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Permit
I CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00058 7'111'. DEVE SERVICES DATE ISSUED: 3/23/2005 503-639-4171 PARCEL: 2S109DA -SR049 SITE ADDRESS: 15136 SW HAZELCREST WY ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 049 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: DM139 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,564 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,386 sf GARAGE: 693 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 290 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 2,950 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 < 3HP: 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: 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 COMMUNITES LL( DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in 4230 GALEWOOD ST #100 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules Phone: 503 387 - 7538 Phone: 503 387 - 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: $ 8,539.98 1 - 800 - 332 - 2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils /�� • Issu d By : / Permittee Signature : �( C/ t 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. =I, t , , `° Building Permit Application •, F OFFICE, use ONLY , ` - • ^ DateBy:�;yZ,� City Of Tigard Received O� y%� C/� Permi[ No.:�s�O / � '`�GJ V �/ ` � n � : , 13125 SW Hall Blvd„ Tigard, OR 9722 In Plan Review J �i C', ',;. Phone: 50'3.639,4171 Fax: 503.598.1'.0 EC g / ��^t•S i ^41'lll DaDate/By:/14A./ 3 —/7 -0 s— Other Permit:S( eo 7 ,/ O,rh '4, t Inspection Line: 503.639 _ D Ready /By: ]uric: ® See Attached Checklist for ` , ,i i ,, 1ntemet :. "www.ci.tigard.or.us FEB + 2005 Notified/Method: -3- ! 6-- Supplemental Information CC DD .tin. y s ^. _X. - is �":1` 7 -r 'a,g. .�C °:�:' � " 'DVVEIlIi - i: �{� �,c D "DAsI'A�,1' ='- .� 2= E'.'1 • .fe,..e.M .,. }t. n• aT�LI'•• lU O�. �, rr : ':,.. AN ii-,z, 1Z+4•x'7:,.�. �. = -.. v. :,. m. >_ <.. ,.,: :,.. VtL�./1 ,_..,. � . It �'�• O i � .,�,'. iit;+'iz,�: 4i`f4;'n .,,,. *,. _ - .- .. r.., ..e fdi�•-^,.i+s'�- fff��JJJ V •*.w,.,v a:� .,sir to , New construction e t io l iV Permit fee are based on the value of the work performed, VVV s Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the . work indicated �.,.:.;.�,- ��. d red on this application. ;'v , CATEGOR `o: CONST UC , „ . i; .' :; ;: , ... - : .4 : _vi ., ...�.s }.. - .: - F s, ; e. ",..,•, �....,..,..Zx - �,. �sv !',>�t ^>tisr - ,r:; ?,•tL A,,;A4'.35t 5,..... z.,.l �_, �.:...: , . n _ . _ ... � -- .... . :, r.. : Valuation: $ cg 1 ci , C o El 1- and 2- family dwelling ❑ Commercial /industrial `"I ❑ Accessory building ❑ Multi - family Number of bedrooms: 5 ❑ Master builder ID Other: Number of bathrooms: x.: - °',i:,rkvi': .�Y:';:�.ia ,:t.�' s`7x`.'.'"�:': F ; ,, •ast;,Y.r}i +t'- ' ?r1Ftr;':: %tiitw � y :,,:A:, :i2",':�4 „ A;•:ik3;iU ; rx,.” k��; :.t�.. it - ' °1 °- :4;1'ii ?sRa�,r:;'.}ct:- a ��.:, 7i �! - 4 :ti�F `: „�:.;TM ; -. .t�'x}.. ;3 r.P"` y,..3 ; r" t;,,,; t), C t,,;,1;sifai - , _' st r'•ATf : „:.y; - .,�,;,+';.: I 5 : •rr,.t' +�: Total number of floors: w . t, - , JOB "'f$I�tE,,,,INFbRMATIQN; ,r ND , O xa) 4 0 kt a „.. ;.,. : �- t'• � �� �,+a co.:, �' v`';��:. �i! w;' t.,: driS�' r:.,. r, i» si Sr e- Pw1. �t�MiY. w�S'X! x: x{ akt::<< re z< r .Yatr.�.