t++++-h++++++-h.I•+++++ F+++++++++++++++++i++-F+++t++++t++' �+ 1 p CITY OF TIGARD Electrical Permit Application Plan Check 1312.5 SW HALL BLVD. r'lec'd By_ TIGARD OR 97223 Date Rer'd- Date to P.E. Phone (503)639-4171, x304 Print or Type Date to DST_ Inspection (503) 639-4175 Permit It Fax(503)684-7297 Incomplete or ►llegible will not be accepted called _ - _- 1. Job Address: 4. Complete Fee Schedule below:-__-`-- Name of Development_., Cafe A 1 f c g r n _ Number of Inspections per permit allowed - Name(or name of business) Service included: Items Cost Sum Address 12386 SW Mainan4a. Residential-per unit Ti d 1000 sq.n,or less $110.00 _ a City/State/Zip B OR Fach additional 500 sq it or Commercial ® Residential El Limited thereof $25.00 Limited Energy $25.00 Each Manuf'd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $88.00 (Attach copy of all current Ilcent;es) 4b.Services or Feeders Electrical Contractor OREGON ELECTRIC GROUP Installation,alteration,or relocation Address 1010 SE 11TH ---- 200 amps or less $60.00 z 201 amps to 400 amps $80,00 _ 2 City Portland State 2$-"Lip 97214 401 amps to 600 amps $120.00 _ 2 Phone No. 2.3L�-Q-Q�� 601 amps to 1000 amps $180.00 2 Job No. 72225 Over 1000 amps or volts $340.00 _ 2 Elec.Cont. Lice. No. 26-95C Exp.Datee 1677 Reconnect only - $50.00 _- 2 OR State CCB Reg. No 203 Exp.Date, 7 98 4c.Temporary Services or Feeders COT Business Tax or Metro No. .-Exp.Date_ __ Installation,alteration,or relocation 200 amps or less $50.00 201 amps to 400 amps $75 Signature of Supr. Elec'n / 401 amps to 600 amps $1U0 00 7.841 S Over 600 amps to 1000 volts, License No. Exp.Datre- see"b"above. Phone No. 234-9900 ---- -- ------_--- - 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: o1 The fee frrr branch circuits with purrhase of service or Print Owner's Name__ _-_ _ feeder lee. Address - Each branch circuit $5.00 -- --- -- b)The fer, or hranch circuits City State _ 71p -_-_- without purchase of Phone No. _ _ _ service or reader tee. First branch circuit 1 $35.00 35.00 The installation is being made on property I own which is not Each additional branch circuit $5.00 ---- intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not Included) Owner's Signature— Each pump or irrigation circle $40.00 Each sign or outline lighting $40.00 _--_ 3. Plan Review section (if required):* Signal circuit(s)or a limited energy w panol,alteration or extension - $40.00 ----- Please check appropriate item and enter fee In section 5B. Minor Labels(10) $100,00 _4 or more residential units n one structure 4f.Each addltional Inspection over _Service and feeder 225 amp-3 or more the allowable In any of the atove System over 600 volts noml•;al Per inspection $39 UO -- -- Classified area or structure containing special occu fancy Per hour $55 00 as described In N E.C.Chap.sr 5 In Plant $55 co _-- #Submit 2 sets of plans with application where any of the above apply. Jr. Fees: Not required for temporary construction services. 5n.Enter total of above fees $ 35.00 -- 5%Surcharge(.05 X total fees) $ ---1-Z -- NOTICE. Subtotal $ -3-6 Zd--- 5b.Enter 25%of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review ifreauirkOec.3) $ NOT COMMENCED WITHIN 180 DAYS,OR!r CONSTRUCTION OR WORK Subtotal $ 36. 75 IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT A TME AFTER WORK IS COMMENCED. Trust Accou;d M_____ S - Total balance Due I:IDSMELCOA APP nev Woe CITY OF TIGARD ___.__PLUMBING PERMIT__ DEVELOPMENT SERVICES PERMIT#: PLM2002-00016 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/17/02 SITE ADDRESS: 12386 SW MAIN ST PARCEL: 2S102AB 04000 SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: M FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTUR_ESLAUNDRY TPAYS: SF RAIN DRAINS: SINKS: _T URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Inst311daon of commercial backflow prevention device. _ ---— ---- FEES Owner: Type By Date Amount Receipt DOUGLAS LEE PF MT CTR 1/17/02 $72.50 27200200000 12386 SW MAIN ST 5PCT CTR 1/17/02 $5.80 27200200000 TIGARD, OR 97223 Total $78.30 Phone 1: Contractor: PLUMBING CONCEPTS INC PO BOX 1068 CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone 1: 658-5232 RP/Backflow Preventer Rag #: LIC 97587 Final Inspection PLM 3-293PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work 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 requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. rsued ay-obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. IBy: 