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Permit . CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00089 K:14-44111P' DEVELOPMENT SERVICES DATE ISSUED: 5/10/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA -03900 SITE ADDRESS: 15495 SW GREENFIELD DR ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 016 JURISDICTION: TIG Project Description: New SF detached BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 28 FIRST: 1,570 sf BASEMENT: sf LEFT: . 10 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: 310,157.30 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,190 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 • MAX INP: btu FLOOR FURNANCES: VENTS: I 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 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 HOMES DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in 4230 GALEWOOD ST 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire STE 100 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the LAKE OSWEGO, OR 97035 work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503_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: $ 10,613.79 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : �� 42 U�� 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. • Buillling Permit Application= - FOR OFFICE U ON Clt of Ti and 0 u bt� LC (1V ED Received Permit No.: n 1312 SW Hall Blvd., Tigard, OR 97223 e 3 /17/d� 1V5 tt 15 ; �2p/ ��(7� p Plan evieH/ Phone: 503.639.4171 Fax: 503.598.196 Plan R �R 2005 �7� /✓l � J � ' t� Date/By: J5 /! ,, P6 `O 5 Other Permit: j f� � /5 —VW ) Inspection Line: 503.639.4175 c-'.. _ Date Ready /By: Juris' El See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Y f '4 i� 1 c.\ Supplemental Information pi lil nrnmn nIVICI(tN 5 �� L'� )\,-,o ■ 5:�rYa ,rV'�.'xx.,� �°,"t T£ : iz �},*"5'•.:i` a�?�ras. ";i' ,���`.'� :>' - '-Y,:}" S %:Ss Ill ��'�'� b'a$`z`n1i.'�2, 11'IYiSYEEIk .'�,m.- ,i. x+tT t ^) - _ °r� °�" -w`z �r �' .. a ;., x,, . "'t. .�,y; � ` . =�,.:z � :.�F� ^. ���, .J ?:. � ��a'I �s , � �` t. � :;ray,a.�z�• „�r. -w -� 9r '5Vni; ” "" � -•hd , ,`' Tv /PE' ®F�WORK S y a C rg ' , RE QU IREDh ArTtA.�1='AND 2-F'i1MII;Y,DWEEI Gw ,- � `' � r� =�^s*,���,. �:� •w,n� ��+=_ �. ��� -•c=ur w,•. �..•. m New construction ❑ Demolition Permit fees* are based on the value of the work performed. d \ Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the w', ;mil h y.'__ z a ".n'= : work " :i F;'" d `_ " r 'a rr:r _ " ' kT".,. oindicated on this application. ", ,,, r ,„ ,At 1 : .,2 5 G®RY ;®F 7 GONSTRECT' ION °,4 '` ' ra .' r I 4..-,,' o s a cation. :, .. ^cfi�;� yr��: �a' ��x' s�-? �t�. ���s�' y; rtr.., �s:,; e: �•. �t,`�r��'�s���ra'�`?� " ^^,�ar,,A< a . �� Valuation: $ rr + "k ' � ; 0 ❑ I- and 2- family dwelling ❑ Commercial /industrial t ( Q � ❑ Accessory building ❑ Multi- family Number of bedrooms: Li ❑ Master builder ❑ Other: Number of bathrooms: S. r " b:tr sw� >, ^, _'.: s.» a aa'A xhxru a <sren t. ° �' t" ° r` Total number of floors: , a }, JOB SITE. IN�F,ORM'AnTIONp= =AND .LO`CA = ION« r -, �.,�,;:;�`:.., ,* -y �ll!:y ��r:��=a".,:�,�a��"�� ^t=� #, ��aars��ars3x .,s��su�;lt�rras€aN'.v-rr., �r�,���q;. {a�. ��u`t��: �s ,.