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Permit ,. , ,... CITY OF TI GAItD MASTER PERMIT PERMIT #: MST2005 -00093 { � �itl' DEVELOPMENT SERVICES DATE ISSUED: 4/28/2005 `--' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -02700 SITE ADDRESS: 15235 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 004 JURISDICTION: TIG Project Description: New SF detached BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 28 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 407 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 308 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,190 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 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: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes DON MORISSETTE HOMES DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in 4230 GALEWOOD ST 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire STE 100 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the LAKE OSWEGO, OR 97035 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503_387_7538 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: $ 10,600.47 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : 2 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. P FrFVED Building Permit Appliication . FOR OFFICE USE ONLs �-� City of Tigard t1AR 1 7 2005 Received DateB : , I - Permit No. i .It --con 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 ylof Da[Date/By: t y - D $ - O Other erin� Lt, � -oCJ05 �� - Oth Pi ) j 6 ��p � A\ Inspection Line: 503.639.4175LITY OF TIGA I3D a. Date Ready /By: _ turis: H See Attached Checklist for Internet: www.ci.tigard.or.u$UILDING DIVISION Notifi (7 f7 � 1 Supplemental Information 1 - 'a : .,y, � • , .�yy": °^ o .. = ;" s,a:s. - axc.rp- , „ u; "sz'� r w J ¢ �`� W/ � , "`� ^;xt : 7..ist,^- .�: £';,�.- ;ass,w1.: .. 4.Z F ° . .t , ' ;k,: a . ?, ,,, i;;; ,,._ , �" t: x , kzx� �+rt .7 m” ".` '. :." ++;= a ..fip� 1-- ` ?• ' .: "srZ" i E R i+^ i 5 .:.,37h$, ` ` "'t * -44. - mAiivs '�: �li* . , , - " #Yt , : - ai -,da D D l FA D E L RE QUIItE ATA.&l , 2 MILY' L �(J New construction ❑ Demolition Permit fees* are based on the value of the work performed. VV �� Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the V :V� + t ' ggg 4N CATEGORY OF``CONSTRUCT ONftPj, V,R work indicated on this application. r <.0 ❑ I- and 2- family dwelling ❑ Commercial /industrial Valuation: $Li 1 lY („{ W . i C1 ❑ Accessory building ❑ Multi - family Number of bedrooms: q ❑ Master builder ❑ Other: Number of bathrooms: `n/ ::.,,. r rcs s'Is.:f * z �w, .; _.sx r =__„ ; t.a'x ,,: r ^ da : ;_. ::.,; t 1'',11r t s ^ L JOfi firi ; gilia t O AAND • L O ; � CATi Kr - t r g t Total number of floors: Job site address: /5d3 CD c cee nc i e1 r o p New dwelling area: 319 O square feet City /State /ZIP: '11 Ti Garage /carport area: L-gy.}. 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 4 R DAiTAj COIYII'VIERCIAL US EiGHECKLIST (� as Y:*. rc' 40r ig4 A-: ua:€ ?M-'-9,::84?`-"S'?s,?`*6/104M* ''.SM „J ?.'a:14PAS1/44 tiei�` ?tgainh=`M"a'FAVT Subdivision: S�rn ` v 1 k , Lot no.: 1 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 :_ +,• °1: fir^- •.,..:�. :.;` t . !...x.:s.: �eE "ai:.'h'..a' #` L' a'-#, 5? ?