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Permit 0 CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00109 - � I � DEVELOPMENT SERVICES DATE ISSUED: 5/12/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA 03200 SITE ADDRESS: 15355 SW GREENFIELD DR ZONING: R - 7 SUBDIVISION: SUMMIT RIDGE LOT: 009 JURISDICTION: TIG Project Description: New SF. BUILDING REISSUE: DM199 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 40 FIRST: 1,610 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,790 sf GARAGE: 605 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 329,608.50 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,400 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: 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: 7 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FCR: SIGN /OUT LIN LT: ' PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVC /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: LANDSCAPEIIRRIG: 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 ST # 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: $ 10,791.10 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : Permittee Signature :1 2.--- 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. • ffuild Permit Application '° "' . FOR OFFICE USE ONLY • City of Tigard i. ; E C \ " l l ,,, Received P ermit No.: 1312 Hall Blvd., Tigard, OR 97223 Date/By: � S p (�2 VJ ; `Oa i I • Plan B Y Review Phone: 503.639.4171 Fax: 503.598.1960 _ di I � dl �' '� Date/By: Other Pemut: S��'� �I ���"' � inspection Line: 503.639.4175 MAR 3 0 2 � L. �' .. - Date Read B Jur ��.. Y Ready/By: /� H See Attached Checklist far Internet: www.ci.tigard.or.us Notified/Method / / .,I !7 is: s� L. r ru- Supplemental Information r'IT�i (W Ti cii {D 5 Gf�K.i �/n �,'. _ -��<. r � �; R ; � •%;:', 5.. ... K,�LS- 'D ":+a'w„"Ywid.. i;_ f@- �'ia' s"�.,'.'¢.rrv`n-ir.T.F�- �. i�'':x#'. ' ` �2 :?'.•i` "ir ;.<:Fi�` ='fit " .£."iC+eu:. " ix - " -k. d, �" a }, r l;, fi.z •3 ,` . `�. � T'.'r�j .`�a' # � • � } 3r� G ,q t ` �G'i,�i ". M"3i �£.y:, ;; ; S';:.. .*'¢ ":4 ,,,, E<, '. ,:1,� =. _ E a ORI . ;kg _, t s - - E °Y A: 1 % AND 2- FAMII;Y< W ELLIN z{','. ;,�,� M�����'£t. �+� � �,�� r. _��� r� � RE QUIItED AT � , D, /, G "w_ � x � f i Nth � ��wr,.. „h!: �rYi �*: �" csr.. s�; a nya� : ��;�r.�:�t;z�'aar.' ,�, �..� � � Q New construction v +� _ ❑ Demolition Permit fees* are based on the value of the work performed. V Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the _�tw A �' i Yt , aff wit x f b:t WgfR 7df fit- " ` , ' 1 Yr: ' 'i work indicated on this a n - ' 'CATEGORY OF , COIYSTeRUCCIONty ` 4 ` 11 s pplication. �, �w "��"p �' '� 7 �, a�. '�.�` r_ �` �ir»e i 2 s � .t�s� Y= ,..�.�.` ' a �y ,� � , ,.. _.,u � �,� �� �.. �.rs..i<,a���,�a:... � �r?. gym.., �. .�� ,� 3��,. ��"X_�:: �E°.,�'l �. '_��,�.