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Permit CITY O F T' " MASTER PERMIT PERMIT #: MST2005 -00038 e�.�I�i� DEVELOPMENT SERVICES DATE ISSUED: 3/10/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 109 D B -S R075 SITE ADDRESS: 12996 SW HAZELCREST WY ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 075 JURISDICTION: TIG REMARKS: New SF BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 630 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 . VALUE: 313,219.00 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: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 311P: VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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: SIGNAUPANEL: 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: Owner: Contractor: This permit is subject to the regulations contained in the DON MORISSETTE HOMES DON MORISSETTE COMMUNITIES LL Tigard Municipal Code, State of OR. Specialty Codes 4230 GALEWOOD ST 4230 GALEWOOD ST #100 and all other applicable laws. All work will be done in STE 100 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire 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: 503 387 - 7538 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Re g # : LIC 162512 952- 001 -0080. You may obtain copies of these rules or TOTAL FEES: $ 8,732.78 direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By • :` Permittee Signature : vl Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next 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. - ' ,,, - , t. 'lBilding Permit A DJI 1 i �o' pp ' u ' i FOR OFFICE USF, ONLY" City of Tigard Y�� N Received - Date/By. PermitNof 5 13125 SW Hall Blvd,, Tigard, OR 97223 Plan Review 0006 Phone: 503,639.4171 Fax: 503,598.19 [[�� 11 200 5 p �ly � "'1 Date/By: OS r O ther Permit:5 0(J � - >UOD'SZJ Inspection Line: 503.639.4175 ■ Jy��Md - '!i Date Ready / : �/J. i El See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: ri ` y0`�� / Supplemental Information .I � J E - e Si;. t? _ - RE U " r , -2- �'DWEL r Y'1?E .b fi» ' -r•. a '•.>r.:. IIiED,DAII'A •.,1: - . D. .EAMII. I; G�V`e " OF TIGA RD ,.- 2 ..a t ,fin_. A ...,T,. � . ... �,,, n .t .. ., F. :v -' . ,... :cl„ fi' = > � ` , -,., ..- - ,_,, ,..,� .. ,r,,.._....,� „ti �.,.,i :: -,,,.. _,- .....�.,v. ,..... � = -rca.. .. a,,;- _ , L � < , ,, ... r',. , - =.,u::.... ,,.�'a� = :e:\ „.,.n,,.._. .� . ,.......n_ New construction ❑ Demolition Permit fees* are based on the value of the work performed. VVVVVV�� Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the - �. - s! •.. - - . - :.! %: - q'iY,k.{,aF��}af:.,: - ':'u ".f.:i c ::s `_Se'n'�i'§i�i i *t4't = - o work indicated on this application. PP lication, °a:ta 5" � ,, << CA TEGOR , ;.• ;� OE?''CONST���UCTIO _ u:�;.,'u�� ,..x.�.•{.,.,.:�., - <w�: ' t .............:._ r>. �": ���_ ��,. �__ �-,,:: ttk`. e • ±.,- �•a;�;,3t,:,;x�. +; ma Valuation: $ ❑ 1- and 2- family dwelling ❑ Commercial /industrial El Accessory building ❑ Multi - family ., - Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: 2I j Z - ,K:.y, , ,. , ;..r5,° n +: ,,:c ti r 7 '+ ay:t±a:.:P;.'t„t = `.;'P ,,,2:. '. ;9; ,1 "�x'a:, ">_ ::.5::;o-'i" - y'; t +" `iY�` "3 ;, ;' :: A ;4"'Il :;t '.l!? �. , I ";ig:: - `'•P rte, I % ;'�. _. }; i . v.