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Permit CITY T I G A R D MASTER PERMIT PERMIT #: MST2005 -00040 111 DEVELOPMENT SERVICES DATE ISSUED: 3/16/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -SR028 SITE ADDRESS: 15284 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 028 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: DM192 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 2,020 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,630 sf GARAGE: 616 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: 5 VALUE: 357,906.00 OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 3,650 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 6 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: 5 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 FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 7 201 - 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: 0TH: 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 COMMUNITIES LL DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in 4230 GALEWOOD STE 100 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 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 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: $ 9,125.20 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils Issued B Permittee Signature : c 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. r • Building P ermit'AppliCa• pli�°�.J IVED 'Flt FICC USE ONLY I I �°' Received City of Tigard DateB i /04470 10117110 Permit No.: 4� / r41 0 13125.SW - Hall Blvd., Tigard, OR 97223 i A Plan Review ,. Phone: 503.639.4171 Fax: 503.598.1960 FEB C /r''� ' `i{'� +I� DateBy: — �O — 0S (rl Other Permit:M� '_. )0 43 Inspection Line: 503.639.4175 r Date Ready /By: Juris: 13 See Attached Checklist for Internet: www.ci.tigard.or.us CITY F T " —"� Notified/Method: Supplemental Information BUILDIONG DIVISION ' rev- ,., t ...... ..... .... .... {. ,x:?..,,,s4,... a:.'!,, :.,.:r._�.; <,1,. - .:.Q• x :`4`: '•` Y .� ��� .fi . +,fit,: {i-i �.^�•�. ti +; "n« ,. - .. a .. , > ,rte.. _. _... �:.:: ..: _ �.., .,n- .!: c .l A�, . ,... .> - , -_ ,i.. .:�Y.',^tS "'£a�• o, r, - - `f � t • �. - -w.., ..,, -,. .. k ..,,,. ..., _, ...� a .t,. ,, .e.. .. .i n. ,4:. x �,t: -, ";t: �; :'+:f , ,, , -Y ` a - , ,_ .. -,: _...,a,.. F,., _, _,...,, , E.,,OF . ., ,.ORK< -, _,. . T . =,,, ,_ -.. .fi... , ., • ., -_._ E .. t ^„ < , . _ 7�: �r,"�, .• : � 'RE [jIItED:DATA:i1 AIY .�2 EA1VI =`; • - „-; _ . .....rr.,'3.: .- .l,,f• .naz =, ,a.._., ,.. Lx .v... >r,. ., ..a.�, a�tn.. - ..; txr.. xx. „ �. ,z •x �,f ? ,ax, �.,. rs, - :'Yi= - a: -.. rc r. 3Si. �,:- �-.:? 2. �,:-: �. c:.:.....,. ....:... .... ... ...: ... 1...,,.'k. l4x.., l .,. _,,.. . ..._n t .». rr� .. - P�..___,. s�ia7_ »_..... .....1�DE�.,�Y.:,`.,. -:. a, ._ ....- i, 1 ^ia;.'.ts' : New construction ❑ Demolition Permit fees* are based on the value y 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 - - -- - r: s=” s i':r::•Jl:,i7:,: � : , , , x :: € - - u se -`: .:;a° {•� � rasa:, - :� ;- work indicated on this application. .;� °> w ,s �sGATEGORj� OF'.CONSTRL�IC r..,t� • .� >�, h',:s =,; , ,:'.a`,.,.,,:� =wi = .,�,z.;,: _ "� ?