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Permit r CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00027 4'1,1%411,4W' DEVELOPMENT Id, SERVICES 9 RVIC 639-4171 DATE ISSUED: 2/24/2005 13125 SW Hall Blvd., SITE ADDRESS: 15027 SW GREENFIELD DR PARCEL: 2S109DA -SR043 SUBDIVISION: SUMMIT RIDGE ZONING: R -7 BLOCK: LOT: 043 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: DM198 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,290 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,360 sf GARAGE: 430 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 257,550.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,650 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 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 +amts- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVI E W S ECTION 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: Owner: Contractor: TOTAL FEES: $ 8,284.12 DON MORISSETTE COMMUNITIES LLC DON MORISSETTE COMMUNITIES ( This permit is subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes 4230 GAL EWOOD ST 4230 GALEWOOD ST #100 and all other applicable laws. All work will be done in LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 387 - 7538 Phone: 503 387 - 7538 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Reg #: LIC 162512 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : ',1,,,,,- _ _ _ ,1_1 Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Building Permit Application .. . , - • -' FOR OFFICE USE ONLY . '- . City of Tigard Date/By: tr Q` 0 ..) L i 4 Pem it No ui d 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503,598'iL�Yc���` p�� ///amltipliM1'i`1(# DateBy: MA✓ ,�'2`} - d Other Permi '5 tZf a C Inspection Line: 503.639.4175 ,,, ix. Date Ready /By: d /aAiVe { `' Juris: 61 See Attached Checklist for ' Internet; www.ci.tigard.or.us 1 g n A "% Notified/Method: " T)(1- Supplemental Information New construction . j r ,rt 1: 1, mm y ^' x v � irt. , � o- f ` E x: ` - UIIt ' = ° i D 2'= FAIVIIL'iY:I e �. i r' � � .104,,..„ -:.!� ,4' ,. 'P 1 . °%:.:::,: v4..'..:. � {s - s.t.Cr:... _�_:: �x::q`- : ��,;. x . v.e' : »•:��'I:'�`a_.i.Rrv:7), T._,.. - ;, h S^:.i:..,T.r_a... ..N. ...•.. - -. �' - 11-Y _4. i...Ytcr ,,.. ±r, ..�,�}.. -... P..�Y.4. %: "il �: �•545�2�" .v4. ,i ::. - - ice.. e, - . .. ...e. !_. ...E r �.. -._nw, :. \ � '�� ,_. nd to th a valu (rounded on the va f the performed. MI L° tion * the value of the work performed. to the nearest dollar) of all t' ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ' ::FH i'it`.:e ''jji.Ai:tl.'.'l:I.i -v r'a>('i ?.=i �l.I.0 'k�.a - - :tf,". - e,ll: -- : +�itkF'i�"e. = ;;��- -;_; work indicated on this application. _' �it� ; is zA _�3;; <':�r':= _ ::ii ° =.:.,, ;,3 t ; : ",._ (PEGOIL -,OF- ':CONSTRUCTION'{ t f - -a•., l _.,;,.. " t. =Z — e1 ,. ,: t _ - ":"+: +� ";; .> - s.: }'f': ,:�kt'�t :..fl e'.l$., { . a - . ...: ,,. . .. .�.���.Y ^ .'', . ..., : . .. . . ..,, . ,...- ....... . .. .... »..,..�t_v..._. ., 4. .Liliii\- 'ii.:' {�1u.'