�: M" a'; ?. ","S':>a�;":t?5` ='.1 °x:Li+ix;: '4€::. ":_- 3,t:.Tia: z� ;.s °s"P?# ., t- it; "'w ".y "t' °'.y: ;3 , and the profit for the equipment, materials, labor, overhead, a e r a{ '' , f � si ' DESCRIni. OE yoi k ,t ;I,f . a � it' work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet a�';�. "== :;�.�'; , ��as, �,.; �. s���re�: �� ;x��aza� ^,•;?;;�,��.� <, ;�**'a� i� ° - a3� `{v.��' "` ,:��,a�s:`a „_�ng�zr�;,• �s= �;' .. a � s-t1PROPER'IiY ,OWNERS s �O TEriANT Number of stories: Name: , IV Vi D1 t G t>,rvµ.. `F j L L--C— Type of construction: Address: k w ' � ow (j ) GI ,° � ( / �, ` r, Occupancy groups: City /State /ZIP: L_t e �c + OK. ' 70 3 Existing: Phone: ( C 7 y Fax: ( .2 ) -3 C.+7 '7 Ca IS New: :;.,.nvi.,t, i ` .. , , °` ; �,, ...„„•,' > " ::,111 ,m f t, - ,'�'ti: ��,. ` sn. .m..: iv,ixt':r^�'ii.,5 x „,iF z 0 -3 ' � 1. # II 7 ; f lki, v ' owitr m :, [M s. w , - ; e .: ate, 2 ^ 'F. , x L ' ° n . i , . Na u. APP 7 �. . ,,, � a,,C A S V PER5 t > ::,E"' t, ~ �x:,,t' r- ° ”' as h`: „ a W . . v. ,rmr s K a`3 - .h A .., . as .. s a ..xz ��� •: , - .�` ��- NOTICE V � cS . .: Business name: 'N� f �a All contractors and subcontractors are required to be Contact Warne: 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: ,, r.. a , 4 :.,#i^ , , pf, art- r�:.Yas°'.`aa ='-�::� " k`;:z !,t:;,r;' : .rc �,.:. . .. u. ; "' cry'; r, °•. n g.. :t /1 . t Y *i .el, a s } ``"o i� t . Business name: L .y-..-..p.•:,. "t� *�;. €.-vi"1;s,., -'a <.c-t~s t. *, . �'rO " �� :� , • , BUILDI„,,,_ ERIVIIT'. *" - . ;,;''t$ Address: ;t�;3z:r;,esr =zx:v.,_ ,F.r'r':t =;F,' >'` Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lic.: i L9 . 2 5.12._ Date received: Authorized signature: lkset_ � �K� � l Thi perm a pplication expires if a permit is not obtained , within 180 days after it has been accepted as complete. Print name: i �( T�^ � � Date: i3l i 1 D� * Fee methodology set by Tri -County Building Industry 1 Service Board. i:\ Building \Pei mils \BUP- PermitApp.doc 12/03 440 -46 I 3T( I I /02 /COM /WEB) Plumbing Perm i trApp i , • t o n_ 0 F OR OFFICE USE ONLY Cif of Tigard Received _ City g 7 Date/By: Permit No.: - 6 13125 SW Hall Blvd., Tigard, OM97223j E 2005 y' l �t � v Ry Plan Review Phone: 503.639.4171 Fax: 503.598.1960 b ilr��i61 �dl�t I + Date/By: Other Permit No.: 24- Hour Ins ection Line: 503.639.4175 TtGAR® ri I Date Ready /By: Juris: El See Page 2 for p - , Internet www.ci.tigard.or.us C TY r.r. tPll�l Notified/Method: Supplemental Information ;,� _ ; :.u�,�,,• � ;��«�- •�� a � r � :�:�s , r -r; ,; �,nr..��;.;� O tt . � .�; F, .; " = %a, ,; s f � wriE OF WORK C : '-a 4 � ., r e `i v . , : efts ` .';rr. ` : -7 ,, -: .- i,, o' aka e,.. {. .- ...a -x,4,, ,k, :.,,,,,�3.b =,-1 ''t.s� wi,n-,� " rk e ft,it' , . ' 1, ,, , ireaS.V,O.A ,_ 7 , FE ix E SC E �a.; tWI ,,,,,," ? ' ,i" . � zx. JNew construction ❑ Demolition For special information use checklist. • Description Qty. Ea. Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ql �'?`' ='�4`'=flF` - ' %1:±y '''�"i'i- *,��.