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Permit a MASTER PERMIT CITY OF TIGARD PERMIT #: MST2005 -00104 Ai;PA'il' DEVELOPMENT i r SERVICES 3- 639 -4171 DATE ISSUED: 4/19/2005 RP , mums& 13125 PARCEL: 2 S 109 DA -04600 SITE ADDRESS: 15380 SW GREENFIELD DR ZONING: R - SUBDIVISION: SUMMIT RIDGE LOT: 023 JURISDICTION: TIG Project Description: New SF detached BUILDING , REISSUE: DM192 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 2,020 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,630 sf GARAGE: 617 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: 5 VALUE: 356,270.30 OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 3,650 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 314P: 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: 0 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 /OSVC/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 REVIEWSECTION 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 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: 50:3_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: $ 11,019.53 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils Issued By : /f , ,�C1 S AC P ermittee 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. Building Permit ApplicIFd E j!D FOR OFFICE USE ONLY City of Tigard y � /�Har4aNl Received �• / Permit No.: 1 SW Hall Blvd., T i g a r d , OR 97223 V r � Plan Revi • P hone: 503.639.4171 Fax: 503.598.1960 �� ��'ip �d6 l �l� DateB y (/,2. y:r A) ,— --6 O ther Permit: ,(y � ,) if75 —O0, 07 Inspection Line: 503.639,4175 0 4, ,� N otified/Method:y / Date Ready /By: n J t's: Su 0 See Attached Checklist for �� g O � g lemental Information Internet: www.ci.ti ard:or.us f3 I { PP auras a to .: "G >� + :t i3F ..� >aix _ .... - -i l/ 1� • � - '' /m 4'.r+ * 'L",'; i'1,` wit:;.�.+'.. �_ >:i°il "�"z`".kt #... � ��,i.h. -^=�-' ,,.s.x3•� <.'� �..;av�':3,{s' u •r'.. s' a•„ "' _ - -a°,o" ,:{ r � =:a , %�i"''ti " .-,.�Y � it`d+. , sM� X 4 : 4: , ;•3 •r� ^�,� �; � v,,,� °as �,'w: =,, �# a -m rot .owmt;':r ";t YPE o -wwORK �I '�'t<4,,• fi ° r,: ,: ( t zailtiIRED 1 ,ADk2 F AMIL Y ;DWELLING i . , „ R ?. { [cw'`�`5,k-i nr't' ice':' `.,`�.lts, *,, .., „.x ,. „.,,,a,,,„:„ „,,K ,fi b *, fi .. �.,= ��:'+�«��a�":.��•� �� >,���NS��:;��t, �?�?�:;?�.a�:c� �k, ,..{ ���' ��.�;��, � =,,,i a ^.�t,�>a,� 3�r. ��: ���<•_' ��4t =��r�€- 'rr;;:�,.,:�,�a�z��.�?'� � n,h: �[J New construction ❑ Demolition Permit fees* are based on the value of the work performed. VVVVV���` Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the f =.` aNni �` A � _ ;z. -H *t:, i �, Arai e,;.e. ; ;,, ; r,. . n� ' § ,.lt :Ea indicated on this application. '"� work mdlcate ,�`;=�s����;;;, � k »,�k�.•�.,:. �� �'�?al< =` �'C�A�TEGORY OF'�iC'��OO `NSTRUCTI®N'`l.� ��'` �i;ra �,�,���� . '.r��r ` ', C 2 P :4i:N� dwellin lef, t:. im: ' x+; vA:irr;t.�:n?.tse-u:::.; s+ rr x�e uvr. ••' .sA+t- 94,7A Xs. ar.. .t : -: ;., $ �t 5'o. 1 1- and 2-family Commercial /industrial Valuation: ❑ Accessory building El Multi-family Number of bedrooms: 9 ❑ Master builder ❑ Other: Number of bathrooms: ; m�ra :.ti ,. .: v7r.• rea=; ± � ;,s;';;1<',�es:y� a ^: rKa Fa„ i�- e.:: g:. a, �a'. p , ��s�aera�.:1a'�^;:.• , .z..v'�.. '; &'= '§'r�:'h`y'..