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Permit X CITY OF TIGARD MASTER PERMIT PERMIT #: MST200 DEVELOPMENT SERVICES DATE ISSUED: 3/2/2005 5-00026 /2 20055 00026 ' - - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S109DA -SR029 SITE ADDRESS: 15252 SW GREENFIELD DR ZONING: R - SUBDIVISION: SUMMIT RIDGE LOT: 029 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: DM 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: SF FLOOR LOAD: 40 SECOND: 1,670 sf GARAGE: 630 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TWO sf RIGHT: 5 VALUE: 321 OCCUPANCY GRP: R3 BDRM: 5 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: 4 GARBAGE'DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 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 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 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: This permit is subject to the regulations contained in the DON MORISSETTE COMMUNITIES LL DON MORISSETTE HOMES INC Tigard Municipal Code, State of OR. Specialty Codes 4230 GALEWOOD ST 4230 GALEWOOD ST, STE 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. ATTENTION: Oregon law requires you to follow rules Phone: 503 387 - 7538 Phone: 503 387 - 7538 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Reg #: LIC 35533 952- 001 -0080. You may obtain copies of these rules or TOTAL FEES: $ 8,786.06 direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils Issue • By : � �A. -4 _� Permittee Signature : V '---C......._\ Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next 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. ca Buildin Permit A lication �iw FOR OFFICE USE ONLY ' ' . City of Tigard &��� V, Received R i / /��i PemutNo,: c,m - _w( � Date/By: ` V) ,y J� 13125 SW Hall Blvd., Tigard, OR 97223 j� pp Plan Revie ' Phone: 503.639.4171 Fax: 503.598.1960 M� JAN (� O 2 . ! / > ,nMNI 1101 '�� DateBy: , 'Vyy�! 4 A . - a9 - u s— Other Permit:5L l , 2 J) _ '� Inspection Line: 503.639.4175 � NI.-' I Date Ready /By: — � t � Jun : El See Attached Checklist for Internet: www.ci.tigard.or,us Notified/Method:J � —Q5 Y55— - (r Supplemental Information ' GITY OF TIGA ® o k w� d ': sZ `I E .r4. •asst` '??: tY:' .,,;y' 3.Y -.1"i rugs x•v`t,V pD .�rM , m tcA t 1 2 =F . ILiY ,ELL . N G �':1'P' �+ =, _ , �° UIItE�� I) . ' . D. A1V '�`= s ue .. 3' , �, `� �iFS,.. - , ]. '4Y' w +, .� ;v' .r�. .., _ ;.t.� At, . \r�' .. v:.w. -■. �,,, •..,, �.. � ", ,.' .Ya -``� "_ .. .. ... ... ... ,,..: te:".., . ,,. t ,, ,�, u+.,.. ;:�i.� .. a. S1�x,m -_, an�,� = ... �s<!x. -. f4•.. ...<,.,,. ,.. .,,. �:. .. ._- . . New construction ❑ 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 .t:: - :'i tttd. ".!z,$74.3gwP.%t;`-+s:: - sal: ' ,qf: `. - pr5 ,; : ::di;i +� � > �:�.; ,> �;�': .�r.�: s:: = ; ;kt ;z, -. work indicated application. ,a;,��( �'' a >- ,.,'' ed on this ,a >';r: °` ' - - >. ?in <cGAIIIEGOR .Ok' �;COIYSiT 'UC,. ..N r':,,,..,.-.-':. .•,, ,r; ",�, `'.,.J � :7t.. .,�� •`..I:.�t ..3.�'1i';'' ??�f,g � `:rs.,� '• -r c g �.= �a�Pr:� >:. ,... c ',;-:.�, -.tx.- .. �_....,,= F,w;.-....,:..0 ?E,` s....... .z, .._,<,.�,;ti�. _,. i7» d# Nd, ls, 4, i` �; �t;.+ v,_..,,,, ..< ., �a$i;., ,,, ..... "�' Valuation: $ ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 7 j ( 7 t = aa,t: Y;G =si- e`3tT+:ue .' :`v.v :''' . ;: :P4 ':A U'4�po . , d) .:.n ?:iii t "izw : 5 "�;:a; { ll f J �„ C • U:. =: " f „�'�:.s - � 7? �' �'' .iyid+- , 3s 3:� �:xur:b�i `:' t ,� , * Total number of floors: .' - . . fi;f; g ; � ,t; -JOB=,,3ISPE 5 rsI ', URIVIAT fix` : DtiTAO,CATI o ., 11 ,'':A,' l s itq , t:: `:."