�� t.C�9 - %SA. - nt�r ^ - N'c { . i.., .,ky ,:� �,,. � i - .Y,v., �`la � ^. X , .tN": ..��- .i3.'Sll.�+h;i:::14'.' ;:Y. t ,.. �....,....r ,_ , ...,: §;:..,.� ,.� ='f'i :.'� ,.. ':' T�tii:'fryi::,:l:"'.c.xy:.. -. �v3i:° v_ ,s..,..x,- .,- ....,.., -e. _:f. v •.`:. ,.,:.; ' Valuation: $ 3 , a? ..sO ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- farriil Y Number of bedrooms: `l • • ❑ Master builder ❑Other: Number of bathrooms: J t J oD - ,'.a-: 'a,, i+, +_si?:'o::; Cn; -`. ±,;.s,rb:v 'ikY� u: &.Ai(''.u,:.':•, r.� ; +v. :.;f:'Y:'7.slr�i:si e „r': "•E ;i , .wi"ii , ^ fi:; , 'y7':. °:a�z ..{)�,` *g .x _ - zP. . r''` 7..rw:, ,f of ,, 4 '�"� fl -Y•`` Total number of floors: ”' , . ;i = : 1 1 1`x ; i; . u, : .; t F„,�.,, o ::n;d ie . ; ,4.- ;:;=. , -,:-. 4 , xw i iSTId I FORIVIATIO ::.yA l .: C•ATIQ u, r <0+ <' t ,, ,rl �;S i... «3,,•- "t�,:<. Ala'- :t,,, , • N�dt°:v ;, :•., f,i > .° : � .',;' t.. , ,s tt ,t: . >.,x`''. �.; {.�4:t ;. �.,: a:> �+ �-,, w_. �a, �;` ns �xa.,.,...., xRra�.. � „ uR.�.f��, . m�st:_.......zn13:, ass: r>r:, x, �._�a " �a_;,`a!z�..,.s,x,.t- ,, � . - _, Job site address: l' � a-t_i 5(..A... C�j ce e 1� �� �(' New dwelling area: c . C) square feet City /State /ZIP:. 5 t - ��������� ---��+ Garage /carport area: i c Q J square feet Suite/bldg. /apt. no.: Project name: - " - i Covered porch area: square feet Cross street/directions to job site: d Deck area: square feet Other structure area: square feet . ,- ut;;it?,w4e.�'7V , .:'?a v4 1 . - \r •„ srra:^"xiy ' +' -'ll'l tt 51. ,�...., {3R :., "l IREQVIRFs I0ATATt01VI1y7ERCIAI"I,- .1. ` ri i4Aa,-.-'..a,.°'vms`r`13tf:1�' - 4�Kgt4 -1,: ,.z."n ^ ..ol io, ir,' i•- i' 4,• c,:.`, oYl ,Kf w,ei- 1.f-1t*,i=0..i (:'V Subdivision: `�1rn t (�Ae\ Lot no.: a 8 - Permit fees* are based on the value of the work performed, v Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no,: equipment, materials, labor, overhead, and the profit for the ,, M'fi?tfi;;.- ;'r`,;:n",:, y.;3n;.q.4".r +n". I,K:':a:tk;t�u v!" -1 ;; ifA.s .;t ���' "';` -, ;` , -,.' : .�„ �' work indicated on this application. ~":ii;�`> I;,,u - _ �'��;,, D'E.�'CR'IPTION „AF'WORIC.z _':.t.. {.s's`;;i:t'- :k;-r::'�• ;�:: ;'�.,. ,,, ;.�,�. 1, mss. =:z „^ ,�s , PP Valuation: $ • Existing building area: square feet . New building area: square feet � t ai •., r. ,,'''' 6 1-; al:'..:: „,zz; .M;kvc(i `.a i,�Si! a "sY,:'ti ”: °+ , k ;q let,l , kl,. r-s :- t, Kr , ;'q,':,. � v;7_i'{ "u;;:lia att `y,'?.�r , s N: t x• ! x t 3 7 : €' �, q / .'i }`w,.,, ,. ;,y, .ir< }, ,i`.�;;'`:;;�:��.., ..r,._.., , X%, a �'`� ,t,.,:,.,,, �.. • ,�' x..,ai,,- a?�'t� � T� NAIVT rv�• � _• � •� >, ^ Number of stories: ,Yx,,,rr -,�_ _ - .,�v.��,m,��; _�d�... -,,,,. _K,3 .,,.,7na�� ;t u,��.�__:.. +.a:.,, -- s +r4 ....:- �- v ast , °az�i {:� rih<:�'z >4�3 ➢�;� Name: 'vtU!r 4 `aF GC1 m mu 0 ti 1 _L ,Q) Type of construction: / Address: '" f� 'f'P�..�� �(, � GT. Gj (� y �,� Occupancy groups: City /State /ZIP: 1 .6 e (lk -3 C + 1 17 / 0 3.E7 Existing: Phone: t te l� / ' �� Fax: ( . ,5) � 7 7 CA [ S New: -: v,.,, r,;::,:., :o'�- ` "".r=:ct %i= ,;; {� �; ^.or: �.a." ,� ? � a ,. } ,: o-rrk;r - :e. n_i . .,� s -, t'•ti:: ;\ `,'i °.;.: 7:L*� tu - _ I;s t;." >,�£ q,:\: ^ q r-v:� P L CA 1V . , 1 ,. la N T . R s .. t..,..,,,. t,, .,.,,, ..,., s. ..s m ..., n .A -, t'i..,,t•_ ;;, _> "•it.'