Permit • `'
CITY OF T I G A R D MASTER PERMIT PERMIT #: MST2005 -00009
� � DEVE HOB ME � SERVICES
39 -4171 DATE ISSUED: 2/18/2005
SITE ADDRESS: 15092 SW GREENFIELD DR PARCEL: 2S109DA -SR037
SUBDIVISION: SUMMIT RIDGE ZONING: R -7
BLOCK: LOT: 037 JURISDICTION: TIG
REMARKS: New SF.
BUILDING
REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,600 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: MF FLOOR LOAD: 40 SECOND: 1,670 sf GARAGE: 410 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 315,879.20
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,270 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: 6 201 - 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 +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:
Owner: Contractor: TOTAL FEES: $ 8,746.09
This permit is subject to the regulations contained in the
DON MORISSETTE COMMUNITIES LLC DON MORISSETTE COMMUNITIES [ Tigard Municipal Code, State of OR. Specialty Codes
4230 GALEWOOD ST # 100 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
Engineered soils
Iss d By : kt,... _ /el/ / i_Al_.L 2 Permittee Signature
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
h ..i- <•
t � Building' Permit Application • FOR OFFICE US ONLY
r% " See Attached Checklist for
Received i
City of.`Tigard �� DaDate/By: : l ' -u TG Permit NoT�d5 -p pP�9
13123 SW'Hall`Blvd., Tigard, OR Plan Review
'63 "' 503.5.7.* 7 � G,r4 Other Permit:^ ��
Phone: 503':639,,:4.171 Fax hs�yp Date Ready /By: Juris: Date/By: Pi AV - / 7 -O S 1 �.NI�l7�/? O
Inspection Line: 503.639.4175 (� _ __, / ia
Internet • � � Il ') Notified/Method: i I o ��� f & Supplemental Information
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N ew construct sow Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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❑ 1- and 2-family dwelling ❑ Commercial /industrial Valuation: $
Li Accessory building 111 Multi-family Number of bedrooms:
Number of bathrooms: a.
❑ Master builder ❑ Other: Z
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Job site address: I v S0 ° I 2 D K. New dwelling area: 3 d --i 0 square feet
City /State/ZIP: '11)jLO t Ole_ x Garage/carport area: V square feet
Suite/bldg./apt. no.: J Project name: n w _ Covered porch area: square feet
Cross street/directions to job site: �" V� Deck area: square feet
Other structure area: square feet
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Subdivision: Lot no.: J 7 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
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Valuation: $ •
Existing building area: square feet
New building area: square feet
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` ij'.. .4 ,.PROPERT,Y 64x4, i. IN .'l liti ;1 ik:41� .:,,am,, , , k : vi,, -U .1
Name: 1 , 4 i c C- M M U 'L1 ":,S t u--ti Type of construction:
Address: " 1 .b 6 c �� ) i
j `Z r Occupancy groups:
City/State/ZIP: L` lei ud, vl p + q i l) Existing:
Phone: It ✓) 7 jV -- ) /7552) 2) Fax: d/.3) ?'7 < ‘7 („, is New:
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Business name: 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: •
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7'.' t`:,` „' ".?.- , o., ,ILDIf!TGsP ; ER1YIIT FEES,n _ ,r„e� .:u., = s`1 tt , ; t%. ,.�N:st ::'!': °,-_ • . ; .,? •.', rvs- x ... -.� ,. , :.r�..,, >: {,i:;:t4.`:: ”
'• ;;- .- „-
Address: '
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone: ( ) Fax:( )
CCB lia : Amount received
.3� Date received:
Authorized signature: �, Igtzfre This permit application expires if a permit is not obtained
tilf\ek, � � within 180 days after it has been accepted as complete.
r, Prinl nme: i �� "r � K )6 , Date: 17_1- 1 O � * Fee methodology set by Tri -County Building Industry
/ 1 Service Board,
is \Building\Pei ;nits \BUP- PerntitApp.doc 12/03 440- 4613T(I1102/COM /WEB)
•
Plumbing •PermiticAppl_icati • , • •FOR OF ' USE ONLY ' • .