�,'_' p;Y ' , l �e :ii $TII AfiYr CAiirI ,, Tr Total number of floors: Job site address: 15 -0 so3 C c 1R Q l eQ -0 ,, New dwelling area: ` 5(3 square feet City /State/ZIP: 'II Oa /0 , Garage /carport area: ( r+ square feet S ui ten) ldglapt. no.: Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet . > � v�:: �`.:. �` z�y, � �r: ��; �r�z, .`��'�.:�t ='�r�;�ssar.s�r�:�tp� , .�; > - REQUIRED DAT i 4 ERGIAL� :=USE ?CHECKLISTS c. W^i;ire?t.�:°r,: stglay.fom ,S`:`,3ra r. Ks.' f� `- ^,1",,N±3Ntat.'.,iVAT�2o-v=�il Subdivision: c x s wMfy \ \ t TZ Vi('I4 09 Lot no.: � Permit fees* are based on the value of the work performed. Tax map /parcel no.: "4 Indicate the value (rounded to the nearest dollar) of all t•= n -n:, rN „3 . -. < >::, :. ,` N a, N¢z<f_ .,.': F :,:;n.. a and the profit for the equipment, materials, labor, overhead, a e r ' -r. 'eb 4t:, I , V DESCRIPTIION OF „,W®RK$ s � t� r� work indicated on this application. ac' ,,. 14,0.h-ft��.�'%1`w,. "°s S - a,l..rsrk sa �i�`'7...: li .4 , 7 -- sz.v'kPr`t�' .-i .ti sir - a illak,. - nt. "1• Valuation: $ Existing building area: square feet New building area: square feet <v.: - v ' A , �; r. - � �'. ��.� *: x�x � - •_�: �� , a�,'"�� �:�'i ,a PER 01 ,41 i t� too ,, TENANT ' z �” Number of stories: Name: ` tE Type of construction: Address: i � � '�� ��, � ��. � � 1� Occupancy groups: City /State /ZiP: Li �� � 7 / / o 35 Existing: Phone: ( ) 7 �J' .9 Fax: (i3) .3 - 7 (..rte / 5 New: w + ^1;.r3 =�•',;; =- ..:,��..�,-k�,s,�„�.c� �':�,�_ �s�•��;; c?;,*.��t}.: �z ��rar3i• �'.. .��t�.�,e,,�-�,”; =uss� >';:wt::. ;•,µ -.Gk '�s.' �e. -• „�:.� `� �. •,c ._ �” rvt „ s ,,-, r. !r .; r?;. - a' ,�,.,�';. ,, � ?�- R $".: = ;; �s 1':� -`:r rr�' °` � �, >° �-, , ® A P,PLICAN T�• = ;n „�.,.rt« .�. , .. �r .. ,.r -• ��CONTACT PERSON a . �:s.a�v ;;r�;, ; >z� �.� „ „�,�, �' ,.� K � ,.�., n��, ':11 . ��• ak ' s # .:.•''^ z ;.:t -� :; „�a s tit rC^3 :T . ,*° � ,. .a r ieA NO 'it,,f?:: g. "} NZ 7 � :f _ a:, m , .. a ._ S: n� Asa ` �;: _�� �" �".: � `.�.'� €S� '#J *, �,s Xtn,.�,S.., a�o:"a�tk a �:Fas -.1 .��s.cY '`` .;33"= � . 4 r� S Business name: ' 0 ► t e (`—� r�� ?�w`� All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and maybe required to be licensed ii 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: `.Gd: ° ;ii ;,.:r : ' ;�, ;�+�r'.t - :. ,pn � � 2t;a�. '. >;;tz.:4.i .as,^a:`g` , gfi , '"t':'iae't:�. ,, ��:;��g� .,t `3�-,, ='; ^aw,,. , ;_a�:es. `: - , " ' N 1 '4C *R 1 "� CONTRA "CY6VP ' P btu V j` y M ....4:::,'‘. ,... 5 ;. e1- .rta,. i + ,- §.?.,v i *.y.rsu;tUe. +N. ti' ,. :,--', ei?. rbt,....'e 4, Vtia �.i..Q. "rt. ?tY Business name: 5:� `�C, / `J M ;.;,.g- t' - 'r' :.as oi. -, i,Yx<n+g ,ta- rr, �.,.�.. , .� / ,r.1 + `t ;WZ IJII ;tWA1SMT,I' FEES* ' .' " %. :.�'i..��:r`+a tyre '. �.xl?�; �'a:c•- 'iaer�. v,� -r 4,,,,,T,�. a ,a._. � _,'�'c . _„u,��.n�_ `t' ..�,�. Address: Please refer to fee schedule. City /State /ZIP: ' Phone: Fees due upon. application ( ) Fax: ( ) CCB lic.: 5527' Date received: \,, Amount received Authorized signature: /CAA, '`�•" " . �� � This permit application expires if a permit is not obtained within '180 days after it has been accepted as complete. Print name: 1 N 4 . )e4, z . Date: ND \ OS * Fee methodology set by Tri -County Building Industry Service Board. i. \Building \ Permits \BUP- PermitApp.doc 12/03 - 440- 4613T(11/02/COM /WEB) FC NFD Plumbing Permit °Application FOR OFFICE USE ONLY City of Tigard MAR 2 4 2005 E iew ived Permit No 13125 SW Hall Blvd., Tigard, OR 97223 �v� Phone: 503.639.4171 Fax: 0 548.J 960 A /0 rF Other Permit No.: ` r r I IG ARD � I illi Date/By: 24- Hour Inspection Line: 503.539.4175 Internet: www.ci.ti ard.o8.1s1ILDING DIVISION DateReady/ o Juris: S See Page l If g Notified/Method: Supplemental Innformation ,, ��, _ q; ,�; \_,.