�,. , - e `� u : a ,' t'rr '' ;::r -i <. „ ire, {�, . `'� ? � � o �,ti,�. s.. at',�.d, } a a ,,, Total number of floors: 2 - _ I 'i c.. ; t : TOB °Srl?0;'sT ®)?MA N' 'D hg -. A TIO. ;41 , 1W6: < .: ,t?`j: t ` t T - , , �/ - '.ls: �, � } ; ; ;.\. - {�d °;< ,F' {,' . ^w`�lY- ;n•u'1`xd- ;=t rep ��..�t�„'.:,•;'ry, nY., -. ;1f � -pit 1- �;�+',t, ., ;�:��::� �z2i"d:.. ,�a,:3:- ir,.Ha3 +: �+. a. , .ts*s "': - �SSb "ELRa.4i' ,,, Z'4�':r. �.., h -:.., �' .'F }r .'r�341.,r,�'.. , ,S . • „� "aC ..,., , Job site address: � 6 1 � ;i�c�v-• New dwelling area: 3 t.'-( square feet City /State/ZIP: Garage /carport area: W square feet Suite/bldg. /apt. no.: Project name: � 1 ♦� / Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: • square feet =s::n15!2;=t: "t��r i�:�z;� { "t�'A¢i +t ..�;s:.;c:egca - ., , 5t'Y;" <tn;�,,.. - ...,;. >:. �;i�jREolooI%D pa R0AL:`{15 Cp�CICLI } ‘4_ e. „•..trl,,ae�. ; e c s.;,,.1;,-,�. ,- 1•. ; ., = "'"� r, h, ti ° L'{ _ '- ,.mis`,i�r mS' V �4�^l'{`LS6,i:' ?itt� 1�.. i i.�:ii'r>'�.r'} <� �_.. Subdivision: 'Vi,Vvf�vu2 f4 Lot no.: " .... 2 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 - - s..Y ^':'.` -.i: F? :,r ,;,.�:a.�+ ..1.feA': is "f� •`.hi::, -: �? ma _ ". '. } <v:iy: s':�'i +18.. %.Ri r; l:, M��=y' .:ji,� .:i.i {4.x 3-u TSf�f _ l:i A °:`v: •'d?it tg.t ..t,P 'te�_r,!rc?::U I. I nt 2,'. °. >`.. -- i:+ ;,. ;u`''ii,• „r.. work indicated on this '�,`` - �1.,. , 4° - , y I t.,�.,;.,:;r:;�,.. . il> , �- :.,;,,�,'� E :.- .. o t s a :t:., „DESCRI'PTIOiV..dF',W,OEt;. . i4 r it 3. ,A -,• application. Valuation: $ Existing building area: square feet • New building area: square feet ;:u ".. }; ^ = :s :W , .,r':' :` "F:'r' ^' ..:r;. g. }f, : " •, 'a`_�;ti+.ti•*427'! " - wit = - "- < ti,11; 1� = fi''4 L t r ' 1�: t - ; 1 M1 ' "'* .;, `ti- y,i„, t,..- y', - - t , a 7. ,,, r g li , r,< i i P RdP7ERlT , s , k v o x fr NE I ,, A : « -x % z ; . y :,, ' . . T ENANTS!; } ., t m ov , 4 1 ,3_ ' � Number of stories . . ;,: �! =t - _;sr W ,,,; u �"'n �.- M1 .ij , �s �. � �?.:a�k�; , '�,.;'x°U �i "t', �� - ;;Ff + ' P,•�!^., "`.'x`i' _, 4c: 4 ,4 t.,.._4,'� ?..,�...i,.t�o-a. .f,;,.,._. 1..,...i �, _.: ,.< Fi�7, r, E�+, �,. .:�..Id;N'o,,- .,�'ti?;ee<<.,<Sl +k ..,k. _, ,. . w..-. Name: Vt ` - i l• C'0 M M u i11 DIES f L,Z •.0 � Type of construction: Address: 1 — t a _ b (i ) s i cb'el �, l Occupancy groups: City /State/ZIP: L,I N G C _1 C) ! ~-7 / 0 3 5 Existing: ■ te Phone: l � 7DV / - ` Fax: a).5) / - 7 (..dam l 5 New: � - - - - ;: a.;e- ah'•:: tnskr . , fl' � .•.re , ; -F' t,� - �a.,�;e`_ +�'` 'sa. 7:�x;��A': ^; _"v't:SZa �'Aa ;;'d "�p: %a;;ai;'; °ri':� t c� •' ls ,,..,e?.. waa t:l ' :' ._ 4 ... � s .. �- , .,:;i -'.:. .rvm :,, ". :e*.: t� � 1 }i. i i! ..P "-,y;.a, ",'.15i ": ?z f;r °ar; ii` ?:_ s,•k, ,: ,ABPL CANT,: 2 . -- ,, 'r ;,n ��.00NT l",I„SOri`'r = =s.. rm _ : ,xt , ,.a, �,,. ... ,. . _n .. ., ,,...