•" YS•, -0t +1;, , si :.niA :: t` 7 {: " `;# h �„ Y;• �y i it » ''d;E:'i- i.�i:?"�va+. , � "> .,,. ;`• ';r:�....`h' , - -- . m'fx }..,= Business name: GJ f-1. ? 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: rrF y 'l1+ j :�,f } ` `;GON� RAG'I?O Business name: ' ame: c r,i.::•, ,;; ,;; >,,��,:,.:•;;:�_:s.. :::�:: 1���Gr('/ u ri ABUIli I1V�' PE '.. a?`, -,,, Address: ;=,�, ,::4, ray` 1';.- ‘����, ,. ;. �, , ^�,a':,�,�;c.t_,;,�:-;. . .,:,. ;ak-�.,- ,- •�',-,',�s °''.,... Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) CCB tic.: Amount received � Date received: Authorized signature: � ff . 1 � / , , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: A( T )C�,, Date: 9I61 I OG) * Fee methodology set by Tri -County Building Industry Service Board. • i:\ Building \Pet mils \BUP- PermitApp,doc 12/03 440-46 13T( I I /02 /COM /WEB) r t Plumbing Permit Applicat tEN ' FOR O FFICE USE ONLY • ' City of Tigard Received ,, DDate/By: - y: Pemut No.: fST600 0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 E� i , e tiM1lt I,' 1 ' Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 [i ik!J' 'r_! W Date Ready /By: 3uris: See Page 2 for Internet: www.ci.tigard.or.us _.q\( Or 1� 'i 0 Notified/Method: Supplemental Information .r:,.- -,�,�w•:. �•e .,..:�, ,,. t_.p:'.`r,.-, glal.i/,< �ni�'i-t, .t,. - ,tp ^.€ _ �s s + - ,..x .._r . a ... „ - x s (YC to , �::s!`va. fp -; -,.. .,,. .. �...rk ..... ... .... _ .....,.+ �.. ,......._ -,., .. .... ..:...�. ` �....+.,.. ... -___,_ .._.. t-. ._ F_ r, -.,: 3,. <.k,.,.. ,,. ..,t:,., � ., -., r .. . -.. ;�i "r.? .a ._. .;-r i,_- +rx ..::x �.. . -.. ,_. . - -, c.. ... - , -_. I�New construction ❑ Demolition For special information use checklist. Y Description Qty. I Ea. Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) h ,. , m raj ,• t .:: '.;, @AT'EGOR. ..O ._C,ONSt UC . -s,'.� SFR bath ,�'`: ,��. ,.t:t., ] () 249 20 ❑ I - 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: au;:( ¢.are >:n _ :, rrre,..., t - Fire sprinkler ( sq. ft.) Page 2 13 INFORIVIATION':;AN'D LOC "ATION,« •:'%, ,.f:£ `i: '-." 3 -•:. ( "•. . <.x! . G.,' I;. �,:,, i! in ,.;1r .. .... .. . ....9 ',.....�,.. ,":�iS . .. .,,,. ., ,, a _.,.. ., ..._ -, . -, -i ... a- ,....- _:� .�.:..�, S ite utilities Job site address: i,DQ'L 7 ..., L) ,.. e ire n � P i d C- Catch basin or area drain 16.60 City /State /ZIP: T�o . c\ 1 c) , v 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: Se m,n,-) L �,�ciQ , I Lot no.: a Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item ::.+ r,.t: +,:;a ,:y,;,:: ;x.: ,. <._ , +,,:;u „tt a, x' - y : „'., ; , Absorption valve 16.60 p� ;. & ;:,. z :. /�3n,r7z'•:e;i•:.i +'o - `� . h� 4.f V � xr`:. �,K�/,`• ",f: ^. s W ^. ,. D;E3CDt ,T"ION ,,-,,, =,WORK iel., ;,:,,_.,, �,.,,ivt , i v::rt rnti:;, ..:i ,/y ..� +' .. ±._ ">� -/.. s .,.t^ a`,':t'!tf' . , t p•r'v. <.d:, tSj ,3y ^i �. , . ,.,,, ,,, .,u., ��� -,. �.., ..rs "r,,..,,.. ,.,.._,,.., . -,.., x .,�,,;,�•:.. _.: _a,..��, :;3.3. >... <. �ta: i� ;r��•:.,...