1 C �� i_JPermittee Signatur#: Cell (503) 639-4175 by 7:00 P.M. for an inspection nee d ffi`ie next business day Plumbing Permit Application Date received: / /? (9,5;Z• Permit City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,,rigard,OR 97223 t'uv q Tigard Phone: (503) 639-4171 I'rojecUappl.no.; Expire date; Fax: (503) 598-1960 Date issued: By: Receipt no.: Land use approval: — _ Case file no.: _ Payment type: U I Rc 2 family dwelling or accessory Commercial/industrial U Multi-family U Tenant improvement U New enmtniown YAdtlition/alteration/replacement U f,otrcl serviLv 'J Other 1 t i Job address: Description (ftt. 1 ee(ctt.) total Bldg.no.; 15uite no.: New I-and 2-family dwellings only: (includes IM)ft.for each utility connection) 'Tax map/tax lot/account no.: _ SFR(1)bath Lot Block: Subdivision: SFR(2)bath Project name: SFR(3)bath City/county"Ct_ — _ ZIP__ C�_ZT 2 3 Each additional bath/kitchen Des prion and l I ion of work on premises: Site utilities: A n �'•�tinct c1.r,.� a cc(_i�, I a�•�.J--- -- — Catch basin/area drain Est.date of completion/inspection: DrywelI i leach line/trench drain Footing drain(no.lin.ft.) Manufactured home utilities Business name: �� _ L Manholes Address: D. Rain drain connector Cit : State: ZIP: � Sanitary sewer(no.lin.ft.) Y ` Email: Storm sewer(no.lin.ft.) Phone:r� — Phono.: 7 Jr8 Plumb.bus.reg.no: f Water service(no. in.ft.) CCIY Fixture or Item: City/metro lic.no.: _ riiort valve _ Contractor's representative si urea .Back flow preventer Print name: 1t: Backwater valve Basins/lavatory Clothes washer Name: ----- Dishwasher Address: _ Dfinking fountain(s) City: State: ZIP_ Ejectors/sump _ Phone: Fax: E-mail Expansion tank Fixture/ ewer cap Floor drains/floor sinks/hub Name(print): -P e — Garbage disix)sal _ Mailing address: . . Hose bibb _ City: Stateo/Z I ZIP: q - ? Ice maker Phone: r O Fax: -e I E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation PiTimcr(s) will be made by me or thrift ntenance and repair made by my regular Roof drain(commercial) employee on the p5qii�,Nwn as per ORS Chapter 447. Sink(s),_basin(s),lays(s) Owner's si natu Date:/—A Sum Tubs/shower/shower pan tlrfna Name: Watercloset -- Address: _ Water heater City: State: ZIP:` , Other: --- — - Phone: Fax: Email: Total Na all Jurladlctlone recap credit earth,please call jurirdicttan fa mrne infarrtWlat Minimum fee................ Notice:This permit application Plan review(at _ %) $ ❑Visa U MasterCard expires if a permit is not obtained Cada card number .� / / within Igo nays after it has been State surcharge(896) ....$ —�,-00 - - - Ecptrc� ,Iden aw shown on etedit c&4 $ accepted as complete. T07 AL .......................$ Nater,of c Cardholder dpwttre AtttOM 111}1616(GOWCOM) c_ - & PLUMBING PERMIT FEES: - PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES (individual) _ QTY ea AMOUNT_ (includes all pluml.ing fixtures In PRICE I TQTAL Sink 16.60 -� the dwelling and the first100 ft. OTY .(ea) AMOUN - -- ---- -- for each utiliy connection) Lavatory 16.60 I --- - -- _-_� One 1 bath _ $249.20 Tub or Tub/Shower Comb 1660 _ Two(2 ba) th - $350.00 Shower Only 16.60 Three(3)bath $399.00 Water Closet _ 16.60 _ -- -- -SUBTOTAL Urinal 16.60 8 STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal 16.60 _TOTAL - Laundry Tray 1660 Washing Machine 16.60 Floor Drain/Floor Sink 2" - 16.60 PLEASE COMPLETE: 3- 16.60 4" - 16.60 _ Water Healer O conversion O like kind 16.60 -� Quantit by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _ _ Capped MFG Home Now Water Service 46.40 Sink _ MFG Home New San/Storm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination _ Roof Drains 16.60 Shower Only - Drinking Fountain 16.60 Water Closet _ Other Fixtures(Specify) 16.60 Urinal Dishwasher _ _ Garbage Disposal _ Laundry Room Tray _ Washing Machine Floor Drain/Sink: 2" Sewer-1st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1 st 100' 5500 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _ _ Storm&Rain Drain-1 st 100' - 55.00 (Specify) Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 - Residential Backflow Prevention Device' 21.55 - - Catch Basin 16.60 - Inspection of Existing Plumbing or Specialty 62.50 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelllnq 6525 Grease Traps 16.60 -- --- - QUANTITY TOTAL _ _ Isometric or rl3er diagram Is required if - Quantity Total Is ,9 J ---- 'SUBTOTAL -- - 86/,STATE SURCHARGE (/�> ----- - - "PLAN REVIEW 25%OF SUBTOTAL b Required only If fixture qty total is 1 9 TOTAL a "Minimum permit fee Is$72 50+8%state surcharge,except Residential Backflow Prevention Device,which Is$36 25+8%state surcharge "All New Commercial Buildings require 2 sats of plans with Isometric or riser diagram for plan review. IAdstslforms\pim-fees.doc 12/26/01 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP _ Received _ ___.