� . {,t,.,, ... x ,.. ,,., �..� - .. n ,�,.. ,.,,., .._�� .,, _ a . - ,f _ ..;,.a�t,��' :;. ., ., _ �s �., _::a• t �l'� ::�}, r,.,F „2`�c� "�� ,,+ t ,..NO;IIICN:�., ...i5:', Business name: " p,� �� ^� �� All contractors and subcontractors are required to b • q 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: ( ) I Fax:: ( ) E -mail: . � `CONTIaCTOR <g y ;� r' Setlt a' . "tip -,.. ..r .., ..- .,., � = , �' ` l... _ , Business name: �y =t >^ E ,,. „ : ,s; =;^ ; BUII( DING: PERIVIIT ,,„,„,. v Add ress: :'.:tu, . ,,.. _ ±.0 ,:t, „,, .„ _n ,: :_ , ,u:.,_ .:,_ -- _ ...., r; ", . . • , Please refer to fee schedule. City/State /ZIP: Phone: ( ) Fax: Fees due upon application CCB lie.: _ ( ) Amount received /(o 1 Date received: Authorized signature: j 1 n / '/ ,/f� This permit application expires if a permit is not obtained j f / (, within 180 days after it has been accepted as complete. Print name: 1 112 - : )e Date: * Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permi}s \BUP- PermilApp.doc 12/03 440- 4613T(1 I /02/COM/WEB) 1 1` j Plumb Permit App1'Qati m-.. r , . • • • • FOR' OFFICE USE ON LY ' - City f Tigard t L f' I V Received Y g Date/By: rn y: P e n t No f � T O r o t ) 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 y/m+diit +F \ Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 FEB 11 20►_ ,� ryl i or ris: Internet: www.ci.tigard.or.us s ..W Date Ready /By: ® See Page 2 for g Notified/Method: Supplemental Information • �.. s., +._., ... .., _ , , -. <,...= _,., .. h"39 -. 'A' .a . - � pr w1. ?tea ; " ,. -.se: ; l Y - �:_:�` -r r,.i,:5t:9: -�; ": �'. _ _ .... .. ........ n 3 .r...5 .v._ .. .. .� - ...i_ _ . 1 LM1 , t �, a .� .. , :•5 .,h : .�' v4;,} - _ - -, _ „. `t... ,..,� .p >�, .�. -, . r _ , �, .... .4 s ..i ._r , a „: a Ci -a: °;rye - �: F x`:i : -,��:� ..� - ..r.. Q '3 :�>'=td• �:;.�",,: ,,�' =::> . ..,. ,� ;;gym. � , _ , .. ..:,.. r43.:.;•... �.. a,,.;, s. i- .;w- .,...,n._�,_.-^..,.�w.,.A - ,'1?:'�. t�,:.:.a ",,.. .. ___ .`�.: ..�- _- .t�*!,�.__.,_�.._,..W..,.. ,.. .., r=v = :p,a .- :�t... :.erv..,, .�.._,.r _... a_. .. __._ . _. ...,., I�New construction BUILD' 1g3DR ititig$ION For special information use checklist. i Description Qty. --- ❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) ?A i ..iy. p .a;a ",''''''''''''''','''''''','''''1'-' 'xi h ;. „ ' q y 'A _T.:3 - ; ":li tt7a - r." - - _ .-.. a ,,, : . ,* - : � ::4 = - ` LL �c. - - , . ,: ; =t.. . iGONSTRUCTIO : .: <;i' t :, • 11 FR 1 bath , „ 7 _ ,,�" ';rt: ^a- .�=; „hwr, - mss-.. S O 249.20 ..� nrr'l,) =.� . .. .... .... .n. x,,....tT.rv.- _.N`_...H ..i •..- .,_�_.,.. ..- .: -:.. stn ?VMS'i'Ff:T,3�'4F.:.:f._ -: kti��: '�. ..,..:. -..., :��� .-'4, 2 .. ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Master builder' ❑ Other: :-rxr•4:r : b,, ,:1:4 ::,,;- v,:.- 4 ,- w v,..1 ,,t;:.t,3twv- ,.r i!, l,', . Fire sprinkler ( sq. ft.) Page 2 : : _',1 JOB;4SITEi IIY'FQR1V4.ATIU? D;`LO, A. ON. .. , t . , . r- A Z ,, ,i t;W4::.F... § >:a; '� >k' . , . ..,- ; ;.: - .. _x.. ..i: i : , - _ r��x,;: :, ,, ^fc :: t;.;r� * *M 0 n s,� „Y:;s ,,,,i,. . .. ? . ., . __ y� Po �;; 4 ` . � .t ^c "iE•�'):.; t .