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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00123 .4 1, i , DEVELOPMENT SERVICES DATE ISSUED: 6/21/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -02800 SITE ADDRESS: 15273 SW GREENFIELD DR ZONING: R - SUBDIVISION: SUMMIT RIDGE LOT: 005 JURISDICTION: TIG Project Description: New SF detached. DEMO CREDITS FROM BUP2004 -00260 APPLIED TO THIS PERMIT. BUILDING REISSUE: DM186 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 28 FIRST: 1,527 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,948 sf GARAGE: 640 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 340,692.40 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,475 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 2 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: 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 FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 8 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FCR: 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: PROTECTIVESIGNL: 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 ST 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 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: $ 8,174.36 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : Permittee Signature : a F 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. Buildi Permit Applicatio 1 ` FOR OFFICE USE ONLY R eceived City of Tigard PeradtNo.:HOre90pS��raJ 13125 SW Hall Blvd., Tigard, OR 97223 APR Date/By: I Id lir) g �1\ Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / / +/4 4• i d I I A� Othe rPermit: L� p�� (1NI' Date/By: �B ' S�s C.O�o�S� OM Inspection Line: 503.639.4175 CITy Date Ready /By: .. H See Attached Checklist for Internet: www.ci.tigard.or.us y O Notified/Method: /� ( /36- Supplemental Information � _ UIL,�T�TQ n r GA ) sR a)c, -, w /e) �aAA'� i'Y�" : 'm y ., 4 Jet �' �,"�-.L•. y'bd is +f �{'4..= '`v.w Y'+}� , `,?iN x , > rfir3'u ` .;ek°..: - `x,,,, -- Pa.. re. , , , .-1. 4i7"sO ,, - ;?�' '.. •r . t r -.- ;a =,��� '�; - '�* . .:: "r.�"' - ; ` +�.� _ ;�, t' �"e 3v h .xs A,�N._ ,�k� - ssfxi",r„.. a9.r : sz.;::.a.'z•�s;:,§ +;a :.:�mr: 4 .,a' ' r� :'ti'1?a" ;;T ' , E a FW, r : ; t. s `'° K 0 1- a `,.•. f-r.w t, ,. -: �;,. �. +d. 7 :i . O W��I2K ', n r L - w. RE . ^;. - ..w..f'E•� � +. a :���s� +'.��,� h�w� �,;� ��a h, r ,. �# �3 � �€' ° .st;�, �, �,;, QtJIRED "DATA. lr s A1VD` 2- �AMII,Y� 4 ` ��... i' ��", d;'•151.'�,,..- .?+E�'.�'., ,r...zF..,t�°u C,«�,sts...,.. � ,.�= �d:fi'��.r� i'arL- '31u'ts`.�`i c�c2�^ki3�s.,2tn�€".zS._... .,,._ �'"�fi..ia:. �?�a:ah.. New construction ❑ Demolition Permit fees* are based on the value of the work performed. VVVVVV ��\��\ Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the :41.' ,;;,x„ ; +t +w._ `�. -a: °: 3M�. ��§Y� .:asa:� --z, -- :,r °•'xa.•a:;s: r; mra�, a.:- i ` '- 4'„ .