__._._ Date Requested _ Z Z AM PM—_____.� BUP _ Location _ _ ' � ' Suite. _ MEC Contact Person ___-- Ph(_ ) PLM 2 �<-� Contractor —_ ___ ___ __ Ph(_ ) SWR BUILDING _ 'renantKhmer _. ELC —. Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: G SIT — Post& Beam ----� '� Shear Anchors Ext Sheath/Shear --- Int Sheath/Shear Framing --------- Insulation Drywall Nailing - -` — — ---- — Firewall Fire Sprinkler --- Fire Alarm Susp'd Gelling ----- --`— — -- ____--- Roof Other: — Final _.— PASS PART_ FAIL PLUMBING --- Post&Beam — Under Slab ---- Rough-In Water Service -- — -- ---- - -- `� "---_-- Sanitary Sewer Rain Drains ---- --- - — __— ----- — --- --- _ —_..- -- - Catch Basin/Manhole Storm Drain -- ---- —_—_.---� ----------�__—___—.v_ Shower Pan- Other: a -----� -_-- -— -- -- —. - - Other: r_ PART FAIL Post&Beam Rough-In ----.------ --- Ras Line Smoke Dampers -- ---- — -- __.----_ Final PASS PART _FAIL -- — — - ---- ------— __ ELECTRICAL — Service Rough-In UG/Slab Low Voltage __— Fire Alarm Final F] Reinspection fee of S _ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITELL_ _ V F] Please call for reinspection RE:-- _._ _____.._ [_] Unable to inspect-no access Fire Supply Line `` /Q,,� ADAoech/Sidewalk Dab EX! PP Other: Final DO NOT REMOVE this Inspection record from the fob site. PASS PART FAIL BUILDINGPERMII' CITY OF TIGARD _ PERMIT #: BUP2002-00144 DEVELOPMENT SERVICES DATE ISSUED: 4/23/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S102AB-04000 SITE ADDRESS: 12386 SW MAIN ST SUBDIVISION: ZONING: CBD BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: REQ(J — FIRST: sf N: S: _ E- W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? _ _— TYPE OF CONST: sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 00 St ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED. GARAGE: sf OCCU SEP. RATED: ST OR: HT: ft BSMT?: MEZZ?: _ REQDSETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: — ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR HL.RM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING. VALUE: $ 8,828.00 Remarks: Reroof-tear-off and replace. Owner: Contractor: DOUG LEF COLUMBIA CONSTRUCTION SERVICE 12386 SW MAIN ST 28395 SW BOBERG RD TIGARD, OR 97223 W ILSONVILL, OR 97070-6769 Phone: 503-684-0130 Phone: 503-684-9123 Reg#: LIC 116607 FEES REQUIRED INSPECTIONS_-____ Type By Date Amount Receipt Dr rGy t after tear-off 5PCT CTR _ 4/23102 $10.38 27200200000 Finallnspection PRMT CTR 4123102 $129.70 2720020002 - --�-- _ Total -----$140.08 This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale of OR. Specinity Codes and all other applicable law. All work 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 requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1-890-332-2344. Pennittee .1 i - Issued By: -- Call 639-4175 by 7 p.m. for an inspection the next business day BulUding Pe>Irinit Application �i— t)ate receival: Permit no.: �{ City of Tigard — '-� - --` ProjccUappl.no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 — date: City njT��ard Phone: (503)639-4171 / Date issued JBTyj.,,k eceipt no.: Fax: (503) 598.1960 Case file no.: Payment type: Land use approval: _ _ 1&2 family:simple Complex: - 1 U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction 0 Demolition L' Addition/al teralion/re ill acemcfit U Tenant improvement U Fire sprinkler/alarm U Other: 1INFORMATION Job address: } ' (,J. X11 t L ) � Bldg.no.: Suite no.: Lot: Block: Subdivision: , Tax map/tax IoUaccount no.: Project name: Description and location of work on premises/special conditions: a V -at •t 'L 1'UL FOR SPECIAL INFORMATION, Mailing address:4JJW I &2 fantlly d"elling: City *11.4,t/c State: V Z1 . 7 Valuation of work Phone: r 1', Fax: — E-mail: No.of bedrooms/baths................................. Owner's representative: Total number of floors................................. Phone: Fax: I.mail: New dwelling area(sq.ft.) .......................... lugg[slog Garage/carport area(sq.ft.)......................... Name: _ Covered porch area(sq.ft.) ......................... Mailing address: Deck area(sq.ft.) .... ................................... __—- - -- -'--T:- - Other structure area(sq.ft.)