>,"� 105
Permit Received
City O Tigard g p� (; `` ® Put No.: 2
13125 SW Hall Blvd., Tigard, OR 97 2�3,IV VV Da teBy: ll
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 AR® /Garordl,� {III\ Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 O F's IG 14 � L !' I � . Date Ready /By: Juris: gi See Page 2 for
Internet: www.ci.tigard.or.us G, ^,A,L1D1vX Notified/Method: Supplemental Information
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I�New construction ❑ Demolition For special information use checklist. ;
` Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
• -, : „vi x i'e ,.: - i_3'i} "•;_ - - NISI _ :i 54
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,ii. s .aCAT :,99- : OF 991-X TRUGTIO -`1�? - 41:
r� -a ,.��.� ;�; .��x:. _ f. N= K ,t:,,.r, ^ ���, SFR(1)bath 249.20
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❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other:
utilities
s ar, ,;;, :a,;r =, , =a4s,• ..;,,at <.rr =:cu'G "a '" ,; .y'a, ,'i:,: Fire sprinkler ( sq. ft.) Page 2
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<.. ea'r': U .:; -.,,,, ..:�c. ,..::. ,-. �. rt;= xr,,.: eir, ,'•8xur.��......., ? +:,� ".i; ° -.: ;�x s: .�.ia ���, ,ta>;'!.. ,<.., Y_ •:_.r<;udk +n =,. Site Job site address: Is 2 ,bY Pe Catch basin or area drain 16.60
City /State /ZIP: 1y )2 ,�� ct-1 . 1 ,, ,,,. _ (,� Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: �� Project name: `fit1/�•�" �-CI Footing drain (no. linear ft.: ) Page 2
e 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: Lot no.: 3l Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
,,;z. :,' -ti :A�;; ;•. : -: Bret;,,_. •I, „ =s•,' a'ar.:;,', ,w ,,, Absorption valve 16.60
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Backwater valve 16.60
• Clothes washer 16.60
Dishwasher 16.60
or;. :a ::�:: : -. ;r::s•.., ,. �° -. ;, Drinking fountain
1. , az;t_ l.x:_f,. a•°t.r: "i g 16.60
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��,.,\� ""';' ` " °'`" Ejectors /sump 16.60
Name: t' V9V ' / , ' 0 in Ma i/ i , ( I t r Expansion tank 16.60
Address:'! � Le '' ± • , 1, L Fixture /sewer cap 16.60
City/State/ZIP: / C A re(3j'). 0 , 6/ Floor drain /floor sink/hub 16.60
Phone: j �) . 7 0� � 1' Fax: 6 -2� ta f Garbage disposal 16.60
. >• �, ,' - r_e > ',t':is<,:. „:. ary M ;;, •.;,,, , ,, ;,,;,;�:u , t .: :<n + .:tr:,xM: Hose bib 16. 0
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Business name:
Interceptor /grease trap 16.60
Contact name:
Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
,:. r.,a.,,x,y_ser , a:'- ;,.r,;, .,, :. ,; Urinal 16.60
�s ?ilc{ 'i3 i f. 7:''i'i' i 5 :'l.l:,>,>< i 4Urr ? • i
=M - 7xii_' rasfix,', - , ::.t:;,;,;F % ^'•z•, °':;. a! :t•,
:; :', a ..• _'_, : e 6 ,„ _ : - °•`, ." , 1. i�,a ,t
:iii; - :r�r; ,,,.�..,CQ1V;I'ItAGT'OR`.,.� :1,,.... x »< .,..
s '.. . .... ........ ;x�t... -, : .. - •:, ,;:,.., .:z't ,:4, t , s~<. Water closet 16.60
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Business name: ,
' , ,ir � n k �; Water heater 16.60
, _
Address: /0 ' . 1. 4tiJ� Other:
3
City /State /ZIP:.CL-72,X.�� Gn- 'L�/� Subtotal
( Minimum permit fee: $72.50
Phone: ei)aj) (f�1��7 �(, 4 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: ^tnmbin Plan review (25% of permit fee)
���� g Lic. no.: ���� State surcharge (8% of permit fee)
Authorized signature' t.
TOTAL PERMIT FEE
Print name: ,� 1 3 _taw' w Date: r'2 coil This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i:\ Building \Permits\PLM- PermitApp.doc 12/03 440 -4616T(I0 /02 /COM /WEB)
Electrical Permit Application . FOR OFFICE USE ONLY : .