.E: ,_.,- ,E�i_..: ne . ,.,if it: ^'' -: :'.:t� ?: .. -, „� ;u . , . Valuation: $ ❑ 1- and 2- family dwelling ❑ Commercial /industrial - `. ❑ Accessory building ❑ Multi- family Number of bedrooms: III builder ❑ Other: Number of bathrooms: �' aF;r „sr. :.>!:. - . . S -T.;=� �ai:1` - 9;� '. 5.;;'SF:.r:t?* ,!: }�. , t_5'i`= :'.hG � l.:'i.a:l ,; . :;�,'�: - _ .c, a 4 '!Vlf� s ; � ;i'2 N..t, ;s3. *; - f * \(° ai "4 :� _ w;,,; ;"�j.P.., F " l'r:=.s' "3 „ _z. -,' a`' , }�,,.,,,,gyp ,'; i a:,:,..,,,xc „< Total number of floors: r.`:' 1, ' =,r ";;`;k je OB k f,, , :P 'sI : IO1� , ; N'D';PI OGrA r.,;,' r;- %. ;# ,,,, s �— - tiw64fs, ;, : ..af• , :f s�'i� =.T, ,., lY - ., . -.� t. , :�,.� +..., . ..N��? t k,. .x?t;{tg�_�'�`r2;!;>; ;:. /��^.?r ,._.._., " _ :, .��,!`F =_.,,..ac��;�i, "v;W� .:;cam: s�.asuux au , �,. rx .�:f.�+.t "r,;: .,.,�,..�.. >.,, -.,� Job site address: '� New dwelling area: j square feet i na �/ � �j���1 / g ' q City /State /ZIP: - Garage /carport area: q square feet Suite/bldg. /apt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet ,` a: �i? 9',•( i ;H? }i`'K'z' Y't::t''i.5- .°irti ; C " 5r4 " d „ ii;i' ..`,SY.'4,;:::r` " . a #1 ; i ' rTcfi4 4 St nt 3k .,- :, ,,,,�,..,.:, � ,-': Y.iB] QUIRF A is CQ,1VIlyi l - JSIE1C IST' rss,n a`Tm,n ^v:teiJ4 / ".. .isvi.Mi:', F '`/.` SY. L' H,` i+° i' u-:"' i •t.1:`t�b,/bl,`AiS:YUe , i.)n uY ": Subdivision: ✓WI .. �� �i(� � I Lot no.: �j Permit fees* are based on the value of the work performed. Tax map /parcel no.: ✓✓ Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the - :`a.:5:.:r••t,�,.':'C: =FS.' ;'t2;i' '.t,.,_, :nR- 1 °.3, ?��r_ +':�!: ;:7;,�1:r"v;YYfr;kva:PStt�; ± - r••=in,:..+•'sP:. � _3.�F!:�` � „a ? „<- - 'f�iSfx:,:'.>r c ^,c4::a `.*,t �r�•: ?' att.w {,_ "'t-�, ��`; ".''. ' -z =- ' { ,�;��r.� :'�:. work indicated on this application. a % -= s c ;: DES'CRI'PTI.' N *' F 1t,WORI� :� t ,Yr N.. k :V. i..:•.,. •., - . . ,�._ � . _. -.. . ,. ",_, ,S: ... ...... ......rk�rt�vrs_..:h':;,:.. ,. r_.. ,._+�;�:r���.- __,.._ .,...3 .._Y__.._._.>_ .�'� ,a. 3 _ , Valuation: $ ' Existing building area: square feet . New building area: square feet `�.xt ;' %i��:,t:h'iia„��a?„. ; n?' �4' 3: �F »st'I'�;.,..;'..xrt�:: ^ �� " i 'r'i � 4.„ :±:!.,.• ; ,.:4.,, - 4- _ ..4,v ^ _y :t ' . ,:,.i .. Nt ti� tit�4 _m§'.:3",=::,.s z.,,.; + �tt; : ' ii a'a k Number of stories: °,. ` :. »,i, =." - :,F , i ries iT. flk- ,.. : R P,ERTwY' °OWNER r .:q < ; t ;, ' li t:x,' l ., ; „t. , , T A 'A1V 1. 1. , , , .1 :t,iS�rr.Y. ,.:'k,�,¢:t� . '+ x; S; �Lv> r A: a<. Kgi• r'. an..: �.t- r',�n7��ai: ;t,.t'b', :�, t 1 ;t�'e _�,t;'+r, i;?;), .�..�-.�t_.:,�s' 3l �a�ty,,) k,:a..� . ;•>�i1. ; tkry Eii ,i•.�, t'r' , 6„'1`*,'s:'t „ t efE; f , t `-,tik?: Name: 0h-1 ” f 0 Co M mu N) 1� 5 r L, j•.,Q,, Type of construction: Address: a,. ,C7 (, ) G1 . c ( lam 1c40 Occupancy groups: City /State /ZIP: LC"(...,l�i �p i 2 q � E Existing: Phone: ( '5) : 2 0 D 7 --5L ! F a x : ( ) �7 71- IS New: _ _ fPY.2`A35+, =c ,' - * Y .v „ Jas:. ?s,4Ri. "r §': gk'e =' ;`LVi;° Y',i`afA`# t, r\ n .v"1`; ". . ,.�'<1^r`£+ J. : -fib 1:,3' �r :ci §F:v . :.a = , .nets." .. a,. - 'i: �: a . :alt . z- E - - k . f, � e 5�. , +ckt`v. �..r { 'r.17 a l.� ”, ..X, -n;;. �...,a:. ,A CAN, <i, r.0 NT �RS�O N�1:.f - tr ,��. - ,:`,n, :. §-,_ „��r;��. !