�,'� ❑ I- and 2- family dwelling ❑ Commercial /industrial Valuation: $ 3IQ 1 Q 1 i bb Accessory building ❑ Multi - family Number of bedrooms: f-! l ❑ Master builder ❑Other: Number of bathrooms: a, 5 r e Fes" '� fi • fr s .s rt a': u .rr K'. , : t°1µ '%,'141 J.OB, SIiefl• F ilaiION l∎I' :7 x' 222 A Total number of floors: S, ._i C✓ iiii iL - ..#, -ir 14/il?i • Z„� ,y_ti.";4:4 ,t wi- iik"� f i v 1 , gre i gj iau L'6; Job site address: I5 -Ss �IJV C. re n.Pe \� oc New dwelling area: 3 Q square feet City/State/ZIP: '11 TUG i V Garage /carport area: ( 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 e rrs= :•n':.�ro� - =n _a,:s:..,rsY ,_ +:., « psi � t REQ 1IRE ipm, �� eOMMERCLAT;Iediefirdi IS ,Tr L ",7g%'rim,"fST' ktlU`..,... ,. Yo-.:+.a'` ,,,,',i " N:K; fw iii,,,,,,',., —, Subdivision: <-_-4.1 NA M .(� '� Q � , Lot no.: CA 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 i' i"r ZS . Pt' a-, �+' " [ *7r"', A:� - '-�; 4' �: an.: t'sw� �'= -.� en h•,`-;, � � ? ; .; i -,, 1 ., - :,art / ..; , z �;ss, •A i „rl; ,�� e DES CR IPT IQNri OF: $WO „ . " 12� a K 4 - .- AWN d�S work indicated on this application. < „. 2'P.�, .:�;:,;� i� �� �a�a a, ,i:e.��? err =. .,v^ �• �iz.,s n s'r�,. ,,z •nvu-,w�?; �a^ra k;�c�. zS� . Sgt �w PP Valuation: $ Existing building area: square feet New building area: square feet k q r jl ;' b. " ^. .;:s .s<'t , v:,3 r : °.,: se ," t .', z ° i °' . 'LT PROP,ERTYYO,WNER f r +s a ;TENANaT� ;' ° 'ti Number of stories: Name: Cz ♦ ...^ .. ,ki `.( --,'C -> L-�(- Type of construction: Address: j -1 p�'� p /� "-(3 (1 r' ) GGT. ""� ( �, 1 Occupancy groups: City /State /ZIP: �---i � J _ J � 7 1 q-2035 ,c •� J p 'J� �•--� -- r i Existin g: Phone:l,1� I.J ✓ Fax: ( ,3) -(J / �C..J New: :t > « - °:;�:� :;�.:� _��,�' ,''' " °;-� "" , �i=�`r fi .rr���;;w�:r:. �xs�i��,��, >•:u- .�.ryx� +:.�'fl °' -�;a' x i �:APPT;Iea t ee pi V p ay i CT ` «PE i n " . —vi ,. aWki3 1�s .� � a a I. RSONa ; , ': k "'Ny nom :, "` a- ` xt , .........� � �„ ,,;t.��,;�»•r�• <M ��;.:Y;r- �,. �...�:�5� �w��,.:..� �' �';�.�w�,�.�:�rn a��`��z; �.r. >�;art,.<"�� °-,. �� : ° � .sk! 3 ,'# �a.,�� , t. .. ;#•'#i ,. }v,s J ^ "„�` Business name: 5 �� e N All contractors andsubcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: • jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax:: ( ) E -mail: .;1 IVW:'': >''.,,'. Z::'r <' i;3 ;'.;:,, °: `, e t'iq'• gr�..q:- ni 'w< .c:...:r=t-:t'.; T fP' "'� s �::t$ -tgi' ` . ` " , -ta a i. i s Wiz' ',% -: ; • �. r- i�:• �s' 3, .S 'i�..,� -3 +. x,�'r;°.��. . •',l- ^M .a:. Q yws.., k i .t ki I CON 4M, OR" ,. ,' t. ,y t. tar r'.. . < .. ...._,� s�.'.'k:.n4..= .:=,s ,. ,:-� ° w,,,. s , ?, -:� �, ^,�,n ¢ •;�'�?� �,�;'� "•`�. # " ".s :.,. �.., esti' ..:,� ; � .x�✓:�,u n; � :r'�`Rw ,:a: itw "r!i�'3�..rs.W,,:k,;,..:;.: Business name: 5' t f.l.. PC E : a ;}�:. tz✓v �'� X1.3 r��f �1 °�,.e,S�i-h 1' 4 ti. ^ ^:.v` p:�. , p.Ttz."ai.'1 `. 