�'.xg�: zs -::, - r Fiat 54: +gz :�.&,��;w _ �;:L�= �^���;:�.:a'n".Tr.#�;: ,•.4 s l,t.. 't ��?M'.J� �'��actr` ?t ,, - , ; �4 xgCATEGOR, i G®NSTRU�CTION h ,' , 14 , SFR (i) bath 249.20 ❑ 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: s* - at's,er;r , ,a;..,, E;t 'xwr, «r:s: rte,t.rr.4u3 w: c s ^: c ;,' ;� Fire sprinkler ( sq. ft.) Page 2 y 0- JiB SITE INFdilVfION AND fLOCATIal ' : i�` • � .. .,w4., ,,, r&am>.:cc?sv4e, 0,. ;:r,.',,,,,m, s:. eei . y F ;. .. ys ,:, t?k R,fv 1- 4..2,� Slte utilities Job site address: �" J 5_ a E e � Catch basin or area drain 16.60 City /State /ZIP: J � Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision.G, �rrv\ Vin � �1 Lot no.: LI Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: `• 1 Fixture or item °f .:.,s,,r - .._,. . fi x- �',.rv,., Absorption valve 16.60 t F 7 i b x .� DESCRIP . �OF WOo ., t� . a7 - .01b#a Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 „, m ; a? x� a:c ,,:r: ,.. ' :rs,s x ; r , T r�� „ a. Drinking fountain 16.60 PR OW ` t• 41 - m„ ik" . ANT s . a=^m 0, ; ; m c;ru � - �� .t, 1/ 1A-A l t � az i e ,. s Ejectors/sump 16.60 r . ,. yr-r `•t'& 1,(_ L Name: f�. „, „.„ s _ y f Expansion tank 16.60 Address: •1 je ` ( r tLi -- j 5 L ii 1 C l CO Fixture /sewer cap 16.60 City /State /ZIP: Le ci- f � j , ( ! Floor drain /floor sink/hub 16.60 Phone: C-1; '7 ) . • 7 � _ 1 Fax: (,) 2 S Garbage disposal 16.60 lie V,4;A, - `" �` ;s' ° - � 413 fit., :,. tr A CTS i41 , ; ? , , # FEl � v , . sri;: s .. �s :� %1 1 ' ;7:; Hose bib 16.60 r .1.. . ,.:' is `:50 APPL "ICAN 4( 1& � , W k ai®Nr`TACTy PERSON Ice maker 16.60 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: - : .t,: `s »rac s: f; , r Urinal 16.60 k i ' , r -�. ; f':: z + ^ Lu -�`iz, ^5 Ji, x „,.",,,,,,k6. r f ..,,, a - ` ,,v s l a 4.* ON TRACTO R p ' t A 4 % u 1 ,1, � F rev, 0 Water closet 16.60 Business name ;r � ? �� \)`\ \. Water heater 16.60 Address: ` 0 �,,, b �/ ` ✓� Other: City /State /ZIP: e6-2 X. /" C Subtotal : $72.50 �-(�/ � ( ,,y Mi nimum permit fee Phone: (j)2�) �j 4 3G. Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: 10S ' hnnbing Lic. no.: 2 7 .3'Y'VO Plan review (25% of permit fee) Authorized signature 'tJ State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: j 1 /�;� � -J 3 � 1 (v Date:/ I L4 / Q� This permit application expires if a permit is not obtained within II 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. is \Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T( I 0 /02 /COM /WEB) Electrical Permit Application FOR OFFICE USE ONLY City f Tigard Received y g a Permit 7) T2-oo5 OD0 �� 13125 SW Hall Blvd., Tigard, OR Z223 223 Pn e // t� Plan Review Phone: 503.639.4171 Fax: 503 � 1r'9 y 6r- N E D / ��Ip l Date/By: Other Permit: Inspection Line: 503.639.417 V. .'I I' Date Ready /By: Juris: 0 See Page 2 for Internet: www.ci.tigard.or.us N ifie g of d/Method: Supplemental Information nnnn 1 t inn a:. ,... -wi -,, 74"b -','.' . 'x l-1 .rae y >fn a. itTr'"-��„ r. .: nos e ;, - , tog �«x - :`r' r,= - s ,. YPE:t,OF)�W,O t -0 W . ,'; _ �`.����,vude'�:'tm�, • - ���s�� `, ���� ;��,�:r ,.