� c.4.;sc °'s;1' work indicated r, i ° ,,;, 4 44fifATEGOR,t r f CONSTRUCTION „ • V , ,4 i :4. Gated on this application. ❑ I - and 2- family dwelling ❑ Commercial /industrial Valuation: $ 33(0 ) 0 i ❑ Accessory building El Multi-family Number of bedrooms: L El Master builder ❑Other: Number of bathrooms: Q ' / * OB, SITE „. INFORMATION,KAND '0CATIO 0 Total number of floors: . , a�,,.. a- °? pax . r a a /a ,az va ,° .� ,. 1. 4 4 :M 1 'VII 't'� t4 Job site address: .- t ' L . i [^ I Dr. New dwelling area: 3L.115 square feet City /State /ZIP: IIty . ` ”" Garage /carport area: 9H O 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 t : ? "xi;�Y A, � `x.:`� .. F::' s !€.T:=:5i'73". 3� +'t ` ?.'i. E - . T S „— „, ! . :� : :: t”: REQUIRED DATA:, MMMER &ITISE A � `�� v 1 fi`.N 41 :£ kOrr C X." !l rt,�'.?'&1M1dw.','"",- '. >'3::1 L{+".Y :',L,,,,,, ttuN1 ':e5'.`:s:A #t t '.CRZ ,,, Subdivision � 1 Y 1 �kuCVQ El 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 5 .. `}K , - „x , equipment, materials, labor, overhead, and the profit for the _;� ::. „ =._ . it l' , r. .. DES'CRIPTIONt.B , t W ®R IC ; ^�° x & 1 tt: work indicated on this application. .a ;,..g��.r,,, r., �,:; c` �.. �a�s+,}.., ��`!=«. r�.,,...: ra: �^ ���s1> �a�, �..^. ��. M. �,..`, �:°.,.,,. k: �' a••.��5,c1 ; ,�6+; p • • Valuation: $ Existing building area: square feet New building area: square feet - .4 *,r .. ��r��aw: �;. �ttr= •�xa �� "F,•�4,�. •�ti=�ur��;�_�h, ...� ; ';.®i PROPERTY,` �u - i ` � -'' F ®TEN+A ll '' 4 Number of stories: L e', x:61 xt7aa44. ,. eA A "k s•: l O ?,.� s31,..r .,,,,i . it ..r e ql N 'me: _ . ` S, .— C On 110-(ES, i J Type of construction: A. dress: �a f � (1 4 / k .y �� Gv`T /°' c5-1 � ^ ` �` �/ Occupancy groups: City /S tate/ZIP: LF � l� /3 ,11,1 ?. i0 , l Ate t O' CJ' Existin g: ^� Phone: (. / �j� /' �1) Fax: ( i3) .3 / -7 . °2(/ AI5 New: t�° :�. ,�.„�;�,�a,��- ��.`,,nt, ; ,.. 1 . . ��1^;�k: :,.� . °�., ..�.sz�r�u±;a„ �:;�aici ^°;a`N�:4�� ,,�;�.:r�'.. i” e ' '.? 3 - APPLICANT'' ` ' ;sl r.., ' 9 �,f' ; ,`�F,^+:fi ® ,u r> w itl t o °a� �.v,« r .wrr;rr�:a,, r ,. - , , t :, . ,�: . ; t, :t 'I: ,. . ,,, _.. - �.. ., 1e -. , , _ ,,. .. . ;, s , . . , ,.CQNTACT xPERSON ,,., - , fir. s ue' , , �_ , <� .. / r {. � ?:�? s, �+• . .a.a�µrs�.,...a.�1�; =�,.,�k.m�• .. s,.+ . .,��.rE"p�r.<,,..�i,,:.�.:�r:, v. �., y��.: ams�t •,r,;�::.�s4•.n:,sa;»..'�., '� • � �V` � M -,Y�., �. .��!r�..,c ak °J� i .,•,Q,�'?�• �: ':'" _• _ -u, ;�._ p., � t E . NS k � a,r� °�.r,4':� r?� ;� r �;, �" �= ���rNzTIC ;Er�r'�- !�?��i�f�;l� >a���rr�;� Business natr e: 5lr �` eiNe All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name. under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /Mate /ZIP: , apply: Phone: ( ) • Fax:: ( ) E -mail: g N,- z''1.€:_'t ';in::�,r,, `:'S.• ,�',:4; ;#z "a ; =`rti-iW ^_:: rs .tilisi`i,V, , �a, ,.; . „d.' ..`°ten.': "ci;;�:>t' � ,i,, ,,,,',.-..t ; yC.OP.ITRA'CTOR. °,.., ., 4.n4N`, P..,P, ;,, , .. � ^<;<: :fir- T�=� "i:� , . ?