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Permit r CITY OF T I'G A R D MASTER PERMIT PERMIT #: MST2005 -00060 yc DEVELOPMENT Tigard, 3- 639 -4171 DATE ISSUED: 3/17/2005 PARCEL: 2 S 109 DA - R022 SITE ADDRESS: 15412 SW GREENFIELD DR ZONING: R - 7 SUBDIVISION: SUMMIT RIDGE LOT: 022 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: DM197 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 17 FIRST: 1,900 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 694 sf GARAGE: 662 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 258,312 00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 2,594 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 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: 2 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 0 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 3 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL /PANEL: IN PLANT: MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes DON MORISSETTE 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: $ 7,914.69 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 / 0 Issued — , /' /L 1 _! . Permittee Signature : k 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. ' "^ !g Permit Ap iicatjo' r�1 FOR OFFICE us e ONLY 1-�, of Tigard ° ,l Received � i — �t ermit N o.: �•� - r City SW Hall Blvd., Tigard, OR 97223 DateBy: �p��� P f - - ) 0,066 g Plan Review Phone: 503.63 .4171 Fax: 503.598.195018 2 5 2005 ^ ^ y�.silttir 0 0,i# DateBy:M 3-1 / —G Other Permit, fda‘ 0 ,. Inspection Line: 503,639.4175 pJJ- _ Date Ready /By: Juris: 63 See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method:j—/l U �� Supplemental Information • ' R DIV �-e. I IILDING S g A) `(' -dUi t __see t .., .. ., . ,_ , ...... . __ .> .., ,..., ,. .^-. `u ,. - _K, - : c,- t . zt - d =v - - ` " r' a rt,,. TY'P F',: RE LI D± tI ' t ''2 'EAIVIIIiY ELli 'O . ORK;''� A A +;1` =ANII W - :*1.: :`%5. +., .T..., ¢\'' .r :,x p•.rtn_ °tG +.:s.' <: +.`�.',.._ e � ^ ? : i_ v.. ... _.,,, •, .._..max, ,.�: ..� >t. .v ._. r ,.. . _ � ., ...n, b^,. _ .. ,,ks,: ' -, - .l ,C •s.}:. -T.G r... .. z:P:. .., r _ _ : .F :, ^.. -� .........� .... , `_ �o`{. ' 'x;�:;�'"��, ^:Vi ?.. :^:' =�:,. as•;'.r,: ,z ..,.:, ,v,:r. :"t„ ,,:.._,,.., „n�S`1..1, .. , a., ^. .. :_ .ri, " :-- �.x,> -a' -. .r." _. :, �•n . c: , .•. ,: . New construction ❑ Demolition Permit fees* are based on the value of the work performed. - VVVVVV�T\ Indicate the value (rounded to the nearest dollar).of all • ❑ Addition /alteration/replacement ❑ Other: • equipment, materials, labor, overhead, and the profit for the • +,_: y -;' ` ,t.,- e t s ,':` :'w., indicated on this application. - '.;�w.`` :.='i e y< ,..�d': =,:. [:' �4, work to ' - ?! „ = a-: .,. +� v Oii'iy�COLYST UC'PION,; =tt K,.� Y r .4. :,71. .,: ,.'�+'�' �ii+s -:` :,r.'- . �'1s,i , .? .R, . .3 .. -,a .tPnvs ±,.X -.. nt ?ir <s� = "w x .. : c,:..: ., 7i- `,.�•; ,... _,. _. ;; ,:,�;;x„ a, "." .. s :.�..r.,:�:,., ..,. , ":�t,.,., , :s,.,.:. +,:^.., .. _ - Valuation: $ 1:1 I- and 2- family dwelling ❑ Commercial /industrial Q59 ; - 1 . 