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Permit w , 6 Ah CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00085 '' —. DEVELOPMENT SERVICES DATE ISSUED: 4/6/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109 DA -S R2_119 SITE ADDRESS: 12996 SW BIRCH HILL LN ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 119 JURISDICTION: TIG Project Description: New SF detached BUILDING REISSUE: DM199 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,640 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,760 sf GARAGE: 741 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 0.00 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,400 sf REAR: 15 PLUMBING SINKS: 2 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 7 201 • 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 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: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes DON MORISSETTE HOMES INC DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in 4230 SW GALEWOOD ST 100 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: Phone: 503 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or Reg #: LIC 162512 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 8,908.72 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils l Issued By : _ L"- -7 Permittee Signature : ______ Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. . .. . 'E" Building Permit Apiphation • . . • - , - 'FOR OFFICE USE , , ' ,- .._, , City of Tigard . . -- \,L I - y VED A .. ..._ Received Ai 1 t o 5 66 Pemnt Nd0610 __. g 5 Datem v I A A AA 13125 SW Hall Blvd., Tigard, ORP9A28 7 7 Plan Revie . Phone: 503.639.4171 Fax: 503.598A60` 1 2005 4"1411(/'\ Date/By: c b 3 - .) W - 4: ' 5— Other Permit:S fa:6 –6'041 Inspection Line: 503.639.4175c/T AT , ,..4. • Date Ready/By: n ..„ __.. Juris: lii See Attached Checklist for Internet: www.ci.tigard.or.0 OF T./ - 4/.. Notified/Method: F, (.- (,), 0) Supplemental Information p,,. r GA ,.., "-qDfivr, %-•7 'WO / . tillitoon.. 5 y 0), ( - ) /43kk,i 1'4'Pl.11i'.:We0:14.1114;1.i'43404%:WAiiiiirolVeVegRigIV.At-VR * ilgiria A'iqigarIgfhiktr:trkgiki=aiaVBW.ig6W:': ,,F ., . .,,,,A,,,,,,.t4,,t, ,_,. , ,,.*Avi :,;(4;:;V,.::,:-p-apy,,114",44,14-m%w vli!;,!,,,,,,let,,:h4,,N,..w.,,,,,IL.,ALt.,,,4.41,,,;/;...,;;■.:(wi,g'..=1:A-',!,,.::' x Permit fees* are based on the value of the work performed. New construction 0 Demolition Indicate the value (rounded to the nearest dollar) of all 0 Addition/alteration/replacement [1] Other: equipment, materials, labor, overhead, and the profit for the ----x,zPo!-:j-vg.Pit.f.',:vi.c work indicated on this application. .overi,l'iw,= Y =`1w-:::-:?; 4 m., ,,,,,,,,,,,,,,,, ,,,, ;., El 1 - and 2-family dwelling 0 Commercial/industrial S .. 1 Number of bedrooms: 0 Accessory building 0 Multi-family L i Number of bathrooms: :'. 5 0 Master builder 0 Other: ;&z,?R:;&i, W ,,,,r Total number of floors: 0ii:f!.„Ii5ii4A Job site address: i -c c !p id l a L , New dwelling area: 2 0.( square feet City/State/ZIP: •—T\,1 , Garage/carport area: — 1 LA i square feet Suite/bldg./apt. no.: Project name:■1 ,,,„k .- Covered porch area: square feet c._ Cross street/directions to job site: Deck area: square feet Other structure area: square feet . PlitraWilikaati. 