�,. s�: ��m...,..m,':,:�::�+u.:�,::^ yy£�'���t` ^��; /yy��[ \� � 1 �:',ws.,*.ruY2�:xa §3r. "fix. Business name: 4:5"1-1, � • �i7� .N i r (t L? a4:1°:w.':'4 1 ''""''`k _ 4 .< -l?_ ^.. e� -_ .' . _. - . �+ MOVE �/ t l,74 ' ,t,-;'-'4r). DIN IJI LG • ' PRM FEES * 'k . • a "ft• Address: , i§�e:t :a-3 : �&n E x .s zg.a± .tis?. e: 'S '.. ! r . Please refer to fee schedule. City /State /ZIP: • Fees due upon application Phone: ( ) • Fax: ( ) Amount received CCB lie.: '7. Date received: Authorized signature: - 1, / • / / This permit application expires if a permit is not obtained 1 1 -( — • T T within 180 days after it has been accepted as complete. Print name: Z - Date: ' 05 * Fee methodology set by Tri -County Building Industry Service Board. is \Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11/02/COM /WEB) Plums ing Permit At,' .' .i n FOR OFFICE USE ONLY City of Tigard ' Received VO emrt N t o.: 057-0W DateB - 13 125 SW Hall Blvd., Tigard, OR 97223 Ap , y' P No.: �� \\ Plan Review Phone: 503.639A171 Fax: 503.598.1960 6 100 //rem /rdl,l l � il i Date/By: Other Permit No.: 24- Hour Inspection Line: 503.63 Date ea /B sa ris: r °' t Rd y o Supplemental See Page l Information for Internet: www.ci.tigard.or.us ® �+ 'T'r Notified/Method: Supplemental I - ° � •^'xe +,'*yw.,. °WiLSp • /fi' ;'a 1llw- ..i�.s :f .�¢z �: 'tr- - k:. _ _ x'.ct:.S; '^ _ _ _ �' , �" "�; .x s " „ . � , �{;;�',�` •a'"� -�� �� ] - o- � `f ��" r+',t� �;, r "�,'? ""4n �� �"s axc ,r ;wrrv:,� .cy s;.x, �a a ,5 kaa+'^ - tflari p t °�' r y 4 " ;�` F . . �-„;} ,° "'P,*. ?' +SI ,��:, x.�e,.=^• '',,,°;' ;, �' "?« � 2r � : x . 4, � �.'�h.,,'��'a�.�.'"F'�� � ��,.�, § a�; �,. ���r.: ��; sF E E3CH E D � U LE� 's�"n- ��.°;sx��.�:��.�fi''� �"<.,,h:� ( New construction ❑ cafeliIt For special information use checklist. f Description I Qty. I Ea. I Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) '44:,+ � �'+`� r fia� „��.� �`. ":5��- e�tw:•w,n�s z�, � g"+aa`s�� -:.i�. x�c�,:� s;�w:+��. -- t �,;,a.�4 , ar•. . �e- v..a:p : 47 • ` 424"- ' @ATEGORY O F"1C O NSTRUC TIO O N ` `.:: '�_ .. IN ( ) 249.20 -: , e� ,; " .; e s , . -T E, AU.`4 F1.0:M,,,._ >r,..1, :fi te.,. l.:' .f ,q •',st &-, SFR 1 bath ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: ars,J. ° x F a n,.< Fire sprinkler sq. ft.) Page 2 a ..„ ?, , ineini IN FQRM r ATI O N: A LOCATION i "` ,,' ` ,-„,,, -„k+ - ita„ ,c -. Site utilities Job site address: - 13 a Teen ,ea d ' J Catch basin or area drain 16.60 City /State /ZIP: 1 19 ,,- � n Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footi 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: AV\ A 1't I A�:�Li Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: I \ Fixture or item °Fw ; f s Y . u :. s.; r a b : t 7P r .. x . v . rid: a<. „a.. Absorption valve 16.60 � tik " ;. - ikriit CRIP�PION OF W,O:WV47 0 • spa `, t v t #- _r :a; c .. �� s.r. .,,.��, �M u�,' ���' a� ,* Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 r°=° - l` l gt Drinking fountain 3 fit. ;x�`� �' ? � : �, i � ` '�; * ? �x�,t���,, 16.60 PROPERT _OWNE atu• - 4 -i , t 2• az,:m.;�. . .. ,_.