„. `_ 4I� � 3.4, New construction ❑ Addition /alteration /replacement Please check all that apply: Cl t Y or i tint t„ ['Service over 225 amps, comm'l Hazardous location ID Demolition 1 I�rOt�aer:nIVISION ,�� } Fts „, a ❑Service over 320 amps - rating ❑Bulldog over 10,000 sq. ft., if - #f ' C AQTEGOR oF*GONSTRiJCTION �( t { . i N � ...3w Y dwellings 4 or more new residential � - � �°� �, �� � of 1 -a nd 2-family dwellin iial ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure 17:1 Multi family 111 Master builder III Other: ❑Buildin over three stories ❑Feeders, 400 amps or more a5 ,,. 4 , .., -, a.x __: - . ', , M ,, a te , .: :, .,- a . 2 r, E , m ['Occupant load over 99 persons ❑Manufactured structures or S1 7 k� .tJ OB' STT ,INF A1 VD,:L O C,AT� IO N r r ❑Eg /lightin plan RV park Job no.:" Job site address: ,�p,� of ❑Health -care facility ['Other: ► 5a 5 S� C�.t e I D C Submit 2 sets of plans with any of the above. City /State /ZIP: `��Jt a. / j The above are not applicable to temporary construction J v service. Suite /bldg. /apt. no.: Project name: rocl,wir miwootwoccencesam Description I Qty. Fee. 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:- k.-.-- "! v flev -A .. . Lot no.: Ea. add'1 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: 1 1� Limited energy, residential 75.00 2 , Ff , ; ., g , ,r yfF # . k . i _,. j ,, _ Limited energy, non- residential 75.00 2 %:,- a- ` ,ipr f e DES`CRI, P�TION MOF ' q i tt° ' 4 .a' Aim h - . 4.�� . . _ - :a�,. ,, s. . _ - , .. ss o � t 4.e .:- ii 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 ; .,; . Ta0— 4 �» , ; , ,,. `'mow, "" . ra • v , ;: - , . ,: _ -: , �-° -,: 6 ,,:,, :; 201 amps to 400 am g _' 2„ lwl `PR OPER. Y OWN ; ,kr .M c� ' , 41— 10 T EN . -, '' s' �` r s 106.85 2 MS P p 401 amps to 600 amps 160.60 2 Name: ih' 9 , ...... .,.,�,`t re_ LLL 601 amps to 1,000 amps 240.60 2 Address: G'�. W l�wy i L / '�1� Over 1,000 amps or volts 454.65 2 � V c i vVV Reconnect only 66.85 2 C� City /State /ZIP: � 0 � Temporary services or feeders installation, alteration, and /or � ,6<,-,3 b Phone: ) �� - ! '�� Fax: )� � - .,7 1S 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 . n. iil i+:,v aT3'a k a. F aP #' i.i.- . •, ;'f. «., - rer wkM:Yfii v „we, =r . ,w:°g^A6' ; -'- vt; i :, ' ^x? " ,, . `r'i ' ''_ a 1 '" 'i=; F s r A. Fee for branch circuits with 1p wtlii,: A PUICAN I M ,. ) f c:,t -., CONT.AC' T PF�RSO,4, del-W Business name: service or feeder fee, each branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, Address: each branch circuit 46.85 2 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 circuit(s) or limited - 'tut' "":} s` 4r: "3r:::K,? °'�*"�`?ey�a?ry' =: "" -; fir .; x..« ., �« i.,��q oski'Y'k'". ` "'! :';; a c a! r C;1?