_;.;;.:,'i.:�;cl t- '''�r. _d,. :h:t °:�+ z.F _.:Ft'�:z. § > "'; ` *r ��;: .. , :,r :•,� -.. �:: }} :rigs..!.,..:::: s uL, .. 3 ?N`, :,:: :.. :.i-- 1..�:` �,.0 ..� .5 ..f...t.�..t-� .2Y %: ', .,....t�ru r.., :,'3 .. xf. i, t.: :V?v.+:;:'nH2�v`x- %`ic "` °.ri. -, .�,:1J�:t?9tijlnSf '� ;k�= 3'T' �..�.,k.;- H;Y p:ka a.�?� -.t' i; .'t�;t t v �. ,7 .,. _ , ., .� a.. ,. ce..l di ^: rr .th ....- .,'''y.'- $vY:. *;:i� •- .,..liii)�' iv�i Y S,., .4 it' fir. :. �.i�'::i::t s'k n...:V '. � s: , : . - Business name: K,/( EE r\•.. � F' 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 City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax: : ( ) E -mail: i' .f'i �s li il.' C OIt - :. - Vii, . . ,i 1 - - . e . , .... u. , ..__, ,.;5'3:, "is4 i., .., ��.Y:tts� ";<l91 � ,, . .:�•i .:'.i'`.,. .,<x.,.Y ..� ._ f1 ,, ,c, __ Business name: p - 1:; °}' -ra;a. .. ��"� � py^' �r - ` is .�':�S,.a" - ` r `'rs : >ti. =. � t l"k�l,�/�/t'1 `,;�,;?�e:': ,, ,,.:::B���IhDINC` <.P:ERl�1�IT�: �`,�.:.: ziy _ ; „,,U `0E`; y : FE1JS Address: ; .. ,..., = >3. ..._ +s ., , s, - ,,.,..., . ;.� .:. . . .. .. . .... Please refer to fee schedule. City /State /ZIP: Phone: ( ) Fax: Fees due upon application ( ) CCB lie.: -7 Amount received / D ate received: Authorized signature: aittka n � - , -� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 'Print name: i A IT?: ) �'., r � Date: � 2 /� ��� * Fee methodology set by Tri -County Building Indust y ll V Service Board. is \ Building \ Permits \BUP- PermilApp.doc 12/03 440-461 3T( I l /02 /COM /WEB) Plumbing Permit wE® , F OR OFFICE. O , City of Tigard E CE!iew ,/1 A� 2 a 2005 Tigard, OR 97223 �� ' `� Phone: 503.639.4171 Fax: 503.598.1960 //NM ipNI tM1It t / I ft \ Date/By: Other Permit No.: t 24- Hour Inspection Line: 503.639.4175 ,� ` Date Ready /By: luris: See Page 2 for Internet: www.ci.tigard.or.us T%G OF ' a � � N to Supplemental Notified/Method: e mentallnformation L,. .w:x. ,.4 +� � ¢¢ !l • ,,i. Y . 6: i t - ?' ..2 Wit' ,4.. . },; ��n' :.. i • . R P -.{ - li .. ',,.L� • ^ y: �j..- `:.ti's- ti'.:'�:,'.; ;TYPE:: �;�, O�` _ ._ .__ .. _ .' „:. f �.s ,.,+ , � �i,..'as.' -, ., e`.nr ......: ..... ... .� t F ° . 5'irti,;i`,:;:� -`i - - - xnkfw?:'�~- :,- ''v'' --.` .:t5 - .... _" -. ,., ., , �•.... .:..et n_5 .... ,x .. J, .. ��, : ._ -... , ,_ .SC. I:,._ r :s,x 8... -: •: a ., � .. ... :.L k.;% :.. ... ..,_s :;'t.`` - +.5:'•5 <::'. � < ... ...r...< - ri -n>�. ... ii; 1 .. .t ez 3, m � . � - .. ,. i�$i �.4...iT, .iv... ".t' � , .... �tii�i; ..:1 ^. ._ _ -. f. - ^!.:'v:� - r or F or special information ation use checklist. f I�New construction ❑D emolition P l T Description Ea. Total ❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) `a S `4, �`CAT'EGORY:� %;OF =ICON TR � CT ON <: ;�'� - St U •� SFR 1 bath 249.20 _.. ..- .__v,K� •t4 l i�"J7,u -, j x., y : _ ❑ I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 E1 Accessory building El Multi-family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Master builder ❑ Other: : >., -> >, l:, _: e s,:,,:,tl:e::; ., ,.> ,,., ,,.., s'; '� ,,, Fire sprinkler ( sq. ft.) Page 2 ;z4x•,? ni`a - - - - A`" +,` y .' �., t q #',. ` .