1 • a_o El Accessory building El Multi - family Number of bedrooms: • ❑ Master builder ❑ Other: . Number of bathrooms: :N:n'.;• •�Nsk:: ; KX' :;Ci': `,S:.yr ^ _ 'al'„ vYF�24 "} ':'Tl { - i' "4k'e'i': ",; 1>4 t,.. . d a y .!<,4�; � Yhr':rt��. '. (tr l' *'!,`Y •t,,+u.,,'» ` t .- , v:i'`t`;.011r.0 , d'`s;]„`. •S?.�+ �: ..r;, ,, :• r/ -"t.'•r'is`3 &1:,,sAr.� -?-.a :'.Y ' 'iti% , •J,S , ; ^� ^t: »<f J n . r "{ ` �,� i , c r k,:fl''e,� :.,,, e, � r a ,r. _;,': 114 ,t JOB SITEr,t�T , ORI VIA '1 , ,'D :CL O'CA TIO i : a0 . 1 ; i` ' itig • z Total number of floors: i ,. >ii :ma ;�., - ,<,i�„ ,.:;' ?:� .:-. , - , ± A:i,,��r�>oalt: z��tly�: °;9�,;. >.. .:'s.�. ".�, _.�:,ia'm;».o . ,,,,,•a3°..?esau�isx ..k,�`zr:4',ii�'+s.. ssei�ea,:�.a;k,.:;�:+� r.:.. 'w,^ A._...!P ,�,...,.?<F� -., _- �...:r� Job site address: / a Y` Ut x � .- P� -�—I,� I (1 New dwelling area: o7\JCI L square feet City /State /ZIP: G I Garage /carport area: L0 l 4 r� square feet m i 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 �' nt{ z��sa�Y'- �sxi�,'" s �^ �'' '� <�ifit,t "G °_r,,twd.�.t ^ ";><p;v �'� t'.. aF' r"s.. „£;b,r;:ga- °:a:r:)� '1i Eok :Ia' A A (OlKME C i 'E,1CHkCK1ST1i ;.; Ft .?* ,,,giiz:c.!<t,gv,virillvAm . -s . •7 u.:ant,Sirsbfa:t:.x,,,.. ,,,, TYai,ak`aSo-L Subdivision: c , ( - y ) k . , 2, fQ_ Lot no.: � 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 equipment, materials, labor, overhead, and the profit for the :`• ' m ,,.s, r'l.y . d H: i . ' .i'F' 'd1 , ,3;`,• _ ., r ,.> .at, Y: a „r1', �, > ..r ='id.!.ii'. „- = •:; =-_ . >':� .=G :�•_�: indicated on this application. ;, i es. ,� work indica a y D , RIPTION't . OFu:: ORIC • .., -_ .�r , ii ,,,a s?} 7�`t „r�' S:C , . ,W, ;= ,�y.t�,.` ,la „� �, -1,� PP ,.� f_l -. .�n_..,,�. ..r.. ,.” ,,., .,, ..�,.. .a,�a : v ;} .a. n :'[d'a.r.!':i^ �, ..,.,i:x�ti,°. .. -, .... - .:F "+',. »,e., -.. �.. .., x Valuation: $ Existing building area: square feet New building area: square feet - �Sati ±'s 4;iaw;>: :'A iri+ d: �;' + "s ^:a ? ,�,1 _: , ,c �ii: a� +t;". :�•f;;f -, ": � n'�Pr,: - v °. 1 . ,. , , � 5, <'F r,�,`�, <, _ i�rX;�e:;hl ,n,!t :%ii ' �'Y fx'Sk `�i; "t ?r r' u' -_k „ «- •fir _$ ,,? . '�', ,' . >•y.:a r �., . r,s.,i4r,'; 41.,;'v. ,,,.,� `r;:..< ::;t >T' ;. t.«. ..i, ,- ... . 5.7 c4.4,1 - : Y A :NER.,,. .. , :, .,,,F 4 . - ,, T r,NAN , l y k i; ; ,. s. r: Number of stories: ,..'",,�,' `:,' _ w -� °m 'diw„t_�i, '., S'i•!.yw "= t "-T �.i. � ' �t�t ";F_. t:� .,, ".. _,: - rte. s:.;tp fry . < *e.'2"-a;r.�iA +'"�,k•7Y�� }?, .. _-r `es;.i ='.' ,''.��r .. .. a�i`.` ,�,��,i�.'i`,"ri- �,','s� t�`+:ea tsess2� hcs :,r.�xt:r-= s`i4'=ri.�Y��!'t =�. *•f.: sit a... Name: tbs • GO M i tt t1 r i „L'.� J/ Type of construction: 1 —('' . C Address: �t7 L �( ) 61 j ( �, ! Occupancy groups:, City/State/ZIP: L4 p c �L + � --7 '70 ` Existing: Phone: (j' :J) J J� -- �� Fax: ( ) j / `- f.„ [ 5 New: �.», - - - at:;?,a4.4-7`a ".`Y » - : <a•vrr:', - �: :^ - v a, = '',a8!;• •,fir xaii'' -i.�' ;'r;;t,s_ - .,.ta.; o »t : ,.a S ,`t;I. £tb'1 =i S; ?�- - ' "c'•4..�c< =Gih;:tri` :., F ,. t , n -C ;t.iT:u5{ � t�. : }fie i. . `v a +,;:d `:1'; z.,1 -- f `. V , � *,`� .r£,,, -:irF;rP•'2L'br[,a� - `, .N ry . l; 1r � 3 AP,PLL .., . - ...,� n. 1' t I i .._..,.{: , .•, . t te TA @ ' PL'' O ; F 'sl ; . - u ,; ” «A_. . . .._.. 