`.. ,, ` , VZV ;4 ` , , , t CONTRACTt1 NNIBst, ; *�:, It - I ener panel' alteration or extension. Describe: Page 2 2 C A name: � L.," Address: SV `� Urh � y\ S) t .. ,' r 7 Each additional inspection over allowable in any of the above -7 Per inspection 62.50 - City /State /ZIP: 1 1 `C d, O'' � v _--3 Investigation per hour (I hr min) 62.50 Phone: t 1 L..pq i I (']. Fax: ( ) J Industrial plant per hour 73.75 - � J � ' `LELECTRIGALt, EEE5_ 'e 1 IN CCB Lie.: y ),_ Electrical Lie. G Suprv. Lie.: - 3 .5j � Subtotal Suprv. Electrician signature, required: / Plan review (25% of permit fee) /�� Date: (� )) I I ^ State surcharge (8% of permit fee) Print name: r .. � 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- 4615T(10/02/COM /WEB U uuo� . Mechanical Pe placation FOR OFFICE USE ONLY Y "City of Tigard Received 13125 SW Hall Blvd v igird ®RT9(7-27�3�D Date/By: Permit No.: Plan Review Phone: 503.639.41 QQ Fa t x ' ip5 i i v1 N 7 1�i I�� Date /By: Other Permit: inspection Line: 503. 39:4175 e, I t r Internet: www.ci,ti ard.or.us �.. Notified/Method: fieed/ d/Meett o: kris. See Page I g hod: S Supplemental l Information .:,; „ ,. �H t,;� ; - ' - ff �,- 3 : ; _..- ;€ ._' -yn: ,n ".Y�' i -Y �re- +aur,:ir'ywsue4yax { ;s�rt,..:r nss..�� „.,.k,� ,��!", . t - .. �. +,z'c >-a�5 � *Y�ebt.,r.PA�r, �sa�.'. �' �e�t��,. z�, tee�am .���tr..- �:..,��ixmi.. .n;,< ��ssu:Ka- w_ s , ,7 a-'" W - A` t�, j WiV E _ S ^ , ,f:� 1 : ' v .4 , „Pa. ,#,. l s as r '-, , ",fe „ „ v� ..�,, j , : ,�� ,1 t x _y „ FtEE1 S�HEDUL, iLISE CHECKLIST .t hla _ 3 �.�?, ri�s�.e7�tr.``a , ea- s.�tx. se..a� <usr � a� 9F��^s�., -,- = Y•;. e�.�.�tr"�.�5`.z ,.-srr✓,- �aa>ssrr �u�.ra:a�am�r�-�a: �a� �,,� �. n�`. �i �� �s�,��9r�saza,._.:,szdd� New construction 111 Addition/alteration /replacement Mechanical permit fees* are based on the value of the work lITT����� performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. ' y +3°"f4`+ ' �,' ..''- ''ri`5S3?.?:f+i: ih4 9. YHYe; W5 xi9sr :4`e j'Ya:E6= "d!'.. ;`."':N:dF! it r ^5� x b f 6v+•s 1i �*. -.- L . {y '. W .' fiN`X .. - ' t , CATEGORY; OF:CONST RUCTION' Ott, 1°6„1 T i p' Value: $ 1,,,;,,,,,,1.6,, ur _, �_.v -s":= , •,, t,. ;;,,g,XP, xv, - ,,c,, , , a;rs r %r rr a ,, ` zt...,,,' +',,,, € •:`u .r t st.1 V r:''= r:t 3'r' r 3?.:✓s. gNe. t 7 ^t hr r .ixm d,. g, ❑ 1 -and 2-family dwelling Commercial / industrial # K RESIIDENTIA1�EQU1PM }FEES " : y g ❑ ❑ Accessory building ❑ Multi- family El Master builder ❑ Other: For special information use checklist. ;--'16 , ': *" ,_:` ;:x,. R,. Description Qty. Ea. Total , 1. 1 r , , ` JOB` SITE IN FOMAT I ONS *AND i LO C A TION x • r "�" ' " rfl " ; Heating/cooling Job site address: 1�� /��� �p (C� Air conditio or heagtp ump ) ylfr i' / 1 `✓� re uires site tan showin lacement 14.00 City /State /ZIP: _ - Ny i y . I Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Pro 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 Subdivision: � 1 M '2 G Lot no.: Flue /vent for any of above 10.00 SLY t 1 ! Other: 10,00 Tax map /parcel no.: Other fuel appliances „Ea <; A N -- i - 1 . ';' y'p `' ° : ,u,. a: `- ; :w ;s»Y.<.... arm. * -r ;r ' a- :f ; r - CSC 1f , ,r, �DES OF WORK x :i- . 4.4 ...',L.^ , , .- n,L 1. . § . - s-aasae'°w.,.ms'+.." '.,.«,1. -a.. „aa'.. , _ '! �� Rx� f e Water heater 10.00 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 y; e • -:ms; , _x ,_.'::_. ,,:,_ a - te..r. i , #"` i. .,,,,,ate - ,Y,,,., pA4 x Chimney /liner /flue /vent 10.00 ~ -, :' „PRO - i W m w ` y w 4 ' t TENANT 44 t , «., :ma ' rc -, ��S. « = <, Othei: 10.0 _Name: \ �� , • - �'� �.......