�,,. :" # �a ro :�'v r; 7 ^ „�n�' :i:'eR ... ;4: u�.t4r- �' - x p" , - ram' "-+ ?r. ;:ia z +R Cn =.,. ..� .• ;._s .. ., <.,,.. f x Z w " t e +x' ?, 'N Fl 'T :ter. ` l f+r'.t` "';' ' " £„ - v� ' r > : , ., .- _' ' I TYPE O, - - ,®R,a ,, s A- a ,r„ d , ,, - t - > t FEE SCH'EDUL a" ,,` • `" �t:�;'C:?v;'� Y�.����1�„�iI •�.,: � �'; s,,,C+�: ate;.:# �fi< gSf s��: s�s��s����` �r�� `t.r;'�`ir°���a ><.;. tt„- cv.. ' •: �dlu. ��,;„ a, ��,+_ v:> rai "�'�1:.+�°: ^r��.rz: > ^,�,.^'_zn �s „a, '4�' " , ''k c4 � v : (:.� vh f � -'Gam e�zc,: � u � +„ ,.ar $.,..:"tea' � � ,'' ((New construction El Demolition For special information use checklist. Y Description Qty. Ea. Total .❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) shit> 'a "z3 F'Ee %+3'`.:4s��* w�rh. °- ,�;:�,�,.- �; ����e�� ;«+�,..4�a,�;�:�::;�:.w -.rc' ._»�'"P��'%'.kEe�, " 'a.#a��r4:�;�n� " - SFR 1 bath 249.20 � ,e l ,iaf RR �,CA1 A GOV - , F CONSTRUCTION" , *€� T'" X _d..:x�.��, :. ... m�.°;q�xi.'k >M s•a::as:,;� s.x "_rk...w`- �ei5.sa .__��m:F #a�£+.�1�C�r .ti;4$:'uWr� -��� ( ) ❑ I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 El Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 f g, i * . A V i `SITE] IlVia ATI®N�AND L' OCATIO", ' '`0k it , ',. a.- x,,,' ,4.. •vt,Ac.,t, ,162z rrf.,_. , A6ti.ssor,: ; sr?< c :.-« :- l.: ..;a _,6 :: a,.,z _4..,L rs Site utilities 1 Job site address: I 5 • C / . 0 $0 ( Catch basin or area drain 16.60 City /State /ZIP: I to tom(* ( 1- Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: v Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision:: tam i-� Tk" V I Lot no.: a� Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: ;.,,. :s� „• >,v- zo�a,. ,xx :xs,: ",, <.;•, . ,,., Absorption valve 16.60 tg . MP RR" "I DESGRIP/TION OF WORK`°' " " a� ��$ `� r - '*i ii * w..* r 43 : „, ,,. „ .rs ,,.+ . , „%li, , ie424. ��:� .r itiz. Backflow preventer Page t • Backwater valve • 16.60 Clothes washer 16.60 • Dishwasher 16.60 ,' ' :k . sk ;: l`* ' ;_; : I ;"• , ,r.5s-..,,s�„)`? •A raF ti;µ„ :a; ; ,` :4 ;• r m ��:. „ p .. ; Drinking fountain 16.60 0.. .,1 r_ waP„ROPERTYOWI ER .4%WW� .�' , •,.TENANT" : ;,_ ; l Ejectors /sump 16.60 IA Name: 00\1\7 Expansion tank 16.60 Address: 1�� , 't Le ' 11 / . / - ; I � Fixture /sewer cap 16.60 City /State /ZIP: J (/I'-- `G i3 Floor drain /floor sink/hub 16.60 Phone: j�) 7-. 7 Fax: (t)9y . 7(r( rte Garbage disposal 16.60 un>E ;r, „'ter,,_• ,.,`; r ,. , t, ei. ,.�a.< �x =s... ,,.;, Hose bib 16.60 „ ' `k : ; " ,ZA�PPL'ICANrilatt �r�. r INIagi CON+ refi grali ` � 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: • 9, r s =a- r »srer.. Urinal 16.60 `. n : :;;rs w si-riS°�` e r`. :: r„� , i y� i a ;:l;* Fir.'