4 , ... •. . , 'sY. .>.. ...t, '::i .�:, ..,'i ,.rx: ,rr i R, �Fk:',r }�.: , -. .' a!,, �T n ._. » „ � •. .e, ,. x.... . :.x3 .< , A ,_ .a, ...,, n. ,.. ., r._ - h..,.]. -: .,3a..tt, i .. _ �„s,_.:y1r. „ - r4 - 54u . ,•1, \O' Mj _ r }'ti: s ,:J;,y thi, { .ir` ”' ,._• i;tl ".;, rit ,S1',+7,• ''--- e P 1:s.< -, All contractors s and re re , . ui ,:ed to�` Business name: All contractors and subcontractors are required to be 1 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: l _ 'r ., :ja `i%t w., }: Y,: 'x ";r'i �,.•' CONTR'ACTOR.1:- •:4ti:: i''e Business name: c. � P t BU i� �'' Nave, , , -i:, ' :,,.,x:; �IT�DING:.PERiVI�IT�`FEESY.: 'Address: 'r:r: ,u. �,.. < '• Please refer to fee schedule. ' City /State /ZIP: Phone: ( ) Fax: Fees due upon application ( ) CCB lie.: _ Amount received • Date received: Authorized signature: bitkel—' n This permit applicatiomexpires if a permit is not obtained � within 180 days after it has been accepted as complete. Print name: •�, 1-2 i Date: a, l ib O * Fee methodology set by Tri -County Building Industry Service Board. I: \Building \Permits \BUP- PermilApp.doc 12/03 440- 46I3T(1 I /02 /COM /WBB) i l • 'A 'luuthin � Per mit Application • ' . .FOgi OFFICE USE ONLY City Of Tigard Received Permit No.. 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: ° �� 5 2'�O Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /i, 'athtrior i i\ Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 !' I �F�� J uris: Date Ready /By: ® See Page 2 for '� Internet: www.ci.tigard,or.us Notified/Method: Supplemental Information -' • .. . _„ . -. . ,. ..F .. .. ... ... .. .... ... .. .. �. ......- ,,, 7- ur.. a , <:,� +s "y,',. '..a,i: Y� ,i. z'z+i- rsr.rs - 4JC _ _ 3. J -,,w, 2.- ,1_r, . . w ...:. -., -..., . -_. ,, r,. .. t .. „ , :r ._ _ r. . 1.: +i.:...._ . ,.,. _ _ e- iz ""x.- t ^f: ?t .n, ..affil. -. ,. -,�. ..,.-, . ..E .t ,..,. s._ r -. .. .. ...... .... �, e..- s .1,14.,c'1.. :-1 - _ . ,�5,, <,- ..' .= f„Y+'' .:'t`F -y"., <. 4u . ,i- r .'4;. , . ,k.. .. -�.� .z�, r rN - ;,i' 1 -t - vi•F..'. . ... .... ......,..... , i _, -a. . ., , , ., ,,.., - .�, -.. -,r °, "fig:_ - 1` °':::.`.�.r. :.t' >,. .... -..., . - „, .. - , OF.. WORK. ,.....�_,, a.. , a�.w .r... ,_,�..,- •, ,.,:,.: ,.k., ,' � „� � x. 'r. �..,,�.. ,�, �$ t .r. p ``FEE, .SCHEDUI9E:n�'<:r,;,:- '. .,.., - a. 8 -: . � ..-.:. �,' - ,..��.. us ..� -, .t.. ..,. .!�L -... 2... .,..,�[�3. a�.. .?._i .r._. ._. -.. ,., .. ._ .. ... ................ ..._:�.t,... >_..7, >- Y_- . ". -._. .,e J.a?w, -. r.,_,. , .,.� ,. ", :J... .`itti ., .���Y�i .. �... . %''ioz %3'�::a:.srk:.,,:m,�.,, _, .r, ,. -..3, _.. ...., ._.. New construction ❑ Demolition For special information use checklist. Description 1 Qty. I Ea. Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) m ' �?sf`: :x s:*," _ i i w -,,�: --., • - •;k7 „k;A,.Y.i g :' a'[ s m ' ' CAT.'EGORY' OF "'CONSTRUCTIO :f , ='.;, , ':: , >j . ,.,., <<y �'� - ;,, SFR 1 bath 249.20 , ❑ I and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 t ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: =-;, ti ._a , - :- :. :',: >: s ';v Fire sprinkler ( sq. ft.) Page 2 .=> JOB . LU ` G ATT O N :a =.... ,t= .