3. " ,, ^ �"��Y n tJ °'t' 's BUIL . - 0 FEE ° Address: ):. (� r;,x gar, ic�te" °. >`._t r ': (:y �, ; , t _ City /State /ZIP: Please refer to fee schedule. Fees due upon application Phone: ( ) Fax: ( ) CCB lic.: lips ri Amount received Date received: Authorized signature: at r _A 17/PEA-4 M -� This permit application expires if a permit is not obtained i 7 within 180 days after it has been accepted as complete. Print name:, ,t T2. f � /' Date: 3 j ' I 0. * Fee methodology set by Tri County Building Industry V `! Service Board. i:\ Building \Permits \BUP- PerrrnitApp.doc 12/03 440- 4613T(1 l /02 /COM /WEB) AECEII\I'E Plumbing Permit Application FOR OFFICE USE ONLY ' .. ' ' 3 0100 ->� 1 31 Of Tigard i �� 5 4 Received . J ` U q City g Date/By: Permit No.. � �/�� J l � � o 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 98 Phone: 503.639.4171 Fax: 503.5 1.966 � OF T1 GAT4i. y Other Permit No.: DateB 24- Hour Inspection Line: 503.639!4'175 7 -� i - t .' L� ., Juris: v tJ t i >1 �T T� T ! �! ' '�.. Date Ready /By: ® See Page 2 for Internet www.ci.tigard L/t V ioil kij\ Notified/Method: Supplemental Information �:' " .:t/.;r. - -a ,;:, -, ,,;;:',> : = "' ., 44 '� - t:. •4', � ty`-,.t ,t - :vac sn� ,�::t -r -. s_. w;; .,. ti ' a:�°,e:v�:.,4�- ....��, W rt "`iv;. ;} , rat`'�'�".' ",. "�fl� ',r,�.�. ,', ` ?:„4`�'ir" "r' .,�:'F.�t �:;,�,,,. ;,fir„". 3'-� ����€a�. I .. y ,. . n,.� . ,,_T,YPE',.tOF: WO ?; `''.r, r,> .�3, ,; s: *. `s .,,,,,d :: . ,,, :� =: -'� � ,���.�a��.� � ,.i��. v2,-,,..,,y,,„ `. :;fir° `�1� =' �` °�y�;`'.�FEE S ` -gyp., ��a , - w °.: -�,,�, a ., �, .�'�i3 =��'k4.a_"4� .x5. �,_ ..ro. -.-., � -.t ;: i. rlx�: t: �r:.-. r� °�an:i�t.`dm�_�,$•".v"J;r -tA� .�r�r�".•�;� �"�?'>;7i"�'�`,�.�a�:s: c�>�:'.c�i . �.'Y;,- ��,�i, �i:ry:x °r.�.a�:::>rr�ar,� a�nr;,x.,�.r>4,T� a` �,rA� .?." ,,,,,, !N construction ❑ Demolition For special information use checklist. i/ `` Description Qty. E a. Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) . .,m:�: ��,, . �'_," ":a�`�`''�,c:�'=�. � <�:+ ���<E �+xi= raus�kra.-,r.:��^' '.�'�`. 'ISM �,,n n. `v , :`- ; f fv a a t ICON Te a ', . q vAr r . i'' • rCATEGOR OF S RUC4 249.20 i +� �-�°.; , '� : t -.s "a ;� �•. s TION ,��:�.,:.: � "',� "' SFR (1) bath ,�`x ar,..,�, r € ,�.d.x e'an- nz-;Bnas:;�.v :�:�= �:Y'.c��:�.�:r_s��u-a' aa�, .3<u_,.,'.�t"- .�i� .. ���;�:...'� ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 1=1 Multi-family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: y; y,. y):`, " wr.: x rgn,, : Erm ,,u Fire sprinkler ( sq. ft.) Page 2 , i s Y _ 4' JO B. S _ITE „> y [ NF O Tb .A:..., . ` i J Site utilities Job site address: ' 1�3�j� 5 C� cee�t� P�,c9 Catch basin or area drain 16.60 City /State /ZIP: oar t l 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: _ MI 'A _ 1 , e Lot no.: • Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: .'.w ,r r e .:v.,- Absorption valve 16.60 r, i v ° ; rrRIA � DESCRIl fION 6AWORK`; '; 41- 4X ,11 lv gi,15� . ,+. E t��. . a `- . `,; Page 2 �_ ,a � � � �:��'.,.. �_ ��°�«��:x�.,�fi,��;� ��� ,,�r,�,,�n� x •?