1411 Subdivision: St TAM ../ t k ZA,C.V Lot no.: \ ‘CA Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map/parcel no. . equipment, materials, labor, overhead, and the profit for the ;...',,. PF§PRIT,W a .,;,W VaIgwnaigginlisOgita%ttii'Aqi:4't,P, work indicated on this application. VW4*)%1MqdX,'.4*Wfliihk Valuation: $ Existing building area: square feet New building area: square feet NIA'Ar*C4- ANtakifillidatiVegqiin PIP, VMP,WGArkkk4O Number of stories: .... a gw...:.:}WATIOtsIMIzr4.,.„1...r.0'. I.tigi4A0 Name: . fr . 5 ; .-C- C P01111\1 ocs ic/L-Q) Type of construction: Address: 17L7 0 (, ) Si.. ,- C sc,.. 100 Occupancy groups: „ City/State/ZIP: Likr, _.C.. cy og.. ( 1 . 70 35 Existing: I Phone: 7:01 -.) Fax: (', - -7145 New: hiffekisliaBSSOM VIRINIC'TirdeginrierligatAMO ATiRg"OVONIV-9Azin"'elpqnkm"'0.w'W'MMXV?','sji*I', ' ,A4-47a%grki,:,,i4,f,,,8-: 0 Business name: 5 t e pcs p\---so\ye. All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the Cit y/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) E-mail: 6WTa.rxi e.44d;■44;'ita Business name: . p \ --1,--1c . , Pcr-- p\--piAe, „,, , , , , mowlitiaiNwpiliwowisig,t - g-Nrow4T Address: Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) } Fax: ( ) . — Amount received CCB lic.. )5 I a ived: ') , e ..........,, Authorized signature: De re t 4 ' .- ,190- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: \ IV- Mt. )67r, Date: 31 i — t ( $ . * Fee methodology set by Tri-County Building Industry Service Board. i: \ Building \ Permits \ BUP-PerrnitApp.doc 12/03 440-4613T( I I /02/COM/WEB) • �rR •/7 Plumbing Perm><i�i , pXicatotn. ® FOR. OFFICE USE ONLY • City of Tigard • A� a 1 _ P emut No.:4C --.C900 W 13125 SW Hall Blvd., Tigard, OR 9 2005 ,• r Plan Review Phone: 503.639.4171 Fax: 503.598.1960 40 0..1 i t h± Date/By: Other Permit No.: 24- Hour Inspection Line: 503�6p I 9:01� ^ 5,. 7- `i ce. Date Re • , ; Juris: PI See Page 2 for Internet: www.ci.tigard. or. us III , u n Supplemental information .,:->. r: ,.,:. o,:..:•. r,.,:. �...._. s..,..�- ,n <,v:..::- ,., r. ...::: ,. ,, �. ^+ .: .,:.,.,e ; ,,., a; , a e.;r <se;, - �.: a �f - s,,.:.,. ..,y, �.:� - ,;:.: . �..- .,. A, .. R. .. , c , ,s +,t „ N :, , _.. ig -Y. - 1 . ., .l . .. <. S , .5 s -:gN1 A gsi, x =MF a,:, _ - rs �� iki - ...r,.;s31.,:'`n t.N,,:.....r .,; �.sw <- ,�. -,- W.. ( r t_. , ,l , v _. �i.. ,�. - ra!,§yy , ,�3n •«"tr','e;�lk� =a' ,..�?s�•: ,'� ^�`^ .n. _Ya. - ,�. 9, $ �:.,,.ak_. ... _... . . ..r _.�?..�.,_ . .... ..... . _ ,.- .w.:.,_iWtt....:,.._. 5,, - _.R,. ., .. - ,... .....a ,.,.... :;,_,. .. � ., ...,t•r.T�3 srca:,�a,,t .__..,s . ..� - .n .�.:., ., .. .., tom ._. k... I�New construction 1=1 Demolition For special information use checklist. Y Description Qty. Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) :ixM � _ .yce] - _ .:.t,- :,,+ r,F14'.a'4.'S'tFr.��Equ: ?4: �}; •' °4'. ^:: = :'.i;; ::t. ". ,.'J. "' *r : r >, :.JGATaEGORY:a`OF' CONSTRUCTIO ,: :•, , ,-. - - .;c' N 'a�s._ ..�`�" ,., ,: (;;'i� s � . SFR 1 bath 249.20 jN�;:�,.y: e.° i _ _ "r. .l ,iv:�'n�, -, n.. r: i7. s:>?::,c;si'... fyz . r:�,, ,, .. . ,. .. - .... .... .. .. .... . ...., ... ,�...._ ,, .. �, - :., vim_, -„ ._.. ....