• a." y `c }tip -�� :PX,x :. i ,,., . , '. �.,lY ;. '::i; , , .: .L. .. fi _r . " -5. ^ ,., -.a. :,,,, stG� ... : :YiGd*: r ,. ..,...., ,.,_._... ...,:r. t utilities Job site address: I 5L.1 I ? � L reen tcQ � l � l � Catch basin or area drain 16.60 City /State /ZIP: Drywell, leach line, or trench drain 16.60 / i S GfC� 1 OSZ. Suite /bldg. /apt. no.: 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: c XJ ( - mil 't "Z,19 Q I Lot no.: aQ Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item :• ,: a <•:.z Gr :,'.; c ams,: >s :r r „ =,::, x.,:m:.�.,��s Absorption valve 16.60 . i:fi;c �L- `!y }:'• 3,x,7 ,rig, �.,t5 ,1.�._„as.,, r..- ,.4. „i�:�;�;R'�iG'7 ":i+�r`,,,,. ;t ., ''a `' ; s DES`.0 D RIP :IONi pF.�..t' = p %; 4 r .x �r.�,.t, : ;:: . �,1,,. . - - .,!t,.'iz. .'i3` - ,i; t {r�[: ,..✓..a .t.: :a:.;"s „ ±±�.[..s;= .;i.iYk J ^,�F,.t.,, rx4tr.:jrt__;S,rc, c @,; -..y " . . .... ...... . ...:. .. � „ca:;- r�<; ?,.,_ ..,_ ,. ���:. _,: -..... ,~ -, __:; -.: ,..�1._„:jv <:.� . -a,. �., ,.. �; F, �.:, r,:..,. �,�:-,:6�.a,a..:�,- ....,E,A�,.. _.. , , , Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 _ :,: w.;. r:;r., -s t r = ,�.r [> -fr.:, ..z,< ;,.s : ; ;.� f4= . _ q,4 Drinking ountain 16.60 i 3':' ° ' 7 ' ° - �' +' - o k.; *.lr. ".�}.,..5,. Ka,. ;y ''.ti. - + -� �. ;,:;`eF��li:;t' �� � g c j -i ''��i ®, P, ,,t:t tI',S1, : , :Riiik� '; ., it , W,. „ . , :.tT' s ''�^:_r '.,: ,..�.. „::a,.,�N ° ilaf'�a. =��r.,,� X�; EiiTAN�z,,,,.,, ;' ,..-..r._' ar, ,� ?x� ...r ,,...z,t ., •_..�ra�<•,as : t.:,_: -a :r,Mr:- ::.�..:•s.. a: Ejectors /sump 16.60 t e Name: WM c G\ B rn r ruin' c- - c l l s ' � L L ('. Expansion tank 16.60 Address: . tot ,�e -� , c,J1L/, [ Fixture /sewer cap 16.60 City/State/ZIP: , ` Floor drain /floor sink /hub 16.60 Phone: j%-2) . •-• 7 o ' Fax: ( )� �� ( rte- Garbage disposal 16.60 a ''. \ . :r ; fX` ' +i' ' t'' , : .?;: ;: ' tK >' + . S ', rb 16.60 ® ` . 5:. r ' ,r <,. >;,.GON Iii PERS© ,1 V �.. .,. . _ :.. � _ " -._ ,S .,aC� °....:.F9,e�4. •.,.. .......... ,. . A --.. _ a. >f :. v.ri.v.,: -. * .! ._ .Y,k"e�:,..., ,_,_. tAi ?L -,, .•A Ice os m aker 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: ( ) I Fax::( ) Sink/basin /lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal . - - - >,r ?,41! „:; l:ti"lS -",tali;; -:�,`. , ^1 ,... - :'�. �k,'i.' - in '. { .y: 3 i, -:12. ',�C;, - '!i'�. `:t < ' : -° Ls . (' �":j„ s" ..11,. fig,.;. - �'',' Business name: V Y K_ Water heater 16.60 \ Address: 1 Q t c:1 Other: t,y,• Subtotal City /State /ZIP: 1,(4 ( l ` /F-. Minimum permit fee: $72.50 [rxPhone: 525) 3t, Fax: ( ) Residential backflow minimum permit fee: $36.25 t :CCB Lie.: • 0 4. 6" - 744 .--) ^himbing Lic. no.: 2 7 X17.1"5 Plan review (25 %ofpermit fee) State surcharge (8% of permit fee) ?'''Authorized signature r yr' � TOTAL PERMIT FEE :`°`Pr I .s.