-n ie:, r vd' iy: ' ifs , .. JOB ` - SITE?'[ NEORIGI =ATION;:,'AND::•LOCA'PIO •, : ,,.- : r lA 'e ,t ; . , n'. , Job "t 1 ° :, -,..a _" fi t,,. :: ., , t� r :: .. - ns Y;!:- �.;;.:, xsm5s:"., a�4:,;..-, s es s�txez'... �r.. !.>; ,• "......z'x..'n..- .:..:...... ..... SI tO Uf ddress: ` t � 5W r` Catch basin or area drain 16.60 City /State /ZIP: v LC � Drywell, leach line, or trench drain 16.60 Suite /bldg. /apt. no.: I Project name: Footing drain (no, linear ft.: ) Page 2 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: v'‘rw�� ij I Lot no.: 415 Water service (no, linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item n , ,; s +:; :: v'f k. '�: `,: ,a :,wxr,r,t, =Y:, x,:.. ,::.,,•,,, +::,, «: >, Absorption valve 16.60 - - '::4;. y: ;�.i` :.:i't "`i �= ..}�, ,1� '^^i;.:g�1sjvt t`�tw'.` -,. r.f': .:i•�'t'� """,,� `k. ;7,,v. ,. ," 4i:; :. _eDESCRII'3TION sem , `�{M, . , ,,x -�,: r .4 ,,, . ,,,,,.e. �•, ;, :, ,, ;;< '''�. ';:i�: ; i.. _,.ii?:, w + .._, a, � . a , I .. d " < x, �.�.$'.= 'x:^t�r.? lt�t .z ,f:=�.. •,.Y� i w_...�,. ��y�u.:.>. r., �:, �<:. �: �.,'=:-, cL• r��,-.,<..,; ��S,., r, r. ����, �s; v��s�.-,,. �.~,,.,<,, ,t,,a....,,x.,,.�.....,. Backflowpreventer Paget Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ,, , <",.• :;"�;:: {. , rx':,,; ,3 ,4:6 .':: it {er.:: = :,_ >.-: Drinking fountain 16,60 ::; +: �r`" :��i; :y,�'r-� �E.�e -, _ k.. - .e- � >;c�;�773t,.. r'!t, - :.� 5. ;L��.��,/.;� =�'i Ou .., ., g :, I P,ROP.ERTY OWP�K ' al. :,A; W,° lI „ � sT,,, .11a, eft ,. ,,; a ( "` `" Ejectors /sump 16.60 ;Name. V C0 I I i ( /t-( J. E x pansion tank 16.60 (�7 � ` .. j G.�� p � Address: �� `► / ,1�� J / cJY/!y Fixture /sewer cap 16.60 City/State/ZIP: -° ' 0---b �.� C / f �• e i(J Floor drain /floor sink/hub 16.60 Phone: ).-22) . 9;'7 •-. `7 J1 Fax: 62, .:5 S Garbage disposal 16.60 ,:..: s ,.,, - „ :4ca: : r .. ,,, ,:,• y ,k,�,_; rrtt,. :,: -;, ti, :;F„ ose 0 • bib 16. '.li<t ,- � � ! "t u . .,i r "�:y i1+, 4,'- •:: •;: ' t ": jh 3 i. \'� ` 4. ,6 � : iie. 6 - 1�p:: 2 4.,, LrI1PPLI „ �,� ..I - - - > ,:r,,.x.�`,.. � -s ,� �'s�� o , � ': :.� ;> :3 H GAIVT ;' , 3 ':`;�rn.»s;? > .',� P,•F✓R ,/,., _ , :� _.._ . ,,- :r'YC*?a ,e?nLr�ra. +d -�..:. r4t�;- ..;e4,.,,...,,. »a.,.a3:Y..,:zF..U::'.... n:3: =:rs .+.: LV; t1s '.`5.,.,. :i�C- .,�.1i....,.�ef. Ice maker 16.60 Business name: Interceptor /grease trap 16.60 • Contact name: Medical gas (value: $ ) Page 2 Address: Primer 1 6.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax:: ( ) Sink/basin /lavatory 16.60 Tub /shower /shower pan 1 6.60 E -mail: Urinal 16.60 . . .. - a .-.... ,:••o ..�, _ 5 vp';. ; :i!.+ ��L• /'• :;a;!r; =nY{ ; $..`: F: :.cdlp.., +v+�, .4 *.t: ; d,�9° {ypt .,t,._ der .:.n. . ?'ii - :r � ' '"�'t s :o t ..a - _- - . y ' t i., N q .`{ _ �::�^ ,..�::�;dt�:v,• i CC';w ?e`: txt.? {:;1:�4:tq CO "i ' " `� - - I`r 'CTQR' {;t , :t!` n�' Fc , s:u;r ? „o,;t; =';yl;:. , - .., - ,.:., .•: - :, ... = » .. - .f ,, .. . .. ,., -. �, ..,,,: :.:�...a::: r';::;;:1; }. Water closet 16 60 Business name: { V " � k ? ,lAli�.0� Address: ' �'�l L'" Lrtlo ) Water heater 16.60 Other: City /State /ZIP: 'h` 4 ,` Subtotal Minimum permit fee: $72.50 Phone: `f")6)`-' - 3 / Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: ^hunbin Lic. no.: Plan review (25% of permit fee) C 0(i).