� .. ■ , dwelling ■ Commercial/industrial SFR (2) bath 350.00 0 Accessory building 1=1 Multi-family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 0 Master builder 0 Other: Fire sprinkler ( sq. ft.) Page 2 a t O• o e o o Site utilities Job - • - • 1 • . Catch basin or area drain 16.60 ■ City /State/ZIP C ,-� o'e , Drywell, leach line, or trench drain 16.60 V t Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 I Project name: Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: 5V.NI v 1 1.- ?, V e ......, I Lot no.: N `9 Water sel vice (no. linear ft.: ) Page 2 Tax map /parcel no.: ` Fixture or item ;• :.•'er: <1, ar,r a ., •, „, :: :,,,F., . <•, _.,,, s,: ,• t,e-�� - :a::' Absorption valve 16.60 r , - , P 'i`til.^,.=/;=Tiii i'.�i:'3:: - `�z "' ',Y {'`rntU u�7h',: :,s r,,. n- ,J. .. j.p ;:•:t" a., ° <. #..�i >'�;j° :r „�i.,n3� � ntk.�.. _ . ; ,� _.1 ,. �r'�Y �� ,l' 3 §:�':� r,. ;'t :.,,_ DESCRIPTION OF „,, w.,C , ?; :A' 1`-�,t ':6.l'`:w - �+irm':+ .:u' +':;i•:e'= - _ �L:1:` ,:,s? _.:.p,J,. . +; ., ,�u, •,dl•.v, yr�� =,:... �, �,..uestt,. ..,x.$ii,�. ., ..:....:........ >, .., �,. �,��.ax�..�,: >rcrs!a-se;n� =.,., x ..:..,� „t� ,..,:<, �° �> �,::, ���z�" va ,�xs�i.r:u;�;7r,�;..,?''.,z,,., Backflow preventer Paget Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 'tr oe. < >•.ti ;;:titr,^; -Jt - , > ;:.s aJ> _,•�':e ='e •:= PtY- �=:;t<•s't Drinking fountain 16.60 r<i :�:'>se:- - .;.<,..,': ;o , 1...,,;� ,.,,, _ . i�;.s;�= :.�.�� :'.., M;. + °vt g t.. - µ. !g.1.` -: ®:.PRORERI` M)Y.PIE'"ns, f . . '.0 :4, •:,,, .f • 1 r , TE. ANT .. . ; , y.t �h.,". ,..,t,�a •u�..: __�. <, i':;. a: •• . a.. kaP.:S- .,�.f.x..1 _ ., . ` Ejectors /sump 16.60 Name: �' ko ' ' crn inl((, . -t: Expansion tank 16.60 Address: ��� . ' tie' '+ 5 I Fixture /sewer cap 16.60 City/State/ZIP: . • / gaff') • /> ✓CJJ Floor drain /floor sink /hub 16.60 Phone: j�) .J 7 7 0,-.b l Fax: ( ) 9y / -7(.o( 16.60 Garbage disposal YKk�E: -:ti: "tih <^ d' trrtilF^: %d:'h14M:`kf:r. ;.,r, t,32.5 '-4. »,.'::t "• �>`T <i4i•: ,44:3 ?f ":"xt�i';,', ^ttr: :FJ;'�. • • • • 1 V:41, 1, . =,9 e.+ ',�` '}. „„.;:;,:.xi:.- 'rr.`Z .`,,, �:'/ , ar e s� ^ - - i 's �+:ru sir :iH; ''.>>« , FS i.:APPI7I ;:ANT ,;'i" �,,.,, il t:,V. tr�,4 . is G©NT':ACT IRERS®• r.> < .i,> ::,:1 � ?::."'t :; .. `:'.,�::.•� ., : , t,. - . ,,.v= - ,sRrtc l .q;�. `'j',:�1'n ��, �.��;. ::td. ,;,�„ . °�'il^t'.. +4 , ; =.1.`, _,... ri .. Ste _Mfi.N,::iPl ",..•,rii -,.2.i .ati •1 Business name: Interceptor/grease • 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof ' ` 1 Phone: ( ) I Fax: : ( ) 16.60 Tub/shower/shower pan 16.60 E -mail: Urinal z: •.,,..3',; -N.,:t : „� 4444: ss ; °;.a`F,:.. we;: 1 ::r1 ��es; �::',;,r CO. RAC�?QR�., ��::;E� ..rt,. >l�,r =,.. ,sa � „�,,. .. ; • ; :,� s - -�. . ••,,..:: �.