�'� Job site address: I 51-195 lt Chem .P i Q p New dwelling area:.. \ q O square feet City /State /ZIP: ' �A� e Garage /carport area: 1_.I CI square feet `J 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 w;w.,:,"4,,,A„, :i=3,,t # tq e::.tT:7,.. 241 {, c R;j ,":tP.i�t'».•r "L d:."'�� REQEIREMVTA ,COlVI1GIERC ° ` t =ESE, Z KLI -.-° tr:nvb`.?h2�" SAC".:* ZF?..- i�' ki 'cit ?R:.e:'i.�trti.•i'+r- r�.L�it 3� �1P„I ".�dri,3'=i `P. #t. ":'a; 4' ih:$ ri` Aty ':_'i5„�:,:�i. ^:.F.ti"nd�L'`�st Subdivision:, '�t/�`�e Lot no.: 1 D Permit fees* are based on the value of the work performed. Tax map /parcel no.: l� Indicate the value (rounded to the nearest dollar) of all 70,4'044 .,, :Mx; ;. M ;=xt tr =r ;,.:,,.. n ;: # x t:a Y cx ,w $: •�. 4« , , : equipment, materials, labor, overhead, and the profit for the '4 *' a, DESCItIPT ;I filar at , � P tw work indicated on this application. Valuation: $ Existing building area: square feet New building area: square feet 0441.4N7 ��z:s�r�:�e?�.�t:�z ^�r'&7 " �'�3' •� �=fi'u i '� �,�x z.�+� <s �a �;""� �t rx=P.ROPERTv +Y '' =.. , f s� tr Y,' O - 0 WNER � ,.� � L TENANT ) r � Number of stories: € :, =rr . .f 4 3 si : ax, , x � 6 cwt c_, Name: . �IJT — ` L 0 I ., ,,�„ , � „',r_' ,....5 �.� L Type of construction: Address: i y �p�- -� f „� � � � G -1-., � ( �, (.x Occupancy groups: City /State /ZIP: L1 t () ,& L 7 � q 3-.) Existing: Phone: J�j� L� Fax: ((i) �7 '7 /S New: .4ir -�'f K��4;?�k ��; ,�s:,a;.�a?:s�t: . ; :�,F -, � *�a a�•, ,.�.s��.;�� .+�a^ . �. ��:a- �'-"^'� � - •:�,�".'.r�. "ret e arc' fr ¢L. TRW c I' k , i � ' � � tk�� . � ��ARPLIGANT,�?• �.� ` �� �, 1�.� x� "f s� CONTACT �PERS,ON �� ,. •,�� i��� r� � n •z � ;n-z • a c+�, €s��?�x�a; „,; �WZ � ,:�. r f.•.w ti ,.���,t�w:... , ;�rt�a � w r ��� a-: f�: �a � � '=�sL., rr.- »f���sx�.>� =t� t t: )` :;�s'..a'� i��"�� NOTICE'` J '` t ," � ��� �.`a p ax: Business name: 5 t�o e „awe: 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: ° *11 "'�.' ii i: ,^: e � i ' m , .s:3 «- . ",,: k. : •:ds:k'c'n.J ��« * = ntjgyat:EV;si3.ts;z W- n , .. � . �,' 4 ^.;t 'k: #; ". .,' „'. ',t , 4 ' -¢ a F't ; ?.. •�v,` 1 .. ^ i !A. ;•tp< `Y,, �. "rdl i onr, " ". . t kz: =a VIV 't- ' t. , z s'. � ;+ s ': ;,• -;iyM ati fg/"'�.kt tk t -S'c , > ;r A Business name: 5 I � °, �.,,�,.:� Y - t .° , BiJILDINGs:PERi c w e igEES * '" :,,, Address: '�t_ r' ', 5c. •. 4� a`sr .*;t:�air:. x a•a' �.rgycacc„ ..• .',t n Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) CCB lie.: , Amount received °�j / Date received: Authorized signature: i f � �/t i,' I C / �� This permit application expires if a permit is not obtained /�, within 180 days after it has been accepted as complete. Kin Print name: �� 1.12: Date: 3 i fJ / O6 * Fee methodology set by Tri- County Building Industry / Service Board. is \ Building \ Permits \BUP- PermitApp.doc 12/03 440- 46!3T(Ii /02 /COM /WEB) Mechanical Permit Application - FOR OFFICE USE ONLY City of Tigard R EUhNE® A RE eived PernutNo. 13125 SW Hall Blvd., Tigard, OR 97223 D � 1j6 Goo Phone: 503.639.4171 Fax: 503598.1960 _ pnp � �[ �p✓p�p . Date/By: Other Permit: inspection Line: 503.639.4175 E °1 �oOJ . � Internet: www.ci.tigard.or.us .. Date Ready /By: _furls: I� See Page 2 for g Notified/Method: Supplemental Information CITY OF TIGARD �i ;'r?