��.�.t..�,ze '��s�� Backflow preventer Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ; zn,7 a ,12.5 �_.li� , �t�: i : ;;: au - > z ;.s u,� �: is •.� r, Drinking fountain 16.60 �.t , t PROPE O . § t ' t t ;� :; T IA4L 4 -. ' Ejector /sump 16.60 , Name: . ` f Ls,r, 5 i el-p . -u,.�.. �.-. ` � -,'Ci } Expansion tank 16.60 Address: -L ,tl fjQ �, �° JI , ., I - ^"`' , ��j /'�� Fixture /sewer cap 16.60 City/State/ZIP: Ch !, C /!-- �. Floor drain /floor sink /hub 16.60 Phone: )-7-,) 7 7 . Fax: ( )-2y D7�(a S Garbage disposal 16.60 y ,�:�.' �e. , &wNr+:sL+"F m: ;. a n: - ., 's� F�;s'�i"i � .' }.:#; rtsTa�i3;.I' ,i; :tce'A a: g .,x;+ r:�;�� 4 '• n 1` " ' :.` ? Ik `_ c M•fa r=. i xr Hose bib 16.60 , :! ,z, •,, • tL,.. LIG fA N T. , `." g r t a ' n . Nl .. _ r: t; .,xz4x; >x. , � 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 'z ,4 -,2 - 'n y � `x ze „ ; , x'k9xi " J P" . 49 it 6q x r; '* -, i , = . -,a'a #P r , Av q C ONT RAC TOR a� = k'`h , '��'" ' x ` ' ` . r m <- _ . �:. ��,: �. �,,* �.> ti, �.'.,..: i��: r�: ���Yl� ,..�.�'�?�,4€�b��F�'�,.x,�r��,. �:t�; Water closet 16.60 Business name s ? k & tr Water heater 16.60 & i.. : Address: 0 ' 1, Other: City /State /ZIP: �� Subtotal ( Minimum permit fee: $72.50 Phone: ) 5)'' ,..., 3 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: IDS-74 ' ' i imbing Lie. no.: .9 .3XPO Plan review (25% of permit fee) \ i , State surcharge (8% of permit fee) Authorized signature j t. TOTAL PERMIT FEE Print name: k1�4Y I I\ g Date: 31 a i I n e� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i.\ Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T( 1 0 /02 /COM /WEB) Electrical Permit Application 8 ®!/ E P FOR OFFICE USE ONLY �d ��N Received City of Tigard Date/By: Permit No.: Di1 p9 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 � j a,q/ Plan Review MAR 3 0 200 idp N Date/By: Other Permit: inspection Line: 503.639.4175 ' Date Ready /By: Jurie: a See Page 2 for Internet: www.ci.tigard.or.us raw ni TIGARD Notified/Method: Supplemental Information "kb '..a A ys.- r r _ "', G+!•Fia+:.e.r.: y�c�,�- sr:h-, ;:, -... - . - - -, �l'i�i - ',:�. �`� - �x... y et� l• °•� •� ..two 34,'`i ^ „ �F; °ir:? -, v_. _ _ ._ 't. , '- -a. . s p -'3.., z i t'?, g, .3`"" tt.: s _"fC*it+a;:,'t. , °s,r _ • ;-�'- .4;� ��,_ �atc. TYPEOF`WO� �,,";': �n. ='':i t���,��. _,.�. *,, 4 1` - ,�. ' .k: :1 ry ... �-. wt �•r�a ,' �;�•�:,� '°�a >� 'y.�,r��:t �, � � xw - �..,.�.u�, s a• �n „��. _ ;� ,rP.LAN REVIEW.•.= : >:;.n���� ., �h�- ,i.'�, t8' �,. ., >�.�.te!a.,:?,..,.,�v�.'» G:;. �. aL! ��:,,,,::?,,.,., �•„ �,_:•. �— �. �, �-u- �u� .a:w`'.n``'�'``.,::m -r •� New construction ❑ _ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'l ❑Hazardous location ¢: '���;, :Y'a��'.- ,- '.'