-,:,•, .' .a a.: �r:c.,,�'s.,:,r .0 t. „'t> Y,. ,,, x, „ � .:n. _ : t .............,<.....g,: , :4444 :.::.. ..::......... ,4,,;44,4 <.: Water closet 16.60 Business named • i( -� l h rYv , /LA ®i Address: O t 1,151 Other: - Subtotal City /State /ZIP: , rop A &t o ,` Minimum permit fee: $72.50 Phone: (525) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: ^lnmbin Lic. no.: Plan review (25% of permit fee) WS - 7 I g 7�.3 � Authorized signature State surcharge (8% of permit fee) ,;� � TOTAL PERMIT FEE /� Print name: I , `�� � 1 J �i Date: . `(� I This permit application expires if a permit is not obtained within 1 V 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \PLM- PermilApp.doc 12/03 440 -4616T(10 /02 /COM /WEE) Electrical Permit Application FOROFFICE U ON . r �� I � Il City f Ti and L� u !1 ® Received �� y g Date/By: Received. Perntit No.: S i o lQ�'j — (3OU 13125 SW Hall Blvd., Tigard, OR 97223 g Plan Review Phone: 503.639.4171 Fax: 503.59 19G,0 h/Ml 1 1 2 1'� Date/By: Other Permit: Inspection Line: 503.639.4175 �tw 2005 ? "Li Date Ready /By: Juris• H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental information n'r , .. -...,, o ' - .,�_.., :;k >,. ; 7.,.,,f44 4.1. ,16X, . �. "t a:l ='.. :trkiic;=i 71��:::t: - - , -+ .. .., :.._.. . <_'s >..., xi- .,��.,� . ., _ . .-, .ra:a,,S ca•�.s.._..., `k /,'i�s� e�:::i�. -F > ..Y :'{ . �'. � s.< e�MV: � Y.,s�� .,� -- ,��_� + . PI;AN:``RE�'IEW. " - ,t_•: _'.. . � 1'� #\ � L i "f � i 5 ',`3.`�5:': �, '; ' :3•,� '" `; - New construction ❑ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: over Hazardous Service r 225 amps, comm'l ❑Ha zard location .: - . y <.,. t�zJ'• j : ti., «_. - q . _. -. - _ - ft., Service over 320 amps rating ❑Btlildng over 10,000 sq. ft. r"' CATEGORY,.OFr`a:CONSTRUCTION.._ •:.��<�_�: of 1- a nd 2-family �.:�; r ��" r, dwellings . � i� � :.n's i.r¢f.'•'1,F , - i s. ).,a., . •, ,_ -„ . , Y 4 or more new residential g _ - e:.Z.!. . <rL a �,. _'+:.:;;: <,�,] :�.}_H.:.,.:: -: =rte - .,,�, n , r. - ..,.:u,�•;vci, i.ruu d`:.: K.7:'r'+^' a..:,: _. 4, - ..`e4a�:t.. ...._.y -5 ' ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi family 111 Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more -r : L'4s - = 'gi=n er.. ,, ,, eoa :,,: ❑Occupant load over 99 persons ['Manufactured structures or ,. ' : c " , , RV ark B "SITE` ` - �[NFO RMAs1'IO, '�'A''NDYsTsOCATIO ; . •J N:. N ^���' ;,,: • : �.�;,,;, * <t� E r ess /l htin plan P ❑Health -care facility ['Other: no.: 'S � 0 Job site address: G1! „ � �,(� I-4-a L 4 Submit 2 sets of plans with any of the above. City /State /ZIP: "h C c yt lSl The above are not applicable to temporary construction service. l•.,✓ .uia i�'xi ='":,v1a'(£.. tt` e , . ... :,_yn;.:,;:: iN °rx.j l {'(.:,,,_,. } Kar �'ri.,' k'9'FE)E,* ;SC'I'IEl ¢'�.li ...... ' ; ,.,: a a... `..i:`? ' Suite /bldg, /apt, no.: I Project name: fit:.. ,,,;.: ..,,. ,.,•,.- Description =- I Fee. - ,. ( Total `* Cross street /directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision:, i t ¶ kci, Q • Lot no.: t./Lq Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map/parcel no.: v Limited energy, residential 75.00 2 ::" = -,..0 : _ ,' , energy, 75.00 2 Lt nergy, ,x„ 's,r, �..R`if -' l4 ' 1.: K; ;t.Ci>`: ` ,•, y;4i" gi' - ;:�t, - �'rw. ,, �':I)ESCR'hP`:PION.. OFw ,ORK . _ �•; 1 , �:?�> . ;i;� ,�...,.. _� "'�� . -, -._ ..,... _.. _., ._ 'at:�t. <.:._,_,, .., <. «,.,_�.,:,,.� .:_,,.,.,,, �>: F: ,� °� "..'i�';�,.�.�,.k.,` „_��> .,:,3��. ^. <l:us5 Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less . 80.30 2 ..., _ t s_s+:: - , +e - ;, xx, ^ n:rr..:t < , �• - „'+,+re _, - „;.” �7 r ^:t • - nlxys 201 amps to 4 «.'; • ; o ;.. -� } i"x 0 .01 t4.,. J •,7,1,s . o.ar' p o 00 amps 106.85 2 ' , .,: r,.,,: . , � k , s° 5 1 , -- „ ROPE,&,64- :O,WNFIR'; a .ktil . . ': ” ?'" ,., ' EN 1 ,' ge ^`'s5. :i e?