#° ?`.*..: - � �„ "4':?.a:. �t�i't's�� :..� _ �,�Mtir x - -- : -� `:: ; ,;,�:,, r�3 .:sau :�.r. •a�;�s�r; -w� :.v �,�s�s?� �.v .:.t,sus. —, e'rr rsn .rig:..: :,rr; - :; ss $ti ' i '; z, 4t1„ I�p- 5V A . 3' " , t a �;9., . ; :,,, t _c t `1 <i ' -.' ` „r ,: �, , ;IeY '. PE OF , WOR `: r- = COIVIMFiR NkUSEiCHECKLIS ,:r�.� . �.,,.• �. �. �i,. �,-,...... �.._:. ��,: , ..._ � � �r<: �m. �. �- �- ,it �: ���: u�-- �.. ��nF L E�r� :;7, :-�.�..�a;e�.: N ew construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work !!!!ll ��� ��� performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. „• r ` s` ,a 44''' fi -.�r. , "`241 Value:$ .. # s , O Fµ @©NSTRUC,T +IO ,, fi i; ; , .... : ,..i.':, 'S ..�r..a =. sly.. �,':: a,._ �., rezox. a� , •sav ^.rad•avw.- .,��- +,+n...,x ��.�rro,, .��..u>. tsb.:��,.: .,� ,�atsgyj�k :r. �, . ��. e�raznx �• ° -�+•�k. t� as:7g °. -; �,. ra .. , re w_.cr a•'. .,. El I - and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building t4gOk WENTPAL EQUIPWNT SYSTE 4§iE" ',! 4 += : For special information use checklist. El Multi family . ❑ Master builder ❑ Other: :_.. ,..,,.« -ha.z xn,;.,:: -,:_. •. -r.F� Description Qty. I Ea. Total .,z1 �, '�a:;t�t^, r� .° ) r���� :� �;�+- ;;x <r. ��.�� =i r „ +�bp- �� ' " h: .,n i , 7 : JOB:= SIiefiklFORMATreiR A ilea 9TI®N x' i`v ?y' "'Its .s. «,., xw1 ,s ;' a.e.dkI :..1..,. , o: °,,- .., -:..:, .a.,,,v,,k. ,,z. �k,, .�,;;�.e .o..., Q. iA::,. „ s Heating /cootinQ 1 ' w e tcan r„ p „n ( Air conditioning or heat pump Job site address: l �l i `11 4 � ` • (requires site plan showing placement) 14.00 City /State /ZIP: _1 I Of_ Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: y>n k ee� ` n n Lot no.: t Flue /vent for any of above 10.00 ` Other: 10.00 Tax map /parcel no.: Other fuel appliances `.: ,3 ° -s ;.a4` :`x. ` s E: =° - ; ;,n- .� ^re..usr..apH �"axsm , r.e'<�q.r'w,;" .,. - ... Water heater 10.00 sir' n _ �' I, M �� ; M r � �'' "� . � . . 011MAIMMAWr ?DE -,,..— ...0 ,OF �W®RK• �' i t s ." Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 ;t; .. - fl+ ~°_ Chimne /liner /flue /vent 10.00 ' r tine + i ,i --[ P RO PE R TY O V N _ ;:. ; r1 i. T ` ,,, ,, l i Y � �,a � a Other: 10.00 Name. 1 �� ` ��7� �[7!• _ tr +- + .e-5 Environmental exhaust and ventilation Address: L �lJ D Range hood /other kitchen awe.. j � { � ,p � equipment 10.00 City /State /ZIP: c '"� i �- �o s Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: W, .- ) p Fax: ( '{,1� �r 0 toilet compartments, utility rooms) 6.80 ` gin "<'rd � ", . ..zT iiir a,. ru.*�£.,, - pr : Y. `�,., r ... , e „ lni ..tom `-^` .°stn'�r. `,; :a.: r�r�. � u rmnm.x e,.;,' r ; , Atti l ' r -' "�� � fir,* �`�- � � t IBS � � cicraws ,: tl* - ®tA.PPLICANT k - a li L @O,, L ERSON }^, s: p ace fans 10.00 .,t�i`.�� �- ¢ss^sas+ r`. .:;.., ,,.ems �+.*�-..nanza��z�,; at •�. sx. , � � K i4� idz`,.. . �,�r nx .may- ,x- :xc�tart- +�3�+� �nL�2"_., Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater E -mail: Fireplace Range .- .' ..<: -: ,: 4 C : `.i > �'"r ;C©NTRACTOR `,e W t Bat becue Business name: Clothes dryer as (�Gl.� L� (� ry (gas) Other: f ( Address: .L �� � °��,�� � .