�. Site U e5 tllltl . . Job site address: t( "' `�• . C - 1 J\�� Catch basin or area drain '16.60 City /State/ZIP: -W6A„G _, , Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name:��� Footing drain (no. Linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: ‘,A, n(t, f ..\^ ?,1( ) / I Lot no.: "! Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: T ��. Fixture or item »., .. Absorption valve ,;<>'t, ',:.k,l <,�,.:,� �;. ,.: � r. �,:- z' 3 :. '; -,:,1 ;'r «::��:1� + ^ � = Ab otpt 16 60 ,;; - r M „ xr?xi i .i,p' k;. % �.. �' „r ,j. ; V'ti r + .«Y.,...&. ..,;:1.0, rr`;< 3r A ,� c' `> h} r DvSC$IPTION,irOF� �'�'ORK`lt.; T r a t g I , n.�t;: 4' .�,._.. _ ., .._ _v.� �-:�.. � .:... _ ,.,s.�_., .1 , , < , _,4, _�... _ . , . r.._ .,,,n ... � . /a,�ra4.,�- �;�a�:..::,.,... -.. Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 1.t H, =:,:- :,r'•.�,;�; M;_F. \ + +,;a::�, , F,v;, ; .:r.4.7 :;r:�; ;;i:. :;.£r;' ; >;:, : "- - ,: 'rr. =ki Drinking fountain 16.60 •f.. ;�L ":��,~i', - y e } �,„�. ;.t .��.,.4.;�. 6�:'; ^; ���, _ >�., j�f��,�. :t: '' ".< :t�,:#�;''' ,a D ®P,I20P,ERiI'X SOWNJ R.ue,.�, IF a I 1 .,. $� = FNAN P f , .1 ", r.`:•�'- , ' . .i',:a 3'�n;.,.- a °a�ti;. =3u;. •�°%:: '�" � �s�.. s} �: ..!_"5?.S- Lrl', . :�,., x.�q,w 7 „ <_�. ° {, l'� .. , . ... -h i'y,^. EjeCtOrSISUmp 16.60 Name:'? -? / ' e l m 1 t eg , (_L( / Expansion tank 16.60 ■ Address: .'L 2. , 9a- L F ik GI. t?' , I Fixture /sewer cap 16.60 i e i City/State /ZIP: ( /� j�f ( , 7 Floor drain /floor sink/hub 16.60 Phone:) . 7 7 7 ` - � o � '� ) Fax: 69y . 7- -- 2 ( ( Garbage disposal 16.60 e'. <, =: ±t ; l, :;:, ,: „;, •: , r :; , r .:•;u ,, l:fn a ^r,x cn ,: ;Ih >< Hose bib 16.60 ';'rte - , i ,. \ r:. o, ; - L',,n, ax -s�i; ''i:'::, - - : t i 2.2 !., ,•, . rv'.i.. - "� nx ,1, J..stiai Y '' "t °: ri � sii AP.PI:I .,v:AL I,n::"t =:,'::�:,�' # : C©NT'AGTSw.NERS©; ff, 1 - - t }.cr: wT:�>• /n> . + E Ylrr�4�lS;n - - vi .+t. �.f: . ..... ... .._.-- ,._._..x.,r�P =, =.._... .,,,...�:x,..as:��- ,..,n�.,.,..,,_<r:�.,:.<,u.. �:�,,.,_..�>l 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: ,5f ( Urinal 16.60 ,rF - . . , - - .,. IR ::, .1CONTR:aYCTOR' ; ;, _': 's 1' -': at r ...,.. : ,. a; R�t�: Water closet 16.60 Business name: • ( -_ ? i Y .A . Water heater I6.60 Address: t O ■1 Other: City /State /ZIP: Subtotal � r ( , k- Minimum permit fee: $72.50 Phone: 5,)x�)(�j/) �6 / 5U, Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: `"' ' �� ^liimbin Lic. no.: 7 Plan review (25% of permit fee) Authorized signature State surcharge (8% of permit fee) ` TOTAL PERMIT FEE Print name: J hI 3 , r� Date: 04310S This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1:\ Building \ Permits \PLM- PermitApp.doc 12/03 440 -4616T(10 /02 /COM /WBB) Mechanical Permit Application FO C E USE ONLY ' . • City of Tigard Received `/ Date/By: Permit No.: S �� (2 0-5---- D r 0 y( 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ( l �UUU Phone: 503.639.4171 Fax: 503.598.1960 A ' f,\ Date/13y: Other Permit: .'' Inspection Line: 503.639.4175 -''`I Date Read /B laris: Internet: www.ci.tigard.or.us "" y See Page g Notifietl/Metho d: Supplemental al l Information • - ,..7 .. .. -., , -�v-, `-,:.xx .. :. ':..C'. :.r -. � ,.._. ,.