�i.�tt , :.,rir# �.m:#S�ii:�ya`u,,; u:. C;r',.x ,.,): isy - +;; dt_SG;- z�:,ic.. e.-« t2':;: S+ h”: t + ":k- `,Yo:_�'x'N1d.'?gt t:ta;rs., ;n ,s�`,7r„; , ,..St'f::��;:v�. _, :' 't�i4� Job site address: 1 5:).5::a New dwelling area: �(�� square feet - 11 City /State /ZIP: 'c,, „ Garage /carport area: L square feet i 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 ' �"! r' 4tv= tn$ s":#' 3' j �i �,;, �tn" � y" '`.' � j=t ��. 15 x�: ��. t" �`:�1: 1 ; 1-': st" �,�'-' „ 1#,i.};4r'�`iv a`wt , "�?; - r +� ds:(:aa::; i tI3Q.U'IRED�I Q do :A blkT1 y I R@I�'L-'1 JS El.arkiC;:,:'71:'.4';' IS ? r•;� gr;ai „ ) ;N t e P : ,,, ni ad.:;,.':l'tg4iidxlant t:;*, Subdivision: r(PC ./1 j Lot no.: 2c3 Permit fees* are based on the value of the work performed. (j Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the ,;:c, "and• ' "t�:x +!. u e� };:: i.:; - ,: er..0 *�.1: is:. °,. Y.'Yi�;. , .'l.xl;:. ��:i t,= 9c....; .. giYl`: ;; -•c t: -Z. ,:lif?.. _ '�td� .e:`b�'r;9;`�1:__- .. ?,'.x , .., " ^',7 ° ,,,_d,,'� i"' s - t :i, �k�`B'i „ s,:; ,..x, t + K �S °-' - sa,� ,' ',' ",� , ,,, „•a.�fr5:' work indicated on this application. i„ ':F: 5.<,s; S:C ONsr'O ,,WsOiiI� >- :,;•a "l 1" , ,,..,:.;'n:., PP .:- t " ...., ? ' ::. -. 1 :, - - . `- ,sty �:'... 'J � ; '" i:t�rx ;:1:. 1 1 fl 1. +� :. , .,._.. awe .v,,.,..r,.r- ::F �.: ii•� „i' %,5N'i�rp.y AS.:- :.”, +a.4 �. C ; _.., ._� t.z. ,.h�i,,.�,,�t: ".s?1:ti &i°+!;5 Valuation: $ Existing building area: square feet New building area: square feet t ; 4 .,: ,:� :e.#u:A'titi'53QS# 5 »; hY: itleg :Yr -' s ti r r - -,� :nt,, ',tY„_ t ', � ` �`;c - i k t�= ° ` -.17a. i :., '. r' t - , i n. € ; i c k F ,,,, ": ' :"s "%',4,"; x't ` -i Y, , t , 0. F .: y, -::� g' 's "ir rs�t: .. #e s aa ; ,, ;',„ `~r,,.. J.'IrRdP;EI$ T'., A ovoiltivy r- „,. h . "l , #� . ' } k.,,:,a ' , N-t17H Ts,." tr 1. i t. i 1 . n ,.V : Number of stories: xy't��a r ,3,; ;�, °a' . , =�s s ry:_at:..� L�!;. ��#x��;, : k, �.,aEk�'t'}�.�.��r.;:'�,.�i��.. �s�'. t ::... :tea,- tr,�' "�r":r' ,. r ,�3�r -�,ia Name: VtOr —t ( C;0 wilt u w it J t U-..t Type of construction: Address: 44 (i ) ST. '- f i �j ( �, 1C . ' 3 Occupancy groups: City /State/ZIP: L ad, c , C —7 ._ .--2 q✓ 7 / o 3 ` 5 Existing: Phone: �� '2DV7 - Fax: ( j) / C.AL 5 New: y >a, - .. . , :.roc ; �.,- % "r.' - -v.. 'uk6r'r +. .t6z::' ;. v; :ai'ii'S-2 - . !_r t , . v.,,�Rq .�a,?(,:w {r¢��o' i�' 4 °' Rr' :. �. + x, ,: .. .,- �,.::,. ti - . +,, t= � e_ y�;r °...G '. ,lit,:"' ,. ir. ' ..ti;� °',= - ry r�+�. : w. -, „r -., . i -re ;; gy a : . , •, m. r •;, , a., .. u,. 3 P;• § -...,- ,. , . : ^ ,,::..,.,;.- .:- :..'oa -rd - @ , xIW >x ":,a, 1, -. '•;� a („ ' y ,•,,,i' l • A ,m0, o t s .. ,.,. 0, ,„ ? ,4 0 i ..- 6 .- , .- r ,,,,, , ., \... u ''+ .'r „E,,. ,�AP,A 'LCA N§I;, >..{ . p,, t:.. J� �: ,'f =.” 6' c eUNTACT�u'PF,RSO' r..r, :, vra,, ?-t -...� .as . , c._ _:,r -x ,�::. `i �t - .. 1 ... F, . �lx,�. - s. - :nl .: ,li:x 'ao; ”, ,.�.�, tr5a'., a ?.:: , :. :'. ".. r..�. . r. e .., �: _s *v ;:x t ,.rr,+ rr ..,, ., � ,_n �.,.._.,.,..,, °�.t..xi ., -.,3„ .:., , ';w, ..