� . > K u. ''AIVIEC CAI �EERi I IT' tEE S * '"` =- -- �� 'AA 1. =$; o ` : alb, o - ,..r o.,;. , z,,,00. rrxs .:oo,ss s.•�:1 x,C - .. , City /State /ZIP: \+ 1 ` q 7� �5 Subtotal / Phone: .�j�7 I Fax: ( ) Minimum permit fee ($72.50) • ✓' ! Plan review (25% of permit fee) CCB lie.: 07) State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: •' �� t/ MI This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Mil eE`AA , rig”( .4 Date: 1 b 5 * Fee methodology set by Tri- County Building Industry Service Board AR A i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -46I7T (1 I /02 /COM/WEB) Electrical Permit A��p1cauwn j F OR OFFICE USE ONLY City di Tigard "V DD 1 2UO DateBBy: Permit No.:A/61 _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 �• I40 Date/By: Other Permit: Inspection Line: 503.639.4175 CITY OF TIGARD '---- — Date Ready/By: lulls: 0 See Page 2 for Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: Supplemental Information ;:�'M -. {; �- y t g rr;• - ; �"".'. c ^ N � k> �= m � q -�. .s.:r:� ^�,:�,;;ss ,ax. -, `ar�.+"��$':`""'i�,�` '�'` °r�' � " t - t'„ - - - - - "S" " ;'. r m `-; '. -; "�k? ^dr. : °.' ` h"' ,„, a # . v k :.. i'%:" 9 _,. g 4. , xxx• . -�-.:. iii .., y,. „ 4zI;; g .,, � ,r i v • a. r,t 4 . - "'.!, :,-„ �-,,v "_i YBE ;,..- -WORK k,'-n_ . '` ;F'` t,- . . ,.,'_ . , : .. t ?t' br ,v , 'r' ^. ,•."4:. . -1 : ' ,L ., "x., a l. ^? atk" ,. .�n',�n�s ~•r. ,�;, �._ .,��� w_�r, : {_. ,,a....n: -�,. � ,,;e,�� .�,K„ ��> �� t � ka � � . "�'� AN, RE�'IEW� y � a , a :ca : �;� � � ,���5 � 3�. .^3°r- 'ua�.. ti..a_� u.r€ti'Lr�s,r "r-* T„T,�- .,,..:.- 4�.,,.�...�_, .,�I - .��it;^�' #st- �.'P� - ro_ New construction ❑ Addition /alteration /replacement Please check all that apply: of 1- 111 Demolition III Other: EService over 225 amps, comm'l ['Hazardous location .; ; -e nr o l , . 'y , <, ;,, - ,; ,, ,, : ,, r »h "n; -, , _ ,, , - x �, ['Service over 320 amps - rating EBuildng over 10,000 sq. ft., f' a „ t ; ,e i � ,� , tiri tQ Rs Yi ', OFrCONS T RUCT AION P , ' 1 j;,AVM and dwellings 4 or more new residential - ,. . t _ ..r s per„ :iN„v4.,. .4, .:Eavar..,.. „,. -.4. 4.,,rn3 ,_..� �A5. 41 d 2 il Y g ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi- family El Master builder 1=I Other: ['Building over three stories EFeeders, 400 amps or more :, ,, ., -,, •, ..,.,,. „ - ,, ,,, �,�, ,,, ❑Occupant load over 99 persons ['Manufactured structures or CA 030.054.4.TE ll�FORMATYON AND LOC TIO-N ”' - � ❑Egress /lighting plan RV park Job no.: L Job site address: �' ceei ❑Health -care facility ['Other: c �� "�'t i{ Submit 2 sets of plans with any of the above. City/State/ZIP: I I C / v r I The above are not applicable to temporary construction service. :ro. , ,„ FEE* w °� �;� e-' „ Suite /bldg. /apt. no.: . . ' Project name: .: SCHEDULE t:, ,fk, Description Qty. 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: 9, p Lot no.: Ea. add'1 500 sq. ft. or portion 33.40 1 Su ��'` "�` �� Limited energy, residential 75.00 2 Tax map /parcel no.: ;; ,,.,,, ws . ,_ _ Nom - k r � ,, • �, Limited energy, non - residential 75.00 2 ,'. €" A., y `DESCRI •TIOPt OF014:`Nt" t, ?1t to - _gym:- :,�`,�: �1�:;,,`. ��� ..1��_�...- ���,..��..� „,����.�. ��.,�.,;��,:.