-7e4 g � State surcharge (8% of permit fee) Authorized signature• t. y TOTAL PERMIT FEE Print name: � (t 3 P\--FL: \ Date: 1 \ b5 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. ' i- \Euilding \ Permits \P LM-Permit App.doc 12/03 440 -46 16T(10/02/COM /WEE) � t r Electrical Permit A s s licatio_n . FOR OFFICE U ONLY ,i City of Tigard . . Received ^/� �!. /�)�;� 4 _.. Date/By: i Permit No. G7re& 1:(/(/ ;: 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax 503 598 1960 Other Permit. Inspection Line: 503.632 MAR 24 2005 4175 A Date Ready/By: Jar 0 See Page 2 fur Internet' ww'w.ci.tigard or.us N'otilied' \Icthud. Supplemental Information CITYTOF an GARD PLAN REVIEW [ ;New construction BUILDINGIVVISION emenr Please check all that apply: ❑ Demolition El Other: Service over 225 amps, comm'I ❑ Hazardous location ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. t1.. CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more nee\ residential 'l- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure Li Multi - family ❑Master builder ❑Other: El Building over three stories ❑Feeders. 400 amps or more ❑Occupant load over 99 persons ❑Manufaci red structures or JOB SITE INFORMATION AND LOCATION ❑ Egress /lighting plan RV park Job no.: ' o.: Job site address: ' ( /VAC facility ['Other r ` -- �" Fie / AC Submit 2 sets of plans with any of the above City /State /ZIP: /, / � O 9 , 7 The above are not applicable to temporary consiueiion service Suite /bldg. /apt. no.: ! Project name: - /y� FEE* SCHEDULE / ro r �A443 Description I Qtv. I Fee. 1 'rural Cross street/directions to job site: New residential single- or multi - fancily dwelling unit. Includes attached garage. 1,000 sq ft. or less 1 45.15 Subdivision: 5 UM e y3 Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 -' Tax map /parcel no.: Limited energy, non - residential 75.00 - DESCRIPTION OF WORK Each manufactured or modular �� / 'Q dwelling, service and /or feeder 90 90 _2 A/ G) ui5E / 01)316- Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 I 2 ' Vi PROPERTY OWNER 201 amps to 400 amps 106 85 3 ❑ TENANT 401 amps to 600 amps 100.60 2 Name: 073--A) �✓ f a151 — C dM Ai UA)/77 LL, 601 amps to 1,000 amps 240 60 KIM Address: 7 ' ` - - ` - I " /� Over 1,000 amps or volts 454 65 3 °` O 'A' J �•-� 5.�- J l S I' G Reconnect only 66.85 2 City /State /ZIP: J A 6 t d bk. "17 © Temporary 35 G. � orary services or feeders installation, alteration, and /or relocation Phone: ($j� 3 ___,,,- Fax: 3) 8 76 200 amps or less 66 85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 1 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each Business name: branch circuit 6 ' 6 B. Fee for branch circuits Contact name: without service or feeder tee, 46 85 Address: each branch circuit Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) FaX:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal eircuit(s) or limited - CONTRACTOR energy panel, alteration, or (� extension. Describe', Page 2 -' Business name: i-�rj, ELPZW1 C LL` Address.40 • 330 Each additional inspection over allowable in any of the above , PX 17. Per inspection 62.50 co City /State /ZIP: / M 6 0 o- 95 775-Z.,„ Investigation per hour I I hr nun) 62 50 Phone: (563) 36- - e6 28' Fax: (S-03) 6 `i3- ."y4„ _ Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: t 3 l Electrical Lic.:3 _1 Suprv. Lie.: ya 7 5 Subtotal Suprv. Electrician signature, required: Plan review (25'S., of permit fee) Print name: �40t �OU� / Date: 3 . /®/5 --- PERMIT suiehatge (8"/0 o f perm t { �/ TOTAL ER FEE Authorized signature: / / eeC ((( This permit application expires if a permit is not obtained ssithin ISO days after it has been accepted as complete Print name: Date: ` Fee methodology set by In- County Building Industry See\ ice Box,: l •' Number of inspections per permit allowed. - t:'.Buiidine \Permits \ELC•PerrnitApp doc I2.-03 4ao- a61 51 lon)'sCO\LoEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* Ti Burglar Alarm ❑ Garage Door Opener* Ti Heating, Ventilation and Air Conditioning System* Ti Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: Ti Audio and Stereo Systems ❑ Boiler Controls Ti Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation Ti Intercom and Paging Systems Ti Landscape Irrigation Control* ❑ Medical Ti Nurse Calls Ti Outdoor Landscape Lighting* 7 Protective Signaling Ti Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i tBuildin its\ ELC- Per.tApp.duc 04(03 Mechanical Permit Application FO O USE O NLY ' City of Tigard REiev ived Pit 1 v No.C�J� �67 1315 SW Hall Blvd, Tigard, OR 972 RECE IVED * P ernt Phone: 503.639,4171 Fax: 503,598.1 / /'h i \ Date/By: Other Permit: Inspection Line: 503.639.4175 8 201 ..__ Date Read /B Juris: El See Page 2 for Internet: www.ci.tigard.or.us 114.1 1 _� r Notified/Method: • Supplemental Information 'PY.w � � r?t: `S, f sli• .t t`n � S== CO _ H , ` _.�. �['y `. }. 1VIlVIER�'� ' ;:, , >,. : >:<�� - CI. AI= FFE..„•SGHED.iJLE�`.:.USEi � ! ��tt�� �4����� a,, r k' r' r:,• a!; at•.: i,' c::: al.": I. :r.,.t ?F('r:w.::e::li:i'.: b:k':tl'- �:.:e':: New construction ��p ❑ Addr li ite�rration /replacement ,W, Mechanical permit fees* are based on the value of the work ✓ ✓ ✓ ✓ ✓ ✓��``�` performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. 3- wt Value: $ �ATEGORY� , _ ,<C OFr,CONSTRUCiTION.:. ,,, y �=w; , 4: RESIDENTIAL EQUIPMENT (/SYSTEMS FEES * " ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total s X17= ": k`! :,t:u� ..iy.1 � - " : z ri i .J 0,1 3 r S IT EI NEOR ATI ON AND:=IsO as:; - .�. „c?r =l " a.= � ,r'«� Heating/cooling Job site �` � address = Col° Y 1 w ��JI[ Air conditioning or heat pump /' [ e� i (requires site plan showing placement) 14.00 City /State /ZIP: -�; ( �- Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: I 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), � 1, in -wall, in -duct, suspended, etc. 10.00 `± /CI , J �� / Flue /vent for any of above 10.00 Subdivision: L ot no Other: 10,00 At Tax map /parcel no.: Other fuel appliances " - '•:': :.: ;: '':'giu,s,:... o G7:;` - +'•;i,.i7 "e:,� l : '' ' ',1 0. .04. .,..';;i: A:.3. -- ;• ;.:� °:�. :,, °' n, ",4: -� na,mr, _ ,. „.,. r... „t.;.,,�:,.., ry n i: t Dlj, , .RiPa 5w ,.. it is >, ' :::: Water heater 10.00 ; :;��., „t; - ,.,�, C 'LtIOIYt.,4E�5W0 s xli;: %.,,- ��;-,,. .