......................... City: „�State: IP: Phone: ___ Fax: E-mail: Commercial/industrlaUmultl-family:H11) Valuation of work........................................ $ Zia r l Existing bldg.area(sq. ft.) Business name: (lttil int c� ( 4'�I' Ct, tv New bldg.area(sq.ft.) - X Address: t' - City: ,J un�1 I( state: ZIPS �l�[a Number of stories Zj < II; Fay `��' :mail: TYI.-of construction.................................... Phone. — Occupancy group(s): Existing: rCB no.: /1 0(.C)`1 _ -- New: City/me(ro lic.no.: Notice:All contractors and subcontractors are required to be 0 1111 X"vi 11>- licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction when.work is being performed.If the applicant is Cit State: Zlp: -. exempt from licensing,the following reason applies: Contact person: Plan no.: — - Phone: Fax: E-mail: - - Name: _ Contact person: Fees due upon application ........................... $, Address: — — Date received: / C City: State: ZIP: Amount received ...... ................. $ ' Phone: Fax: E-mail: _ Please refer to fee schedule. J I hereby certify I have read and examined this application and the Na all jurid"ao rcxp credit cents.Plebe call Wdkuon far more Infatruw0c attached checklist.All provisions of laws and ordinances governing this U V A U Mastercard work will be complied with,whether specified erein or not. ] credit card mamba;-..____ _ __ 1 Upires K Authorized signature: f P C/ 1 DA(e: c� v �` Nara of cwJWda as dawn on credit card - Print name: .�} t` )_ (11)tm' l�je($ir7 __�--- ---- _S alp azure �marot Notice-This permit application expires if a permit is not obtained within 190 days after it has been aaxpted as complete. 440A13 ft WOM) RE-ROOFING PERMIT CHECK LIST RES INITIAL ONLY - Class of Work: Alteration ❑ REPAIR(MAJOR) (plan review requ red by plans examiner) Building permit is required when spiced sheathing is covered by solid sheathing and/or changes are made to roof line. SUBMIT TWO (2)SETS OF PIANS SPECIFYING: A. Roof area and nearest street. B. Attic vents: Provide 1 sq. ft. for each 150 sq. ft. of attic space. Vents shall be located in the upper 1/3 of the roof. Provide 1 sq. ft. for each 300 sq. ft. when eave and attic venting is provided. Note: No permit is required for residential re-roof if, (1)not more than three layers of roofing will exist upon completion of the re-roofing o;, (2)sheathing is not being applied over spaced sheathing (spaced sheathing usually exists when wood shingles were initially —La plied L---_-------- — - --- ---- COMMERCIAL ONLY - Class of Work: Repair STEP 1: ---------- --- — ❑ RE-R_OOF (circle A, B or C): A. Exiting built-up roof covering to be REMOVED and deck repaired. B. Existing built-up roof covering to REMAIN. Note: Applicant must submit an engineer's review of the roof structural elements. Review shall bear the seal (or stamp)cf the architect or engineer licensed in Oregon. C. Asphalt or wood shingle/shake. (PROCEED TO STEP 2)J—_ COMMERCIAL ONLY - Class of Work: Repair — STEP 2: NEW ROOFING ASSEMBLY _Material Documentation UBC Appendix 15) __-- Please fill out applicable section and att ch copy of roofing specifications. Listed Assembly (Circle and complete B or C): _ A. 1. Specification#: SU u w y r 2. Manufacturer:--/TPy{ -C 3a, UL Classification: _-A--- - Listed UL Building Materials Directory Page#: i— OR 3b. Warnock Hersey: -- Listed Warnock Hersey Directory Page#:_ —� 'COPY OF ASSEMBLY REQUIRED B. ICBO Research#: L l`i 7 /I S T-i 1 E(U S may._�A_fi✓t ��+ ' t Dated: C. SPECIAL PURPOSE ROOFING: WOOD SHAKES _Review required bylans examiner.___ VALUATION OF PROJECT: $ _ _sgftZ-Z -.' db of roof area Pe —�f�Z-� U J�-- rmit Fee based on valuation: $ see Buil_dinPermit Fees chart 8% State Surcharge: $ --_ 65% Plan Review Fee: $ (Required for major repairs of Residential or Assemblyitem"C"above: __----- _ ------------------TOTAL: $ --- --- — i dsls\fomis\roofchecklist doc 10/05/00 ROOFING MATERIALS & SYSTEMS DIRECTORY 2001 This Directory contains all Listings and Classifications in effect as of December 15, 2000 for product categories covered. UL Online Certifications Directory Listings and Classifications are updated daily. To confirm the current status of any UL record, please consult UL's Online Directory at www.ul.com or contact UL's Information Services at (631) 271 6200 ext. 22897, or fax (631)439-6018 or e-mail info@us.ul.com. OFFICES AND TESTING FACILITIES IN THE UNITED STATES CORPORATE