�yj
Received /' I y-10 - l.r � /
City of Tigard Receive PemritNo.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C \ \' 1 ��nnWHh I l:�t� Date/By: Other Permit:
`�- ',
Inspection Line: 503.639.4175 � , II Date Ready /By: Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
N I fl rl 'Inn;
:. _ .: ._ -, .- r,. ., TYP,E.Ob� WOIiit.._ .,,.u , _,.,.::, -: >�: •x ",_ ..r. ..!�. ''PLAN �'.'
g , - !.,., �, . >.�. : >.. :..nom,.:. - - ew construction ❑ Addition /alteration /replacement Please check all that apply:
CITY O %; r l
['Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: ,tnir nr fS1ON
Service over 320 amps rating ❑Btlildng over 10,000 sq. ft.,
Yr =t , -
ATEGOR. . OTI+. =G NK.
'iC ONSTRUCTIO of -
= 0 1 - and 2 am ' 4 new residential
`� d i "
f il dwellings or more ne
-� Y g
,
, 4•r .. .. , i-i %x. ,, - ,. a ,, .. ..- ... .. ?^ , v.v,r v._.F.., .a ,.r ,. .,.. _ .,:?3v:, _u d �• . i_ ...�.., .. ..... _
❑ 1 - and 2- family dwelling ❑ Commercial /industrial El Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories OFeeders, 400 amps or more
❑ Multi - family El Master builder ❑ Other:
«,$ ry ❑Occupant load over 99 persons ['Manufactured structures or
_
try :�.: . "f.
,
f
- ITE`�INF,ORiVIe(sfi � IO•� ' %'.
RV park
°�1� �;`JOB, -S ON.,.A1VD� TO.CAT N. , <,< .; �' ^'�
�'' ,a��;: " ' _ ��, : : , ❑E ress /li htin plan p
Job no.: 3Lt 1 0 Job site address: I 50 Z cW , 1 Oa. ❑Health - care facility ❑Other:
�j� Submit 2 sets of plans with any of the above.
City /State /ZIP: `�rl CA `-- % Cr] l.( The above are not applicable to temporary construction service.
I `' ;1 �;� / :n �,�;��',�;g��'r�t�;i1r y9 .. .., .,,�wr'`�1•`lrjlis:zt.<
i r ;;,:' „. `'r; `' ?�,,:FEEt f°SCHE 1 E a: 4 :.
Suite/bldg. /apt. no.: Project name: ,,f t4.F„ v u, '.. v �, ,.,,. ,.., . >'t.,.,....,..r ,., ,.._.R ., /:. <,.2..;.,- :_...;'' ,;,;' ,�,.
Description I Qty. I Fee. I Total I ..
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: Lot no.: '11 Ea. add') 500 sq. ft. or portion 33.40 l
Tax map/parcel no.: Limited energy, residential 75.00 2
: ..:.:....... ..::.. :..:.' energy, non-residential 75.00 2
.