�l;r- :,,,.,t.. h.; FS, �: r. �;” �' �=:,,_.. ��, �r.:,: zr_;'_: raa��- .xfi,'fsr ='s,.:;.xs,.k., aax,,^a�,o.:., -, .:r_.�.�” �?� +s�+�t "'sn. *. 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,, ,:.,,,- ;_t ,: ,",, r: tl: r Chimne /liner /flue /vent 10.00 ® ,,. s 7 W _ wT'i Fr .`..1..� °.r:... c if t i2, . � =PR'OPER _T' - ";0, ,E ,.�+' - ?�;.. ,1;'; � ° .:4' : �; ::,s =x ?l,;,,v T W1V R `�,�� _ TENANT ,. ^�� ;ra :` �.� , ......,.,kn._w.' - .. t Name: .. r Other: 10.00 � Alb � � �►i L c r1 ke, L, t 1 C� Environmental exhaust and ventilation Address: ig. - {, / ' ) C L J , lll..�eeh .e , l ( /// Range hood /other kitchen j equipment 10.00 City /State/ZIP: '' I 61 " )Q 77 Clothes dryer exhaust 10.00 ` / Single -duct exhaust (bathrooms, Phone: ' - - -) Fax: ( ._ (7, 1 toilet compartments, utility rooms) 6.80 P c'3 -N c'. na a,,,, ..rt, :xe 'r��- : /+.;.. ::c, x;= •,.cs„vz•; ax:'• • S1 "`v ii 4a .,ty' �:Y , ,�, ?i4� �i:'.$ :s' 1 +, ,: 'ij 0: :F:-. N ci : .,ry ,�' , a .}, 1 •ftAP:P- .L1"'- v ^ 1t•A .,,m.. ,_ ;„ ;•,:• .,, Attic/crawlspace fans 10.00 �� % "' C ,ANT ,:; F�s:,s,. C�r,CONTiACT- 'P;EI2SU,Ni•�,' ,i?, ^ ��,��� P ..;::.:� ^°'. �`_' . .,,..:1,,.:: ,.v „�:.,. ..,,.�,vr. ��i.d;.y.,y .f;...�.. -..- ..•: .o- .4�.,, ....,- ..,'fsu •- �N..iU k,�.n ,t• A�.t l,s a,r, .. -. .1 �, -,.w� ,�F ,ter t.., _ •F.- ., ".1 °�'.� x it.. S,. ^Y}�. ^ t -, 1 � -i 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: ( ) I Fax: : ( ) Water heater E -mail: Fireplace Range - '('. .. _9µ art,: CONTRACTOR'a� -,� •. • - Business name: / - `a<' Barbecue vet J ., I 01 . ” Y ry i �9 ...i.... d 1 � '.. t . l�� Clothes dryer (gas) Other: Address: 0 • L 11 ., :itt :;: : V J .:' µ = CAL`PERIVI'1TFEES . ti l � I • .µ>ti� ilk - ,1VIE- CIf'ALV�I * . �:`� �:,'':.: ;: • "' �. LA),,,,,_, Y � ::�� 333:- ;+.,E: < ' 7:_,:r,'.. ,•, _v,• •i,s: _:m.:RrR.:;,:;,n. : �,° + : : .. r ' : .;. V City /State /ZIP: (1 - 20 5 Subtotal ; t Phone: ((�j Fax: ( ) ` Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: ) _ State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: „� b ' This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name: I �Yll� lallif •. ( I Date: Ko,(/. * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (II /02 /COM /WEB) 1- I fiTrg.107.)5-077 ....-- LIAAAAAAAA AA A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A IAAA AAAAAAA 1,4A _ 4 A *- _ 1 STREET TREE CERTIFICATION ... -44 , 1 I, _ i)A-te,., Ar"-I-A, ____. ___._, (,)v,mcr/Agent fm- V M 4. • (pLEAst: PRIATI) (PERMIT 1101,011,1) 4 ..., 1 I no hereby cal if)/ that the following location 1 1 nicels (ii)' orligard/Waslinigton County A 1 I 44 land use and development standards ic.ii sli Irce installation. to- A [ ANVESS: 117 5vo 6Aifoic,L0 Dr . i . ..oT: 4; i- simi.)ivIsIONI: Y: _51 __hoe- ' _ DA . 