��s ^r -aa.� a � _�' TENANT°`• :. , ""'. - ": ''�-, ' ° ..:..f,= �,k;�;� ,.._'- s,:t�a 1 �� ::�� `��.,,�:��= .��Fla�f,wz��r�i °'"mss .`.Jn >rLq Ejectors /sump 16.60 - Name: C JNA 5t `- '4� W OA' ' Expansion tank 16.60 i Address: d 1 2 ( e_ t L ° Fixture /sewer cap 16.60 City /State /ZIP: ( 3 l .) 04 q Floor drain /floor sink/hub 16.60 Phone: 7) .9)7 7 0 Fax: (a)� � 76 ( Garbage disposal 16.60 ' R; >" 1¢` :5> ^» Y F ut� ^azc t �r :.s m'. z : :, . ; 16.60 m s �� 4® o.tr A4x = w , �* ksv @aime T- �PERSON Hose bi b .r-V4 .._ _ ,„A saa At v � � . Il'a -'z 3 r.... 14 :i .^ ...c.c,. ,a 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: i A a" ; h . , .r.,:t ,-.m�ae >>: ;r .� y f l - ;, s: � , Y .: °,; . te •. , Urinal 16.60 .ti ; 0.1 . 1 { ,g s SS NT RACtT®R � " � s p x r a -_,, � .,�.. - , s _ �� � -i �',0 , IW -sty - , � Water closet 16.60 Business name: V Y i 1 �(\ • &-. �� Water heater 16.60 Address: l/0 ' �� ' " ✓\ Other: City /State /ZIP: x t,e_e Subtotal ��- r ( - Minimum permit fee: $72.50 Phone: 6)(1 - j.._ j 3 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: �'1 / v ^lambing Lic. no.: ' -- i U j Plan review (25% of permit fee) Authorized signature j State surcharge (8% of permit fee) _AP- PERMIT FEE bf. Print name: J pH 3 1 1 I. Date: L-/6105 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 12/03 440-46! 6T( I 0 /02 /COM /WEB) . .. HEC i -- Electrical Permit Application _ FOR OFFICE JSE ONLY_ Supplemental Information City of Tigard Da ` te / By / qP teBy: Permit No.:� — 0-05_66/ 6 2, 13125 SW Hall Blvd., Tigard, OR 97223 �' Plan Review r r^ Phone: 503.639.4171 Fax: 503.598.1960 Q / /gs'dl� ( ' il \ 0� DateBy: Other Permit. Inspection Line: 503.639.4175 1 A Dat Ready/By: Juris: _ 0 See Page 2 for Internet: www.ci.tigard.or.us 'auk Notified/Method: .. .., ; .. .� = - .,�...- Y .r-.. :: s� s3, `2'i<4N�. �':karrr,rYY. N 2 W A Notif r�,N•,1 . ;3,a_ . �,'r'y�'+.:?>, ., ; �...,�r�. s,;.. ='��i•�, >',��'. :���+;�a yst:J?�'�}� — '-+`z.;b'�i ._ �>'~!^t "t:l � 'fl p�'a:' r;c�: =� - - }ti -. ,. v;. ._„�. i .,TYP -V, e ;s ; .:,.LJ%. T:0 ` ., .,�' , t'""t'�...'"`-� x ` "�'„ , U , - i �-,. �,.�:� ,., S �'.c � ;t' 7 ,: ti ;, ' j,' � �;•.. °. - �Y / E, OF WORK n:�,,,:. • ` � .+ a� -�� � .,��;''�ttrz�;P,LAN,,.R EV3EW ... ,u �:,'t ° -�_., ` � "� .. ... ........ � �:' � e..... t , '' �, •,- ��, , .s..- .��w_�..;,�.,, = ��.�s"`°`�',s�r���' .,.fir _ �. p; �.s:�t�.,,.�,�,r ��sa��' °�'��� „.-� ��,::� <:H:,.• New construction El Addition/alteration/replacement vl V Please check all that apply: El Demolition ID Other: ❑Service over 225 amps, comm'l ❑Hazardous location ° ":xat =M ary.,, J ., -,;. ;K; : »rte kQ:,v s, yam.:, °'x ” ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., r . h.. . W;;. E � , •* VCATEGdktcofret1 ftriI TIONl � trfrR of 1- 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 - ,, , builder �.k, ', . ,u. , ti , � may„ a ❑ Occupant load over 99 persons ❑Manufactured structures or ,.. , `:17111 SITE- INFORMtATIO1V AND' I CA�T�I®N "may` 7 7 `'` �k " _ ?i RV ~`�:.._ � - Ili.