��:...,�. �'���tn�r�".�,���,s`� „� 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 r� i W h .. , ter l :. .mi < " .vs. '-'ifs 1 201 amps to 400 amps 106.85 , ;,, , OPERTyY OWIV .,,zw 7 � '- '"aw..: ° ® TE T- t r p :�w,� '.� era .. -. c� e m t 401 amps to 600 amps 160.60 2 Name: C O3 .. a......:�.& +- t et 601 amps to 1,000 amps 240.60 2 Address: 1 + 9.. �' �(. U-cua IX Over 1,000 amps or volts 454.65 2 L �J UI w �� Reconnect only 66.85 2 City /State /ZIP: � � ' Temporary services or feeders installation, alteration, and /or Phone: 0/ • — ? Fax: (65)3)�2 7 — , 7�1 -/ 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 b eta i: •;s,; i ,,., , , A' »..., y ,� -;es .a.^,: y 6 ,; a e o,"Ns e ° S '"rii - , , �r-s�,s x i ^ate , , , " - •.t'u axaa ,; .a uw; : . ;ssxk .%tfttl4rz, °rt ' f� _ a ''l l r ® C®1VTi ,T P,RSON� fe 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, ' Address: each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or inigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - �' Eabn ' 2 f a"�^k av�,- .i".,•'},. �, r..ar� - - , a,X- h;^,- .i ` .s.Fzs "+;1; ="'w ' i ka.i. ar KOTRRAC ,,� ESU ' ener 1 energy panel' alteration, or _, ...: - ?sw .r. =� �;�i"�`� +.t: -� � <si ._iw _ -f. _ 1 �? k:�kx..' s��3<., t3 'I��,�,s'�;;�`�* "�?�`s����,°t�s r extension. Describe: Page 2 2 Business name: �'�( �7 �/ Address: ..)C./CD �JV `) u i7 e„ „ ' 4 , r , � 7 Each additional inspection over allowable in any of the above �Fi.V V Per inspection 62.50 City /State /ZIP: 71 gai or_ t - i - J Investigation per hour (I hr min) 62.50 Phone: (1 ! t vV Industrial plant per hour 73.75 — I I /V I Fax: ( ) ' " rELE;C"_tT_ RICALPEIt_N1Ie F � it .,..c-505 t;l�a�' ` "1 T,� ,EES * CCB Lic.. L/ ( Electrical Lic. Suprv. Lie.: Subtotal Suprv. Electrician signature, required: / Plan review (25% of permit fee) f �„ „ I Dte: a A Os State surcharge (8% of permit fee) Print name: ��� r , TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri County Building Industry Service Board ** Number of inspections per permit allowed. i \Building \Permits \ELC- PermitApp.doc 12/03 4 4 0-46 1ST( 1 0/02/C0 M/WEB Plur Permit A pplc at t 4 VED FOR OFFICE USE ONLY Cit y of Tigard � AR EView /,,, R 205 D Remit No.: M5 e _ 05, 1312SW Havd., Tigard, OR 97223 P Phone: 503.639.4171 Fax: 503.598.1960 / /omtg 4, try Date/By: Other Permit No.: 24- Hour ins ection Line: 503.639.4 75 . ) I p �' I 1 OF T' p c A I I • Date Ready /By: lulls: H See Page 2 for Internet: www.ci.tigar'd.or.us Bllll rim," Notified/Method: Supplemental Information , sti. � ; s:" ' "z" '" . � <t i' ��� ' ;r �» ":a�so- ^:,.�;as� �:u ;r.9ar: "��'d1y..? as�� tr "`�.r�:. ,,,,;,:.. �,� °,„ � - ,' -' u ;:, - 'a a } wN, � ..`'e'-.�, gf s*,.py `. r;3. r ,f >,„ :.. # „ ,-w ., .:,, g ' i ",: : �.' , T•'*,:. *>.�"'g aivsa:azsa.Y $. ,m"mir. . ._4. .w v = : _ �., , .1,� ,.� .,, 2.:A rOE �W O „„ w. '4 ,� 1 i:, - = FEE ?S CHEDULE =... ;_;gF: „: , ;0 , s, i ; „na } ,e,. . }�.�i.��� r < A.> a, Rn�k.. s+ �'- �. wa.,. �.: a. � r�x C< r�.: ��eu�: �. � b��,: ��; �:5.:�Pp;?tP������",';a.'�1R �.xy.�..,.f.��tr�.^��± �� .R.�:r.::�. �� '�. �,s. �., _ z: „gym a: .�;:.�:ver <. �sn„,x � fz w _� �;c1k -= TNew construction ❑ Demolition For special information use checklist. Description Qty. Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) S tip; > # y .w a .,�i rX ;, ., . a .w v =F =..L . 'y�i?;='l .�; ° � � � �, r �. � ,�, �� d . , s "� . per ", a� �x: - `f;, ; ; GATEG.ORY ,OF ; :2,, ,:� .4 : " -jai.. €te ,4r ' .. _ ) ..: i . ,ii: ,f F „ SFR (l) bath • 249.20 ❑ 1 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 111 Multi-family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath /kitchen 45.00 x a?. M,u }, ` rwb a� ems: s ;ws r:;,r,nr �, Fire sprinkler ( sq. ft.) Page 2 ,,q , .p, JOB .--:. INFORM ATION.- ;AND,' t r ,1 .: at. � 4, � � , DLO @A,TION� r `: r a ;:m.a,a.::; =v��� �,��.t4',#' 's�~v� �, w.a_�aa�.r�::Ci>,�es.:�mu��..�a ���_ _ �te"r.,��E�`a Site utilities Job site address: � /19S 5� el ( e7flPLQJ& Dr Catch basin or area drain 16.60 City/State/ZIP: 'j 'O� Q I la • Drywell, leach line, or trench drain 16.60 � Suite/bldg. /apt. no.: I 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: Sk �W�m ` � R1 A/1 Q Lot no.: I Water service (no. linear ft.: ) Page 2 ��f`' Fixture or item Tax map /parcel no.: r.<.. - ...`ar v,..v "x :;aa Absorption valve 16.60 F "I ` PPIVA CRIPTI®N�K Oil,, ` " , " r; ' } ') ,;,�. t�. .keilw, mliim, ..- «t~ :., Josaat .i1 ~ J = � ; 5 Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 :Fr „^ r4�Wa ,t:. a :..,,. >, Yt k4 n� Drinking fountain }t�.��.� "c - ;� t �� t 4�. µ >.�...� �. ��'���, g m 16.60 ,, X44 ® fli'ROPERTt] OrVai ;�_' ` Ir TENANT, .. ` ' ` ;-3, , :s:+ >,-C=ivi.i?.ir., 41,1.6;,,,kaR.4v: ' r"'-" ' ;I a.r: 4C,' . a.ti�ks�-..A :.,mmis..4kr4..�: ts ,,,. �.t='*kt ` Ejectors /sump 16.60 Name: Ml7ti ` St �m 1.1.E u'ex' = Expansion tank 16.60 Address:-! -0, .. ' jJ ,Le. C� �, s . / _. l co Fixture/sewer cap 16.60 City /State /ZIP: LA (6''"'y n l ae_ € T7 - Floor drain /floor sink/hub 16.60 Phone: Fax: Garbage disposal 16.60 , v,,--v-w, e ' `rq ;° °azrLn, r,A--y , t=e v 1 # <tx: ;- tin,V3egtr e �;.smow -:, v Aim Hose bib 16.60 iz _.,.. .A., ,51)., PP MT- r i.. , ro W # R ONTAgINFERA -A ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: • Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin /lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: A = a, tr a a x a ,4m ;. xwyr, Urinal 16.60 �` f ' C©N 'P � ` SA � rl � �a� _. 1S �zp � :w �.41A:Mr VaA Water closet 16.60 Business name: i j \ \) „� l0��n( Water heater 16.60 Address: 1 ' " ✓ Other: City /State /ZIP: et.-, 7 � -C���� C/j� Subtotal ( Minimum permit fee: $72.50 Phone: ) ( 'J(.,' Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: f ( 7 - 7 'iiimbing Lic. no.: 2 Plan review (25% of permit fee) Authorized signature. . �'l?�/ cw State surcharge (8% of permit fee) /�,;� j k...1,- TOTAL PERMIT FEE Print name: J 1� 1 „LiI I ' e Dater 1 IDS- This p application expires if a permit is not obtained within 1 V 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building industry Service Board. is \ Building \ Permits \PLM- PermitApp.doc 12/03 440 -4616T(10 /02 /COM/WEB) M5 s OZ�.S— o- a-cs-c7 . :, A AA ®AAAA k � A I ®® ® t ®AAA } V A Pt- - EE CERTIFICATION E A i.4-6G 4 , , Uwner / for Dmr. fv;: ‘c4L 6 ,,,,h.' / s 2zc: r. (PLEASE PRINT) (PERMIT HOLDER) - ,, ® i . it y . _. ® yicet 6 h7attj h°e following location 0. ;sit � �° � `4. `� '�.