� :.>:,��°,s,:•...,. Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 w < :ar, x ;'t : {,i,a ".� i+ t ;ia {e - ; ktrutrs�irf- rn' ki Drinking fountain 16.60 „�'', - :'.r "ri'' '. _ „xz ..i, ¢ ,. : t`�? ; .:'i'N. £. , , + »�{i"� - �i9 ° ` .�a. A +• ..- :.ai.�t ?i•,;{'F,'S g F,RTl'" 04 k, +;;� a .. < TENANT + >..,- J >;,,_�.:�. u ^•z:..,;t,:aFt . •t;.,..;:,.... Ejectors /sum 16.60 � � t�n ,�r,?yA'3 � ;,.�&.,y,�;�L4o $ in: ?: �. is�a }�ti7aa�ra� "m. .... 7 -, k :Name 1, 1' t/JV-' 4 s `r Mart t• ) (, L ( J n i 7 [ I , G a � Expansion tank ] 6.60 Address: �� t � � ej , l��(� ' 1 c.J iL- I Fixture /sewer cap 16.60 City/State /ZIP: . away� C /I, ')) J Floor drain /floor sink/hub 16.60 Phone:.) $•7 •7 0 Fax: ( 1}y ' 7 7 a ( s Garbage disposal 16.60 t;r;+ c:. ,„ _:.,, ,a-q, - ,a v , na:, : *tv ° v ter >•r ._ r,:.ya:r� :: :. c,a. i;:.,: , t . Hose bib 16.60 . ❑ �' :3'i ' `i, vv =, s ;t�r.�t;.,�.i t , :i:t+- �f'd;5,.t•. - _.,is:,:� . . P1LI�AN {„ .,, ::>. _ „C{ =G0 1',1`AC I ; >:,t' -', +..� ,._ ..n...,_ _e:'4',•�'+* °.Mm'2.u��'{.' e. t� .. '', [5 r =as3'3 �� .< ,.. e..ro..Y:' e.: e....S S,� ,.. _;,,r.:'.;lA':t .�. :iby:',+ „ib „_,.N,rk 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: Urinal 16.60 .:nV -r. "Wi"'•. TT ;: \. - - - q�t�" �'i i l .t'ti.: M1•:se'4a'$a'�v1 i:`�.' �� w< ,4 e »" - Water closet 16.60 ., . ,� - _. - , .- . ...L. -.n ' ,5 -.- ?�Y„•z:is - -.. -,. n., ..4,,.a•t- ::f•t'- cC:� -.a. .9u.. _.�F h�:,��'`v,.....r , Business name t� ` r Water heater 16.60 Address: O 6a G�L1/ Other: City /State /ZIP: , 4 C ' Phone: o Subtotal 5) - � 6 r r ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Minimum permit fee: $36.25 / 1.11 n Fax: ( -ry ^lnmbin Lic. no.: I / g 2 ���� Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature' t ■-• l TOTAL PERMIT FEE Print name: ,•_3 l J t 1\ Date: a ici1 OS 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 12/03 440.461 6T( I 0 /02 /COM /WEB) Electrical Permit A tT 11 : . ; ' ' - FOR OFFICEVSE ONLY "---t - ---,- City of Tigard Date/By: ` Received � / / .2---S- y� � permitNo.: d r � I U � c ' O 13125 SW Hall Blvd., Tigard, OR 97223 pR ®® R PPlanReview, e'."; S` r � 4U f ld P— Phone: 503.639.4171 Fax: 503.598.196C 57 ��� ' ✓N � i Date/By: Other Permit: Inspection Line: 503.639.4175 [ 7 t!'L Date Ready/13y: Juris: El See Page 2 for Internet: www.ci.tigard.or.us (_1 -. ' p g� Notified/Method: Supplemental Information Bull pit* , . , A ., /t ., ; 19 r PLAN REVIEW [' New construction • ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'l ❑Hazardous location ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential TX 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ID System over 600 volts nominal units in one structure ❑ Multi family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more CI Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park .Y ❑Health - care facility ❑ Other: Job no.: j i Job site address: a H .y � T ,1.1. v' fl i, 2.JI fir / Submit 2 sets of plans with any of the above. City /State /ZIP: - 7 s t The above are not applicable to temporary construction service. 