- :�� •;r.�.�e�, . �r�,� 4�� ,�s���� �_ >.,��x� k.�� »" ,�.�p.r_ ?���'��.;�.�'�,�;�`�? ['Egress/lighting plan park Job no.: 35 Job site address: i ► EHealth-care facility ['Other: A a II .All Submit 2 sets of plans with any of the above. City /State /ZIP: `"�"I�J� The above are not applicable to temporary construction service. Suite /bldg. /apt. no.: Project name: t 'I'` ;FEE SCFIORI F r ;~ x 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: 0M q t 1� Lot no.: 5 Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: t V 1 Limited energy, residential 75.00 2 b mar ";; �.r= '' =aaf�t >° r ; Jt � u �,;.. P.ed;�' �� ;•, .. s,.�,,:.�.,,�..� . , q",rJr'"��� � �°` ;�'�; � t `;s. �,;���. r Limited energy, non - residential 75.00 2 ,.; , t4, f�` ' � DESCRIPEtRtloF, WORK° ,.."t.. , nafta� -. g , €_ 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 iwtri? -,^?r : , ` a. - u: --- -F;,- ,,n - it=e ms >a .: to : tl ..,- >'...: ; ` 45. g- :,, a pl i , .;,..x a ; it 201 amps to 400 amps , il r t - a ;,,, P TENaA EL— ;� 106.85 2 P P ` V : -;ra ,. - ,.� m� .�. ,u�r 3 401 am to 600 amps 160.60 2 Name: \ 1 f �� $ ' * • , 10 " 601 amps to 1,000 amps 240.60 2 Address: —W 7 - > t� Over 1,000 amps or volts 454.65 2 f Reconnect only 66.85 2 City /State /ZIP: 1,ad 0`� V /�) I 0/ '70 z Temporary services or feeders installation, alteration, and /or . Phone: ) '--- Fax: )3)'j' — 2 — "Ao'IS- 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 re , ;#a"in' a. : w• . p; xg I . �f,,;a g ar se €, , ^ „ °'t*,n x4T ` %1 + 4 Vt, A - , '�.- _<a .. i ,' it- . . «r,: a en »-. : r x: sr,, �xi a , ' APPLI CANT t t it p i , t o ® $�GON ACT i PERS �- 6 � 5 A. Fee for branch circuits with 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: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - i w Aa VE w :x S CONI RA TOR 1 ; ; q?s; ? ' VRIMI t.., AV energy Panel, alteration, or extension. Describe: Page 2 Business name: (`� �� Address: mop - v L4.rV I �LW V v 4 — -7 Each additional inspection over allowable in any of the above 2 1 1 ' Per inspection 62.50 City /State /ZIP: 1 G ) (Nr Cr- 7 J g -3 Investigation per hour (1 hr min) 62.50 Phone: Z.-I K yl t [" Industrial plant per hour 73.75 (( ff"" �� Fax: ( t u `1 _iSSVE CTRIC'AL'.iPERMIT IF..._-...* .f ;: : CCB Lic.: y0,_ Electrical Lic.� Suprv. Lic.: � Subtotal Suprv. Electrician signature, required: J Plan review (25% of permit fee) Print name: ' A" ��G'1 I Date: / c/ iO State surcharge (8% of permit fee) �t �t � I 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 \Pei mils \ELC- PermitApp.doc 12/03 440- 4615T( l0 /02 /COM /WEB Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard F es ) E C E vki F V:: Received G Date/By: Permit No #7;200.5 -O0 I,;2 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 //aayrd t Date/By: Other Permit: 6 �'dP �U� I '� y� Inspection Line: 503.639.4175 APR 6 �' 5•' I I Date Read /B kris: Internet: www.ci.tigard.or.us c " �` Ready /By: Supplemental See Page 2 for g NNotified/Method: Supplementt al Information • a :,�k;, ...'