�,` A meets � ' tyxof i �g a rd /�X1°ash . gton County land use and development standards for street tree installation. PP- ADDRESS: / 5 _5) C�$EE►uF1 Ed n (b1z LOT: )1, SUBDIVISION: S y,- pi ;1 ei ,p e_ 0. BY: DATE: /0 -- - OS 1 1 RECEIVED BY: ..1\-- - c DATE: I VI Z 74 \ Vy VYV ' VVy ' y®® y ®V 'g" VVVVVVVVVVVVVVVVVVVY , - VVVVVVY ' ; P VV Y "; :, __ CITY OF TIGARD 1 BUILD1NG DIVISION PERMIT #: MST2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 /onmmm % I ( , I Inspection Requests (24 Hrs.): (503) 639 -4175 .. 'I INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 68 SITE ADDRESS: 15 495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: 10//212005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 018069-01 503. 209 -4837 N Corrections /Comments /Instructions: • )KLPASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6 ---C " -.-\- , ' 0 Le Date: f 0 1 I 'j- Phone #: (503) 718 - 1- -946 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 00089 , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5./10/2005 Phone: (503) 639 -4171 v trn . :' . Inspection Requests (24 Hrs.): (503) 639 -4175 AW I INSPECTION WORKSHEET FOR DATE: 10/11/2005 TIME: 7:08AM PAGE: 67 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 10/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 017964 -01 503. 209.4837 N Corrections /Comments /Instructions: 0 No )b o 4 .c—•t �1,"- Vh H/ 0 0 11 IP' g 6 e_ . -t. .?' -1-e- 0_9 U i 14--1 & 4; L -P✓l- c 4 ck ixr--- e l ft o D 01- I .1 t 14-1.L i 1€ r- s y , s,.e -vo ese ,k, - K g S Gic,- 1.i K. 0' 6.2. 0' L plzr I- h s/4 // Qr i�o p ossed Per gye0JI 1 I PASS ❑ PAR 1AL APPROVAL n CANCEL n NO ACCESS 't ► '+ \ L 1 4 . 7 L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . ' Inspector: 111‘.11(_4 Date: ) 0 — If — 0S Phone #: (503) 718- CITY OF TIGARD BUILDING *DIVISION PERMIT #: MST2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 - 4175+ INSPECTION WORKSHEET FOR DATE: 7/26/2005 TIME: 7 :07AM PAGE: 23 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSLI.I E COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 7/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 012165.06 503-519-6452 N Corrections /Comments /Instructions: • • X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �� Date: '^ t Phone #: (503) 718 - CITY OF TIGARD ` BUILDING . DIVISION PERMIT #: MsT200E 00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 a irw`ay�� o41 W1 l i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/2612005 TIME: 7:07AM PAGE: 22 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 0.15 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETfE HOMES, PHONE #: 503 -387 -7536 CONTRACTOR: DON MORISSEI IE COMMUNITIES LLC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 7/26/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 012165 -07 503 - 518-6452 N Corrections/Comments/Instructions: • X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION - ADDITIONAL FEES ASSESSED Inspector: Y Date: 7 ✓d, b- Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 0008! 