1 L: 5 [ A CEIVEl.) BY. 1)/VIL A - ' ArITYTTTTIVTIVTTYTTTTYTTTT7T7TTYVTTY*TTITTYTT/TIFTTITTTITYVTTVTTTT1 lib. • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 00027 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24/2005 Phone: (503) 639-4171 / � i �u d q�n�y � ° 9�1��i1 • Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7 :12AM PAGE: 20 SITE ADDRESS: 15027 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 043 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSN I 1E COMMUNITIES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 5/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 007315.10 503 - 209-4837 N Corrections /Comments / Instructions: r ,v0 ,..n (/P' ,.t. `ri -,.o t- A -L i t o `' r.p/t -t.no evit.) PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS H FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: - 6 1 A / � .-, Date: c j I ° (i s 2 Phone #: (503) 718- CITY OF TIGARD f BUILDING DIVISION PERMIT #: MST2006-00027 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 2/24/2005 Phone: (503) 639 -4171 �nr Inspection Requests (24 Hrs.): (503) 639 -4175 ! W INSPECTION WORKSHEET FOR DATE: 5/20/2006 - TIME: 7 :11AM PAGE: 56 SITE ADDRESS: 15027 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 043 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 603-387-7538 CONTRACTOR: DON MORISSE.i f E COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 5/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 007385 -07 503- 209 -4837 N Corrections /Comments /Instructions: • • • N / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r )7U/ 6 Inspector: V "\ Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 &00027 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24/2005 Phone: (503) 639 -4171 ' �i'�GLjiii Inspection Requests (24 Hrs.): (503) 639 -4175 , ' `_I. INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7 :12AM PAGE: 22 SITE ADDRESS: 15027 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: p43 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSE I 1E COMMUNITIES LLC, PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 5/19/2005 Pour Time: Code # . Inspection Description Confirm # Contact # Message 199 Electrical final 007315 -09 503-209.4837 N Corrections /Comments /Instructions: • PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 5 ---- done #: (503) 718- ITY <. �PTI A C ,O G R D BUILDING DIVISION PERMIT #: MST2005-00027 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24/2005 Phone: (503) 639 -4171 4 t '41��lpi�yl l i f t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/2012005 TIME: 7 :11AM PAGE: 55 SITE ADDRESS: 15027 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 043 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -307 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 3874538 Inspection Request Scheduled For: Date: 5/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 007386 -01 503 - 209 -4837 N Corrections /Comments/ Instructions: S S �;,,-� ( Ni — &� v 1 .)(_ ,,_c., 6 °/\ vi :1 L k . }35 t 3A-0-, ( icv,-,,, % 1 , .„, 0 b c li 6 Dtrio A PASS H PARTIAL APPROVAL ❑ CANCEL NO ACCESS l` FA ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -----/ , Inspector: `�` Date: 5 //dphone #: (503) 718-