.'�,.., °`.. -c,; - ��; }i; ° �'xs - ;;5, �a - >��•'"�"�" +� ' �:. R" s;.s. nary: w: s�- �.�.;w�aee:;�,:x!xass,. n- , >..ue.�:: •.,c��,x -_x �� ' k' 5 : Cil ? " Y ' ' .:r' ; ri�:i;s x' �5 , -. i 111 0 " mot' 4® � r ` ` _' _ �*, ' .. . s l VP " .r a * - t ' 4 7' � �... �• < :�r. _�;�, �^s��;.r,:�',.,,,,- ��a��� �+ }�:.u._�; - °' ,:� � �.� ''�������(� ® MIVIERGIAL�4FEEv��aCHEDULE ; " ,�USECHCICliIST.�+ ,. e ti cr•�, ` mss' • - '�4(� �)�..� ' arw'' i - d�,a�?5 }a- �a Fig.• ?( � •,i *mz�u. s,. ra :..h- - #a • 4w. .rexi��e� >rx< ,� New construction ti I 1V 7f � f I d Mechanical permit fees* are based on the value of the work / /J���JJJ������` ❑ Ad�i 0 1alYLsrat on ep ace ei3f performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. "` -' ` - < "} ;i:L?'`.> '� -- ,"�'y -z `- > :::+.e.`nr,:+;. : - +.�ar.�,.:a;:�; AOS�� aram.;'vzsM:.arnr::�. <:.vw"fs::,. y ai^- w ,�.• Value: $ .,, M� , gig CATEGORY P1r.0NSTRUCtI I®N , , a , n : , _.,, ,.. v _ , - :: :,_ : s... . �. u� . iii : 19 • RES D NTIAL E : UMENT = =/ Sl'STEMSAFEES *" '`. � ,rtF�Q 1P ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total j ,;73.:e �ac'c�t•. 4 @ � r3 �' ` " w eirs.: a xx.: a- F :- i �a..: � , �a. �. sa e,;�_xa xz,:rr. �zsr.:a: � � � ; a u Y�au: ra _..wn,' w :»;�w ..��,nv ., ;,� �se�?s" .,r`�. - : x -kr41.114-1 r467,'� 3 i ' ,, a , � ' r 4. J OB SIT AN , �, ,_ , Heating/cooling Job site address: , - ‘5'' _„ / i. • Air conditioning or heat pump - _ e , J � _ (requires site plan showing placement) 14.00 City /State/ZIP: I I _ P Furnace 100,000 BTU (ducts /vents) 14.00 os. Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: I Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: , n n A4Lot no.: Flue /vent for any of above 10.00 w Other: 10.00 Tax map /parcel no.: Other fuel appliances #R= :'t etgra lox'"' "': ;a ;,riyta',::T;r'='.< , .r - •s,;:r.' :.,:•,-r� „s ,:,e :.` ' } . t p'.,:,t'> twn. r V' - , DESG^ OF4ORIC a C OVE FA Water heater 10.00 , _ �. 'A S 4:.,c. fs - n,0_,,.,,,,,,c:.. 'z ,. a +. _ via ss�-,,N i3» 't ;u.• h Ava 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 ��t?`, �i';,� } -�^�� - �s ,,�`'�,`� €f:r t .�� � ���� � .:,�« � ,� .:�1x;� Chimney /liner /flue /vent 10.00 a� A \ t-,' -P It '-M1 ' '1 ® r � 119 s ip . _ �� :: >nr�� (�'-��y� k� .�e Other: 10.00 _ Name: .\ / / `..t✓c Y iS.V \O \. ��� Environmental exhaust and ventilation Address: ' ;:; ' , L (� Range hood /other kitchen �.' L " "-' 1 equipment 10.00 City / State/ZIP: . % 1 9' 4 7Q -S Clothes dryer exhaust 10.00 e. Single-duct exhaust (bathrooms, Phone: _ Fax: (� - t �.� toilet compartments, utility rooms) 6.80 • �� i T R, `� ,:wry � y,:f # _ t ii ix r : ; i ,>a " wric .-, .r x, ,.,, : ; ,5. Ise Attic /crawls ace fans 1 . ., W �,; ®, ".,, , 4 `; j -41 ® CONTrA P RS;ON� P 0 00 . a.