- i j 4 Date: ju r J Thi permit application expires permit is not obtained within es if a a,u int name: r `J p a , - ( P PP P P 180 days after it has been accepted as complete. - • r; *Fee methodology set by Tri -County Building Industry Service Boardi'_ - °ii: \ ? Building \Permits \P LM- PermitApp.doc 12/03 440 -4616T(10 /02 /COM /Wea) - ,�•'�,r1,',' • : �, •,-;•,40-1.,' • :y 1:` ;i, t '`s -• a.i'd'":;ftWft.,,,3i Electrical Permit Application FOR OFFICE USE ONLY Qty of Tigard Date Perm tNo. \W2Gd.5 l/I 6 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 A4,p'11' p ' ))1h\ Date/By: Other Permit: Inspection Line: 503.639.4175 r .1 Ail Date Ready /By: Juris: 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information „_ TYPE k_.. .� ORK _ ciEIL'AN:;''REV New construction ❑ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: over Hazardous Service r 225 amps, comm'l ❑Hazard location ['Service over 320 amps - rating ❑Buildng over 10,000 sq. ft., :1':v S, 421 ';j 'CATEGO OF =`'CONSTRUCTION,. of 1- and - <j�'^ � nd 2 famil dwellings 4 or more new residential - . -- v': -�. -...' -�.• tea. ; •� ..._ :... -,x. _, .. . -., .� •,...k;1� .... -�:..�; ❑ 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure 111 Multi-family ❑ Master builder ❑Other: ❑Building over three stories ID Feeders, 400 amps or more yY ;a , L ['Occupant load over 99 persons ❑Manufactured structures or x " OB:' SI'l E "sL JNFORMA'FION AND Ld TION''s �•� t,'' , `t ❑ Egress /lighting plan RV park Job no.: Job site address: C C, . I 7)r ❑Health -care facility ❑Other: 1 5� { 1 � i � c 1- LA t� fi Submit 2 sets of plans with any of the above. City /State /ZIP: ' j 0 Of.--- The above are not applicable to temporary construction service. oi �,'j0 : rviv w"p d;1 i, - {1'i, i.3; a,lpi ' .i , vi „ , w,ij„rKi': ,'., ,,s ,t ^ x,.H, • • ,� F ,F ..., : .:SCH ED 'IL i E' v .;,. . -.. ° Suite /bldg. /apt. no.: Project name: . - „.... � ,ir• .., - .. , k.._.�._, ,,, -.. ,.,,,,, ... -.._ ��;.._,. v _.. ' a�'u'_.._... Description Y I Qty. I Fee. Total `* Cross street /directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Jon l'vli t--- qtr CIO . Lot no.: ft Ea. add'1 500 sq. . or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 :,,:.,.,_,,:F.: energy, non-residential Limited nergy non t•e 'dential 75.0 2 i f _ %D SCR ,TIO.IV OB:” „ORK� �'� ,..,tr. . � . ... , manufactured or modular . ,- - ,. ,.... ,. . .<.. �"i ��:'. _ ._.. .':`��S;.:v.:- .. .. x..« . ,. .w ... ..:.a_.,, t « ,., .,: �, fi.77� -. ., �. _...!.c�{,xR$. � , �' {ii U. J,.v,. ,. �.,: Each ular d ,. ..r_l. _)...; ... �: ., z,.., nl, t. t,..,._e ,. -. . -.... .... . , -. �.: ,. .. ..na:- �(�.., ��, .r �.� dwelling, service and /or feeder 90.90 2 . Services or feeders installation, alteration, and /or relocation 200 amps or less . 80.30 2 <; •. : 201 amps to 400 amps 06 85 2 'roi;'.'`,'�:; ` �.�n�:ix -�: ray:= - - t�i P P _a; +r : a..:, i't': € PRO.P'E s; . ....3, i ii , ..` .- .;. BEN "AIV „fi i ,,x ,`` ..,-�, ,- !,�lt,x., _ ..�, n , !;x:. +�Jmk1 :.IS,!3.f:7�, ., k :: - 9 ,; ,'2,..• ' r. , � .. .; � .�. -"(�;� i �43".'`',T :x„.. .:.r.,,. =;,.;, .,,.., � y,:, .:_. , _.,. ��.... �_... �' fi° fi �. j, � �", �� ,: �;_, � ,,.,._ : �_ _.;u�l��. 