- .+,:f.:. ..- .<_::° `,.. tt:. - t•:`I• -53ti Y' - -( - �, �� ,�,�<�• - :TYPE' OF:: °WORK�I�r ,�; =z� =, �,. * .:,'. SC '... .r: a4 ,,; COMMERCIAL FEE_ — USEtCHECICLISI` L ...:. � -;.... :;.,. r.: •c \R r _ F-' .•....a1o. .. !".+7�f` .5",si- ,..., � -.-. °: y;., < . „ ± , .• Ada,:. rx.^. n::: �..: �.,.:.•:,, m..'•. i. s.= rt. JrY:,IIVa::.:.:amr:Jf::.::�..:. ass.:° - • Mechanical permit fees* are based on the value of the work New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. -. CATEGORY` OF:•,.CONSTRUCT Ni " - - s •. G� = ^h t:. :.� , a • . RESIDENTIAL ;EQUIPM'E SYEiVSTI *• `r ° ❑ 1- and 2- family dwelling ID Commercial/industrial El Accessory building " "`' °-�'" "�' I: Other: For special information use checklist. ❑ Multi- family ❑ Master builder ,r; r. } ., Description Qty. Ea, I Total JOS, : (� [ SE: AND OCATIO, :, :a:, : k : + i T - n ( /,. , l � � 9 � { Job site address iJ �/ t (Xjr({�" (requires site plan showing placement) 14.00 City /State/ZIP: 0, i 0 a Air conditioning or heat pump Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: I 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: AA, o p,/ j Lot no.: ' � S Flue /vent for any of above 10.00 `� ``LL i Other: 10.00 Tax map /parcel no.: Other fuel appliances ,"''',' -ti,, :'''""''''' ,V:f , �,k1' i':: - 's C - - 1 .', ,. ��i -. - - �ksr�'.,�' '`r, ;'; +.., tom:., - c ,. < .._ s<:� :•,h . - . > Water heater 1 0 '::'s ^� ,C ' i '.. TION�= ©F:;wO� „�..y:�"�� °i ., •,R „•.k�,; 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 •' .• „ :,., ,... �- :�. ;�:::a <w;� � rr - ,: �,1 = mer /flu /vent - " ": k ^; �':; "� =; 3;;r� +S ifi° tytY�;,= ''alt :,;> Chitnrte er /l� 10 00 ;'t + , � ti; � i „?;K ;, :: '�3ria -,k1: {? - - vi. - ,: _ M1;��yP_. ,:� ', ='r � - ,.,rs;',g:`''',�f`TENANT' fr,'i ^' , xi.. s 'ice :•:.,., z.:: , >., t.,,, i<` ; t Other ' � ' : r ;;��� .- �:, -r„ ,• .r„ .,�;:• a,�_..'- s,.•;�v<�.��s._��' 10.00 Name: � � %1\ lIe'1 I , Lt) OJ Environmental exhaust and ventilation • Address: bt,t, / ' • ? �-' / l I Range hood /other kitchen l.1// equipment 10.00 City /State/ZIP: . a. )Cf S Clothes dryer exhaust 10.00 f Single -duct exhaust (bathrooms, Phone: ' — 7& Fax: (E:02, 7 - 7(0 I toilet compartments, utility rooms) 6.80 :5,,. - zotl'w4 ", z,,,17 . T.,,. :.. '. r;-; +:sa�:s VA :W ":rs;,. x`"w' +nx:; '�:`ii''vt:�.i�t'iil; "ti r= '�i ' "t:..:�3� >,: �, . ' � ;. � ,- r � � I 1 ., s:., , r . : v , .,, , Attic /crawlspace fans 10.00 � �� r!T I- .t.,•„ ..r.,ti.�':+�0 +:.,. v, ..',sru,,,:,a ,, -k , �Rfi.N,t•;..