`, z.., % s3n � " n M s r, "''"P.,4' M; .1.... n1� « Water closet 16.60 Business name 1 ` C ? j) 5 � (� Water heater 16.60 Address: 1 0 L�ll� ' ` ✓, Other: City /State /ZIP: .e�30,e Subtotal ( C Mi n i mum perm f ee: $72.50 Phone: ,)6)( " "4- 3 Fax: ( ) _-,r Residential backflow minimum permit fee: $36.25 CCB Lie.: 10S ' 'liimbing Lic. no.: 2 7 lc Wb Plan review (25% of permit fee) Authorized signature / State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: J j J Date: ?.40 )10 \ 1 C) - This permit application expires if a permit is not obtained within 1 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i"\ Building \ Pei mits \P LM-Permit App.doc 12/03 440-46 16T( l 0 /02 /COM /WEB) C,. Electrical Permit Application FOR OFFICE USE ONLY • 7 '7 City of Tigard n p p {� (� Received e " ti 05 DatDate/By: PermitNo.: :m57--9_09 5 • 06 /0y 13125 SW Hall Blvd., Tigard', / ard, OR 97223 8'111 Plan Review t Phone: 503.639.4171 Fax: 503.598.1960 y m A , , i \ DateBy: Other Permit: Inspection Line: 503.�39j4�1'757F TIGARD :'' I1. Date Ready /By: Juris: B See Page 2 for Internet: www.ci.tiff d. r; 9NG DIVISION Notified/Method: Supplemental Information , I'. ; +� ., �•as.^'2:i' �.. "v�;sf� -i:3r. + rc :::';, N;- +>, - °*,� -.c rmr.:laxA sip. �,:�` - s:s. __ ,�' Ste:; .< ,.�.�..x�,- �;.,,:� �., ,#� "s- �s "t�,- t �+� *"'-- '.,x'.•' - `a< . ;" t y ' �..x_ ,;', . a..tna . �i .� :" `' � .A - -�?' k tit • tr-":; -N„ = 4 ,u ; `+;.. `l , ::, ;;� n � „, � TYPE �40F 'WORK.. �.,, ,.�_ - ;*.�`r�;_ >�"tr =v, :. ;; t , �, � `n iii" , � £ � 's r: °; 'P � _ ; y.;r :i � `�. .�:�' >`r. >, r:_a` ' f+1zi1' -'LANw RE�'sEW �. >�:���,; =` .�. ''=�. F t k :? �.. ir �?f' .... �e-> a# z �' �, �.. �` �. ��,.... w; r.��?°?'.r�+��i�': �e% "+'ers= �'f7d.�a.'.wl w�""k "Ssas•^� ,, kKs�. 3,. �... �,✓, tc��, �§ ss: f., �:,:.- �W..%, w+ rx-- a�� „.�>�.�`;.�c�;4�- .,- �z�a'�z� ^.Lis 'c.. New construction ❑ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ❑H location � =:, ai': :, ;.. =ram. aKP :< ux •::x ',;, ., lea ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., ' P a e , �e reaTEGOI R aY ,OF� CONSTRUC'IJION�• r 441_ �3 O r 'i of 1- and 2-family dwellings 4 or more new residential ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Buildin over three stories ❑Feeders, 400 amps or more ❑ Multi family E Master builder ❑Other: ❑Occupant load over 99 persons ❑Manufactured structures or S ?a” ; . ,ea w .,.: a wper- : > 'az x rr; a7:, : • r 'me, ' .Y;'V ns r yA-'S`""_.1- ^`�>..- a s s t,."'.n'..' '.r. _ ,^,' i Egress/1 i htin 1 P `�'p�����, °, �,�- JQI3.' 3ITE�IIYFORMATION }AN�D'�L�O sst ,�' �� �' ' "� [=I g g p an RV park ,_ �.;�` `�Y�'.t Ea.�,..av'i°s�s,"�exa�� +. u- es.>,. ��s �a�s� > r, .:. .cn,»,mar��S,r. ��t�:�.'a mr5o . �..� �' -> re,�`ti+tx. `fir, I Job site address: r `� + , A rl ❑Health -care facility Job no.: ❑Other: �_I '�I J �J �W 6 M�eel�l LP�� � I' Submit 2 sets of plans with any of the above. City /State /ZIP: l'ICA The above are not applicable to temporary construction service. Suite /bldg. /apt. no.: Project name: , Ie' 1 FEE,- SGHEDI7LE i „' a :: ror Description Qty. I Fee. I 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: Sum1M1 1(�C1 � ,g3 Lot no.: Ea. add'1 500 sq. ft. or portion 33.40 I � Tax map /parcel no.: Limited energy, residential 75.00 2 .. Limited energy, non - residential 75.00 2 tkt : . � a< �`'tDESCRIPTION OFJ'�?'ORI{R ?�k ;'rif° � ,.�� �`,- ���:..,�� -. �- �r� ,.