7 22 Suite/bldg. /apt. no.: Project name: _ FEE* SCHEDULE ** l�r- ^ i . a r 'F" , - Description Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. • 1,000 sq. ft. or less 145.15 4 Subdivision: . Lotno.: Ea. add'l 500 sq. ft. or portion 33.40 1 ----' 9ti °3Al i J!, r Tax map /parcel no.: r Limited energy, residential 75:00 2 . Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular I °° • dwelling, service and/or feeder 90.90 2 ,�'3�xd d" � :i'— 2/ 1 � 5'�L . Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 - - 401 amps to 600 amps 160.60 2 Name: �. i t y , v ,_ �_ J L �7 d , y"A 601 amps to 1,000 amps 240.60 2 Address: * 2 �, �r� '. -�� - Over 1,000 amps or volts 454.65 2 " P > ° '°l i n $ ` l °^ d - ' s , k) 1::,. i Reconnect only 66.85 2 City /State /ZIP: 1_-,4--/-i c5' Temporary services or feeders installation, alteration, and /or Phone: -76 relocation (- 2 j `� ,, -7 - . Fax: (S, �) ` )+ ) _5 Y - 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 ❑ APPLICANT ❑ CONTACT PERSON . A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feedet fee, each branch circuit 46.85 2 Address: 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 - CONTRACTOR energy panel, alteration, or • extension. Describe: Page 2 2 Business name: _- I L a, ,) s / Address: . , Each additional inspection over allowable in any of the above ,� ' Per inspection 62.50 City/State /ZIP: s i E - 7 .0 4 4 Jim (3 7 7 Investigation per hour (1 hr min) 62.50 ' --- Industrial plant per hour 73.75 Phone: (5e,3) ,: .� (., y - - - Fax: (54a )) 6.„.9.. 6.„.9.. e . �Z./:1 ELECTRICAL PERMIT FEES* CCB Lic.: !_ ry Electrical Lic.:" �' > _ 2 /- ? 2/ _ �, � ., (r Su rv, , 1c.: � e � 173 � --� Subtotal Suprv. Electrician signature, required: a ,'r 4 y .+ Plan review (25% of permit fee) Print name: f Date: State surcharge (8 /o of permit fee) v 1 ' T i - ' i ' " lt '` / � � � 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 \Perrnits\ELC- PermitApp.doc 12/03 - 440- 46t5T(10 /02 /COM/WEB Mechanical Permit Application ! ' ..FOR OFFICE US ONLY City of Tigard Received Date/By: Permit No. Ire pry) i/Y * 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review (/ Phone: 503.639.4171 Fax: 503.598.1960 /e Au/P4.1 +I t +t\ Date/By: Other Permit: r °• ,� p�M Y� Inspection Line: 503.639.4175 . q j j Internet: www.ci.tigard.or.us 1 - dfe� R eady /By: Juris: Supplemental See Page 2 for g u 'Noti etltod: Supplemental Information na:- E "OF •:' x WORT{, ,�� , `�:s `r = =� 1VI'MEIt E.,:SGT , " Ei= , 'iJSE i , �HE; s � c .� _.. t ;: -� . , � r -� �.,. - .:.' . - . - ,., . %` F IJL C CICLISTx - ,t�_ v hs Yt::,�:' r ,.. _ « � .. • ,,:. -.5, l.- : 3ti f.» 5* s = t• :.; - ` � . ., :' =1 <lf titer._. ".4 "l�'�_.v�e�L�(•- New construction ❑ Addition / alteration /replaac' e ieh 7 IGA Mechani permit fees* are base on the value of the work BUILDING RD performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: G D mechanical materials, equipment, labor, overhead, and profit. . .U"3.T'.t xet i�y+,: - I:YS: l"i+l.� :;h,: :nSit.l;_ - - ° ".>'`k i,i ;'s Ilr'- ;4E;:Stii "'r. , Value $ .ix -� =:C'ATEGORY::OF::�.CONSTRUCTIO ..T •�a,. 3:G�:' ;::i.�,.<,• �., ... . Y; . _ ..:. .., ,..,` -ae.,k - P:.:..- ..,... .... :: >:f• ,.... sr.. : .