� >':rrv.r3tk! 1P.:,.,.. _..w�, &_�i:�'.�`v., i•. �<- av�,a,,, .ris Job site address: 1513 0 <7-3\t� 1 kc e-1c e -z--c _73 (....) , New dwelling area: 1S O square feet City /State /ZIP:.'TUG i Ole_ Garage/carport area: (00 square feet Suite/bldg. /apt. no.: f _ Project name: Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet ,,,,,fie" d,V',3g,,, #74$;9; 1', cm.,. t „�,,,„ ;^ fie iii 4 4 # : i t ,.._• > ..; , 3,03. IREQ,�[IIREDD4 A.: +1'CO1VIIYIE2CI L �JS -1$ ti. .,rlu z.. �e.maziiaW r}r4=� ,, cw. *.=;t, n es.,,N.4f.F.!:0 :"7«; : -;:i.8 1 ,rr<.-,4. ;.,0 :):r <Ai, "!. : Subdivision: a ,,rn k 20 e, Lot no.: 'LI CI Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: ,:_^ - - m ,, „� :r. > �.� { ,, ;; ,� a :. �a1T, ,�� w^� „t d , y t�.,.r,.�,,,,� „}..w equipment, materials, labor, overhead, and the profit for the ' x'1 , t 5r - �t;,. - : �, tt : t�°,w, � - - work indicated on this application. >..`.�; w t ;, DE . RIPTION. OF:: .,OR', ,4' : :' y . €.:• >aXi44,.. .;,,.,. -,.s \,t':, < . , x, , -.._ ..:_,•,i,,, , „,,,,,,, ,, i�rs :.,.., >.,- .,.. __, >,..., r-•a=, . ,,,,,,- . >.... :aa :� -, .,,. , -.. -, . >3n, :,�.. ,_, :C`,t'.' ^i;! =:.r ,.,:�,,,.r .� ,. Valuation: $ Existing building area: square feet New building area: square feet ;s :i'1; ri - *d :,,, `:tirzi�xt::rnt: ra;k:; +°•V: EgY 4c: 'f5 > gag,= °.�' 4;,r f,r '; , a=ye;=' 34;;3-,1`)• +t�,`;• =Ik x. ? , y rf l r «.n • F'.' i;;d� °�i «'i ts :; M! 1 � i `-, q,<-: , .. ,t k ,., .;�;,.. is , r” a Number of stories: zs� :� :s � , .n. t *O =;<i; "� _ v. -t: 4 .,,,,� ,,..T ��.��.�;;s :�r - = :yt ii,ra,i9f :� ,.- „ \ a�,. f�, a.. �: pn_:- ,t.i4n,..,�i��kot;).i' -`;; ar, :zu, "��Sh.,.lt�-.�'�,,c, ,: I:! iLT : :ri`= �':i"?',' :��fin :rt.�;Ci :� x?�3 ..,. iii! ��Mr ;�••.f :.:4�2!..;r:�.w, Name: + 0'' t CO ,1"lmu � Kt, tics / Lc-Q j Type of construction: 1 Address: f ( (1 ) 4T. l.... ix Occupancy groups: 1 City /State /ZIP: L-1 L (J `J [30 , VI` q -0 3 Existing: C,� !` Existin g: Phone: (c1I D Vj7' 7 Fax: d/3) . ? l , 7 - ' 7 Co [ 5 New: -ia.'= - G. t Y 1 tl -•� Y Y � It4a "� t; a?� °i1�r � -f!t ,•uhf ,,.Ys.:n;.r:... • < : :... : :: uh4;.`: t..xt...s. +i. , h�.: -. F 1'�O : '9 ' 4• � 1 _ . .y'y.E `.�r .a Vi e., - 3h ,. "'F' -.itY rxa .5 : .v. :;� A, AI+;ICA N. ��� "��,., N C RSO,, ., \ =t=:: .. , ,�.� ` :_, <.:•! t, ..,...:..i:J ..: = .a< <..'i. - .rf�>i, _ it, . . s,,.qm -,rn `3 r.,.' ?e: ,�..,,. :r :.W�<.�- •.,�_.�,.... . - ,..�..,..�,�, -� ,.. .. -:.. > .yy.Y ,. s �ll< .._t,.. .,,.. - •sip : .� , - . K ? .�, Business name: 5we N \e A 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: T , T , O R' ▪ `ICON RAC .`. - a ,. .. _ ._, , n .. .. , t. . S -fi.. . 'bt;. > 'S: .., .. s .. , :t " ;, ` tti :� . z Business name: 5 . rC D ^t;:t`;4:. \:•^ i N µ1: R 3,•. 2, <<,,; Ii ;`BUILD „ =z IG' PENTbT rEEE$: Address: ” 4> t. Y: trw,•:.,.. ,,,,.: :;,��r >.,,a,��aaew;;, . ._ ..,.ye. _ .,.., >ri...-,v'� - _ ; - '.,.M + = . �� - .. Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) _ Amount received CCB lic.: i ( t 3.. , Date received: Authorized signature: t n This permit application expires if a permit is not obtained / within 180 days after it has been accepted as complete. Print name: 03.e �( Ti. )c Date: al lc ., L c.._ * Fee methodology set by Tri -County Building Industry J Service Board. is \ Building \ Permits \BUP- PermilApp.doc 12/03 440-461 3T( I I /02 /COM /WEB) Mechanical Permit Application FOR OF FICE USE O City of Tigard Date/By: ive Permit No.