>�.; � : -. ter:.., ���'�aa� M 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 x; .r _ : r;,,;,,, r ,, a. • t s r z, . s - Y�. - k ,, . k i 201 amps to 400 amps 106.85 2 � , 1_/ g ..P ROPE m n f 246OW NE Rit. � I $ , �_ T ENANT - , ` ` A tc 401 amps to 600 amps 160.60 Name: 111 ih. 9 • - 9 / 601 amps to 1,000 amps 240.60 2 �°� 'n=., � �� P Over 1 amps or volts 454.65 2 Address: Li �(�t/ /� Reconnect only 66.85 2 City /State /ZIP: L - V / �) ) Q , ')V Temporary services or feeders installation, alteration, and /or Phone: ) � ? Fax: €6))t) — 7(0 5 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 ;;i.;.,t*a zit T,, �p`” y pE ; , ; - z;-., s n , n .w ,. :p l,r,va a? c:: ";. . .,n.�.� ,. aa - .: , i x ' : =zre :r,�; ,n , __ AP PLTC A V s rt i t � Piyin a ` CO N TA CT IP ERSUIV m 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: Pump or irrigation circle 53.40 2 (, ) Fax: ( ) Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- .+. �,$ ,- ,jam ,; ,,. _._ ,„„... ,. _.. -. ;. �.;,.,, a,�e k,. a �, s a ' > M , CON€TRACTIOR : � VOIS + �• w ener anel, alteration , or CA-- extension. Describe: Page 2 2 Business name: . �/ Address: st v ,,,4,n,\ �t 1 _-,,.. 7 Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: " C� Li q ')�3 Investigation per hour (t hr min) 62.50 Phone: i L.t.L I Fax: ( ) Industrial plant per hour 73.75 t, air i .,-. w �.4 _ � 1 CCB Lic.. ? :: a ; ' , ' FARTI ICAO YERMIT F EES *; ;: ;t Yut �.LL��''��,�� t. '.a'''a 1-1 Electrical Lic. j, (, Suprv. Lio.: J Subtotal Suprv. Electrician signature, required: — Plan review (25% of permit fee) Print name: �l� r ti I✓� ' „v A�/� I Date:3 J I o 3 State surcharge (8% of permit fee) 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 Teri- County Building Industry Service Board ** Number of inspections per permit allowed. is \ Building \ Permits \ELC- PermitApp.doe 12/03 440- 4615T( I0 /02 /COM /WEB Mechanical Permit Application FOR OFFICE USE ONLY City of T,rgard (lam p n (� L � © Date/By: Permit Peit No.: � 5 _ ay off/ 13125 Hall Blvd., TigardR-97,223 �l Plan Review ( � �� Phone: 503.639.4171 Fax: 503.598.1960 /01140114" Date/By: Other Permit: ;CO inspection Line: 503.639.41 4 ,11/1,. ' Internet: www.ci.tigard.or.us IPi _ ��05 I .. Date fieed : _furls: See Page for l I Notified/Method: Supplemental Information �: 'au, -,. *, '-ir - i r- -'* ".e'a`Y + .^g` ^ =p^.em.� ',„,z;'_ ar .... Fy- ;° :4' -;xi: l ;3'<Jat."' � " r ,. y. # r# ' t;'. §.. d +, 3.fiRi7 -a, 'r°^' y.: razr.wr,ssT:. - '+;i�. a r.+ . ,,<; s litiatti : °;e.:+•s x.w.�;Tw,a: .;,: =fl=ea r�•x. - •, r;,, -,mss �.'r+:. , s ; ' , . , x i '.Y' y Na: - „ ' - ; P t, � - "�^.." <,, °� ;r ; 'fs ? e a, ,. . ,114X-• ?:1j ..4WQR ,,,,I, x„ t .� - a_0_ 4 v C®MER @IAL aF 'SC HED,ULE - ' USE ,,,,, r id _ . . , _� g . ,�, �..�1�. R -,�. .- ..,.'?�, ��N. n�,<u '� t `�,.�,����� ��-� �,�,�, ���, >�- as���� • ;.;.������.n�:�n: �� <:�•. ,z�d `w I LU t 1 V u • . • v W . Mechanical permit fees* are based on the value of the work N ew construction ❑ Addition /alteration /replacement e performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. `�� + < t. `r" .' ' :,'.Y%} i:.�4;4:t.".Y :YaA'TT .+ BITA -C..SRmI "44s`tfR.:Y.tiipfdtrT,;! . ,y� '�T�r� ,p. + y .� h+i.+S1R:"�r:;a?' .i'l ,r , �r� ?4P ctG,' ZVII � �, �� ..�'� f ' 3 �;. �� Nj Q. 4 �` "' �'¢ „-?