���'�s - -•. •, �v.,:.5,e'+�; '`��;•4 i,q .... si�,ti- S;�S. :i r: �: �n' n., �„ �, �.. s• �;:, ?= �;. �'- 57<<:,:.e „ t •;,'tl��e:, i+„wtu�C.,,c':xaw:::..•cers* 5....a - �4t<s ' ' : ` 3= i An � z t "�' 42Y,' .>, y .n i # 401 amps to 600 amps 160.60 2 ir Name: A,� , � _ � � 601 amps to 1,000 amps 240.60 2 Address: .2.0..w 11 w Q,u,7 ” la,--4 Over 1,000 amps or volts 454.65 2 ti Reconnect only 66,85 2 l.• City /State /ZIP: IJ� U � ti , 7 V / Temporary services or feeders installation, alteration, and /or Phone: ) . Fax:€ )9)7 — 7(015 relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ;?!,': - - ;:V >::i:y �' i •` 5 :v - .�4:Y " .' "R•'•'tii�v. <,k., - - _ ii<: `. :r1..ixfL4i a'. S�.+i R "',i }:451 ?:r ,;• - - ':' '�. ,: - •r1'ti tY ry 1 5" i}o-. _ - ., A. Fee for branch circuits with :# `,;;�„ w , � ,r ` , �,,:a � ";;'' ~.� % = ` ` .= APPL ; `CANT . h1it ® F 'i ( ON , AGT , •:P -,ER a.... ,t . „ :,.: -:,. •:;.,:;r., »:'_.,,:,r /<, • ., :; , F , ,..:-, _,.-- r•, - -u e , v, :: ,.. ,. < vr, ........;, .u,..., , . s , .,._ ,r , t fee, each . . ..... ...... <.. • ..,: .. ,;1,;�., i s ,: service or feeder ee, a 6,65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, Address: each branch circuit 46.85 2 Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or in•igation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or 'E; t ?:.�: - .TGONTRACTOR;., limited - 1 ;. i r�'•1� - d t ��.4: r i =11' energy P _ � �,� . , r 1 +" :'sia tit panel, alteration or � 1 extension. Describe: Page 2 2 Business name: C� `d , �'l.�'� l�r\ Address: )9( C L,trh /.] t - - — Each additional inspection over allowable in any of the above ` � � 1 Per inspection 62,50 City/State/ZIP: •- Z.44--f C G /V' 8, C -1 '� q'� �-3 Investigation per hour hr min) 62.50 Phone: K D._ Fax: ( ) v� (1 Industrial plant per hour 73.75 .�s, iw;ir�tiflAi e E1J CF �R oolA ERiFIC• *< WW ,t.. _a,• Z Electrical Lic.:, Suprv. Lic.: - 5q(95 :...;.�.,- , 4, _u,r, 2 .. t: tai , ..' -;. :_ ;:;. =: CCB Lic.: Subtotal Suprv. Electrician signature, required: — rJ� Plan review (25% of permit fee) Print name: �1 , \L(,C 1G ._ . AL�-� � � I Date: 1 Z� lo V � State surcharge (8% of permit fee) 1 TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. BBL! ilding \ Permits \ELC- Permil App.doc 12/03 440.461 5T( I 0 /02 /COM /WEB Mechanical Permit Application - . • FOR OFFICE USE ONLY- - „ • . ' , City of Tigard Received Permit No.:I / b5 ( �) � Date/By: "� `� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503,598.1960 "J II / /h di, „ , t\ DateBy: Other Permit: � t rM � inspection Line: 503.639.4175 \ 1 ' ��:'_ i l Date Ready /By: lulls: ® See Page 2 for inteniet: www.ci.tigard,or.us a Notified/Method: • Supplemental Information MAR 1 1 7nn5 _J_. rn .,k W.f - r:1Tk..> Yt t,. _Y�!bi �,� /�'�ifi :. �: TYPE•: -OF- l z.$ .1,.- `. ';;" _, .� ,.. F• �... .._W v ; s ;, s " ,�,a m,.:s : ��., � :� . _ , , - ,. GIAL�F'F]E.rr: SCHF »D.UL- E'' :.iJS E:CIIEC7CLIS'I?> _..., .{^-. �'#• N:;. ��-: �,.° !,T.,r�^ fv,.