�.,,;{,, L� Environmental exhaust and ventilation Address: L ? S- ' 1 1 Range hood /other kitchen 11 l�// equipment 10,00 City /State /ZIP: C _0. V f--" 61' - Clothes dryer exhaust 10.00 l E ,,^ Single -duct exhaust (bathrooms, Phone: --� T2 Fax: ( .el . - te . I' toilet compartments, utility rooms) 6.80 v4.7%4052 - a ": r :�rx y - 3xa y a.:. _ ru � =. p i . _�<inci"r =^:; �'w s: t ! nrr : 3, r ' lis a i s rsr ¢ . '' � :-' t £ ® AP,P £ }"` . CONTACTa° . 0 " Attic /crawlspace fans 10,00 Other: 10.00 Business name: 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 ay.. �'�„� �. <_:�',�:� ..,..�. .- ;..�„�.�. �w. ; .�` ,�.n Range . . .; - ' i? { =� tl 4�a „ , . ,0, tte1: ; Barbecue Business name: (1c f? ' f tj i �9 Clothes dryer (gas) Address: //'� t✓l � lx� Other: k,1 �i ` i (n -.. � t =FEES,L � - ' L = ' V v V`� V '1 7()t .'pia -3_ '* °x': :r.,ec�.x..w zs.,;...,:z .:'r�r �;; �a r`z:c ... -rib m'a- ' =,"`i' gym`% r: � �, City /State /ZIP: a Subtotal Minimum permit fee ($72.50) Phone: Fax: Plan review (25% of permit fee) CCB lie.: ,..D )� State surcharge (8% of permit fee) C, /. 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: , . 0 I \ , f ,, Date: 3 O i L � * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permils \MEC- PennitApp.doc 12/03 \ 440- 4617T(II /02 /COM/WEB) Electrical Permit Application ' FOR OFFICE "USE ONLY - City Of Tigard � �® Permit No.� i _3 O E2iew Phone: 503.639.4171 Fax: 53)598196O ie :idly �a.�(1� t DateB : Other Permit: . Inspection Line: 503.639.4175 005 C a y► ...La Date Ready/By: Juris: H See Page 2 for Internet: www.ci.tigard.or.us ■M 2, Notified/Method: Supplemental Information �s'Y�% "'F_4S` - - ' <�,.. ,a .yx " `� �kA::-r.:",�Ta- �:.7'r.�f ^ - ;as F , .,�,�,.-' a- i� ".!x,c � '°m " as � x• , ,a;: •p ley „• . .�.�rz: �:n•.� . � - <'<�, �.�� -. fi ,,. �Ai�" ,10 ��:•���. ,t�',..,z� .�,- <,rs�, �� :�.,.�:� <= , PL�PI,.,REY�'., ;.� . ,r�ra,: - :n "`al�� . > � � � � s~ f'a i r`. �, >a._. �q: xi „ate .�� a. >.. x7& =. , , ... %.�:._ -� - _ .a:� ,.. , New constructio ❑) Addition /alt�erarion%replacement Please check all that apply: , '�lllus' ` - ['Service over 225 amps, comm'l ['Hazardous location ❑ Demolition © Other: rs :. °. <:4.r» , •<rr t,a, r, hYt - Fs.r; s::: �: 'r = -: c ..:,,., s ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., ;� fas ; l -g o & � GORI?O) ,CON , Tf�RUL''TaIQN n ti t •gf ,., i . • ti:W.ailiii of 1 -and 2- family dwellings 4 or more new residential jig 1- and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure El Multi family ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more _ ❑Occupant load over 99 persons ['Manufactured structures or 107:41it 4,4- TOB S s _ QI1®NE t €� ❑Egress /lighting plan RV. park Job no.: 35 13 Job site address: 1523,E 5 iA t r'21� ra ❑Health -care facility ['Other: 3 Y ,Submit 2 sets of plans with any of the above. City /State /ZIP: IT el f. ¶ 7 22 The above are not applicable to temporary construction service. !!!