+'� Value: $ t „.. , , _ it , CA�TEG + RYA r ,;�. �,� s . ;� , O , OF. C QN STRUC�ION � h ;F.�;� ; '•I: � . � ,� � �.� ...3 •7..:. �s,YaY�?d :` �..: a:. �4...-. ,u<�c:d.:ek.ir.:c�iva�so,.s..,. �e�a <,.b sr.�ro- r`- .�..',�:5..� ..�,'.'�.x5a'�:„�N`s.2.�s... r'a�.b'. �s.e��,?'y:, g _., ._a xx�r r.szc:. . a� �, ; v;'t,,. ='s'� ^�, � waa�ic.,,- ..rr,a�.ye:,.�.:•..r E] 1 - and 2- family dwelling 111 ❑ d rRES IDENTI AT ;3E Q ,UIHMENT/;S Y ST . .: E M S -F,EE * ' ' S -_ Commercial /industria Accessory building � ��` -���'� �� �� � '� -' ° ���`�° Multi- family ❑ Master builder 111 Other: For special information use checklist. E T 1 ,'s.' .Ye.' °.;r."' < .� .' z- r �.n�ua ..a.: .' r,!;ee -.. ±re. - '_ -. Qty Ea. Total s e in o s Description k t � PiJOB"1STTE IN A r , Hejti.ngkot,I rr t,tA-4, r.�.r' -4 $+ ess* x,:r-•am r ...rte'; :- - ;VITAS.' _ €av Job site address: 13r s' O f i � ( s ir conditioning o hegtP pump ) % [ e .. lowing placement) 14.00 City /State /ZIP: TA, j/(a 1 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 I4.00 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 Flue /vent for any of above 10.00 Subdivision& yyl k > H Lot no.: O D...) Other: 10.00 Tax map /parcel no.: Other fuel appliances t:,r: rr tM ����DESC ®F4WORI,����* Water heater 10.00 Y �•w',+ � �.xa =,`4 x is mix roe. , r,- �,',�zv �� ki�3'r.� .�; r,.ea n-+, , ,r>�� :.. -. �r�. 'nz.::� .:dY�Y.�l.*.. � i �#.'x'"�.�'i`FR, .: t.,. v "L 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 ,i'1 , ,, .r. i z • ;: 1,:. Y.,.,::.+z Ib i ri � >, =tIr a ;f Q7 ,._ - Chimney/liner/flue/vent .. ' "" PROPERTY O ` t .A gat .' l Za; '!%., TENANT E; Oter: y 10.00 ., �::�,:.,.4,�. �°<, �� � � 10.00 Name: \ .. 0 :t, ' '1kb/'tfV Environmental exhaust and ventilation Address: U„/i(J IF° � /� .n/` u I , ! - `I_ V 'y + � J f ( D Range hood /other kitchen / ' � r ( equipment 10.00 City /State /ZIP: ikte, akAtety4 g'-)cis Clothes dryer exhaust 10.00 r Single -duct exhaust (bathrooms, Phone: - Fax: (€ Cell, -2 01 toilet compartments, utility rooms) 6.80 ;{ix'af';'�[= ,r�;,_:,, .- .°^. �°: saxs: g ,a:r.•; , .: <•� ae_ , v. „ F ,g., .uAr" - wru- z. ^, +. xie<s, nuz • ,�r =� , 1?,5 c,�' } an , '3 APPL'CAN ; y ,S g i tlI T � .:Wrr ®NT ` A ' C � �,N U Attic /crawispace fans 10.00 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 l keIC.6 '{ _.V. r x w e i CONTRACTOR j _ * ' a , a It : Barbecue r � 7 r Clothes dryer as Business name: lII )) Gil � j am /^ /J 7 (gas) VI ve t t�r.� Other: Address: pQ • rig . ,. :, ,... ,. „_ ;:�,,.....; -_ t ;. ' at.�s, E wra P•.E *+ ' `, • City /State /ZIP: l' t el -201,a5' Subtotal Minimum permit fee ($72.50) Phone: Fax: Plan review (25% of permit fee) CCB lie.: .5, State surcharge (8% of permit fee) C � TOTAL PERMIT FEE Authorized signature: = 1, W '�� This permit application expires If a permit is not obtained within 180 pir days after it has been accepted as complete. Print name: if, . 1 \'1 I Date: ? 1 j©--- * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Pei nits \MEC- PerrnilApp.doc 12/03 440 -4617T (11 /02 /COM /WEB) c c6 r CA...