�c'I -.:. �:° '�e. `: -:�, !. ! ;- Y1- � . L..., r..3Y:s. .... _... °,£ " s... ,. -n_r`J .S>afL- h ue.. . -r � �s'ii . ._ .... _, ti ':.]':' tt'. inu�f- t;:'_. i, 5,,:-: c. i.t:,.. C!:!,: �..: r�: iss1�.'; �: r�... �, gl•:._ r: S .::.- '�Y•:Yi. "n`::t:a:_`t. °-r. n:r ::..: :.��:-- a:r,:�N.:: New construction ❑ Addiaff /YIPtRtton 'Fi ement Mechanical permit fees* are based on the value of the work ✓✓✓✓ ���� BUILDING DIVISION performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 12 Other: mechanical materials, equipment, labor, overhead, and profit. • ra> : ;,� -�, _ - x :n.anq ,:r;m -�av: , F,�:r" _ .,. . >,r:,_vl',:nr:: v�5;: ><;_.ie'� , r.-M.::i,.• }:;" ;_ >.k;; -`y»: ,a'^'� `'ir??' 'f:; 'iti" . [;:' v`;: ; >tt..e.i ";.. :; x.. «' Value: r., -. 4 ;p:'• TE f RYt: a I,;: ; ;I-.-g . , , a,:•., $ �.i:. .,�. '�,,, „ 41 ='.C•A G0, O . CONST,RUGTION. ,�..., >:�;"' r,i.'... ..x: ?� ";':3 ..�:,: -.. :cte,: �';- ..:.�:. -.'4, - t' i .v , :- ... a, ea. ,... .. Wit.. >,,.,.: - =.. 6.::^ x11,= i..,:. r.a r.i.rvbv. +3'.t..., ...�,..._�..,:✓;::.t..<. . - -. �t� , _ .. _. . .�.$ }�: ,,:.e ... ,, .. � . ..:. .... .. .. c, :... .. % 1.M,.xi ems - .. :;;V RESIDENTIAL'EQUIPMENT I ❑ I- and 2 family dwelling ❑ Commercial/industrial El Accessory building SYSTElGI5'F.EESs :' �..r :.:a.z� ++ =:�=r« nay;::. ra.:: ���, �wr:'..«: 4::_ �s. �,, �< :<.'��..,:��.,,,,:�- .- :,.„•r•- For special information use checklist. ❑ Multi- family ❑ Master builder El Other: Description Qty, Ea, I Total I F N D:.'IsOCATIONr =. ;id ,: '•,` K, '_:m •,,,: + ; , ; : �'i'= : '= % \1a7:' J OB . S ITE': .... ... ..... OR AD't jk, .,.�f::.n.• „_. ..v - # r ; . f.. ..... .,a.,'_ <,,f.,, .+ Heating/coolin g Job site address: Air conditioning or heat pump 1 ' ' L o } In , , , ^ 1 .s (requires site plan showing placement) 14.00 City /State /ZIP: t�, i 1�-� Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg, /apt, no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 n Lot no.: Q� Flue /vent for any of above 10.00 Subdivision: k � �\ ` Other: 10.00 Tax map /parcel no.: Other fuel appliances « };: - •k: =Ci; - _ _'.r.'r:: __ _ �.x,E :r,:+.;f, a:l nra:ata^..nn,q:kts'r •,:'a:. : ,;, i ,, fr:; +'X h ' -k ?'ij "'a. .,k( " pa",v ..:t;H:'" r�r,(,y; _S.. .i.$'fis W a e heater 10.00 ��:; - :r, °za -, : �?f�,,{�° a,,,_, .,�_' Nrtx'z� „- t ;?••, r 11_;� r;4 ": f; , ,,,,, SC' ,:Z3ION ..OP' W ® > r „,;,..,• r ll ik,, ,, :14; ;;.4Cl,; t'',n f r,2' ,,...., �:. i. qW. �>,., n:.: t_. r,- ;, �ri. it �l, �"' : a :n�l:r.::. ^:.0 Si.: {�:a ^' "}.:s:�xt: .,i..r- -.,t.,ot3:._ -'f��. '�':2:}F "` - . ...... .... :.. f �:t�T`n!.t..F3n'kx: �. Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ::.+p: V•- ',, <..<:::K'-; , o• Chimney/liner/flue/vent 10.00 ::1 - - .$tY:,: �l'A+ - .. ; >; '�'{t ' . t + , \ i , > : rn , s ,',_ y - .:i ". ,.'i „%:^ 1 +� Vi a: *il`' =;� �f l.. _ „ 5 -� � ''� f "t': _ . rh , . _ p ytg,.i:::; ::�,.•„et: .:•:<.�r''':,.; _;�' _ j• :�_• , TE1 &NT..ksfr : '�:'° ':,: ..:. _... ,- -:.,:�,;:r,h;.� ^�t'ecti..,;: t.;'. :..:a'r �. <i.i..rc.; ., o. r . � � 1__ 'it�.`:4,,, atr , - xh ,.,C� .,. "P,' �u,r - :.., ,•�' �,, �: r . : . � „�7�;�;:;, .,:•,.� ^.�,.: -�_.. <.. < .- , -E Other: 10.00 Name: \ \" 1JY ` . 