-a'r,�1 .... ,., �� �a . t.'NO' IC .,5�i .:':`;;.,,. �I • p � � '. "�- i,,..1 , a -, .1�,,., :Yi -. ; : .v 5 -.,, �l 1e f c _ As.xco... contractors subcontractors s ,: ui ,red.to, b e.,... Business name: � � contractors and subcontractors are required to 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: :.. .. -. ,�. tea . ... .. .. .... _ 4 Qi,C'l GO • TRACi? _RI - _ , Vi N Business name: ";i;;._ .i° is .' ' >F ,r',; =c' �,s +,�.�B,i7IIrDIPi�;:PERMI'T =FEES: Address: . �1. t �- :- ; "nr2a!i;, Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax:( ) CCB lic.: - Amount received Date received: Authorized signature: �j !/' ,/ This permit application expires if a permit is not obtained t � ` within 180 days after it has been accepted as complete. Print name: �� l T i .y \ I K IC Date: tiO5 * Fee methodology set by Tri -County Building Industry 111 Service Board. i:\ Building \Pciinits \HuP- PermitApp.doc 12/03 440-461 3T( I I /02 /COM /WEB) 7' Plumbing Permit Application ' FOR OFFICE USE ONLY (� City of Tigard � �� ®� Received Permit No.: ��4 � 13125 SW Hall Blvd,, Tigard, OR } � ® Date/By: R Plan Review Phone: 503.639.4171 Fax: 503. 98.1 0 k iill`ik, . A' I +i\ DateBy: Other Permit No.: 24- Hour Inspection Line: 503.639.417124- Hour Ins ection Line: 503.639.4175 2 Q 2 05 _ ,.' I Internet: www.ci.ti ard.or,u O L �.' . Date Ready rho -lulls: Supplemental See Page for i. g Notified/Method: Supplemental l Information - 4 V . _ _ ..",I f_.:3 ' -i.:; F•,:e,v- -+.:`ni: ".: ♦,io - 4r,,y.AY�ti•,..r�. -• ..,, •�`. 'nl`i�: - - \,. , ...... ..... �4s Y .w via• T. .:: t . ,r .r ., ,.. � . ..... ...... ....q . ........ t,.. N , - .. '�. .: ... .kT' i,l ^:J' +1 ... 'vN� --i`iN ' -:tc 4+:'.N,t: - iJ 1:�5Y:r. - _ .:� � - G r `r:v:�� r�.ftr.:{ r.i "J `i - �nZ.,.. _ - - - - •..Nl' t? ' , y .,. . v . �.. . . 'n.-- ai�.r. � � :,: >. ,- ,. ,.tc,. _.. r .; ; . , : -..,; u. .., _: e. ..6 ,t ,5 "'.Y._..�.:5 - t,o_- `w, 1`,'�'" . Y. ,'if b � � §'. 1 :f N. " =5 e,.,. , i - `. 21;•�" <ir., < t-.-. Y . . S -. NjV.a _ 1 �,, z y: . ..�.. 'ti j a�AO:. y . 4; t rvh•�.. � ' .,�t... e p c � .- a,. {.: �.,;v�.�_ _.xs:,,l;,r,' .. ,tr s-s � FEE:,- :SCHED UI9E,�.. .� -�� r:t,> <;: E ._ .. +',Y�� 1�y 5.,._K, -; � - � �- ti'd..l,:^f;?' I`K ::�fi.'fi~'ii; el�::v2'.:::7..�1 :__' ..��ar�;:� _- _ t 2 . _ _ _ - I�New construction t'[1 i e3ftb'tlfton L4 For special infor use checklist. Y - BUIi DING Description I Qty, I Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) f" 4, i hr ��;.� _ `. CAT • E � GORYz 5 ;OFr` ' CONSTRU CTIQN. . _ = +' r: ,y SFR 1 bath " w: _.+.. ���� O 249.20 ❑ 1- and 2- family dwelling ❑ Cotmnercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Master builder ❑ Other: „t ,,.�:' {:; ;: ^ ,':x Fire sprinkler ( sq. ft.) Page 2 ,':ai� fi: °;= '.0 .iYPsi',",` , 2 '�t ' � ° ^:j'rf� «I JOB SITE''.INFORMATIOON =;AND ( LOCATION' Y' f , t .t. t j F,x.�, ;,t `' �; .. �. ,z � = + .. :� ° . .rH�, =,+l .,..; a��. _._� •,. Sit u t i l i ti es Job site address. y ���' \i ce �/ Catch basin or area drain 16.60 City /State /ZIP: i �� Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 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: •; Lot no.: �� Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item :ax.'s::j - ..,.:, :z w.,:st,.: ;,.,,,,; <.}s,,,: :; .,; >,,,:,.,:„ ,.,,, Absorption valve 16.60 'M §r.:R; �.J!'r" ':�l 0 - 13.r; y n, : r ?d?„i ;:3sP `. Z'i w-rn�;i; r;tkz < ,.t,. _. t�;•,l �'j.!' - ,..;1:�.,,,r'�5,�2,.,,: �;- �i�;:i ,�,;; +,.�- : .a;,�';s :u; - ; ;tine . .i :.rii c �= aD SC -l u :, 4 t ,• - fko v F'a W40RIC, ' :, .,,$ .P.'k :,• V "y..