*'; :<�,t S�.::;;: ? r, M1t ::p. �.r..p =�+e h,c,:cr --. r .Luc .'ote= :c»a,,:aa' a- r:;:xaaY..d _ - rating ft., � ��,� ° Service over 320 amps ratin ❑ Buildn over 10,000 sq. ft. ter ;, c, � :in ,i . x, ; CAvTtEGOR�Y OFt;C®NSTRUCTION , die k , t 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 ❑Other: ❑Building over three stories ['Feeders, 400 amps or more hg -• } ; , y , ,,r i r . : - , , builder . }, _ $� .- _ ❑Occupant load over 99 persons El Manufactured structures or , `*, -, r; '.. OB,�SITE,a,IlVE®RI�IA I©N- L00.AeTI®N ���,`' l �s t ❑Eg ress /lighting plan RV park Job no.: Job site address: c n / ❑Health -care facility El Other: �5 J ��� `� `3'P � ,e \& 1 . Submit 2 sets of plans with any of the above. City /State /ZIP: 110k /' ) The above are not applicable to temporary construction service. t v "' � t� *,: s s , nx da= �»' "b »:�>,�u Suite /bldg. /apt. no.: Project name: z ,. ,,, t "=: tEE ;SCHEp 7017 i : t_. Description Qty. Fee. Total l ** 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:S .y 1 .� \d r« Lot no.: q Ea. add'l 500 sq. ft. or portion 33.40 1 energy, Limited residential 75.00 2 Tax map /parcel no.: . e; ;;r ; ;n. >. ;<par y „;, a` - a• Limited energy, non - residential 75.00 2 �_ r=�� ,.;�_.�w_�._ � urn „b, ,�„ IQ1V OF aWOORK . � �” .���, � �..• t� manufactured or modular �:'. z.�:�� tte . •.�� .._ w. _ �.b,�., $�� �� �� �;�';,���.in°e ,� ��`, �t'`,;`� "R Each manuf dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 orgt ,, .. k ia, ,,-;_ , azw. -- z f - ; ,• , a . , A•_•,<4„ 14.0., . .. 201 amps to 400 amps 106.85 2 A x 01_1 *- I IIIMV OWNER . � 41 i . ,, >`t .,,.'' ENANTJ 0 -3 '• 741-71,,,,m 401 amps to 600 amps • / 160.60 2 Name: 1 ika i ` _ Co v•-• - •t % �J �� 601 amps to 1,000 amps 240.60 2 Address: — I tT C •U,,U) 1 jjl� Over 1,000 amps or volts 454.65 2 EX Reconnect only 66.85 2 City /State /ZIP: f.a/ p U 6) iDs Temporary services or feeders installation, alteration, and /or Phone: � `-� ) � ? Fax:c ) 3) 7 — 7& f S 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 4 s "I , I :Nt -t ? : APPLI ANA e « ` O 'ti - ,:if". - , ` ; '�: ii . s <' , A. Fee for branch circuits with 4 . � c , .-. 1,, . ,,,. ::G 4, ..,,,,1T - A = 4, 1141 ` „,,c4 Vw. /'. , „, .., CONT :ACTt,1PERS,ON' ` WA service or feeder fee, each Business name: 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) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) . Sign or outline lighting 53.40 2 E -mai I: Signal circuit(s) or limited- , pc J`Sfinws'' ".� -,�' "' �, �`ti-�' `,�� . ..,. .,.• w�. �.5. t;Ig,:;, <'i':; :, {.,n:'' $i'ii e'*'l3ty:s'rt�`.'� -r,,. i"sw: IN ES - _ . , , ,, ' c. ^t "� .�' �,`'',�' ia> CON(P=,RACtkligt .a7:::�' ,� tTil r ?y r'„t., NES energy Panel, alteration, or Business name: �`-( extension. Describe: Page 2 2 / Address: cv c..--w Olin i2 V x -'.. 1 '-� Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: 71(44/(6., Lam- 0 -)(9,9:3 Investigation per hour (1 hr min) 62.50 Phone: , D)5 L.