///111 /� _ ,< � > -�. ,� „�,� .,�., �z� ;:., �4N . ' : ;: : ..:atti° E ,SeGE 1a E;` „£: . Suite/bldg. /apt. no.: Project name: ., / , OY , `f ( s M 14 . Description Qty. Fee. Total Cross street/directions to job site: Q err 154o4 a" New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: d l 7•41-4-v I 1 ' I LT Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 '9 Limited energy, residential 75.00 2 Tax map /parcel no.: .._ w . „,. e a , c ,, _ N , ,� t Limited energy, non - residential 75.00 2 00 SARI. O O'. ORI g' .,• 4, _• :: ��� `its'�.:.�_= i4i1�,,..._ .. .. :: SR'B�= :YCe.��,- aar,'�� G, �e �,':�'<'� Each manufactured or modular • • I / dwelling, service and /or feeder 90.90 2 pew 611 SE W it!NJ Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ''i <: -'N :11ty - , .;� m Dv :•,:.. " - j ' o ,t. z; r ,r` -�c. l i,4. ,, . , tmen 201 amps to 400 amps 106.85 2 rt: ;, .'T`ft . u :,' _ 7 , l'ail iO F A s', a iTENA � :_ ,. ,�....�z.,.wrr.,.,su a .. 3ts1.a s ' (n'�i;=u:c, - +.� , .-'... t r a 9. «» � :r ..i::'�•.;:tM ', ° 401 amps to 600 amps 160.60 2 Name: 0. en's X 65 C, l 60--)v. u AI pi 1 1.7.f."3 601 amps to 1,000 amps 240.60 2 Address: 142 3 a L r 4 L i .' D 5 5oar Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: 1 ✓ 6 - ,� e - 054./ A O K , 9-7035 Temporary services or feeders installation, alteration, and/or Phone: (50 522- . V relocation >� 5 2 2 31 ! , ( 56,3 (� 9 3 '" °� yy 5 200 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 ' .�.� . _ . °' _ ._ ,,,�.,, r n.,.� ; �e x' > -�t,s�< -•.,,.� +. .cam ` ^; ;a,.t� . $��" �, " • A. Fee for branch circuits with tkT Yv ; 3"; `:` b:tF`s�i `'•t.r ° '= °, k, .. , u , :_ �., Z " AP,P IC.< ,,,= m '' ' OIV` A o= .r ^I2S0 �''� �,�xt- ' "'"'�'"�" t `u � "' �` °` ��"`�'�`°� p: � ' ` service or feeder fee, each Business name: branch circuit 6,65 2 B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - ` ' *ty,;-,. energy panel, alteration, or �:�' 'isms =`�`';�t"�� «'Ea %�,•',`s. e`:j3��i'�:�:i�'�'�a���'r�. �0�5:�;��.; - „ . �:e.4':� `5'�:2 =d> '3�:::;� Business name: y i 9 J I C /'% T l LC( extension. Describe: Page 2 2 Address: C aa Each additional inspection over allowable in any of the above ' D ' ��� V Per inspection 62.50 City /State /ZIP: prd t,.01„d' 6 I '77 t�� Investigation per hour (1 hr min) 62.50 Phone: (533) 5Z 3 2 - c 5 I Fax: (303 693-- /liter Industrial plant per hour 73.75 ` 'l T E I'- G A 0241#0,FEES ai' Y::;` " CCB Lic.: 1? 22 22 Electrical Lie.: Suprv. Lic.: 33 5 Subtotal Suprv. Electrician signature, required: $t' / Plan review (25% of permit fee) Print name: 5-4 Date: State surcharge (8% of permit fee) l� / //` "'���kkk��� �� j 2 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 \Pemrits\ELC- PermitApp.doc 12103 440- 4615T( /02 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: � �,��m �,�1»�,x� -- emu,. :H�_ �...,.�.�,• � �� -�, ,� ; t��: ° RESYDE W€ ' - � 0:I Ol W :;" •' ' - = : 't':. * :, Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* Heating, Ventilation and Air Conditioning System* Vacuum Systems* E Other: ra-rr�.mw...� , . �,° . >.�x��:., � a,• `"� .�'"E-'�� ;d �; sue" � '` a � �.. -�- 'Wf5IVII�=Wr.: A ff f)_NLi ` .'^ 7 ° j N t . Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is \ Bui lding\Permiu\ELC- PermitApp.doc 04/03 /L/5 To20 - 6 5 -O)o`1 3 . A ® ® ® A V -4 s TREE. TREE CERTIFICATION .. 