�. -_'S, d, �rv'�', -a e 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 - :CONY 'CTOR =��: ?:.r` Barbecue �s Business name: , ..., ., 'IL Clothes dryer (gas) la , ..,± :, 3� Other: Address: // L ''�� GQ \�C 4 =.r, Adti: ±;<s rt as ;'. �' r- S .S' ;yr; i l ! r ,,1, : 8 4 ; :` 'MECI#ANICAL;,PERIVIIT ; FEES *, y , City /State /ZIP: T� �� � L �l_ >l �.,,_ �. Subtotal Minimum permit fee ($72.50) Phone: 5) ` - ') Fax: ( ) Plan review (25% of permit fee) CCB lic.: . 5/') / 1 _ State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: 4g,: ' r This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print nattte: Wil�� / . 4 Date: ,g * Fee methodology set by Tri- County Building Industry Service Board LW is Building \PermitslMEC- PermitApp.doc 12/03 440 -4617T (11/02/COM/W88) tr Tt Electrical Permit Application ' - FOR'.OF iCEUSE'ONL 4, DateBy: Received City of Tigard I� + r l' PeritNo.:rn r9 O6- O0O ) 13125 SW Hall Blvd., Tigard, OR 97223 , { ''I [. Plan Review • Phone: 503.639.4171 Fax: 503.598.1960 A til p irrl, ' fi`� Date/By: Other Permit: Inspection Line: 503.639.4175 a _` ± Date Ready /By: Juris: H See Page 2 for Internet: www.ci.tigard.or.us FEB 1 ' II _ Notified/Method: Supplemental Information � s.•, -- r _;;: t - x: Fes, � � ,;... _: �:.: r �- :;.� - l .3r •.1').. § ax :6 .z t.. ...J r.# - .: -._. :: ,.tiv �'::: > =:h:: °"k .,•vii,;i ?: y: is {'''." - - ?'Ks, ;.. _, r f4t ?�i._ .a..n...s.'! .... :... . . � -t :t' `,r r:.... 4 H v_.. ,. S . Y4,_....a . . .r^.'. - »1. . -w. .:x -. _yam. -. New construction ❑ Additiot ait4ratio; tfr°eplatetnen`tk Please check all that apply: TTT Demolition ❑ otheBLTIIL,DING DIVISION ove amps, m' douS Service t• 225 am s com 1 ❑Hazat• location a _ r ❑ Service over 320 amps-rating ❑Buildng over 10,000 sq, ft., a �:-_ aCATEGORIC. OF: - - IN" of 1 -and 2-family dwellings 4 or more new residential ❑ 1 - and 2-family dwelling ❑ y g ❑Commercial /industrial Accessory building . ['System over 600 volts nominal units in one structure ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑Master builder 111 Other: ['Occupant load over 99 persons ['Manufactured n stt uctur es or - ,r.,- : �-:p:,s,.., ^- >:... :$-ni - _ nest{:.- i�:1 " I„�.:v. �..: y.�: r.5;,•, ^:A`55 ;� - x _ - - _ _ •- :.: - -' a : .., :4 : r • . ,: .,", - ''kS . i 4 �? eF' ?' ,:ii: _ - iL c.. .,g< ,.� '�.,- "'n_ •:. ...;..:• � "�:�i,: RV park - ,,. <:.:;.,'. _ .- .::,,,,. x.:JOB:::SITE,.,INF..ORNI�iSTIO =ANLI 1OCATIO ��z: t' ' ,.., � N{ .. , . 'N:�� ❑Egress /lighting plan P -. :, t..; - . , . , Jad.; f:: � .VSrr r: „x «_c;uv,z�,n.::n: xx:, :;:a> +:•,max, =te�-:., _, ,,. a , ;ac � ` .u�._..,. : 'i :• " *''.,. - Job no.: 3s lJ�l�' Job site address: I 1 ` r l� III 7. ❑He - care facility ['Other: - Subm 2 sets of plans with any of the above. City /State /ZIP: `11 CAW 6 Of' V `f The above are not applicable to temporary construction service. ... lad: w. �it�' ��, nn'� }:;5; ?;: � .�•t�.�.�1%.uit�'. , *.., _ ° + Giltsi`,�x-{�.r�.. .�;5;: � • i� ;':; = :r z,<ic -,.,.•. a .-;;F:F .. I . .,.,. -�. -,., Suite/bldg./apt. no.: Project name: '” ** Description I - Qty. l 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: i / v . vv\ III ,‘,. ei Lot no.: -7. Ea. add'1 500 sq. ft. or portion 33.40 l Limited energy, residential 75.00 2 Tax map /parcel no.: „ ,; -,,. ;s, Limited energy, non - residential 75.00 2 - - ,��P:a; t; t. _ ":'.