A _ ; Limited nergy, non s'dential
. •`r.- ,',;.. i ',t}' : " - - . �Y.;, u ;:.di;is�n;:F"i%';k`C;:iit- ':gi h:;
; fi t: :'f 'i ,. 1'gii, cif -. ' -
- •az. :, ,DESCRIR< IO1V; F':(I/ w
- _ :!'!'YJ � � O .''1�1�'fy : Vr %,C. .,CT �+.;;�'t''v(1
,..... ,- .. _, .. . _,,....� _ -..w „ a,.. ` ,� pii a Bac manu f actured 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
- r1f*Vi*kktintiegiSERZNI.:.ltlit•Engini - ,��::at� - k�:tr Pa .re.•c;y„�:z 3,;:�'''h'7ri.';:i""'4,. : +.ry %_ %.ex: +.:•r;+:"ca t ° ?,3; i,�4 201 am :, s to 400 amps 106.85 2
i .�f i�: '�.Si ".i!, - j '✓?li ` �i ��,��s, �w� G : L'G,W�h_ . !• ?�'} "`.., ,[• i.•-', :c $ P P .; y. � i" �::. ;3' .r; � t,,, ; _ �, �< "_: �'::��ia:a ..ENFANT,. , , �!,f ,'�'_, - .; „�;�:,. •�:. n-!:,` �:.: r.., w:;:>' W ' t% U',¢'! x; �3 :.FI`::''.:;: + „-tnt.���:i.�,. �,,,'x;'. n•�,s�-.,,, t..? �"� "`�''' °�' "" " "' 401 mps to 600 amps 160.60 2
Name: ‘!� NArypnvoile.5 L � 2 601 amps to 1,000 amps 240.60 2
Address: ma. �--1( /) �/j C-a,, � Over 1,000 amps or volts 454,65 2
(� l� i - ,co Ll/ Reconnect onl 66,85 2 „n o City /State /ZIP: LCGai 0, C1 LI' / T empora ry s ervices or feeders installation, alteration, and /or
) .)-2 ` � ) � ` • 7 7 relocation
Phone: ! Fax: v 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
% - �e}:/-,d.3.`: {i : ` j .,: ♦y.:.: )`F' - " I vxL : e:, *t. ?'_�: 'ix1` A. Fee for branch circuits with
:�.;, 'u..... k , ,; ,t, : �r..z °�,,.� :;� � "', : , a _ = [<
:: i.'�'AP�PLTCANT, � ;14tV 2EAla,,:^,: , :'GO:T''C,_, :v „, aNv.r;
,.. r > - ,. ...... ,..; ,
,. ,. r._ „__ , ..,`......_,t'3hs., _ „nsaa.,. ..ae, :- :_...:!:. ,v,..a., :v .1,.,r
. ^.,�ta., ..,
service or feeder fee, each
6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
..1:. ! -'r ':1115.,'- _ - - t ,;, a „.. 3 ;..�
s. r. , -' -•4” ever panel, or
9xxr, `;7” ,CONTRACTOR, :.�s'� -'r s7 ",�:..;.....�,,. <si't�:i�:h energy P
Business name: ' Cam' ,7,
extension, Describe: Page 2
Address: FT/XI S� � , (� �� Each additional inspection over allowable in any of the above
1 1 Per inspection 62,50
City /Statte/ZIP: ` t (-aj /' 0 - 7 0-3 Investigation per hour (1 hr min) 62.50
Phone: 7 Z -1,L- I f t .__ Fax: ( ) Industrial plant per how 73.75
fv ` v a +r'^ �i; ?{ ei >i) ;�t;iiEILECT1UCAL`s;PERMIT T *:�"` '';-' .4 ;:- ;
CCB Lic.: � — I , _ Electrical Lic. ;. . C� Suprv. Lie.:. ...5 ,,.,n .:.....:........ . SubtotaI....,.,r:, _::. ._..,,..,,,:
Suprv. Electrician signature, required: — Plan review (25% of permit fee)
�� '\� • State surcharge (8% of permit fee)
Print name: � jr t '-C"1 I Date: ( -0 l
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.
i \ Building \ Permits \ELC- PermitApp.doc 12/03 440-461 5T( I 0 /02 /COM /WEB
Mechanical Permit Appli ( c ' .a - ,tion . _ • FOR OFFICE USE ONLY - `
.r City of Tigard u� ./t 11 l� Received PernutNo.:
1 1312 Hall Blvd., Tigard, OR 97223 VED Date/By: A44 O� o09 --ego °q
s Plan Review
Phone: 503.639.4171 Fax: 503.598.1960AN 9 //.ltar I \ Date/By: Other Pern»t:
O
Inspection Line: 503.639.4175 7 10U5 ■ta I) Date Read /B Ju ris:
ard.or.us -" Ready /By: Supplemental See Page l for
Internet: www.ci.tigard.or.us .r. OFTIGARD
Notified/Method: Notified/Method: Supplemental Information
C'
RI /is Y
t•.
r
il w K-a.t .a' ry *���
w - ... TYPE �.OF.:WO�RIC', - :a
=i�'n
:- a . .. ::�,�:45:, ..a�' � =^- = �,; ?�r — C OMM' E F E CHECKLIST i
-..., ,, 5 «u, - .- t�:.,. cis. �- ._,... t: .. - ...:.,��- :::...a ... : �-- 'c,:,.w. +.r.,!:�..r.:a,>.,..,. .. k. ,.... -. .. .,: .iw•.., ,.3`i`.. ..:.fii.::�:i:. °3: a. . ... ..... ... . ..... .. ., ,. _... ,�.., ..'., :. . __,._ _.,.. ., ....z. .... u,<:- .....,:.