401 amps to 600 amps 160.60 2 . Name: OY' C L .I J 601 amps to 1,000 amps 240.60 2 )J N 7 ` ) �J Over 1,000 amps or volts 454.65 2 Address: L'a..L- , l Reconnect only 66,85 2 City /State /ZIP: Lattz_ U1 600 'I Temporary set or feeders installation, alteration, and /or Phone: ) 7 •-'7 j Fax: relocation �). —2 - 7(015 200 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'. �1':.rtt * -:.. , .4 {a _ �. - ..sn.:h,;u. ri�.1Yl:_r'rl. r.t ��" _ =�a 1• i • �,. ':,;;• , f:= ,,�: °<,., �r:;� "';`'' t ;" _,�;;;;, , ..,,, z :: ❑ ' AP,PLT , r ,..,:. i, ,s,;, w ,1.,.. r.. ®''(lONTACT PERSON EAAITz,': A. Fee for branch circuits with :, -. ,,. _.,_ >„ to .- ,..,._,:.r,_, x `s:`x.,..:. Y.ti _„ .. -,. ...- .,,_..,......,... ,,..., ....,..J.,;4 >rf1,.. „z . service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, • Address: • each branch circuit 46.85 2 Each add'l 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 - ener panel' alteration or O CTOR ='•: g r Business name: C� f7� Address: rf/ extension. Describe: Page 2 2 ` /v SV v ° ,,,, ( , r � , t ,� .�� Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: . ` (I4 G /V' 6X q . -9 investigation per hour (i hr min) 62.50 Phone: _ I t .. C- Fax: ( ) v Industrial plant per hour 73.75 4 'ircP;:�?4,'Or {���; t3EI 1`�C RICALi tiii,MI-T'IFEES'" '- y J CCB Lie.: �� ,D /v �_ Electrical Lic.; , U Suprv. Lie.: 3 5 Subtotal Suprv. Electrician signature, required: — ^�� Plan review (25% of permit fee) ���� State surcharge (8% of permit fee) Print name: t A I Date: I y � �� e /•� TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 Print Hanle: days after It has been accepted as complete Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. is \Building \Permits \ELC- PermitApp.doc 12/03 440 46157(10/02/COM /WEB Mechanical Permit Application FO R`OFF I CE US ONLY. r ' City of . Date/By: Permit No.. 131`25 SW Hall Blvd., Tigard, OR 97223 y �� J ��� , �� d..6 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / /y� �NiM� i iii i t Date/By: Outer Permit Inspection Line: 503.639.4175 ��� • I � t Date Ready /By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us c �� W Notified/Method: Supplemental Information TYPE. OF.. � %' ,�. v. OMIVIE "GIAI;- E �D - -t -. R F _., S CHE UL- E• "'�� °sUSEiCIaECKLIST g N ew construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. c�.'45 - _ `- .54;;1 =;. :.l. j sa.0 - a8 a; >t`d" - '"t1' ° -tl ^e: - ;�f Value' {y, x'CATEGOR - OF'�CONSTRUG2ION•:' •, - $ ... .t� ...t ° t .. .. .... ... . . ... ter . v. : E.QUIPMENT� /;,SYSTEMS'FEES ,. „ ;' • ❑ 1- and 2- family dwelling ❑ Commercial /industrial El Accessory building "' ❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist. Description I Qty. I Ea. Total -.i "c',' - v`i`a : +ro �.:, E4a:a:i� „.yy..; : ,JO.BISITEINRORMATION 'AND`; ^liO.CAT?IQN��.;.,, , ,,,.., Heating/cooling Job site address: I �� I /y�} Air conditioning or heat pump I J - 1 ` G re.„, a le) X , J� (requires site plan showing placement) 14.00 City /State /ZIP: I - I`--- Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or 0 hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Lot no.: Flue /vent for any of above 10.00 Subdivision: m1� R ;.Q Other: , 10.00 Tax map /parcel no.: Other fuel appliances »x", ,.rz, �:; �•;,�ar �. rt -#.; ,;n3,, .::iaa: ::•r�•s:.,a >, - .' =r� °v >� <�` - Water heater ;a v 10.00 _ , "t �'i ''D ,T+I 'it'' DSCR'IY F: =xW ° �,7. �;,; - ''xr`i ,�r QIY�::O O • r; :� ; r . .�..._ ..., .x -. ,.3.�•..:�iR': ,, -.- .:tii�':'`- `sr:�, =ex„".. ,., ..�: ::...a.,,::. ;:.t::c.�"•."r'•rn•,.:, �a „a,.,. i..�:''i�,.: .,.:",t:,... a-��t�'..t',: ws.. .._.. +,:,A,:•. 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 - ,;:._, , ;L : Chimney/liner/flue/vent 10.00 ". :.;BROEERTY`sOWIVER . : .T'ENANT ;;k ,:::,,,,„,-.:•.:„!,,', ... ...E , .... .. .- ' } = �:k it:..� . � "� ,�M1 + . =t+. ;?r, - ...�wi.,:.,....,.,._._ _ ,.,,_:,� >,,.,,._ Other: 10.00 Name: . 11a - � XkI(?f .L)e Environmental exhaust and ventilation Address: N. /. , .1 II L ,/? , l Range hood /other kitchen ""' lll���f'//J equipment 10.00 City /State /ZIP: " I (5) �O S Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: -�&- Fax: ( � 7 --- (C I toilet compartments, utility rooms) 6.80 ; :, 5 +,. - - •�':r.'x: v �air, . - s'A,'i %ii L f oicti ':, . "p ,rr'sK ; : 3 : , '` ; 1 ,�;. p 10.00 _ �-t?, + -: E- ,..�•: : :�f',:.a_' ;q,� , tv 4:; � � =,'f � Attic /crawls ace fans ,.AP.PVYCAN,, ,.,. e:_tN , ❑I_CONfiACI 'itRSON,4 .. ; 44,, . P se, ,. �'� .'" i' S�; �7 = �._-.rn m;���,n„ ..rt':ax,v,�r.,.. ,:a:NCC;rI.':,k r;,,ra3t,� "i. ,�,. X3, r.=.S 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: ( ) 1 Fax: : ( ) Water heater E -mail: Fireplace Range c �. • ;k =ry ^: ":> ;, ` TRACTOR rat „> \ CON �cix' Barbecue -- , ...� x• _, cF •,r.::pn f -'c.: : t: , :Yx<S „ al � i'.'Fe ... :. AS�' "� . sue , - n'.EZ:: ...., . . .- i> Business name: , ._ -.: . Clothes dryer (gas) . A �s t (. Other: Address: 0 /'� • L ,li ;,vt = ,,,:,.,.: - ., l f I ,r . - ;�2 ,. MECHANICAL;PERMIT 5 FE „, k „,„:„...,,,,,,,,,„„ . . , City /State /ZIP: V �e& �1. ( Og 7ck .. Subtota V t Minimum permit fee ($72.50) Phone: ( ` _ 2,�� 'l. .l Fax: ( ) Plan review (25% of permit fee) CCB tic.: . � / ✓p � J State surcharge (8% of permit fee) � TOTAL PERMIT FEE Authorized signature: > ��� 'S This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: (/ 0' .. \ O r 'e.4 I Date: 0 I 1F O- * Fee methodology set by Tri- County Building Industry Service Board is \Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (1 i /02 /COM /WBB) AAAAAAAAAAA.,s AAA AA r AAA'?: A - AA A M ® '' . • ,I STREET T REE CERTIFICATION r. .. ® A I, L�k A kit , {' caner /Agent for te Okov i`SSC ) CbMrh,tn eC (-LC. ® (PLEASE PRINT) (PERMIT HOLDER) ® , . a :. N � ., ® Do hereb ice hi tt th`ez f oll ;owing location I � i Y .I =tea:: r ;; ® meets, ty :of i ard/Was °hri on \ County Y l and use and development standards for street tree installation. • ADDRESS: icli12 5 6 reen i`z D p. LOT: 22— SUBDIVISION: a,, /e.0 • BY: DATE: `7 �� 1 D. ll RECEIVED BY: "DATE: Q �-- A V V V V T 1 V 'YYYYYYYYYYYYYVYY W,' VVVVVVVVVVVVVVVVVVVVVVVVVVVVVY Y CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -04064 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/2005 ' Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 I C C INSPECTION WORKSHEET FOR DATE: 7/7/2005 TIME: 7:10AIV1 PAGE: 74 SITE ADDRESS: 15412 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 022 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSEI I E COMMUNITIES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 7/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 010919 -03 503 - 2099-4837 N orrections /Comments /InstructtiQionbs: �A IVb G�} -� T k , ® die a �d� ��C2 /5 _. ,,� Z 1 c 7 . t . 1l1/iai %r.1 , .\-ems- 11 -- o )t A' e t� `.1i2 � C,v f ( 5 NA -S /...A-.7e -- C -- IU ck"v` -ate C i ire ■rQ__.0 -(e_ . A-e_ c.)Le____ 4— C--- CAA -e-- kiQ CL_JA.r-42 9 6 S-eC , t • , • e-•--k— - f .e, � -- u,t- - l 4' 1 G.. f r 5 v �b-� (/VAS crkitki5„ «.�,.`.�'� • "7 ❑ PARTIAL AP OVAL ❑ CANCEL NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: '\‘ 7/ Phone Phone #: (503) 718- CITY OF TIGARD t. BUILDING DIVISION PERMIT #: MST2005 -00060 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 3/1712005 Phone: (503) 639 -4171 � "rr���ip���ypi�hl)�11'� Inspection Requests (24 Hrs.): (503) 639 -4175 .J, INSPECTION WORKSHEET FOR DATE: 7/7/2005 TIME: 7:10AM , PAGE: 73 SITE ADDRESS: 15412 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 022 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: 7/7/2005 • Pour Time: Code # Inspection Description Confirm # Contact # Message • 699 Mechanical final 010919-04 503 - 209-4837 N Corrections /Comments /Instructio : . ti4 (445A U`- 0 Vevv-N' J - f--^-eA/ d•A- tAA5c; - '') -Lc ' t e-cti `P j V2e6 '17 , VQ/ M Ee 4 0- (2-0.N.4 vMY C ) gA ( . , s c,2_,Q � % A.....dte._ . r G fib f ?r,L,iel o 0- `\--AA.a s -i..-. • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: vV' Date: *7/0 c Phone #: (503) 718- CITY OF TIGARD ' - { . BUILDING DIVISION PERMIT #: MST2005-00060 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/2006 Phone: (503) 639 -4171 Oe nmrdi�� „ IP��II�'jll l \ Inspection Requests (24 Hrs.): (503) 639 -4175 _ .. INSPECTION WORKSHEET FOR DATE: 7/8/2005 TIME: 7:10AM PAGE: 2 SITE ADDRESS: 16412 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 022 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSEI I E COMMUNITIES LLC, PHONE #: 503-387-7638 CONTRACTOR: DON MORISSEI I'E COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 7/8/2006 • Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 011057 -01 503 - 209 -4837 N orrections /Comments /Instructions: Of 1 ..... _ m i (,) er ...,... 4 ____ 44 _ W .(....-- ( c.6 , ,,j j ......... k t L4 7—os - ela c..2 9j 6 /C., Cv . i--- ela j-cz-1--c_aS Pc.ve---4-v\-k- tc/) 9....Q.J__Q_,9, P7- te "� s z.,1/4,.......A f \J 0 —, 1 -- ()G <5 _ e -,-1,--1,---, Q.........,2_,,.... ,,,5z,,j--,..„,:,-,--, s . . M'' -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7 / 4 / 4 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00060 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/17/ 2005 Phone: (503) 639 -4171 11 % mpu[I����'� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/7/2006 TIME: 7:10AM PAGE: 75 SITE ADDRESS: 15412 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 022 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSLI I E COMMUNITIES LLC PHONE #: 503. 387 -7538 Inspection Request Scheduled For: Date: 7/7/2005 Pour Time: Code # Inspection Description • • ' • ' Contact # Message 199 Electrical final 010919-02 503 - 209 -4837 N Corrections /Comments /Instructions: AL UNI Afirt4 „ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ` N `14( lit. Date: 1 1 1 1 Phone #: (503) 718-