9 '. r l� eh' LAje./ Environmental exhaust and ventilation • Address: V 4. G / ' 'y Iii I (Q� Range hood /other kitchen • ) Ll l'/ equipment 10.00 City /State /ZIP: . '' 1 q �C Clothes dryer exhaust 10.00 C_ ( Single -duct exhaust (bathrooms, Phone: ' -� ✓ ✓ Fax: ( '- -7 ( 1 toilet compartments, utility rooms) 6.80 ' ',,,,. - - :•?I +r' E_Rt r , .° r ,. ,. , .+tu •:' N,. 6. f. <' - n±;a,; }[_ sn :'.kk„ ".a41 : ,,,, : , i ax.;;'$ ' j'r= .3 " ";?"sk: >?'l, +i'.rt% {gi >,si'�s" S . Fh' . d ° #n';:- : t = ";k1 �:(t, '�z ;s , i .`;i I ' ;�1 < , : v.t :;t+,t ;- .;, �,).;;yr. sr1` r ,�- , Attic/crawlspace fans 10.00 . _ ❑ ,•t,AP,P:T°ICAT,,, a x ' ,,6 ,u : .� 5 y; CQ , . t P ,,.. .. ^.......:.�,.: m ,....,r:, �..,.,.,.,I:r._ .�s,, -.,N g, ,:;ad;~:....F AC� ,, �??�M t r,r) Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater E-mail: Fireplace Range .. , ,. � T T , is ='= GON R O R. s'u+. •,_ 's�- Barbecue .Z -. _ .. ::T,i�'2'.1• . ..-. . t-- � . ' ,1r , - .: 1 � ��::;:.::xT"k':.: � .� -.. ..r..:. , ..a, h�R °:�:, 1.,<. r. : ... . -. (- �- � 1� ' (�/ 3^ , . Clothes dryer (gas) Business name: 111 ► (�� Other: Address: L ; ;li i.i 5rt . '' „,:„ ° :.+:,::I+t,,: rw i; „ ;�,fi : 1�0 l „a, - - �,,. l " MFC FIA iV ICAI P ERlVIIT .E EES * = ` , *.,4 _;, City/ V w l• l� T ` , ` f �✓ I- ` 1 -2t',.Q Subtotal t State/ZIP: ^f>;: • -. �:.r:. ,..,_. -..A 2 r-: 3 Minimum permit fee ($72,50) Phone: ( j .,.. .. Fax: ( ) Plan review (25% of permit fee) CCB lic.: . C�/'j7) State surcharge (8% of permit fee) f / TOTAL PERMIT FEE Authorized signature: • Ma' 1, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: i�.l lk . I , ' Date: U * Fee methodology set by Tri- County Building Industry Service Board is \Building \Permits \MEC- PermitApp.doc 12/03 440- 4617T(II /02 /COM /WEB) Sep .20. 2005 11:03AM CLEAN WATER SERVICES 503 6814439 No.9232 P. 6 C1canWatcr Permit #:.05 - 002782 — 00 — PE ..- rnumikinonl k rA:,c. Inspection Request Line: 503-681-4444 • 2550 SW Hillsboro Highway 4 hour notice required for all inspections Flillshoro, OR 97123 Ph: (503) 68I -3600 Project Name: SUMMIT RIDGE, LOT 119 Project Address: 12996 SW BIRCII HILL LN Issued By: Nichole Vandcrzanden Type: Sani /SWM Connection Issued: Jun 29, 2005 Single Family Expires: Dec 26, 2005 Project Description: THIS IS ONE OF 7 LOTS THAT TIGARD MISTAKENLY ISSUED PERMITS FOR. THIS PERMIT IS BEING SET UP WITHOUT FEES. TIGARD HAS ALREADY COLLECTED FEES AND THEY SENT THE CHECK COVERING WHAT WE WOULD HAVE CHARGED TO SUE REYNOLDS. Owner Applicant Contractor DON MORISSETi HOMP,S INC DON MOKISSETTE HOMES INC NONE 4230 GALEWOOD 4100 4230 CALF :WOOD #100 LAKE OSWECOO OR 97035 LAKE OSWEGO OR 97035 • Number of Equivalent Fixture Units (FU) 16 Number of 5q It 2640 'I'rnatmen► Plant Durham Water District Tigard TOTAL • • I HEREBY CERTIFY THAT '1'HE ABOVE INFORMATION IS CORRECT. • . SIGNATURE: Date: DON MORTSSETTE HOMES INC • • AAA ®AAA AA—AA ® AA ► A AA A AA A AA V 4 Pa- d E .,,,e STREET EE CERTIFIA'i'I�N E E ® -za \ D. , i ,„ ,, I, / k ,4 T f owner /Agent for me � ' s CLC ( 0. PLEASE PRINT) (PERMIT HOLDER) E ® A i E ; Fa 0. ® fr ; - . m, Y 3 C A x 4 k D hereber y k` ,c rf 'l `ata' e f old =,ow location E g me ets t ,f : ® - � . o ga d /W as� C ounty �.. rv.:�� �.: - , j' 44 l and use and development standards for street tree installation. 1 E ADDRESS: 12' 1 5� / 3JQCH 41 LI Ln.) . ,; LOT: 1 // SUBDIVISION: /r� prim; .