\\, 13125 SW Hail Blvd., Tigard, OR 97223 � d�0 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /tiiuroft 1 i I iti\ Date/By: Other Permit: Inspection Line: 503.639.4175 4,� I Date Ready /By: tuns: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information . ,.w -„ r4 \ . , .: ...- .. . r,..:...,.TY,P t,:..l , ..r.. �; . 4g" E .OF: WORK , :, �r.. - „ :; : ; , - L� ,. .its.,.., t c ,, .a., <�. ..,.,. ...: �. ,.._i. -” ..•... �.:: • ` i._ •, - ., :: :� ,_. ,., ,.. -- ..... .. .......:...�„�� -, ,..0 •ar= :�.�� C F' EE..-. : > :USEtCHEGKLIST� ,.<<..t�y .:.! �•'"# s,.., r.... b;.:>E-, 3" a, �:. z.+ t..,, .ee.�S.:s ..:............:.. . >._ t - ,EC..� <-.., Asa-.,. �.. �r:,',:: �: �.., s,-..- a�,,.:..-±•,:.. � ......s:.:�.s,<i,v.;f.,,, ",.s.: §`7a:?:an):siY.':sY..,, -_, - - .,.v.:. `:i - - k; v. � , tu a �::, am, „..csr�,rnes`..n,. >.�. - -�cx: h..r: ,;.;.. �xsv ;c:; .� � New construction ❑Addition /alteration /replacement Mechanical permit fees* are based on the value of the work ✓✓ `` performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. \ r ' .ip -..M - Value: �`C • O STR ON ��� s:m 'RESIDENTIAL='E'''UIPMENT'' / ❑ I- and 2- fancily dwelling El Commercial /industrial 11] Accessory building Q':. :. >• SYSTEMS >FEES ' For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty, Ea. Total ,;.• ,,.. :: R;.,- ,�' „: _ _ - ;>R:r ..y'.L �:'so-`<:;4Y:1 .:t': }r eatin 5 : ,:., ..-.., ., ..,. :'.,. .s, t 9. ;: .JOB'SITE;`'INFORIVIAET'ION�s., AND.'+ hOCAIPION"` ;t�.�'= ,�f:�;�`' " <_.:•''���`.; `:i '_ _ "- -,, "..<- - r.�, •: , - ,,.. .., .. - ".. ., �, -; :: �ta >.r, ?a:,". a <, ,:., ,_ c - •, n.w . 5 - u _..:. a n5s,:; � .... - ',. },� g/COBh ng Job site address: j i �� IJ� ^�^ Air conditioning or heat pump L !- Ict ?e cez, l « (requires site plan showing placement) 14.00 City /State /ZIP: a, i (,) Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision:^ - on i.4 Hl -(� Lot no.: 49 Flue /vent for any of above 10.00 "' Other: 10,00 Tax map /parcel no.: Other fuel appliances . 7s, - - .,n ., i .-t34r; ^t .it! . {,: x`.>i'tY ..r �, t. ;�:�; X °'•. heater 10.00 =a - DESC .TI S x: :w ..r: ; -.s'` vas;:f RIP Qi;`I,.t . IZ1� \tt , a '�;;r�.', a,F rc ,: -, , . <. . - ,x 1 ._ �,... .e . ..rr.,..�•n': Mv,. ..r>•v,�':c.. �. ,.�1;�:azS, " kr,-s, :.,:,a�'1^�: �;`.•.< �._ <,_. �s?q •« .. _.., .s`ss, ..,a^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 ::., Chimne /liner /flue /vent 10.00 .. }PROPER µ i}���:'� ,.. ?; Y �, , ,rt,,,.i:.,i T3'-; :'�,. i:r "� �,,�., , :0` � y'T?�ENAIVT «���'r` ", �. _��" _,. -� , , =r. a��.e2Y�f F i ''�:' : :� n� - /1' Other: 10.00 , Name: � . �7 �(�1_ ' I l l tt t4 - � Environmental exhaust and ventilation Address: 0 Ott. / ' �� L " 114�1 , l l �/ Range hood /other kitchen }� ��/// equipment 10.00 / City /State /ZIP: 1 c q K ” � , Cr-)0S Clothes dryer exhaust 10.00 � �_,�-�• 4 Single -duct exhaust (bathrooms, Phone: —� ✓ ✓ Fax: (� toilet compartments, utility rooms) 6.80 ,$± =:t - - ,�•5:' %•: +.W::: - ..�+p ' "SI;. e'; Ti, - �at:er;u ?.2Y.: kS:C` ', +F.s+ - '.N` I:::Y, .., r!. �,px. - : :t t :� -�L : •i' s .;t'"v`'^lf'- ,: :la „ ''� ' t ;:�rp «i ;�;S,.;t;:7,,�;t := 'r.,��; = fit �- : �� � - a .