�.i� j0•)O� t� Fax: ( ) Industrial plant per hour 73.75 �/ �� `` - AYAB EgRIAGAL EERIV *:F k m : d CCB Lie.: L / 2 aD-. Electrical Lic.40, (2,1 Suprv. Lie.: 35 Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: F itr y///� D \ b I Dater \ I a l I ©� State surcharge (8% of permit fee) { v.d� TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained Within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits \ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM /WEB s� is ,„, Mechanical Permit KOlicati'o`.n IV E ONLY - - City of�Tigard , l - t Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 Date /$y: �S S�GUS - go' zig �� 1 Plan Review P MAR 3 0 200 ' \ Date/By: Inspection Line: 503.639.4175 Other Permit Np . Internet: ww.ci.ti at'd.or.us .. Date Ready/By: : Juris: S See Page 2 for w g �� � Notified/Method: Information y g - r : - a- `"�_F,: -; aL` ;� #, ,�.� - < ' '; ' a �ac. - e,a� :.*ae.. - - - t _� {'.. , veh i *.. '`,'� ",�'"s , .�, i ' a, t; l 'sa' , .?e °sae' - '•�`.`xq• d?�:�1 �:- ! a r • I - t �ua�r:,•.. =r�ecs g�ra•:re_a*zr.�._ _ �- :s�zs'�.;n::�x�„�,.y.:s s�� vNS :.._aa • ;�a a ^.:14.' • �:. � „�„ .4iii OF' *� ibli < „t ; ., - C011IlVIERETAI § 'FEE *" �Sealii LE ;_- , _� � _ s - � _�..'�.,��x� ��?��:r`- �� ..n:�•:� '�� �,t� �USE�CHEeI{LIST�� #s. �' •_�• � `�+',n.�x�? 'mn.� �..x,�,.. : .. s� w, �.n�. ��,..- _ . .v")„� �" �- w•,. .d�a'�ik� rn; . . , -. a•: N Mechanical permit fees* are based on the value of the work • New construction ❑ Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. •'..�.c,.:; P ,� - , ��..«» s .a "uae;,reasa*',�•„rraes- ..,ava °t�s...rmawczrwlar�^.rnrx a.-uM:;a;;, `' `' i§"" �+:5. ' ,2. r N I. v$ -- : s , :. <, . Value: $ , ' {�r�'�,�,,;� ;y� �t� • �CATEGQRYa;IOF. ,�� +, >as"";k �'�.� ,.�„ ,, . ,._-„ _ ._ ./v.,,, - ,v.. 1 _.. - : - ; -_ ,.,, uh, ,p,,,,,,,,,:..,.a:,, vr4 ,.:Mm -,,,, ;a �e.., , ,ktVg ' . ' �sy ...f.2 - - -EA rr ' e Tg �� Y�;4REIDENTIAL'EQI'JIPNIENT "/ 3YSTEM� =FEES * °� [1] i - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Y. 'A" For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total - "^?�:45;i!. s'a:� .�:e -.� .M� =.�v.^ °:.x,�r:.� uiae �c,, 7 ,av,: �,�. �z�v�.n), -wr.ny�,�,�.. ��e »43,� _ :,: +. ` ' ."F r ',c ,_JOB *SITE =fiIN LO N: AND1:L®, A ' ;- ' i � GATION�r �' „,�` �b�. _, : _ ern �';�;x�,� �sz� � ��.,�..u_•:. t� � _:- ,- .,���Gr.�,�,._w � .�•i��a�3�� r��ri? =�� Heating/cooling Job site address: l� �� J p � �� � Air conditioning or heat pump ei i ,/ L. e) l \ U�j vl (•. (requires site plan showing placement) 14.00 City /State /ZIP: i OIL- 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 Subdivision wy ` -Z Lot no.: 9 Flue /vent for any of above 10.00 , Other: 10.00 Tax map /parcel no.: Other fuel appliances 4 V M .7. �? 5.a�. -mow i K, .;l r.arnt�w:�., 'w-,` :u, te° arta..vr r v :a € Water heater : , <x , * rDESC WORK w ■ °� * u� � „ � 10.00 c $? �+.. -,,;'�:ai�! :;3?.�r'"�.': m �Mt�..a., x�'.r� �.as`aw•,,, r, .