<Y:" '' UIPMEN p ?rz:mr ''"'= RESIDENTI` ALEQT '% +SYSTEi6IS<'FEESt,'. `. Q_. ❑ 1- and 2-family dwelling i� Us�.:.:,,.�- .•,_.:.b,;� . �M��...,-.:, �=- �.,,.,.-,_ _,,,:.,u"�s��;�n_.,::�.- �,,�,- ter._- ��.:�- ..:::. y g Commercial /industrial ❑ building For special information use, checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. Total ;, �: 1 :' w,.:''< < <JOB - -,, TE , NEO, TI`O : LO,, ,, ,,ps _:•>: -. _ ,.. ., ., ,..._ : , __.. ,a_:w,: ,., . ,,-, .,. _,<_ e w <! ...,z„ _, ,:� Heating cooling Job site address: i, p� Air conditioning or heat pump �� C� • - + �'� {ee� � p 1 t 'pc (requires site plan showing placement) 14.00 City / State/ZIP: i Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or • hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 t no Flue /vent for •any of above 10.00 Subdivision: UrYl)lYl \ -• d : a < Other: 10.00 Tax map /parcel no.: Other fuel appliances •[, ;d: `'S" .,li. Er' iti -fir" Yi "-'� ".';: _ y3;t :;'" ��� �,,. . ?e; ti k v, a Water heater - �:i� ( - ��'h;! ate 10.00 - -_ SQIZ)p�IpN� ^W� ;�, . a Lx ,- 2>; �a,-m; �Satil�; :. � " <�^`�,tir , . , . r :,_ , ._ _< ...�`i� ad,,., �< ;,,.. ,.r,..zm,....- .. -, s., ,. t 3.._us.,.,s._ „ < „ , . :.,, "1' .c,:. 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 ::- s „, ;_:; :a• ' :E, • i Chimne /liner /flue /vent 10.00 f'PROPERT .,OWNER ?� ::.s:• : ,, -V ®i °=TFi 1 .�N TC , ',W-: r f.P} - a :.: rl ., ti, ' C - v .:4:, ,. , -.._ - n.. @w .,_k �.., -T +.v �..,.,.- i:liGiv.; .,,. :: ., ... ..14 Name: Y ... , .: �:. .�. , >• - _...._,,�N „ u _, , �,,:. <,.y,.�„ r, 4:, ., : Other: 10.00 �! C/ . E� � + � , Lt. �` Environmental exhaust and ventilation Address: 2.- VW ` / ' ) 1 t. , 165 Range hood /other kitchen J ✓" ' lll - -��V// equipment 10.00 City /State /ZIP: " 1 or_ -)Q i Clothes dryer exhaust 10.00 �•- Single -duct exhaust (bathrooms, Phone: `�� 7 : (01 toilt compartments, utility I•ooms) 6.80 fFax:o , r :a`., .w r:2 =.• �,i; �.. s ,.Attic /crawls ace fans 10.00 i `, ® 2,,,,, I TC�SNT rr,�, tr:r,:, ..: t; CON ACT :z ;.»;:; . #z.7. P :F1 � >�'�` 2. „_ tl;•: tt +s< >�Mi..4 -e -=..+ Xn' iilS�m�S_ wr .'.,s.L,�.,f.drlfl:'.ah��?1�.., Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range 1r' s.,l,,t sti . i _ L' . , . , 4 } . :: ;' !;r t41 . -aM :. ; ; .>. ., , k ,. Barbecue Business name: �)) 't�l..al- d, � p%/ r� /" e Clothes dryer (gas) Other: t�.L'l L �/K/L� C X� Address: / 1*,Ef "¢ar.i`r "rc:. :, f ,:: 0 I 1 , -'-; 1VIE. @1iAty "PERiVII +T FEES 0 5 °i 1 1� ^ i ^� / /' �] Subtotal . , : : :.: ., < a;A S ,. , „ -. ..i .n , - i ,, ..ki:.:5' .1v: ?. - ,7- City/State/ZIP: V 1. L 1' ` ` 0 €' q 7( . - " Minimum permit fee ($72.50) Phone: ( j � * L `` Fax: ( ) d 1 Plan review (25% of permit fee) CCB lie.: �. 501 _ State surcharge (8% of permit fee) , TOTAL PERMIT FEE !i� ' 4 Authorized signature: • This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: i' t-C' /a v1 f l( I Date: a /q /0 y- * Fee methodology set by Tri County Building Industry Service Board is \Building \Permits \MEC- PermitApp.doc 12/03 440 - 4617T (I I /02 /COM /WEB) �,{i(��(E/f,� /Zf5 — �9 � ®AA AAAAAAA.. ®AAA,, AAA® AA V[,A ,,, a';A A A A.1 1 1 STREET wfi TR EE CERTIFI dig ;a ® , ' 'S, ® 1 i I, /Ake. r4647e- , O wner /l gent for ad /�n2issGrl. Cc'-w 5 LLC. (PLEASE PRINT) (PERMIT HOLDER) ® `: £` 1 L': _ '', 0. ® Do hereb),:, lgf- E arth fol':biwing location D. meets, y�of ' . and /Wagh!i�:ngton Sounty t;kar!.a'5 x..:.