HEADQUARTERS Underwriters Laboratories Inc. 333 Pfingsten RoaJ Northbrook, Illinois 60062-2096 Phone: (847)272-8800 Fax:(b47)272-8129 E-mail:northbrook@us.ul.com Underwriters Laboratories Inc. Underwriters Laboratories Inc. 1655 Scott Blvd. 12 Laboratory Drive Santa Clara, P.O. Box 13995 California 95050-4169 Research Triangle Park, Phone: (408) 985-2400 North Carolina 27709-3995 Fax:(408)296-3256 Phone: (919)549-1400 F-mail:santaclara@us.ul,com Fax: (919)547-6000 E-mail:rtp@us.ul.com Underwriters Laboratories Inc. 1285 Walt Whitman Road U .rwriters Laboratories Inc. Melville, L. I., 2600 N.W. Lake Road New York 11747-3081 Camas WA 98607-9526 Phone: (631)271-6200 Phone: (360)817-5500 Fax:(631) 271-8259 Fax; (360)817-6000 E-mail:melville@iis.ul.com E-mail:camas@us.ul.com Additional offices are listed in back of Directory. Web Site: wwwA.com Underwriters Laboratories Inc. (UL) provides services from more than 225 locations throughout the world. UUL Founded in 1894, Underwriters Laboratories Inc. (UL)is an independent, not-for-profit organization dedicated to testing for public safety. UL and its subsidiaries operate facilities throughout the world for the testing, certification and quality assessment of products, systems and services. With an unwavering commitment to public safety and societal well-being, UL provides the highest level of conformity assessment services to its global clients. ISBN-0-7629-0644-8 COPYRIGHT 0 2001 UNDERWRITERS LABORATORIES INC. ► 2001 ROOFING MATERIALS & SYSTEMS DIRECTORY 2 ROOF COVERING MATERIALS(TEVT) ROOF COVERING MATERIALS(TEVT) Prepared Roof Covering Materials(1'FWZ)-Continued Prepared Roof Covering Materials(TFWZ)-Continued attained on warm,sunny days.Other shingles with Factory-applied adhesive Formed plastic roof panels, for installation as Class C roof covering in utilize a combination pressure-sen..itive and heat-sensitive adhesive.Due to accordance with manufacturers installation instructions. Suitable for use on the nature of adhesives of this type,sealing Is induced by application of minimum 15/32 in.plywood deck or 3/4 in,spread sheathing covered with pressure and/or heat two plies of Type 15 or one plyy of Type 30 asphalt-organic felt. Wind Resistant Modified Asphalt Glass-Fiber Mat Shingles are provided Class A,B and C formed plactic roof panels for installation over existing with facto%applied adhesive.Some shingles with factory-applied adhesive asphalt shingles when applied in accordance with manufacturers instructions. utilize ban 's or spots of a heat-sensitive adhesive located either on the sur- Formed plastic roof panels,for installation as wind resistant roof covering. face of the shingles or on the back of each tab.Adhesives of this type must be activated by solar heat of intensity generally attained on warm,sunny days.Other shingles with factory-applied adhesive utilize a combination ATAS INTERNATIONAL INC R13866 pressure•sensitive and heat-sensitive adhesive.Due to the nature of adhe- 6612 SNOWDRIFT RD,ALLENTOWN PA 18106 slues of this type,sealing is induced by application of pre"ure and/or heat. Formed steel panel covering designated "Scanroof" or "Multipurpose Foamed Steel Tile Coverings are composed of steel roofing tiles laid in Panel" for installation as Class A prepared roof covering. Limited to t/2 in. accordance with instruction sheets accompanying packages.These coverings thick minimum gypsum board over minimum 1/2 in.et plywood.the gypsum are limited to inclines sufficient to permit drainage and to 15/32 in.mini- board is covered with one ply of Type 15 base sheet. mum thickness plywood decks provided with a layer of 0.002 in.polyethyl- Formed steelanel cover'n designated "Scanroof" or "Multi ur ose Panel" ene coated steel foil underlayment and fire treated battens.These coverings P for installation as Class & r p have been investigated only for fire resistance.Authorities Having Jurisdic• suitable for installation over existing prepared roof covering.when c Class B rating is Hon should be consulted before installation. sting wood shingles when covered with one Formed Steel Panels are composed of ribbed or corrugated steel coated layer of Type G2 base sheet. with asphalt on both sides and faced with aluminum foil on both sides laid ATLAS ROOFING CORP 84052 in accordance with instruction sheets accompanyingg Packages.These cover- SUITE ROOF160 ING THE EXCHANGE,ATLANTA GA 30339 Ings are limited to open frame roofs at inclines suffix ant to permit