� ='ases -,;, �x`z°c ^..a��,s,�,-wve.Y � -:�. :a t» b '� �"�':a,..a la 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 �� ,, > ; t -�_,,, ,,. ,�: >.„�. u:- , t ,, k; ,° .tea^, erg w c Chimney/liner/flue/vent 10.00 n • 7' PROPERTY' .OWNER'` ' A It i 0 ' ,: ENAN C • A i . Y M t � �.� -.- - _.�a,W.�:�,��k.��a ^� '� �r�� �.t � a '.��; ���. -� :�.a���� - .L. � Other: 10.00 Name: \ 40 � � • • �. t,1 - 1--1-15 it C._ Environmental exhaust and ventilation Address: $ CSI ei' 1 , - L' - \.jam 1 r� Range hood /other kitchen J / "'' t e/ equipment 10.00 City /State /ZIP: , 1 6)Q Clothes dryer exhaust 10.00 ti Single -duct exhaust (bathrooms, Phone: •_7 � Fax: ( � 2 ._ -2 0 l toilet compartments, utility rooms) 6.80 . : `# i , . t' t4 v „� ' ,.. ; * II AAPP.LI 1 # l E.©NTf CT P ` " Attic /crawlspace fans 10.00 1 - .[#z „„.,,,,tug - s- �aro+���„r'� s� �ikt�'.-s:t"�` , ��,�,= ;*�a�k .Ja' ,.. ba.;�.. .wx�yaa>�n a -:aa. .. ^. 3 = _ 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 `�j `. ��.:^�;,,�"'�, }�.���- 3.s-;. ; .:� Y �a� x xm- ^-.s_�: � .:a -�: ,•*- e,rE ;yl'; %��; ::�:. - "�r�k�; �w:--- '1`A,?�i.- :e����r Barbecue '.-: ' - '?`�I - •.' : . ' A ¢. flits TR!AC_TOR `t V r �'?' r - tom " Business name: ell a 4' �` l e%% pry Clothes dryer (gas) /`L Other: Address: /'� L •u - - �aa,ma �•.,. aa w, ..:-ar. -- (! / " �' w `1VIEEH /ANI,_„ ..,_ T FEES* ,,` *'` `:• ,, 4 ,,`, h<.�,�ffisc.�.. .::- x;�e4�a. <�ts. kas!ure,�a�.. ra„ar�„e� ryccr-c�c >-,.�e_F 'v��,,�'. j. City /State/ZIP: Wal a ' LAWN t O& " () Subtotal ` Minimum permit fee ($72.50) Phone: ( g--) ' L I Fax: ( ) Plan review (25% of permit fee) CCB lic.: ] �) State surcharge (8% of permit fee) -C TOTAL PERMIT FEE Authorized signature: •Il / ' �e This permit application expires if a permit is not obtained within 180 D � /ry days after it has been accepted as complete. Print name: 1"'r' b A- �- l//ll//�� 1 I Date: l g.\ t 05 * Fee methodology set by Tri- County Building Industry Service Board I: \Building \Permits \ MEC- PermitApp.doc 12/03 440 -4617T (I I /02 /COOM /WEB) //pp��� /5 T oz S —([i) tocf \ ae. AAAA® _711:: AAAA® pia.} AAA �I%AAAAAA .�iz A AAAAAAAAAA,AAAA,A,AAAA A® l ppg�� Pt- 1 . i STREErr W4 T REE CERTIFICATION E .. ® `r �^t I I n , q , L04 C-- J n- , Owner /Agent for Dot . AD../ i ssc Nt 6,,,,,,...,. t. zs. 1 L . (P PRINT) (PERMIT HOLDER) 1 i s ; 4 / ,,, $, ® Do hereb / Cat f t =die f ollowing location ® t? fir: " ® meets y :o ri and /WaSinn on 'County -I land use and development standards for street tree installation. A • ADDRESS: /5 $1 6 vz - EA4= /£4 t.2 DAR 1 LOT: S UBDIVISION: ,5 j ,,,,y,;.