QQ New construction ID Addition /alteration /replacement „ 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.
:�,v: ,;'ns „.. ,. -�:. > u�, ��.s, <,:k , :u;(t; ";S�" ;i��t4.r=t, -, c:;G; -
m %a•.7 3r l' ; .,. II a<<:�, ='viz; >f :1 Value: $
::;i ° - �`t�,- �' CrATEGOEYx:OF� °'GONSTiRUCtTION: ' x' A ci -•`h . ,.t,:;:
t; ,
f t{' : : «RESIDENtFIAL >Ei T / UI.PMEN SYSTEMS`FEES *, � r ='
❑ I- and 2- family dwelling ❑ Commercial /industrial E] Accessory building Q " "`
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
,.. sJOB 'SITE;•['NFO ATION� °�AND� AO
liOCTIN�'•:;•:' ,a >,'- `;;�
� . aT:1;;�° t. -. Heatin coolin
�� -•` f ,4 : ':,.. ... -.. r- .. .. .,, " .. . ....:. .. .. ... .. ..i � a':., ,.e � . v' .
Job site address: ' S��'z- (( '�� y Air conditioning or heat pump
o
_ (requires site plan showing placement) 14.00
City /State/ZIP: -- AyA4, ( Of- 01--2a,^a.y Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg./apt. no.: Project name. Furnace 100,000+ BTU (ducts /vents) 17.90
A. .. '1 ` _ Gas heat pump 14.00
Cross street/directions to job site: I 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
Subdivision: I Lot no.: " Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
':i_:r �';? * {y' 'LY =i"` 'ri. ,1. �.I�E' s:t!' ?;;P. ^, :; 1 ,.:,
,r'� ..a . !a+ v�,x'. ,�, r�„= ..4_. - ; >^ Water heater 10.00
'S; � >;:w:� {,�'fi 'µ - +9�• y[,i - :' {:.. , DIi 4� �4: `�.... ;°� , � =,uti'°d(.'sl'..-..�, ,i,F,.,,:5,.:,� . 7
- �. ; , y , ., s... r :ar,,ry - ' , _ .5..`CW I P.r49, ; r"WORIf, a .,.t: .. Sk, : .r,'.`: +. zai:t�., o.
......,a,. °:��r ;��: s ?''.; �F_';"-: �'.,ik # t = .,_x.,.,.r.,�'�"�l.. ,. �,.,.�,x�u g,._s -nr. ,,,,L R's4rrx,�i=i:, :,,s..a;;;a- >•r:.a:nt•?asunr rlaara =,..�u
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00 r
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
f$ . _•,, :': ,�,; ; 4< _ ;,: s ir..= r e•c:, Chimne /liner /flue /vent 10.00
.. t: Nit,_ „; ° , 'i;';i
° :r ,.. � . PR`OEERTT ':�OWN,, — , a . =`,u...: _,, :..._ .,, ", .;:,., TENAN :: - ,,,:•
�: �.�:a:r; . ;i�_, w,. ><.- • ;, Other:
Name: �. V r MDAXk e 1 � t e / V Environmental exhaust and ventilation
Address: Da" / ' 4, J ' C.. ./� , L _ Range hood /other kitchen
� "`''`` llll...���� equipment 10.00
City /State /ZIP: 1 Of- £ )crs Clothes dryer exhaust 10.00
may ( / Single -duct exhaust (bathrooms,
Phone: — 2 (i ) Fax: (E72 ) . — 2 I =J toilet compartments, utility rooms) 6.80
:( : - !�:" - '}ir' { 1:1 !E;`,414'.'!^ _lft�l�e _ _ai:ti 1. :.�� t'i'Y=;%,: $ e . is >4P_ ^`.A'� }�j: }�fx1 "' 1 a n :: 1
_ `•'l:t " i w , i i t =}.; ?:.YF¢'i4 t , �K. ?:g4d:kk, ti Fs ". x }s .�.{S 1;; "'%!.