� Electrical Permit Application FOR OFF><CE,,usE ONLY :,.' City of Tigard '.FCEIVEllt Date/By: U Vr� �� Permit Nolt‘\ )c�o - U O/ d 13125 SW Hall Blvd., Tigard, OR 97 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 y/ rdi� vl Date/By: Other Permit: Inspection Line: 503.639.4175 3 2005 ` II Date Ready /By: Ia r El See Page 2 for J Internet: www.ci.tigard.or.us J Notified/Method: I1 ' Supplemental Information '� n n nrl v ( 444E . 4 PE b �� PLAN REVIEW ►� New construction I t i 1 ON tv ion/rep�' Please check all that apply: [ ]�A uuttt a teratrlacement Pp Y ❑ 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 54 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure [1] Multi ['Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park Job no.: 3L/ N Job site address: ' 5r 3d' 5 6 e1/ i �� / DP ❑Health -care facility ❑Other: / ! D 6G Submit 2 sets of plans, with any of the above. City/State /ZIP: - d OR 7 22 3 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: I Project name: p6�/ M Ok /SS� �y/rj FEE* SCHEDULE �VW,OD escription Qty. Fee. Total ** Cross street/directions to job site: BEET Bev p ,ems' New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: 5 um M 1, P. (A � Lot no c2 3 Ea. add'l 500 sq. ft. or portion 33.40 1 9 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK • Each manufactured or modular dwelling, service and /or feeder 90.90 2 Di) t u(5 W PR /i(r Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 X PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 0 / ' 4 ,» - 4' - 5 i 1 )7t• C_ _ ` dM P1 041 17'7�� 601 amps to 1,000 amps 240.60 2 Address: L-)2 ? � 0 &Abi: to soon 57 � SiJ /7E /o6 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State /ZIP: L kieE Wi - -a f E q 763,5 Temporary services or feeders installation, alteration, and /or Phone: 9) ] -- 38" I Fax: (503) 3 -7t J 5 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 ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with 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) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax:: ( ) 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: 6 rt 9 l ���4 LL C Address: t O � 6 Ox 2 a Each additional inspection over allowable in any of the above I Per inspection 62.50 t9 City/State /ZIP: ' r' Oi/ O ®f , 1771'6 Investigation per hour (1 hr min) 62.50 Phone: ( 5663) 3 8 z, 7 Fax: (5 63) Industrial plant per hour 73.75 o ELECTRICAL PERMIT FEES* CCB Lic.: 2222_ Electrical Lic.: 3 _go Suprv. Lic.: Li 5 Subtotal Suprv. Electrician signature, required: �,� „ ��! Plan review (25% of permit fee) — 19 11st A 0A, / O. _ } Date: L 12/ 4 e� State surcharge (8% of permit fee) Print name: / 1 5/1 E12/ Gi' �i �✓ ! J J TOTAL PERMIT FEE Authorized signature: T his 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 \ Budding \Pennits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/C0M/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: 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* n Vacuum Systems* n Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: Audio and Stereo Systems n Boiler Controls Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC • ❑ Instrumentation Li Intercom and Paging Systems Landscape Irrigation Control* Medical Fl Nurse Calls I I Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ BuildmO 'Permits\ELC- PermitApp.doc 04/03 AAA . A A , ; A i r f i STREET IEEE CERTIFICATION .,. A \ I, ,4�t��, . - �'t_S Owner /Agent for g am• Vic. i (a..ti...,,,,, �c lid (PLEASE PRINT) / ,,„„ (PERMIT HOLDER) A / :.. iYT, . , F. D. i :, Do hereby c r& fy t : a:If foll=ow location . ' ' :2 sa. `� rte' 1 : .. '1. meets f T ardf Wash Igtori County �.