�... �. � ,,;.... .,,. ' >ro.:`0..`* ..:la.�t.. - �.zl- .,{�a- .,. .: a .,swY.l. s r.i�' .,,,�)- .,�'�a"r: ^.gti;�,, ,:,.. ., :� " " ". :xr . .S - . «K„ r.i _, .� .,�r� ..... .> _ ,. • ., . -.j v -t -., � , , .�, ... >,.,.1.< .,ti >�..>l,�z� � �,..<..��, fl, _.:..,.,4,,. Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 :k,; h,rr; ,-.���,:., :.ca,,,. rah= , <t +."'„w =,;;�:t- Drinking fountain 16.60 '.i�,;" `� ;r: {1. - �'. K,. - :aFwl {;N- cAit:v {;Y° - ?,i� ; '.$... ..ss': g ; ��5 'i r .,;r s 3 �� `n�' •�;5;s ^ -' - � r2� .:.K . ' j .�� � +,t; "•" )` s �;� , x .'S °. , ! tG,',.o-:�, -' ®, m ; , , R t : i�, `iii: • :.. ,: + t, , .:r ° : :TE - ANT -4:, : -, [ , °x,3f�,, ; ,: t r ., r. ..::n tae,: ,.- t. >� f ";" .i < ; .. ..,i ,ta'c- -- s , , 4 a, ... ....r at�n .'�t� . :�,....n s., 7,:�4a.. �._,� :._.1:,.. rM,x ?:.,.. t.�.. ,:.=; x:*: 9- =�r;.,..,a.xsa;r,,,.e,.aaF�.. Ejectors/sump 16.60 "��` '� '" "` j Name: ., ,,<: l: j,.,/ 4 ' C Cfl mart / -0,,, Expansion tank 16.60 Address: � " � ' ',, I Fixture /sewer cap 16.60 City/State /ZIP: / (�� /� f, ,,�j'� j Floor drain /floor sink/hub 16.60 Phone:) .$'7 --• `7 0 -' J Fax: (Z) -2^�bi- Garbage disposal 16.60 - - ::.1`. *4> s.hk,� �'n .,;�.•v ,;x >r «:?4 = *:i�? _ - ..:a'41*c�t- ,.':4'*r.r x�'r ".'' ::,:ai.x;'�` Wise bi • i' ,t , ,x.siN,.} !'-�s, ;s ",'? ab'' g ,, .. 16.60 _::E'iil:r ' =:APPIJI . s- ~I! ^'r'� ...i.:1.: ,,�.':, _ : �'. � a_: i: CANT: ,•'l. ,,[ r «l Ice maker 16.60 x,- 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: - Urinal 16.60 r.p� narw it raf., ,a,,�o ;; c�, :cw: iF o 3 �' 4A v£ T +St< .. ii, ;•ON R�cCTOR .� .,. -, ,...,,....,.. ........ ..... .., - , Water closet 16.60 Business name:_ • --• i 4 i..Y I --■ Water heater 16.60 Address: O 11 Other: City /State /ZIP: Ar Subtotal � I C Minimum permit fee: $72.50 `"1�t Phone: f) . �7 1) �6 / 3( v� ,ry Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: 1 Ueb-� 44 -- ^ll Lic. no.: 2 7 '■3`0 Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature. . TOTAL PERMIT FEE Print name: , � j4.- 3N-F.:.„-- Date: 1 2. 7 / 1 - ) This permit application expires if a permit is not obtained within V 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM /WEB) Electrical Perm' i F OR O USE ONL - ,: ,: City of Tigard eBy• h i /�� Permit No . g Received Dai J /( � rn -r-r C oaf 13125 SW Hall Blvd.. Tigard, OR 97 3 0 Plan Revie 'f V v 2005 / Other Permit Phone: 503.639 4171 Fax 503.5 'f el P lan R v Inspection Line: 503.639 4175 •e���I Date Ready /fay Jwis E See Page 2 for Internet: www.ci tigard.or.us CITY OF TIGARD �� : \olilied% \•lethod Supplemental Inlurmatiuu BUILUI r E OF I PLAN REVIEW 'iNew construction ❑ Addition /alteration /replacement Please check all that apply: El Demolition 111 Other: ['Service over 225 amps, conun'I ❑Hazardous location ['Service over 320 amps — rating ❑Bulldne over 1 0.000 ;q ft • CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more new residential 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi family ❑ Master builder El Other: ['Building over three stories ❑Feeders, 400 amps or more ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION U Egress/lighting plan RV park ❑Health -care facility ['Other Job no.: • I Job site address: _ _. OA ' i Submit 2 sets of plans with any of the above City /State /ZIP: ..