� M`ef'e - ® BY: AM/ DATE: 9 - %G /- a S° O. Air , l RECEIVED BY: DATE: '7-- ® 1,1* � V V VV V V V V V V V V V V V V , V V V V V n V V V V V V V V V V V V V V i CITY OF TIGARD ' BUILDING DIVISION PERMIT #: MST200Ei -00109 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 1 Phone: (503) 639 -4171 �n u� Nii�ll it Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7:05AM PAGE: 63 SITE ADDRESS: 15355 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 009 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSE' FE COMMUNITIES LLC, PHONE #: 503 -397 -7538 CONTRACTOR: DON MORISSEI (E COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 9/13/2005 Pour Time: Code # Inspection Description ' Confirm # Contact # Message 199 Electrical final 015505-03 503-209-4837 N Corrections /Comments /Instructions: PASS PARTIAL APPROVAL CANCEL NO ACCESS f Ill n • I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r Inspector: 7 Date: /l _ 01 Phone #: (503) 718- , 1 • CITY OF TIGARD BUILDING DIVISION PERMIT PERMIT #: MST2005- 00109 13125 SW Hall. Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2605 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/14/2005 TIME: 7 :09AM PAGE: 85 SITE ADDRESS: 15355 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 009 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORIS SETTE COMMUNITIES LLC, PHONE #: 503. 387 -7539 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 9/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 015612 -03 503 - 2094837 N Corrections /Comments /Instructions: ( Qs / 0 4 -- i'REE-.' - i -- --1-4,7--- 117: :1— tit Su L- - A— : ' j mewl I 1 ' A D,Ass ii PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL BALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ ,._ Date: 47/ / Y . Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION , • PERMIT #: MST2005 -00109 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 1 Phone: (503) 639 -4171 Joit Inspection Requests (24 Hrs.): (503) 639- 4175 INSPECTION WORKSHEET FOR DATE: 9/14/2005 TIME: 7:09AM PAGE: 86 SITE ADDRESS: 15355 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 009 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: 9/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 015612 -02 503-209-4837 N Corrections /Comments /Instructions: i 1M PASS .. _ air PARTIAL APPROVAL ❑ CANCEL El NO ACCESS I I FAIL //ALL F OR INSPECTION El ADDITIONAL FEES ASSESSED Inspector L /116_ �.�� , Date: 1-/% Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00109 l 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12./2005 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 Ja . INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7 :05AM PAGE: • 62 SITE ADDRESS: 15355 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 009 TYPE OF USE: I PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSkI I E COMMUNITIES LLC, PHONE #: 503 - 387.7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 9/13/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 015505 -04 503 - 209-4837 N Corrections /Comments /Instructions: \/ . .Z / 73 - II , tr 4#/ / / - - 6 .4s' ' fr 2 r t - 7- - - ". i V a - - ) " 7-- "----4-‘ 1 ji. PASS 0 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED • Inspector: tk Date: / Phone #: (503) 718-