`=L:tuti �:iitr ' }:,v`3� �:r - c- xDESGRI. �IOr N, _ x "- URK %'s� _ ,�.:.es�s �_ Each manufactured or modular .a;; ,- .�'- s� %�r.`r .. - ctur " , ;a. -. . >•.,. {.,.r��.;, ate... �_:4..::.,,�.,�- .- ..v.. -.,�, � .,;:��. �,.w.:;,� >r, »..:,._.,, �s ..,. t ..� ., .v. .a .k +'_..i- .�..t�ti:L ..,- +._..:w -_. f. 4,e5= •KL'':b'iA4 ,. ..at. dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ,:•t:, .;k, ,k',a� :r, n:y. ..;�,. 201 amps to 4 0 amps 106.85 2 `�i" - _ ..5. ';;it+ ".9{. ;�,rr » :ti° j::v'-'•''"`- 0 � S 1Q 5 =tt �= =i oix� -�:,§ >n�_ ° :r "r ,. #:,. ��{;,,�t ..v�a�a . P P r „N,' iI : ,.PROEFiR{r' y� g x ,; i It . , aENAN , O , , ; ;> T'sti4 - :P.:��.T `.'32,Y,;D,WN'�1��" c5•a`�*«.G2�4 Nir�.:ik'.. �i. y: �ir�. <.,, - , sz'� ` •t`i�C #.�fv * a ��:.� �.,,:;. �. � - ���<w *- ri. . �_......3: ».,.. „.�..i, �f. r 4t :..._ -�„�n _�;, >::y-, 401 amps to 600 amps 160.60 2 Name: )0Y\ !�� 1 'A+,�' tlti e L ,C' J 601 amps to 1,000 amps 240.60 2 Address: Lf .? '�(,lJ l I X Over 1,000 amps or volts 454.65 2 � R econnect on ly 66.85 2 City /State /ZIP: L�, �, ( , ,i O , � Temporar s ervices or feeders installation, alteration, and /or relocation Phone: ) � — ? j Fax: �) � — '7 1� 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 ” ':;in S r ,, `': g , =s ,' ,; A. Fee for branch circuits with ` °rtii - �PIT C�iNT:. ;�?�l'�., ,,:,�,rTm,. ,t � , 1 ,�, =�, n., , -., ®`'` QONkI ?ACT':;:PERSON; =';�.:,.. {., �,., 'S:'!: -. - :'t .. Can'i_: Vt _.<,,: �,,,..;u, >:fF,. ; ".,.,:�::.__,':;:;;,;,,.,s ^';3 feeder f ach service or fee, a 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'I 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- at - t , al teratton ar�� = �ti -� � -':•?� ener p anel ' . �:� G,. d; r'..: BY p CCUNTRACTOR,:�` N , o .' {i. Sib. +.'. "� :-- "'�:.. »i, .,t. r. r ,.t al... 3 :.,- „F'ii: ter.. n. ....t -....- ��, t ...r t i H. h. :. ;.,' ”' extension. Describe: Page 2 2 Business name: CA a( V \r- Address: ?)9(E) S Lt(V\ r\ /1 e,. - �.) , ''E � - Each additional inspection over allowable in any of the above YAW V Per inspection 62,50 City/Stat /ZIP: f - 7 - 1747 . 472, Ce q �gd Investigation per hour (t hr min) 62.50 Phone: ( 5 '✓ 41 � r' - Fax: ( ) Industrial plant per hour 73.75 r ..; �1 t 'i , ki; a iEI IKM. IcAL'aPERM IT FEES*. -' ` '. , »....ter.. �. -, ..- .,.,,�; ;..., „`- CCB Lie.: 1-10,21DD_ Electrical Lic.� � Suprv. Lie.: 35 Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: C .0 ,‘(,,, r t z ,/ I Date: `�3 1, �/�� State surcharge (8% of permit fee) 6:....,,b in 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 \BLC -P et mitApp.doc 12/03 440- 4615T(10/02/COM /WEB /II 5 r r aD5 -- o 3 T N�, i , AAAAA AAAA.r, AAA ,x AA ,r:.AA AA4;: AA AA AA V I 1 STREET REE CERTIFICATI ,. . i , „,, . it ,,,, , , . I , _,,, „ , . ® I, I LA- Y L Owner /Agent for }) -,J y c, (..6 r> E ' l IN�M� 1T� S LAG (PL ASE PRINT) ; % (PERMIT HOLDER) 1 - # - : , "# ® Do hereb ��;�c =. t.at��tfi location meets , ty of. ' gar µ `gt d /Washrn on 'County land use and development standards for street tree installation. I 41 ga- ® ADDRESS: /2 /96 Si) A-26 c- 6:57 i ", / -y ® LOT: - 7 , r SUBDIVISION: 5',w ." .i- P r J1 c.