-n9Ard 6 e, 9 7 ga 3 The above are not applicable to temporary construction service Suite /bldg. /apt. no.: Project name: X12 7 / M FEE* SCHEDULE YOM aris� Co M, Description Qt.. Fee. Total I Cross street/directions to job site: g 0 EV D R- New residential single - or multi - family dwelling unit. Includes attached garage. 1,000 sq. It or less 145.15 4 ■ � Subdivision: 5 � � L no .: � O, Ea. add'I 500 sq. ft. or portion 33 40 I e 1� M M't l ! Limited energy, residential 75 00 2 Tax map /parcel no.: Limited energy, non - residential 75 00 _ DESCRIPTION OF WORK Each manufactured or modular dwelling, service and /or feeder 90.90' I Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 PROPERTY OWNER ❑ TENANT 401 amps to 600 amps 160.60 2 Name: Q6h J / 4 yi S5 - ' (' / ^ 6kl•f1. Vt / �5 L _ c. 601 amps to 1,000 amps 240 61) Address: ! f 2 3 0 &A-LE - W i 6 511 ' /` � -c Su,r ' /o) Over 1,000 amps or volts 454 65 J Reconnect only 66.85 2 City /State /ZIP: L 'C � � Q Q 9—,635----- Temporary services or feeders installation, alteration, and /or • relocation Phone:) 36 7,753 Fax: ( n) 3 8.-7_ 7�a` 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 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133 75 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits it'itk service or feeder fee, each 6.65 _ Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53 40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53 40 E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration. or t 7 � ` extension. Describe. Pace 2 2 Business name: g � ��� G � 6. ° °° ��` Each additional inspection over allowable in any of the above Address: P. �� k 2330 Per inspection 1 62 50 I 1 V City /State /ZIP. f ey) o ' d�' /I G i � 7 ? 7 $ Investigation per hour It hr mm) 62.50 C f ` Phone: 603) 3s $'6, 2 Fax: (573 ( .73— .7 yL,� Industrial plant per hour. 73 75 I (� ELECTRICAL PERMIT FEES* CCB Lie.: D22 22 Electrical Lic.: /,/ gS3 Supry Lie y667 � Subtotal Suprv. Electrician signature, required: / Plan review (25// of fee) • Print name: Lke yoliA /Date' State surch T O T OT AL L PERMIT FEE Efpen,iit fE /JJ� a, l 1 Authorized signature: / / This permit application expires if a permit is not obtained nithin ISO days after it has been accepted as complete Print name: Date: - Fee methodology set by Tri- County Building Industry Sees ice Hoard • . Number of inspections per permit al lossed i ' BuitdingsPermns \ELC- PermitApp doe 0 :03 440 -a6 I5T(IOrxP- 'CONI :W6n Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... S75.00 Check Type of Work Involved: Audio and Stereo Systems* Ti Burglar Alarm Ti Garage Door Opener* 7 Heating, Ventilation and Air Conditioning System* Ti Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 -260 -260) Check Type of Work Involved: Ti Audio and Stereo Systems ❑ Boiler Controls Ti C lock Systems Ti D ata Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems Ti Landscape Irrigation Control* ❑ Medical • • ❑ Nurse Calls Ti • Outdoor Landscape Lighting* Ti Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1[ 3uilding∎Permics1ELC- PermaApp doc 04/03 NJ it'( h 7 — v - 0 - oaC P STREET TREE CERTIFICATION y7- § „, 0. �_ : /► I, � - �►�if� . owner /Agent for �N Axv zs5ETi� C , ..4� ,4<., �i�s 2. LG , 0. (PL ASE PRINT ( ) (PERMIT HOLDER) J ' A '7- . «..., ” Do herebcertif t iKtil e` foll`otwing location meets Ctyxof =, 'Tigard /Washington Count l and use and development standards for street tree installation. ADDRESS: fcZ$z 5w 6- YitNFiit,0 ©/Z LOT: 21 SUBDIVISION: w ,�, ,-� !