� , ® BY: Allr ...0 DATE: 3-- --QS' 1 Alli 0.- A 114- o RECEIVED BY: _ � , DATE: 0 ? 0 A ® �VVV VVVVVVVVVVVVVVVVV VV VVV VV VV VIV V VVVVVVVV CITY OF TIGARD � BUILDING DIVISION PERMIT #: MST2005 00085 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6;12005 Phone: (503) 639 -4171 " „' °„i �I� Inspection Requests (24 Hrs.): (503) 639 -4175 "__ .. INSPECTION WORKSHEET FOR DATE: 8/18/2005 TIME: 7:06AM PAGE: 18 • SITE ADDRESS: 12996 SW BIRCH HILL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 119 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES INC, PHONE #: CONTRACTOR: DON MORISSETTE COMMUNITIES'LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 8/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message ?99 Final inspection 013839 -04 503-209 -4837 N Corrections /Comments /Instruction aS(c ( • eZ, • U4 PASS r P RTIAL APPROVAL ❑ CAf'CEL ❑ NO ACCESS ❑ FAIL C OR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector -,4111_ Date: 8 #: (503) 718- CITY OF TIGARD BUILDING DIVISION #: MST2005- 00Gt�5 n 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2005 Phone: (503) 639-4171 Inspection Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/16/2005 TIME: 7 :05AM PAGE: 55 SITE ADDRESS: 12996 SW BIRCH HILL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 119 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES INC, PHONE #: CONTRACTOR: DON MORISSk. I I E COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 8/16/2005 Pour Time: Code # spection se • ion - e • • # Contact # Message 199. Electrical final 0 617 -01 503 - 209-4837 N Corrections /Commen s nstructions: filth 0 PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G—NR– N t L.-C" Date: 1 - Phone #: (503) 718- 24 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: T 0 0 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 „ill- — INSPECTION WORKSHEET FOR DATE: 8/18/2005 TIME: 7:06AM PAGE: 19 SITE ADDRESS: 12996 SW BIRCH HILL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 119 TYPE OF USE: ' PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF detached OWNER: DON MORISSLI I HOMES INC, PHONE #: CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 8/18/2005 Pour Time: - Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 013839-03 503. 209-4837 N Corrections /Comments /Instructions: • • [ri 'ASS ii PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspecto _ D ate: 8 ` 0 ' 0 P hone #: (503) 718- , CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00086 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6l20O5 Phone: (503) 639 -4171 �u�ID���r�t61t�� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/18/2005 TIME: 7:06AM PAGE: 20 SITE ADDRESS: 12996 SW BIRCH HILL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 119 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF detached OWNER: DON MORISSETrE HOMES INC, PHONE #: CONTRACTOR: DON MORISSL.I I E COMMUNITIES LLC • PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: 8/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 013839 -02 603- 209 -4837 Corrections /Comments /Instructions: r • ;Jr • ..tte • `PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: h Date: i/4 Phone #: (503) 718-