drainage. These coveringgs have been investigated for fire resistance only.Authorities Asphalt organic felt sheet roofing and shingles,for installation as Class C Having Jurisdiction should be consulted before installation. prepared roof coverings. Photovoltaic(Solar)Modules/Shingles are composed of flat plate photo- Asphalt glass mat shingles, for installation as Class A prepared roof voltaic module/panels fabricated in sheets which resemble three-tab coin- coverings.Suitable for installation over 3/8 in.and 1/2 in.plywood decks. Pusfte shingles when installed in accordance with the manufacturer's instal- Asphalt organic felt shingles and asphalt glass mat shingles,for installa- atton instructions.These coverings are limited to nominal 15/32 in, tion as wind resistant roof coverings, minimum thickness plywood decks and to inclines sufficient to permit Modified asphalt glass fiber mat shingles, for installation as Class A drainage.These coverings have also been evaluated in accordance with UL prepared roof coverings for installation on minimum 15/32 in.thick plywood 1703,"Flat-Plate Photovoltaic Modules and Panels"(see QIGU in the Electri- dec s. cal Construction Equipment Directory). Modified Asphalt glass fiber mat shingles,for installation as wind resistant Reinforced Cast Stone Shingles are composed primrrily of stone dust roof coverings. Three tab and laminated shingles may bear the statement, and a small amount of resin reinforced with glass fiber.These shingles are "Also evaluated at wind velocities up to 110 mph". limited to 15/32 in.minimum plywood decks and to inclines sufficient to Modified asphalt glass fiber sheet roll roofing, for installation as Class C permit drainage. prepared roof coverings. UL MARK The Listing Mark of Underwriters Laboratories Inc.on the product is the CANROOF CORP INC 82459 only method provided by UL to identify products manufactured under its 560 COMMISSIONERS ST,TORONTO ON CANADA M4M 1A7 Listing and Follow-Up Service.The fisting Mark includes the UL symbol Asphalt organirfelt sheet roofing and shingles,for installation as Class C (as illustrated in the Introduction of this Directory)together with the word prepared ro�,(coverings.Asphalt organic-felt shingles,for installation as wind "LISTED,"a control number,the category identification"Prepared Roof resistant roof coverings.Asphalt mineral wool-feli shingles,for installation as Covering Materials,"and the following statement: Class A prepared roof coverings. Asphalt mineral wool-felt shingles, for Degree of Resistance to External Fire-Class+ instalLtion as wind resistant roof coverings. The Listing Mark may also include one or more of the following state- ments as appropriate: CELOTEX CORP 72634 Degree of wind resistance in accordance with UL Standard 997 1 METRO CENTER 4010 BOYSCOUT BLVD,TAMPA FL 33607 Wind resistance has also been evaluated at wind velocities up to++ Asphaltglass fiber mat shingles, for installation as Class A prepared roof Classified in Accord nee With ASTM D3462 coverings.Suitable for installation cn minimum 3/8 in.thick plywood decks. Asphalt glass fiber mat shingles, for installation as wind resistant roof Classified in Arcordance With CAN/CSA A123.5 coverings."Presidential"shin les may bear the statement"Also evaluated at +-Class A,B or C wind velocities up to 90 mph'.. ++-Specific maximum wind velocity used in evaluation Asphalt plass fiber mat shingles for installation as wind resistant roof coverings.'Presidential TL"r+hin$lee may bear the statement"Also evaluated AMERICAN SHEET EXTRUSION CORP R18404 at wind velocities up to 110 mph' 1618 LYNCH RD,EVANSVILLE IN 47711 Asphalt glass mat shingles,Classified In accordance with ASTM D3462, Formed plastic roof panels, for installation as Class A roof covering in Asphalt glass mat shingles, Classified in accordance with CAN/CSA- accordance with manufacturer's installation instructions. Suitable for use in A123.5-M90, minimum 15/32 in.plywood deck or spaced sheathing covered with onepi Asphalt glass mat shingles, for installation as Class A prepared roof of Type 30 felt followed by two layers of Type G3 mineral surfaced cap sheet. covering when used with minimum Type 30 underlayment over existing wood Formed plastic roof tiles,for installation as Class A prepared roof covering shingle roof. suitable for use on 15/32 in.plywood when laid over 1/2 in.gypsum board or Asphalt organic felt roofing and shingles, for installation as Class C 1/4 in.G-P Gypsum