�e,_:�,�.f'�; ::SI � . �ti� _��•,,a> nt4s'f��4 Business name: Other: 10.00 Fuel piping . Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater E -mail: Fireplace Range - j ` " +. I ' ,, , • r ,� ..: T fi t. r a. » -:.: -. �.*"^.5, , r ' ::r*.-+t+,�^+ �'�a, - '4 :. . ,- ., w " : ` e O N X 4 RAC •. T: . \45. "AU j a Barbecue Business name: Clothes dryer (gas) ��/ Other: n n I ` rte .: a:..,r .0 ,. ,'_, : ' . :,:_, .$� >_ >.. Address: � �'�k n � " `;,'., , , 'StE i1GIECH ii FE •W ' ; ' �" fi ' r.,:w,,,, c,�. +' - zrn•r, ,: .,,,.,,,,,, . r'k,S i= ;:•,. City/State /ZIP: \Ny �y\..V\ • 6 1 - - 2LolllJ / Subtotal Minimum permit fee ($72.50) Phone: ( 5 3 ,-. "� I 1 Fax: ( ) Plan review (25% of permit fee) CCB lic.: . �. )V © State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: ,L�ir This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ' R �° L_� Print name: ,t/ /� d - Oaf NA I Date: / 0 C � * Fee methodology set by Tri- County Building Industry Service Board is \Building \ Permits \MEC- PermitApp.doc 12/03 440 -4617T (I 1 /02 /COM /WEB) . ® // 7g00.5 5 - 0"0/ ,g3 N ®AAAA EE AAAAAA® �t� AAA ;f6 AAAAAAAAAAA A.fRLd: A AA 9A :'2!�. A V 0. A STREET EE CERTIFICATION .. ... ®. A id / r v r: i } I, e 4-k,E 4 -T „Owner/ Owner /A gent for do/ti . /�'7i�r j S'S -en i4-7m gin -4,s L R. (PLEASE PRINT) � . ,, , (PERMIT HOLDER) Do y ° th .he fol .owing location m eets i:t ' igar ` � I d /�Vaslintori County .w ^: land use and development standards for street tree installation. 1 ® nn ADDRESS: i 5' 2 73 51,..-i GYeef) 6 dli 9/1� , 1 LOT: SUBDIVISION: .,5k r r >` L /'� /'7� e 1 BY: ",......._____, D ATE: AO - GB -b 5- 1 v RECEIVED BY: �� � DATE: ' 6 v/p R., V vv-vvyirry yvvyyvvvyy VVVVVVVVVVVVVVVVVVV YYy Y Y CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ■ INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: SITE ADDRESS: 15273 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 005 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached. DEMO CREDITS FROM BUP2004-00260 APPLIED TO THIS PERMIT. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 603-387-7638 CONTRACTOR: DON MORISSE, JE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 10/1812005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 vlechanical final 018637-03 503-209-4837 Corrections/Comments/Instructions: 01 fl PARTIAL APPROVAL El CANCEL NO ACCESS n FAIL pi CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: Date: cT1 lone #: (503) 718- Cg, Y OF TIGARD EIFILDING DIVISION PERMIT #: MST2005.00129 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639-4171 i tifilliAlic' Inspecion Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/18/2005 TIME: 7:10AM PAGE: 4 SITE ADDRESS: 15273 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 005 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached. DEMO CREDITS FROM 8UP2004-00260 APPLIED TO THIS PERMIT. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 10/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 19.i Electrical final 018637-01 503-204837 N Corrections/Comments/Instructions: 1/ 1 . . -,---, \ c\N1NK\/ W\y\V RoK,LA \ N 14 Htkov-i_ (itYp c\PIPs: .-API--VW --- 'Ro , .al \ ‘01 ..\ PASS fl PARTIAL APPROVAL 0 CANCEL fl NO ACCESS fl FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: afi A, , i ,...... - .. —.........4 Date: I Phone #: (503) 718- ) , • CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 I Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 110 SITE ADDRESS: 15273 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 005 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached. DEMO CREDITS FROM BUP2004-00260 APPLIED TO THIS PERMIT. OWNER: DON MORISSE I I E COMMUNITIES LLC. PHONE #: 503-387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 10/20/2005 • Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 018750-02 503-209-4837 Corrections/Comments/Instructions: 0 I., r(-- t1/4 i /./ A//q-( pi PASS j ARTIAL APPROVAL 17 CANCEL 0 NO ACCESS FAIL 7/ CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspect, r: Date: / 2 #: (503) 718- ( CITY OF TIGARD • BUILDING DIVISION 4 PERMIT #: MST2005-00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2005 Phone: (503) 639-4171 72,11:111 Inspection Requests (24 Hrs.): (503) 639-4175 —. --.. INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 111 SITE ADDRESS: 15273 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 005 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached. DEMO CREDITS FROM BUP200400260 APPLIED TO THIS PERMIT. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 Inspection Request Scheduled For: Date: 10120/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399" Plumbing final 018750.01 503-209-4837 N Corrections/Comments/Instructions: • PASS fl PARTIAL APPROVAL ri CANCEL 11 NO ACCESS fl FAIL CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED _ )6,--,ZP Inspector: tf Date: .7 0. . /2 / 1 Phone #: (503) 718- - - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00123 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2005 Phone: (503) 639-4171 Jegoil Inspection Requests (24 Hrs.): (503) 639-4175 L. INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 11 SITE ADDRESS: 15273 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 005 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached. DEMO CREDITS FROM BUP2004-00260 APPLIED TO THIS PERMIT. OWNER: DON MORISSE., I E COMMUNITIES LLC, PHONE #: 503-387-7538 CONTRACTOR: DON MORISSLI IE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 10/21/2005 Pour Time: • Code # Inspection Description Confirm # Contact # Message 299 Final inspection 019031-01 503-209-4837 Corrections /Comments/ Instructions: /0'6 (iZ-?Th avIU _ PC .411 111111 . tYlI ARTIAL APPROVAL El CANCEL fl NO ACCESS [ I FAIL C FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: . Now/ ■■•■■■.,‘_ Date: / 'Z/' e Phone #: (503) 718-