^^ .k ^5i:o*^,: �^nf;:.;':':n: += as= s °.r«:v «v..ti,* l and use and development standards for street tree installation. I ' E ADDRESS: /5 - 2-0 C 6Q CrfCIt/ve cOv LOT: 2-6 SUBDIVISION: £r rte,,,,, ,4 1 BY _ DATE: 6 -. -o S' It- d r 1 RECEIVED BY: - DATE: 4' 2g' °S A ® - VyyyVyyVVVVVVVVVyyyyyy * V VVVy VV VV Vy VVV VN,. CITY OF TIGARC . BUILDING DIVISION PERMIT #: MST2005.00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005 Phone: (503) 639 -4171 / V//NV��gpuu(I' . Inspection Requests (24 Hrs.): (503) 639 -4175 ,,I \ INSPECTION WORKSHEET FOR DATE: 6/2712005 TIME: 7:09AM PAGE: 17, SITE ADDRESS: 15284 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 028 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORI SSE I I E COMMUNITIES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 6/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 010228-01 503- 969 -9707 N Corrections /Comments /Instructions: pp • - .., F 4 r '6..%L L.1...."_-%.-, ' „4--..0- ,7Ci...., PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL (l CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: Date: , Air Phone #: (503) 718 - P CITY OF TIGARD BUILDING DIVISION PERMIT #: T2t� -00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005 Phone: (503) 639 -4171 °'� ��'�Nimy1ii��l�l�li l M Inspection Requests (24 Hrs.): (503) 639 -4175 ��� INSPECTION WORKSHEET FOR DATE: 6/28/2005 TIME: 7:09AM PAGE: 52 SITE ADDRESS: 15284 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 028 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION:' New SF OWNER: DON MORISSEI I E COMMUNITIES LLC, • PHONE #: 503 -387 -7638 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 6/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 010313 -02 503.209-4837 N Corrections /Comments /Instructions: USA ��cS /oi■.( SIR_ C�Z 1 ' I K_c T -- / P C r\ it S +`.I 07 - i= i , 1-L-e --- 1-- i. 2c' Oo /1) LZ_.cZ_ ao®S' -- 06 / S © lam Pcf. te-c o& e-14--d it - Zti - c ^` 61 S -) • • Kc,-: 0 fe.:7 dd-rA 6 2_ l 7 - 05 (tz:i;") .T ,,s / 3- - . s ') .. r-t L C-rtzL. • SS • PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS ❑ FAIL II C ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ 1 " 1 " - Date: 4. 0S Phone #: (503) 718- ` CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/15/2005 Phone: (503) 639 -4171 ::rip N lit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/28/2005 TIME: 7:09AM PAGE: 54 SITE ADDRESS: 15284 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 028 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: 6/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 010313 -01 503-209-4837 N Corrections /Comments /Instructions: - _1‹.6- rci r iAi--- 6- 21 c _(''e -.. (-(____. • f *SS PARTIAL APPROVAL ❑ CANCEL El NO ACCESS ❑ FAIL /A i , LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -�8 'd Inspector: / Date: Phone #: (503) 718 - v