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: X5/1012005 Phone: (503) 639 -4171 � �4�u' 1 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/26/2005 TIME: 7 :07AM PAGE: 21 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503.367 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -3B7 -7538 Inspection Request Scheduled For: Date: 7/2612005 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 012165 -08 503 - 519 -6452 N Corrections /Comments /Instructions: • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I Inspector: 14 0 Date: 1 0l< Phone #: (503) 718- CITY OF TIGARD `' BUILDING DIVISION PERMIT #: MST2005 00088 • . A , 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 / Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/1212005 TIME: 7 :04AM PAGE: 65 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: 1; SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 i I Inspection Request Scheduled For: Date: 10/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 018069 -04 503 -209 -4837 N Corrections/Comments/Instructions: . 6- Le--6 lei - CCCZ -- e - us Ie/ 62K) - kriLeJ --- t .rte. k . C , / b/ / Z (,) 1 ,,_,,,,,,,,,.:„. ,, A__. P�112.. -( Rio /\Z- ( 9 . 1 ( Cst 1 . r� G • , . $ , y / T `` �i J 1, yt PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED °/I �/hone Inspector: (/ k , Date: #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 m angy •III Inspection Requests (24 Hrs.): (503) 639 -4175 ', s __.. INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 67 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503-387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 10112/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 018069 -02 503-209-4837 N Corr, ctions /Comments /Instructions: ‘?\?� � ( b /oA (vv\-es c _,e„‘„6 ASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED k4 Date: L 7 d � Phone #: (503) 718 - Inspector: r ` , CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2005 Phone: (503) 639 -4171 r d„ mi p � Inspection Requests (24 Hrs.): (503) 639 -4175 .�zr "fl.. INSPECTION WORKSHEET FOR DATE: 10/11/2005 TIME: 7:08AM PAGE: 66 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSETTE HOMES, PHONE #: 503- 387-7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 10/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 017964-02 503- 209 -4837 N Corrections /Comments /Instructions: :a .A1 IN FA/WM I S I I r r AliWMWAIr Alf NArr-M n PASS !/ = ARTIAL APPROVAL n CANCEL n NO ACCESS FAIL 'I; ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: '' Date: G Phone #: (503) 718- t"' r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00089 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/10/2006 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1011212005 TIME: :04AM PAGE: 66 SITE ADDRESS: 15495 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 016 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF detached OWNER: DON MORISSE I I E HOMES, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 10/12!2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 018069-03 503-209-4837 N Corrections /Comments/ Instructions: PA ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS I I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED • Inspector: Date: ��l 2 Phone #: (503) 718-