Dens- eckID prepared roof coverings. Formed plastic roof panels, for installation as Clans B roof covering in Asphalt organic felt shingles, for installation as wind resistant roof cover- Accordance with manufacturer's installation instructions.Suitable for use on ings. minimum 15/32 in. plywood deck covered with one ply of Type 30 felt CERT'AINTEED CORP R6g4 followed by one layer of"type G3 mineral surfaced cap sheet. Formed plastic roof panels, for Installation as Class A roof covering in ROOFING PRODUCTS GROUP 1400 UNION MEETING RD PO accordance with manufacturers installation instructions.Suitable for use on BOX 1100,BLUE BELL PA 19422 minimum 15/32 in.plywood deck covered with one ply of Type G2 base sheet Asphalt glass mat shingles, for installation as Class A prepared roof followed by one layer of Tamko Asphalt Products"Tam-Cap"Type G3 mineral coverings.Suitable for installation on minimum 3/8 in.thick plywood decks, surfaced cap sheet. Asphalt glass mat shing�l(es,for installation as wind resistant roc;coverings. Formed plastic roof panels, for installation as Class A roof covering in Wind resistance has also been evaluated at wind velocities up to 90 and 105 accordance with n •nufacturers installation instructions. Suitable for use on mph. minimum 15/32 it plywood deck covered with two plies of Type G3 mineral Asphalt glass mat shingles, Classified in accordance with ASTM Da462, surfaced cap sheet, including tear resistance. Formed plastic roof panels, for installation as Class B roof covering in Asphalt glass mat shingles, for installation as Class C prepared roof accordance with manufacturers installation instructions.Suitable for use over coverings. 3/4 in. spaced sheathing (with a max 1-1/2 in. gap)or 15/32 in. plywood Asphalt organic felt shingles, for installation as Class C prepared roof followed by one ply of Type G3 cap sheet. Coverings LOOK FOR THE UL MARK ON PRODUCT 5 Presidential Shake"' Glass A Fiber Ula' Shingle 50-Yr.Limited Transferable Warranty SureStartIm 10 Protection ]0 Year 90 mph wind-resistance warranty Select colors available in Algae Resistant version(varies by slate,) -_ Weight:355 lbs.per squareGize:14 114'x 40'- 4'Exposure (-- L ASTM D3018 Type I �_ LF�_ j UL Certified to meet ASTM D3462 UL 790/ASTM E 108 Class A Fire Resistance Rating UL 997/ASTM D3161 Type I Wind Resistance Bundles per square 5 Landmark"50 AR Class A Fiber Glass Shingle Weight:305 Ito,to square/Size:13 1/4'x 38 314'-5 5l8'Exposure 50 Yr.Limited Transferable Warranty Algae resistant version available(varies by state) 5 Year 90 mph wind resistance warranty Iandrlark"40 Class A Fiber Glass Shingle Weight:270 lbs per squarelSize:131/4'x 38 3/4'-5 50 Exposure 40-Yr.Limited Transferable Warranty 5-Year 80 mph wind-resistance warranty Landmark"30 Class A Fiber Glass Shingle Weight:250 lbs.per squarelSize,13 1/4'x 38 314'-5 5B'Exposure 30 Yr limited Transferable Warranty 5-Year 70 mph wind-resistance warranty 5-Yr.SureStarl"^Roleriion Two-piece laminated shingle l ASTM D3018 Type I UL Certified to meet AS1M D3462 UL 790/ASPM E 108 Class A Fire Resistance R ttinp UL 997/ASTM D3161 Type I Wind Resistance Bundles per square-4(50,40 year) 3(30 year) Architect 80 Class A Fiber Glass Shingle Weight.270 Itis per square/Size.13 1/4'x 38 314'-5 518'Exposure 40-Yr.Limited Transferable Warranty 5 Year 80 mph wind-resistance warranty 5-Yr SumStart""Rotection TWO piece laminated shingle ASTM D3018 Type I UL Certified to meet ASTM D3462 UL 790/ASTM E 108 Class A Fire Resistance Rating UL 997/ASTM D3161 Type I Wind Resistance Bundles per square -4(40,35 year) 3130 year) HlWe resistant POW " Class A Fiber Glass Shingle 25-Yr Limped Transferable Warranty �� -- 5-Yr SureStart"°Protechoo r r Weigh 240 lbs ppr squarri/Size:13 1/4'x 3A 314'-5 5/8'Fxposure .� ASTM D3018 Type I UL 790/ASTM E108 Clary A Fire Resistance Rating UL 997 I ASTM D3161 Type I Wind Resistance Bundles per square--3 XT30 Class A Fiber Glass Shingle 30-Yr.Limited Transferable Warranty 5-Yr.SureStart'"Protection 5-Year 80 mph wind-resistance warranty Weight 245 lbs.per square Size.13 1/4'x 39 318'-5 5B'Exposure ASTM D3018 Type I UI Certified to meet ASTM D3.162 UL 790/ASTM E 108 Class A Fire Resistance UL 9971 ASTM D3161 Type I Wind Resistance Bundles per square-3 C120 Class A F fiber Glass SI angle 20-Yr.Limited Transferable Warranty 3-Yr.SureStam",Protection Weight:200lbs per squareSnze:13 114'x 39 3B' S 518'Exposure r ASTM D3018 Type-I UL Certified to meet ASTM D3462 UL 790/ASTM 1108 Class A f ne Pcsnrance Ralmp. UL 9971 ASTM D3161 Type I Wind Resstartr Bundles per square--3 March 11, 2002 Mr. Doug L Cafe Allegro 12386 SW Main Street Tigard, Oregon 97223 RE: Restaurant and Apartment Reroofing Project (Pitched Sections Only). Dear Doug, We are pleased to submit the following roofing and sheet metal proposal for your consideration. General Specifications 1. Furnish all required certificates of insurance prior to job commencement. 