0. »a I, 5/4 AG -4TE" , Owner%Agent for p„.r. M s,s-r r a,,„,,„„ 5` LGC. ® (PLEASE PRINT) '' (PERMIT HOLDER) 0. a ■ of - > a., ^ ' � . '-h. .: • .,: `; ° _ q k e Do hereby;cettii th t .e` following location m eets J gam" ® � 0 igard /�'1`ash°%n -gton County l and use and development standards for street tree installation. 1 ADDRESS: l 5235 $w 6k6E ✓F / =6 0/2 _ ® LOT: '7 SUBDIVISION: 5v km wi i I- o 1 1 BY: / DATE g,;,, - O ® i Rt. of. 4 ® RECEIVED BY: DATE: 0,/ ,,c-- .. .. A VVVV 'VVVVVVVVVV VVVVV V - VVVVVVVVVVVVVVYVV VVVVVVVVVVVVVVVI P - • • CITY OF TIGARD BUILDING DIVISION / ter.... PERMIT #: MST200S-00093 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/218/2005 Phone: (503) 639 -4171 ag4p��Iyii�l� ICI+( Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/31/2005 TIME: 7 :03AM PAGE: 23 SITE ADDRESS: 15235 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 004 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached .OWNER: DON MORISSETTE HOMES, PHONE #: 503"387 -7638 CONTRACTOR: DON MORISSE I 1E COMMUNITIES LLC PHONE #: 503.387.7538 Inspection Request Scheduled For: Date: 8/31/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 014693-01 503-209-4837 N Corrections /Comments/ Instructions: 4; 4 ASS H PARTIAL APPROVAL ❑ CANCEL [l NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: v Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2005 -00093 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2812005 Phone: (503) 639 -4171 " "'�'��ml�l��l� Inspection Requests (24 Hrs.): (503) 639 -4175 :!�� __.. INSPECTION WORKSHEET FOR DATE: 8/30/2006 TIME: 7:11AM PAGE: 90 SITE ADDRESS: 15235 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 004 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached • OWNER: DON MORISSE! I E HOMES, PHONE #: 503.3uu -7538 CONTRACTOR: DON MORIS SE I I E COMMUNITIES LLC PHONE #: 503-387 -7538 Inspection Request Scheduled For: Date: 8130!2006, Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 014574 -04 503.209.4837 N Cor ections /Comments /Instructions: t i � . I -A , ■ n C( N .! -L - ; CAP , r--- ON . .6--- in/A ,ILLS k—e(- -- 1 ' ( p 11 i I tiZgict • PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / Phon #: 503 N � ) 718 - r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00003 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2005 Phone: (503) 639- 4171�uNMypi Inspection Requests (24 Hrs.): (503) 639-4175 ,-41.N. `__1. INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7:11AM PAGE: 91 SITE ADDRESS: 15235 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 004 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503 - 387 -7536 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387- 75.38 Inspection Request Scheduled For: / Date: 8/30/2005 Pour Time: Code # Inspection Description Confirm # Contact # . Message 199 Electrical final 014574 -03 503200 -4837 N Corrections /Comments /Instructions: 4 PASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS ❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED I l q - ' Inspector: p �� f Date: - ' � '" � Ins Phone #: (503) 718-