IIi' =" ° :* •... a ,: ; - ,-.',l nl`..w:4.r J4;C30NTACT , ; '4:. , _ s, Attic /crawlspace fans 10.00
... ,pt.,r .., ,r�-.ns :��,.,,u:>;x�r::_,r,. giant ^f,,; *�;�i�.^,,.,�7= P'<'.�t, irii?:. x�' tt,; �':',: 1v��Yp� :,.�-,:.,.,.,,xa.�Ai:,:`a:.. a:�..,�ON;i;%r��� {, �:= rY:��
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
:.CONTRAtiT OR, � ..i,.� -1,-- . , Barbecue
:.- ,..:.- -hi "l:,ysw<. v..li: x.... L'. ..., .,rY, .:{. .:itli•4��. �~S*�:]t a ,x
. si`.ij,� ljo: +s-r e ?�`"�.wp ..
Business name: (�,,^^+ e Clothes Myer (gas)
s r t Other:
Address: L r > i . i .:.
;r .,40, ;`;1VIECHAIVICAI(PERMIi .FEES *' -g `
City /State /ZiP: ' j ' y\,, Y \ 7 L : . ' Subtotal
Minimum permit fee ($72.50)
Phone: ( j �j 2 - ` Fax: ( )
1 Plan review (25% of permit fee)
CCB lic.: ..J State surcharge (8% of permit fee)
/' TOTAL PERMIT FEE
Authorized signature: ` '� This permit application expires if a permit is not obtained within 180
days after it has been accepted as compiete.
Print name: i' 't f b ,(/ . 1 ) 1 Date: / 9(O " Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermilApp.doc 12/03 * 440- 4617T(11/02/COM /WEB)
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006.00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2118/2005
Phone: (503) 639 -4171 � A�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/12/2005 TIME: 7 :08AM PAGE: 76
SITE ADDRESS: 15092 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 037 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 5/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 006691 -01 503- 209.4837 N
Corrections /Comments/ Instructions:
co LiLL ‘ Pi ( r 4
q 6D ()1 1, 7
t
PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL n CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
6 (2.
Inspector: Date: Phone #: (503) 718-
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MS1200&00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/18/2005
Phone: (503) 639 -4171 h � llhI/myp
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' __..
INSPECTION WORKSHEET FOR DATE: 55/13/2005 TIME: 7 :12AM PAGE: 59
SITE ADDRESS: 15092 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 037 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 -7538
CONTRACTOR: DON MORISSE.I 1E COMMUNITIES LLC PHONE #: 503
Inspection Request Scheduled For: Date: x,,-/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 006823 -01 503- 209 -4837 N 1
I
Corrections /Comments /Instructions:
G� .
t ,-,./ . , . _,- or /''''2-.
s pg / ,/
� eil //,6
'4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: G'" riad p Date. / Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/18/2005
Phone: (503) 639 -4171 �im� mdbll gli ° ( ,
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_,-14- - I
IF
INSPECTION WORKSHEET FOR DATE: 5/12/2005 TIME: - 1; M PAGE: 73
SITE ADDRESS: 15092 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 037 TYPE OF USE
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503- 387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.307 -7539
Inspection Request Scheduled For: Date: 5/12/2005 Pour Time: -
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 006691 -04 503- 209.4837 N
Corrections /Comments /Instructions:
•
'►, -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4/ ° �— D ate: c / 11 ` Phone #: (503) 718-
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005 -00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2118/2005
Phone: (503) 639 -4171 /Am nv ui pmNP�V9 ° ��
Inspection Requests (24 Hrs.): (503) 639 -4175 Imo' I..
INSPECTION WORKSHEET FOR DATE: 5/13/2005 TIME: 7 :12AM PAGE: 58
SITE ADDRESS: 15092 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 037 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 387 - 7538
CONTRACTOR: DON MORISSEI 1E COMMUNITIES LLC PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 5/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006823-02 503- 209 -4837 N
Corrections/Comments/Instructions:
P
MI
V
', IA ei-lfr
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ktIP Date: -' 3 fD_S Phone #: (503) 718 -