2. Comply with all OSHA required safety standards and procedures throughc ut the project. 3. Establish a fall protection plan for this project. In addition to establishing a safe work site we will maintain protection of your home and grounds. Note: We will protect all outside decks and the Kitchen bay window. 4 Maintain a Clea-), watertight and orderly job site and upon completion remove all roofing debris. 5. Provide a 5-year workmanship warrant from Columbia Construction Services, Inc. and the manufacturer's 25-yaer material warranty• Roofing and Sheet Metal Specifications 1 . Tear off the existing roof materials and dispose of off site. Note: Any dry rotted or otherwise damaged decking found will be replaced at $ 59.00 a hr, plus materials and 15 % overhead and profit, billed in addition to the sum of this contract. 2. Furnish and install new 112" CDX plywood sheeting over the existing space sheeting. Note: This only is over the middle pitched roof area. 3. Furnish and install new No. 15 ASTM roofing felt over the plywood decking. 4. Furnish and install new pre-painted drip and rake edge metal round the entire perimeter of both roofs. 5. Furnish and install new starter course at all drip and rake edges b. Furnish and install new torch applied APP granulated modified membrane to match as close as possible to the new down through the dead valley between the two roof areas. 7. Furnish and install new CertainTeed Landmark Series 50 ya High Sierra laminated a UL class 'A' fire rated asphalt shingles. 8. Furnish and install new pre-painted sheet metal base flashings at three chimneys and one mechanical curb. 9. Fabricate and iris all new counter flashings at all chimneys. 10. Furnish and install new High Profile ridge to match shingle color. 11. Furnish and install new no-caulk pipe flashings. 12. Replace all existing roofing vents, furnish and install 8 new vents to meet current code requirements. Note: The new roof vents will be pre-painted metal and not Plastic. 13. Furnish and install new pre-painted sheet meta! step flashings ender each course of shingles turning up and under the siding at all roof / wall transitions. 14. Furnish and install new pre-painted sheet rYietal roof to wall flashings. 15. Upon completion and pa, nt furnish all warranties as outlined above. Total Lump Sum For Work Outlined Above: $8,828.00. Exclusions 1 . We will not be liable for any interior damage or clean up including damage caused by failing dust or debris. 2. We will supply the required reroofing permit and bill in addition to the sum of the contract for the direct cost of the permit only. We look forward io working with you again. Sincerely, Paul S. Carpenter Sales Manager ----------- W 4 77 C),z CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 __ ----- - BLIP � - Received _ I'^'.a Requested ---__ AM ___ PM _ BLIP Location _–Suite_ -__- MEC - Contact Person �e Ph(-----) 1512 �'�� PLM -------_-__ - Contractor _ — Ph( _._) SWR BUILDING Tew rit/Cwner G' _y �- ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain _ Slab Inspection Notes: — SIT --- Post& Beam - -- _ --_ Shear Anchors - - - Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing - - - - Firewall Fire Sprinkler - - --- - Fire Alarm �5ud Ceiling - - --- ---- ----- - --- -- - --- J 7 Other: PASS P FAIL - -- Post& Beam Under Slab Rough-In Water Service - Sanitary Sewer Rain Drains - -- Catch Basin/Manhole Storm Drain --- +--- -- Shower Pan. Other - — Final PASS PART FAIL - -- -'v—� MECHANICAL—___ Post& Beam Rough-In Gas Line ----- Smoke Dampers _—�_-- Final PASS PART FAIL --- -.. - - --- - --- - �.-- ELECTRICAL Service ---- — — _- - -- -- - - Rough-In UG/Slab -- �- ---- — — - -�'"-- Low Voltage Fire Alarm -- ---------- Final [� Reinspection'ree of$-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART _ FAIL SITE �— [ , Please cell Mr reinspection RE:_ _— ❑ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date _�_ Inspector _T--_-- Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL