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Permit I ' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00056 14 DEVELOPMENT SERVICES DATE ISSUED: 4/13/2005 ° ' `— 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109DA -03600 SITE ADDRESS: 15421 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 013 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 407 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 308,231.70 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,190 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: 1 BOIL/CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 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: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVOFDR: 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 REV1EWSECTION 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 STE 100 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 387 - 7538 Phone: 503 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or Reg #: LIC 162512 direct questions to OUNC by calling 503 - 246 -6699 or TOTAL FEES: $ 10,511.11 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : i� Permittee 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. Buildin . Permit , 1 o '... �� " t 1; 1 F.OR O�FICG.USE ONL City of Tigard Rec eived Pemiit No.: 13125 SW Hall Blvd., Tigard, OR 9722 2005 DateB : ® A , /� � -- g ` Plan Review Phone: 503.639.4171 Fax: 503.598.19 Ow 4 y s'Hrlpi 1111 Date/By: ri.A4 f - '1 -6 - 0 S' $ 45� Other Permit: 05 6 Inspection Line: 503.639,4175 A y.- " 13 11 Date Ready /By: Surfs: See Attached Checklist for Internet: www.ci.tigard.or.us CITE OF 1�y.h`�I� •- Notified/M `� ethod:` -tic --c---1--.. ( eo, Supplemental Information li ,, sk, k-.1. _ ;, a:,tws _ _ �1 :1- - ` �.• µ " ..•, «�_,, ..... -er:= ._:.^, :., -_- .Yi;.`; :.mot.. :..': , _ .. _. .. �.....:x .,..-- ..._., {. -. - ..P OF- .W.ORK � � ,. .. ._ ,_. ,., „�: �UIItED�: sl": AiVD:�2= EAM1IY�DWETliIN.G' -='.ti` III- .sty -. .5:3, r,_ -. - '"-vim.. -. -a h,. c.r. z,,. ra..s ... Y ..ow. vz ,.. _, ,.. ,1,. .. •y'T6 *t'- -.-„1. �< - 1. 1 . �XU: .,.#.3... i,iT'� ... . _ .... ._.,. r ,.. . _. 1.,. � .. ckn V s ..:,, ,- 1 � }, t.- s , .1.,,w, s- . „- .::::isr' :}3 }`: , `S!.Er.tr_ < ... ... .Yfi "] r..1 '" 'ii::: - ,.,..., ."l. _,�4',n. _r .., .. . -„ __. R-o-x r::.:, s. ..,:5 �J. :: afi�'=; ?�•t« as' S”; "T "` " :-? '�,��.E -,_ -_ � �a#.;ra-,�ti >:' New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the -a. ,' ,, ;. a:va; ;,�h„ , ;.: g;W:;; z :t , - ;M'-+ work indicated n, =.r: �:. v�ais ? �i:; �` 1: . ,.5 . r,- ��'�._... .,, , d ated on this application. sa - - ,- F,.S.,, r�•I t �i , ,. Y; - ' } ��',:.: 2s `. , r .' :.S ° °� � ,s. ,. xCA CEG'OR OF': °.CONST `UCTIO :. , 41 _ `. . f. C 6 :`;tc;�:- s�;y t ' � ` 1 +:, a ;.7'.+. - .�:� ;�„ ..x.• -:. ..,� S x� >kflttrRa�' `-.�+; r: -,tf 5.�., „- ,. ;?aib " < ,....,, ..':� � , . ,... _•_.. .......... ... a r.,, n, �s. t a;- f,.;. �.. 1'..:. roc.,.,r.:,+;r.,;,v�.�A s.,�1 =`rti�. t• Valuation: i , ❑ 1- and 2- family dwelling CI $ Commercial /industrial t ( O"1 (0 . \ ❑ Accessory building ❑ Multi- family Number of bedrooms: th of bathrooms: ' ❑ Master builder ❑Other: Number o � a :,s: `, + +•:y ±.�4.i! *.�ro?e ::z• „'-aG „_:rrf= :�e'.,.; �.�:_ x; »x,v” ;ri„- ?,2: ";i?q i, ..,»,w,�s -<" �::4:; ;.'a' "�r,= i;.r; ��t:;• �.,.�,, ''<':+ .,,. .; - :I:T`< t'".id,., r(T^ - 1 : 4 •'1^ ..': "Di :;: .V,i. }.�.�rt�rPf "•c'•,i`, �� =;�:� - ;:.1 '} ,�.,;, r r , '' -,�. ,s/ 1's�i .t,l •r- Total number of floors: k',T ,' l ,s . z .r : FR m,, SST A:-4,2 LA ATIO k pD it T OC'ATIO ,,b x, {.: 64 , ' is }: ..t. , �,;'iti >•t� ^:�cr ,41'x'., „ .s. •��x,•.- .il.�"srr- Wr:;.� ., s.x4�r ,g ,,.,t _. :*.;�- ..r.,�..__.a�d°s,_vv�2.,, . «v,,.: ^3T's±M a".{(L':Ia�„?., +. .zar =s:,- xzXr,l„i,ikS�::;: n:• =.h.r„ ,�z= £zii_ '.S�. �i�'tl,:.t ,.,.o-,......•,Ja,i x. » .�, a, �, . ,.�k � Job site address: `��e�n�Q�.e�\ -0 New dwelling area: �`G �0 square feet City /State /ZIP: { ��. QJ_ Garage /carport area: L 0 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 ;�,, , lc•ce;= y+s�„n�,r �� � �.,.:. �i� °y�, t.. u�u:a:vra=.:,::. �:�q a,� ' , �,,, -, y . : : �, ,� _ °, , . ... . 1;r 114,1�CO.1VS1yIE> (j T 1014EE 4 IST' t ,x��t�r:, ",..r. va,;a!ea'��$zri?Y�;R `,��.± �xt,.a,.�, v,� : =us;:rrre;; ..r•�."f +, , Yt- , ta`ar -z \ot, �, M �,;:. Subdivision: -1 `24 Q ' Lot no.: , 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 - - .:r >,�" t:,y -, ';R : :. , =. _ ,:; ,: > r'g ^;.i;nY'.a "wTfi#:�'S�'.r k:ti:e:.x,: ,t Y.�: "r+ "�<,:��: � „ m ^.i3 :. : 9,4,J. .,t'a;;t.Y•� "Y ,a� s(.Y - �1 t r<„ ;.FiS 4j "�?- "'i i:i 1-` - ; S: '�1i ,+_ v;.i• , 's. §" '''A +.krJti .e .2F.'' : °: _ - - �rd� ,- .._;�, ,t. �. n. ,t.,..,,,.._k- .:,:' {. ?r "�...c work application. ` -'a � .�`���"�';n. x• ork indicated on this a o mi,,,'- <: ,DES'CRIETIOIe, OF'rWORK.„. :. :w .'. ->.�: P s,, ,��_ -. ..'.., ., r•.1.. ,1`,�:., .., e ... .. ... ... ..v- ..; .�'� >l��ife_,ia K,,agP",. .., ._, a§�' -., N_ ,.. _..,_ .�„ _�: ...• >s ..tmi'y'.•11'",+,:.r,0... Valuation: $ Existing building area: square feet New building area: square feet - - 'siYf:?:1:.ki.: ::ti: ^ JK ::.t; `.515 ^iht`:ir >: {. •t, .: p:Xi'.' „} S '°I A ;Y ? -`� : ak:i v .: -3' _,!1:`;. ^il "f `din 2; .'i4 ' ',;.. '.' it ,., r . 0 6,1 „ , ,`' ,,4 RQR,E RSTY/' OW NEII?sr, .e,,,r:, f.> ..: > +... 1`,T NAN ; 0 a'- Number of stories: ,+,� ^;� ':,' ;t d ,':?i`. ..t'<, - - -,nA ;, .. e; <C4bst, yk.'::;k " i�tf §. ,r °'� >� 4 'ctc _ ',;,�`st'izF.ri: "'•R�1::v`I':� r�:�; a�yS .., �...; -z.. _t]t�!:�`:t_ ti.�; _,7.al:2S�•rti�;:; �v: ; ,�..U�.t3,�w ��R,;,3iln�i 1.!t. fs�`ah:..-- ,�,.�;;_.,,. s,,., r _; . �� _, «�.., Name: u l r 5 C C...0 M M U J i1ta �,j,,,Q J Type of construction: Address: 2,,/` �t, Y ' �� � �T � j � V, l.� Occupancy groups: City /State/ZIP: 1--- C"V�L'� � _ �0 +� -7 q 7 / e) 5 Existing: Phone: 7 jV7' . 75 5? Fax: (;.GS) / '7I New: [:', - - 'i::3;'Y' ,i''r2; jt v:•L',:. i'V >!.?' .t}T° ,'�:s;. 'ROOM _fit . # ^' 3 s ':;.j a Fo � - t ?'lu. ... Sri: °��.;%':;. `�u - _ • 4 h „b A' r�r r '�r �., nE C '� z ..DO TACT E r:,.r.`i% _ ...:.......:.... ... ,:: ; .�...,,. ; - :.•�.,.;,x;., -,,, .,, e.,q, .,,_c','�s,a' ,;.r4 �r.�.,,-� ^'at• : .a... . _ ._ . , . t , ..... � r.> = �. . s . �., y.a.,M -. ,..r;N::,;.,C� ps^ ::.e : ,: �M , ',r,�r;k}';s "� ',::f�'d , i:» t ;:,f; tx,3: .��, �.r. . - _.r.;, _ . ,_..., r, +, .,. _.,_....c�,.�....,:., .,,,.,. "'jr. ��;�:� ;NUSPI „ +4 :, , _. � /j y� (J__ , l, . x:. �s' a: �a: �-,.;` ?iE,'. y":° i�w��. r�' P I t ":;::- .;}'�`t "�E `',3- • " = <'�! rpy Business name: All contractors and subcontractors 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: Y -,1'r <k , 6t Business name: 90 j e l ,, * .. >xx I NG : = PE 4 , w , ,. I E EES . ,:i :r Address: ts'i ^'a . , -. - BUILD v;_. « y�ti�tg , , ;.° .: `t� ^r,, ,._�;r.,a ' ,' .�.�zw:. aaY. f.� -` .., . Please refer to fee schedule. • City /State /ZIP: • Phone: ( ) Fax: ( ) Fees due upon application CCB lic.: _ Amount received Date received: ' Authorized signature: 111 ///���r V ��^ r Z� � K� This permit application expires if a permit is not obtained � ^- within 180 days after it has been accepted as complete. Print name: 1 N i T2- Date: a i •a�(�5 * Fee methodology set by Tri- County Building Industry 1 Service Board. is \Building \Permits \BUP- PermilApp.doc 12/03 440- 45i3T(I I /02 /COM /WEB) , Plumbing Permit Appliq iip"p FOR OFFICE USE O ONLY o f Tigard Received City g Date/By: Permit No.: �, ads �JQS 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 FEB 24 / /01E� ; ,,�.li , 9 Date ±\ B 24- Hour Inspection Line: 503.639.4175 �! ., e. Other Permit No.: P Date R Juris: ■ . ` ate ead /B See Page 2 for or.us L �. . Ready /By: g Internet• www.ci.tigard.or.us No fied/M Information , .. . , .. .,._ . ...r . ,. - .s.,�.R:.,.. .� -. t s:', ,...a! -v :o-s 'a- } t aons. ¢x.: Supplemental - e ementa n o ..>�` a�.. ;gi ..,.U1 >. - - - :r�:'- .:•- :,,.... ..mss.,. ., ..�;,. -�' ,. -. s, .. xv;. _ , - TYP j ire. � ` . FEE < „ ;�.� �, 5�` �k - r ,.. rG».. ,,,,:, - _ s ' - L "tea ::z;nY -. _. '. =i:.. ���' ,:x',^S -:. .. ..,,.,..,. _ . . -. , .�. � �i.';',�_,,.,., ".+;^r'.x`_?�;� - - - - - �,t Jk' - . <__ ....__ ., _ .. ,,. -, aft, �'m ;� •: i °:cO +� �.t � -. ^. �- . , _ s't °fi•:- ,- ..� >-r .' sa',�:r;: +f,",,, :�.::�u ^ = ^= °: ' ��a:;`�m ;, _, -<, S,j 1.1 m«u I ae For special information use checklist. New construction Demo P .f Description I Qty, Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) 1l,. E Y T : CAT GOR : F P -RUC. IO i :F v ` '„ ' ,t, Af '� C,QNST .��,._ „r * , }.,, :_ .: _ ,; SFR i bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Master builder ❑ Other: .,> - s. v, •:,ors; r;res - a'.= :> ;., .k i G Y9 Fire sprinkler ( sq. ft.) Page 2 ,,�.� • " :I :: - -� 13, r rrisu : � v , JUB iD;4 .:: $: ,. '. , •m,?aR's', ?,..: -' = �.. xt:g: ,,.._;, : ' ' mot; . ...�r; , .h: ° +.r�t;li *�i.� , . . ., .z._. ,.. . .a,,._ .'r.�. :. . .�., �' ,. .,. 1 CU I I ICS Job site address: \ 5 \ _ Gozcx-\ PAea ,Qe. Catch basin or area drain 16.60 � O City /State /ZIP: 9 � \ C> Drywell, leach line, or trench drain 16.60 Suite /bldg, /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision:a�rn v� �.,cky Lot no.: '1"7 Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Ixture or item ; ,z,,,, - _ Absorption valve 16.60 ( ci >:vi T:.:cs: ',:, t :,,,c .,.,t ^irN.l: - - `a4Et's ::ii'^-�?„ .; °L „�_ ::;.?i;:: ';t:t{�E. „,a', }t:;;;x t . ;,;.,, Ab so .iC„r�.i ?.t„ ,.'i�.ii' - ;.r,P;I:s._ ::' 4; r `'t�dr.i;h' >'��°+i?, ^- cn�g4� {'� .�.-; �i':r7: ^' +:t�.i , - : _ ; . io -- . DESCRIPtI'IONa:OF.rWOR,,,,, . . =.ar:;�.�, ,,er .:,.r,. °.e'y...t£ s ._�,:,> :,.- 'f; =., �.,,y�,,,,;.�.,w�;,.�., .. r,• frU'<:: �, M,:,. �rw.. z.,::. �,. �.,r:.�,..;- .�,: ^�',::�,_���r. .....�- ,. ,� _,� : .�f,9��.,.:,.,�.,,.:a::,m`:r;.. sr, , Backflow preventer Page • Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 r' :; rs,:r <- ; :,'r. - r +;= � = s:x�a.:4 >, -, r. a Drinking fountain 16.60 _ ,, 6�.;h.�'{, n z•i4'�, ta'$ ; 4, i i•,'a.: ,, t�C'....�� }, _ =PROEER, cYr:`OW1vER• :. A, :il a ., r NANT• • .,, , ,y,-,.„, - ,,,�_'.t - m.:.SY'- ''�tff�' , - x.'1 � °�"�'` "� ^ ❑' �n ^, ,t � „1,£;�V'i;. ^X� y ,• • _:;.., r. _.._ „ ..:;, ,s: _, " `: I» 1 T, ,; r ,:err,., .,_,, i t .. -., ,r ,.,:, Ejectors /sump 16.60 Name: ' 0 I ' cm in M1 4 W,S L-L.: Expansion tank 16:60 Address:'14 „ft- /' I '. �„ I Fixture /sewer cap 16.60 City/State /ZIP: ' / A 4) • "' C1 . Floor drain/floor sink /hub 16.60 Phone: 2 7) .$ -. 7 � ��__ ll Fax: ( 7-'2 ( S Garbage disposal 16.60 r: -_h .:. ?a ,.,._, ,, au: , .,;sr +s x:;a, : ,, 1 "'' ":�'":''. D APIk ICAi i,`;r ,`' a 5; A t i R ❑ CONTACT :P,ERS�®ly�` `� ;,`3 i "? Hose bib 16.60 6 �a . n ,�„ u , 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: ( ) I Fax:: ( ) Sink/basin /lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 �,a:;. - - -- a.1', ti�-+r sa:?.,::Atc:.- _ ^- �n¢sa,'. y.,:3:" - :[' _ CONTRALTO ,:, - i a� ;* ,, T y .. - �.,., -„ Water closet 1 6.60 Business name: .._ _ Y"\-5 Water heater 16.60 Address: 1 Q 1/4/1 / Other: City /State /ZIP: �� C Subtotal � ( Mi n i mum permit fee: $72.50 Phone: (575) (1./ ,- ....1 6 / 3 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: t Ueb`7e_...1 ,- 7 . "h Lic. no.: .2 7 , -. . cc --°°I c Plan review (25% of permit fee) Authorized signature- ` : /, 1 "--'' State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: ,.._. � ` �\ Date: 0la . (j� This permit application expires if a permit is not obtained within V 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T(10 /02 /COM/WEB) '4 Mechanical Permit App-{ a _ e,n j FOR OFFI U O NLY - • ' City of Tigard n t A Date/By: PenrutNo.: r /� � 1.`3125 SW Hall Blvd., Tigard, OR 97223 �� yam Plan Review Phone: 503.639.4171 Fax: 503.598.1960 q (�,/ ii ` Date/By: Other Permit Inspection Line: 503.639.4175 FEB 2 `t �u �''I ( Date Ready/By: Juris: See Page 2 for Internet: www.ci.tigard.or.us z Notified/Method: Supplemental Information CITY OF TiCiARD S S• � � .t:r l ".. Y.. COMME`_ , ?:� R :F. E, -, .US HE CIQSIS;I? ='` .. - }':...�, _•- - "=GYM �E -: ..- ykµt" �c?' ra._ h:a:- a.. d': u::' ���,,. we Jt'" I�ut. .:. ,:5i.. :.�ia...�.�� %..- . :,t, '_�r�r. � ,,.. :_ -.. ,: , -'� New constr ❑Addition /alteration /replacement Mechanical permit fees* are based on the value of the work ✓ ✓ ✓ ✓ ✓ ✓ -'._ performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. :: _,:: ;'t. . . i:,: Value: ' = C ' ATEGOB Y : y OF ` TION ,.,.., :'• : V <,, i i S .. .. : r ...�, �... , I, I:.r • Y ' :::. .� .t ... . -. ,. ,.� - _ :, • #.`,i., __ n41't`a ... - - . .. ... ,.:�.:��<.' - � dEi; - - �.LM`L'�;3 lE"ivi-ea y r . : .. ; , ._:, ^ ;RESIDE" . *,:,. e: is : ..,,:n :. ,�, 1AL EQUIPMENT:ry 5YSTEIvi$ Sr (t ❑ I- and 2-family dwell ❑ Commerc / ❑ Accessory bu =` ""' ' ° " ° "' °'`�. - a� " " '� For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: '� Description Qty. Ea. Total :<a •- - ' .cam:, ; ": - - - ' •� s�, ,�': +:: `s` f,= _ r.s - 'JOB�SITE':;INFORM'AT'ION )) .G•�ATI©N� =;� „� �, ,,, N ,li0 �- M:,;:. . Heating/cooling Job site address: 7-,. n Air conditioning or heat pump ' ' \ r �� v� (9 \�� (requires site plan showing placement) 14.00 City /State /ZIP: a i Furnace 100,000 BTU (ducts/vents) 14.00 ---0Af 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: M� �' R Lot no.: �-y Flue /vent for any of above 10.00 �� ) Other: 10.00 Tax map /parcel no.: Other fuel appliances r�• : :;t_ "''t .: >Y:,� ..�``T`' ,, `r4! ` � Water heater 10.00 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 ,. :'.., « - yu,.•• ;' „u: Chimney/liner/flue/vent 10.00 � i.0 �.4... .) E, - : k�r " -: '4 :Sn`� }.'2. r MOK.W., . 9.,M: :rt: TE . ; , �'` " " "- " ° -' Other: 10.00 Name: \ V� �/ Y • ��►i� ' • TC\MkA IE', / +��lll./ Environmental exhaust and ventilation Address: DO, / ' .1' I (V Range hood /other kitchen l l.V equipment 10.00 City /State /ZIP: . '.z. 1 q)077(, Clothes dryer exhaust 10.00 • ��' '�• ��•` `,�, Single -duct exhaust (bathrooms, Phone: l ,, ' --� ✓ Fax: ( .D • - - 2 lc' 1 toilet compartments, utility rooms) 6.80 - -- - ,:xxi ('1,.N >� . # 5;rta` - -- ... .;?.�;x . . r ,-•ira -,k ,.; s=^,;.:a _ �, - ,'R • '''i�" ;�:;`:r�: x : �r ' •: ; ,'if tiry § , v ,- r c. "n �. >I , �' ": N i• �,: • ^ ='� Attic(crawls ace at i ,. '• : ::4k: -4 c .,• >t Inn`. r, : ! P RSO-, t ,. sArl• i fans i p 10.00 ,s, .. .. ..... ,,. -... .,��.t .,`:h�:,. .. a.- . ,... �` 5.•5- :t"i: .: r,... .,n 'kS:••_,.S..i�_:t;�� { ?.rhA, - . -inn Y,? Y:.'' �fvt�:. S' � .:1:,t�,;j;i�fi:�' •.'.�.i 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: ( ) I Fax: : ( ) Water heater E -mail: Fireplace Range " ;:. - w..`, :,' y : ' f : CONTRACTOR- } + . Barbecue Business name: L 1 ea ( -- 'j 0 p% \- /7 Clothes dryer (gas) lllccc���CCC - IJI L ` `'� / �`L lx� Other: Address: Y-. i , -! ,',1*0,' t: t;'I, . Nx *rj' . F '. Q ( 1 � ^ ` ^ I /�}� /� / �] t � ,? MECI�ANICAL City /S tate /ZIP: V Je T `, ` 1� `4 -200 Subtotal ..: Phone: ( )5 ` . 2 1.'' Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: ) - State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: signature: 4,11MFORMY, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ' 40 .; t leA O Date: a 1 ?4 c , * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermilApp.doc 12/03 440 -4617T (I I /02 /COM /WEB) Electrical Permit Aqp tl, t ., -.FO OFFICE USE ONLY „' - , ,, ' �Gt � . City of Tigard DateBy - ' �� i�S� a 7 6d� 6 13125 SW Hall Blvd., Tigard, OR 97223 Pe rmtt No.: r r y ` Plan Review Phone: 503.639.4171 Fax: 503n.„598 \1960: 'a 2005 tai%�d�yd oli Date/By: Other Permit: Inspection Line: 503.639.4175 l C ' 4 Date ReadyBy: Juris: El See Page 2 for Internet: www.ci.tigard.or.us CITY O F T IGARD Notified/Method: 1) Supplemental Information BUILD QE BV %\<' PLAN REVIEW 1 New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: Service over 225 amps, comm'l ['Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ® 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400 amps or more ❑ Multi El Master builder ❑Other: ii Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: 3 5 d Job site address: / p ❑Health - care facility ❑Other: I 1 eavFigl D ` • Submit 2 sets of plans with any of the above. City/State /ZIP: 17 4er J C+ p 1 2 . ) 223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: � f FEE* SCHEDULE N O d norm C r t bescriptioii Qty. Fee. Total Cross street /directions to job site: ,3 EII 17 � � /7 New residential single- or multi - family dwelling unit. /����((( Includes attached garage. / 1,000 sq. ft. or less 145.15 4 Subdivision: $ Ui M; i e1il9e- Lot no.: l 3 Ea. add'l 500 sq. ft. or portion 33.40 1 666��� 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 �Ehl Arndt W 1i241 Services or feeders installation, alteration, and /or relocation / 200 amps or less 80.30 2 isi, PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 • 401 amps to 600 amps 160.60 2 Name: n D 14 dyy S s - C o ty i✓t tJ 12'5 601 amps to 1,000 amps 240.60 2 Address: ' �-y_ , C Over 1,000 amps or volts 454.65 2 4 O �� ' ' "� w Q J - J � ,— � �� Reconnect only 66.85 2 City/State /ZIP: L O - / Temporary services or feeders installation, alteration, and /or relocation Phone: (5 a3 3 g 7 - 7 Fax: (5 Q3 ) � 3g7 _ 76 , r - 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 I ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or 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) Phone: ( ) `Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- '. CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: 13 r,e h r Ex gum, c • «e Address: P o . (�( 33 /\ Each additional inspection over allowable in any of the above ►✓ v Per inspection 62.50 City /State /ZIP: CO M DU Of 0 /2, 77757, Investigation per hour (1 hr min) 62.50 Phone: (5 ) 3 ._.eF 2y Fax: (563) — 113 , (74/9 r - Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 13 2222. Electrical Lic.: N L Suprv. Li S Subtotal Suprv. Electrician signature, required: �� G �/ _ Plan review (25% of permit fee) Print name: A A O Y Cf al ' Date: 5 ` � I r` 2 3 / c- State surcharge (8% of permit fee) / f (J�'L / / 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. is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/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: n Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* ' n Heating, Ventilation and Air Conditioning System* s. Vacuum Systems* Other: • COMMERCIAL WORK ONLY: • Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: n Audio and Stereo Systems , • n Boiler Controls • n Clock Systems n Data Telecommunication Installation I Fire Alarm Installation • n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* n Medical • r • Nurse Calls = • n Outdoor Landscape Lighting* n Protective Signaling n Other • Total number of commercial systems: > ° • ti . *No licenses are required. Licenses are required for all other installations i:\Building\Permits\ELC- PermitApp.doc 04/03 AAA AAAAA AA ,, AAA AAA , ;: AAAAAAA V L w® 4 STREET TR EE CERR TIFICATION .. .. A ® ., if \ ' 1, I, B/ le E /4 ,Owner/ g ent for Dom,.. MDR-4 .5 r+ 5- C M^ Lk. Ni.. 4h; e S LC_G . p. ;, F ( EASE PRINT) R - (PERMIT HOLDER) ® / . a 1 " , A I 0 • ' x < 5, - 4 Do hereby ' er ti y d :: t f t ' �`° r location ® ,c _ � t h.at��t�.he� fol�owing loc i me - t y f . i�g i t � Y ® o , T. an /�XI as hrnon 'County .,x.�u.asc•n #iyy.. 3i s l and use and development standards for street tree installation. A Di- ADDRESS: 1942- ( S ,3 &(LZEi-I t i -D Vhf _1 0,;''' . i' LOT: (3 SUBDIVISION: S,, ,,,,,-,L /OP, E BY: DATE: 7 -2_ - 1 — a - 1 RECEIVED BY: DATE:® A YYYVY YYYVVYVYVVYYVVV VW" VV VVYY YY YY YY • CITY OF TIGARD .. BUILDING DIVISION PERMIT #: MST2005 -00055 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2005 Phone: (503) 639 -4171 /*//I/ jliyi��gi� iiil Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 7/20/2005 TIME: 7 :11AM PAGE: 35 SITE ADDRESS: 15421 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 013 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. 5/14/0 ADDING GAS FIREPLACE AND GAS PIPING. OWNER: DON MORISSEI 1 E COMMUNITIES LLC, PHONE #: 503.387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -7538 Inspection Request Scheduled For: Date: 7/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 011791 -01 603.209.4837 N Corrections /Comments/ Instructions: fh i PASS M P RTI: L APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL C : FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 7 zo . °S Inspector: _ 4 `� Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION " ' PERMIT #: MST2005- 0005E 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ...' INSPECTION WORKSHEET FOR DATE: 7/2W2005 TIME: 7 :11AM PAGE: 34 SITE ADDRESS: 15421 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 013 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. 6/14/05, ADDING GAS FIREPLACE AND GAS PIPING. OWNER: 'DON MORISSEI tE COMMUNITIES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSL.I I E COMMUNITIES LLC PHONE #: 503 - 387.7538 Inspection Request Scheduled For: Date: 7!20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 011791 -02 503- 209 -4837 N Corrections /Comments /Instructions: • • 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r Date: o f I Phone #: (503) 718- „ ,.. CITY OF TIGARD BUILDING DIVISION ' PERMIT #: MST2005-00056 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/13/2005 A, Phone: (503) 639-4171 i 1 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 7/21/2006 TIME: 7:09AM PAGE: 5 SITE ADDRESS: 15421 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 013 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. 6/14/05, ADDING GAS FIREPLACE AND GAS PIPING. OWNER: DON MORISSE. ItE COMMUNITIES LW, PHONE #: 503.3974538 CONTRACTOR: DON MORISSETTE COMMUNES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 7/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message • 699 Mechanical final 011902-01 603-209-4837 N Corrections /Comments / Instructions: • PASS E PARTIAL APPROVAL 11] CANCEL fl NO ACCESS n FAIL El , ALL FOR INSPECTION E] ADDITIONAL FEES ASSESSED 0' Inspector: /- , • Date: 7 - / hone #: (503) 718- CITY OF TIGARD " • BUILDING DIVISION PERMIT #: MST2005 00056 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4113/2005 Phone: (503) 639 -4171 //o gpu�i i it Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME: 7 PAGE: 4 SITE ADDRESS: 15421 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 013 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF: 6/14/05, ADDING GAS FIREPLACE AND GAS PIPING. OWNER: DON MORISSL t i E COMMUNITIES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSEI IE COMMUNITIES LLC • PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: 7/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 011902 -02 603- 209 -4837 N Corrections /Comments / Instructions: • PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector:, Date: 7 - Phone #: (503) 718-