/O F s �. y 1 .7.------------------- 0'' BY: DATE: e - /S 0..S 1 I 0. RECEIVED BY: DATE: CITY OF TIGARD ,._ BUILDING DIVISION PERMIT #: MST200S -00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2005 . Phone: (503) 639 -4171 :uargv���� ��� r � ry Inspection Requests (24 Hrs.): (503) 639 -4175 W INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7:10AM • PAGE: 27 SITE ADDRESS: 15252 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 029 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSE1 I E COMMUNITIES LLC, PHONE #: 503. 387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 387 - 7538 Inspection Request Scheduled For: Date: 6/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 009216 -02 503-209-4837 N Corrections /Comments /Instructions: • .LAIF / AK � ` .' LL /1-... _ / - , - 2 V 44i ..••• 7 1" e> . / ' ' 0 ,,A 1 -e-i- ( U ------- 0 4. ` :e - 2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ — FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: • 4/ Date: .. 0 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312/2005 Phone: (503) 639 -4171 4#00190 1t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7:10AM PAGE: 28 SITE ADDRESS: 15252 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 029 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503.387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 6114/2005 Pour Time: i Code # Inspection Description Confirm # Contact # Message 199 Electrical final 009216 -01 503 - 209 -4837 N Corrections /Comments /Instructions: • y fPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST200S -00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2005 Phone: (503) 639 -4171 " , 'n 1 ��IV��yp1��'I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/15/2006 TIME: 7:16AM PAGE: 63 • SITE ADDRESS: 16262 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 029 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 603.387 -7638 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 387 - 7538 Inspection Request Scheduled For: Date: . 6/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 009336 -01 • 603-209-4837 N Corrections /Comments /Instructions: • • • pcPASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS ❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED lI /— c— D� Inspector: I'� Date: IJ Phone #: (503) 718- CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2005 -00026 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2005 Phone: (503) 639 -4171 / r1 °f /i lli Inspection Requests (24 Hrs.): (503) 639 -4175 , ' - -- INSPECTION WORKSHEET FOR DATE: 6/15/2005 TIME: 7:16AM PAGE: 61 SITE ADDRESS: 15252 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 029 TYPE OF USE: 'PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSEt I E COMMUNITIES LLC, PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSE.I I E HOMES INC PHONE #: 503- 387 -7538 - Inspection Request Scheduled For: Date: 6/16/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 009335 -02 503 - 209.4837 N Corrections /Comments / Instructions: l e 7 I"' 4/ r a 6Lk aliAl CCti . I ! vt, aLA ----- cd4-0-vel ca l' 54 A-4-4_ ti-1-- i7 t 1 i?D 1't9y4 / k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (l FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED / Inspector: "k:: Date: k---1-.0s Phone #: (503) 718-