�a �..,: �.���:�,n:.�:w, 0 . land use and development standards for street tree installation. 0 . 0. 0 . ADDRESS: / : r .,4.T, -r: °e. /4 ,O 0 . 0 . LOT: v2 3 SUBDIVISION: S ,...,y.,,,`.. 4,`ok .-c___ i --Z------ 0) B Y: DATE: F es— C)s RECEIVED BY: DATE: F7 � 0. A L VVVVVY VVVVVVVVVVVVVV' . VVVVVVVVVVVVVVVVVVVVVVVVVVVVYTYVVVVN r , -- CITY OF TIGARD ' A • BUILDING DIVISION i PERMIT #: MST2005-00104 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2005 Phone: (503) 639-4171 4 4941 iik` Inspection Requests (24 Hrs.): (503) 639-4175 .--11A 41 -'--\ INSPECTION WORKSHEET FOR ' DATE: 8/25/2005 TIME: 7:12AM PAGE: 39 SITE ADDRESS: 15380 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 023 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.307_7538 Inspection Request Scheduled For: Date: 0/25/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message .i 6 699 Mechanical final 014286-02 503-619-6452 N Corrections/Comments/Instructions: i r1 PASS PARTIAL APPROVAL n CANCEL EI NO ACCESS I I FAIL — CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: ci(c_____ Date: 0 2-/Ss i ° -. 5— Phone #: (503) 718- , „ CITY OF TIGARD , . • BUILDING DIVISION A PERMIT #: MST2005-00104 13125 SW Hall Blvd., Tigard, OR 97223 Ii DATE ISSUED: 4/19/2005 Phone: (503) 639-4171 e1 Inspection Requests (24 Hrs.): (503) 639-4175 'IL INSPECTION WORKSHEET FOR DATE: 8/25/2005 TIME: 7 PAGE: 38 SITE ADDRESS: 16380 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 023 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached i OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503..387-7638 CONTRACTOR: DON MORISSE] I E COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 8/25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 \9„! Plumbing final 014286..03 603-519-6462 N ti t /I Corrections! Comments! I ' • -Ft ,.., `-- \ 2 .... 0 L \5d • IZO o q.kl: ' 4-e--9 S Q' - \ Za c \fi) imAA __<._.... - ._ _ -VT vvitt,;„"- L 3 4 '\I -- 11 - + S 6■1 9—I - 7 \ - 7-6 ° (10 It • -1 \ ' • A , • • ' PASS 0 PARTIAL APPROVAL fl CANCEL n NO ACCESS 1 I FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: V (-C. .../ Date: AS Phone #: (503) 718- / ' CITY OF TIGARD . - ��uw � n�'u nn����om�� ` ' — BUILDING DIVISION ~~~°"~~^°""~=° ~~"°"~°"~~"° PERMIT #: h8ST20O�O01O4 . 13125SVV Hall Bkd, Tigard, OR07223 D�TE|SSUED: 4/1EV2005 I Phone: (503) 639-4171 1 Inspection Requests (24 Hrs. � ~~~ )'(5O3)630'417G —u��~ « � - INSPECTION WORKSHEET FOR DATE: 8/26/2005 TIME: 7:12AM PAGE: 40 • SITE ADDRESS: 15380 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 023 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON AA{>R|8QE7TE COMMUNITIES LLC. PHONE #: 603487-7638 CONTRACTOR: DON K40R|OS[lTE COMMUNITIES LLC PHONE #: 503-387-7538 . Inspection Request Scheduled For: Date: 8/25/20O5 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final \ / 014286-01 603-519'6462 N , Corrections/Comments/Instructions: Ri „ V I , e\m f , y PASS | ! RART|ALAPPROV�L �� CAN�EL �� NOACCESS . 1 �� / / I | FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: �� C.0 / - � � - |apec�o� ' . • Oata� � �' �� -n Phone #: (503) 718-