- J I BY: ` .• DATE: 6 - /a - °S - 1 DT- 4 RECEIVED BY: _ _ DATE: K ' OS V ` VVVVVVVVVVVV VVVVVVV V VVVVVVY ,,x® CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00038 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10/2005 Phone: (503) 639 -4171 .mm '(I Inspection Requests (24 Hrs.): (503) 639 -4175 �.�� INSPECTION WORKSHEET FOR DATE: 6/9/2005 TIME: 7:09AM PAGE: 11 SITE ADDRESS: 12996 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 075 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE HOMES, PHONE #: 503 -387 -7638 CONTRACTOR: DON MORISSEI IE COMMUNITIES LLC PHONE #: 503 - 387 - 7538 Inspection Request Scheduled For: Date: 6/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 008867 -02 603- 209.4837 N • Corrections /Comments /Instructions: • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL fJ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: `t Phone #: (503) 718- CITY OF TIGARD ' BUILDING DIVISION PERMIT #: MST2005 -00038 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10/2006 Phone: (503) 639 -4171 J ��4NI II l ��l 'I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/10/2006 TIME: 7:05AM PAGE: 77 • SITE ADDRESS: 12996 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 076 TYPE OF USE: PROJECT NAME SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE HOMES, PHONE #: 603- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387 -7538 Inspection Request Scheduled For: Date: 6/10/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 008966-03 503- 209.4837 N Corrections /Comments /Instructions: • Z6 ( <1 d ' (i <_ -- "Sc.) ( ,, C © P c.4_. . 0 . )0 PASS 'PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL j. L FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: /�, :: Date: CJ J o O Phone #: (503) 718 - p / ( ) CITY OF TIGARD • 1 BUILDING DIVISION PERMIT #: MST2005 -00038 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/10/2005 Phone: (503) 639 -4171 / n.;mipu Inspection Requests (24 Hrs.): (503) 639 -4175 ' `:_.. INSPECTION•WORKSHEET FOR DATE: 6/9/2005 TIME: 7:09AM PAGE: 12 SITE ADDRESS: 12996 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 075 TYPE OF USE: • PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE HOMES, PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: • Date: 6/9/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 19! ! Plumbing final 008857 -01 503.209.4837 N 310 "_ Ov-ck...J1/43 . l r 0 - -.n C .'wrn Q.-.---- e ) Co rections /Comments /Instructions: t\if r it.4) (,, -.- V\ . leir7o C CAAA25) ---- -i-55 ‘ Civi---.e. k_X -1-.-e--g \ • @- c- ( 2_,I(j4.--- 6 • -- P — c_ 49 ' 1 / \ 6 x24 cl C 94_<_ / '1/--,4"P ' PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r Inspector: �� Date: 10/11O ' c . Phone #: (503) 718-