� Attic/crawlspace fans 10.00 ,; :r .;,AP•,PItICANT, . , .� v i :fir • t' t. , 5 :r r!CON ?ACT° '.P , ; :e:; f r , p .r`. <til'r. 2 , < ::war ». ., __.,,:.,._, >;'.� =.1�^, ..tea,._.... 'n d,, .:.'r. .,, az�,..,... >,xau;t �:;.xa4 ±vbi= o.;+a�:,res,:g,.�. ,. .::y ,.r 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 t CONTRACTOR .-. 9 : Barbecue Business name: (II , -a a j.-- i �-� :i I 1 i:Li y - e_ Clothes dryer (gas) Other: ; ' > 1VIE Address: /� L `i i :r A ,r{r.t 1 ,:, ;1:.:y,;s..,° = ;_; - � (.! r , �,.c , t VM.,, °CI#ANICAL PERIVTIT FEE {k, City /State /ZIP: V vLC.J'� T ` Y ` ( Ole- -2(4, 5 - Subtotal `' Minimum permit fee ($72.50) Phone: (5 `� 'f Fax: ( ) Plan review (25% of permit fee) CCB lie.: . 5( j ! — State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: 44' / 'fir This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name: ' �. 1 A ( Date: Oil 510 J * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 L 440 4617T(11 /02 /COM /WBB) Plumbing Permit Application - FOR OFFICE= USE O NLY - City Of Tigard • Received Pemut No.: 13125 SW Hall Blvd„ Tigard, OR 97223 Date/By: \\,\31124:05 U �,Z�� e (� Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /4,,R4 i ( ,ft\ Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 j t.1 I Juri Internet: www.ci.tigard.or.us '' Date Ready/By: Supplemental See Page for g Notified/Method: Supplemental l Information �. - . „ ,- ._,1.,... k s ., . 1 wv v�c� :,;.. ,. ,,:., :....a.... -.. •,r v:, !•` .�•.. ,, =,- 3:44" Y ` w - - _:t.: ,.�, . - " :.':?;� � &= obi . t ,y - HY PE - O -_WORK `. = "` • .. , . _ . _. �. „� _ _., f .... . ,r ., _. , _ „ ... � ,.. _:. ...,... r , . ,..... s:.• ;:x _ °::FEE. SCHEDiJIE:�;�` � � •:r: ' � = =, - ,r W„ _. �a, . ., a , .: , ......,__ . . ,•, _ .. , e_s✓ .. .. . .... . . . .. .,. .,z f�_ ^� . � .�• ,hz ' .r. - , ,z � a ,... _ 1._ .C ' � x - _. ,. � _ .._ _. ... z „ _ .. :._ ,,, -.;. - ), , _. • ., ..::, , ,art _. ,. -v, -� , u I - �v . s.. ,.._.. , _ri ,.a. - o__..,. _......°. C4a,. 5,,. Ss«, w_:. i. i 1 _... , . _....� ,b13F�ar,_5,e� .., -vx... •- v ,.. n }. .._.: b: �i t` �' 5 ,.:.. :- ..._.: T t_,.-_,.. s,. w F n r �,:> Y';.:. FrL' tC : = , . -._. -, a'�".::i'S� } -_.P t, • ��New construction ❑ Demolition For special information :de checklist. -% Description Qty. Ea. Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) •S ,r`R "•' - , �- °�'. C G , Of CON$'I?RUCTI . ,Va :. , , • SFR 1 bath 249.20 . v., ...:r.,",vv' ^ , - ...0 '- .,:,. . ar_,.� , g: _� ".:1.'< !`:: r• �- L:=^ r F_ n:,,._-- °} ":';.i0TtYS`CFk?:�::"Nk� . ]:s.., .., E',•r -., _,.._n_, i,,...- ❑ I - 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: t- ,:3a..r , :.,t -,,; ,,,a:' :' :., :, ;,; , >, ;. Fire sprinkler ( sq. ft.) Page 2 r�JOB „ S E��INFORIVI w Tht 3 N'� D;�LOC'ATIO _,� ..,, ... -, � • sz' -. - ,. „ „_....,... . ' Ira ` s ..,. c.- ' =.Fa7 * +._• ..,. �• �•• ,...,., . Site utilities Job site address: Catch basin or area drain 16.60 City /State /ZIP: ' T..t!-d 1 ©1Z 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: \rn 1 - , ci k r1 I Lot no.: `T� Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: 1 Fixture or item :'. = x :', :. v r ::. ::rfr. b .:,,.:c, ca,: w':, : 4 j.;;, ,;.e.:..,t;= ,,, Absorption valve 16.60 7c'. 1' ;?1`ef r'e;1 ` "•tM1 .� •`i`t`.k;�r:. „ I , .i;;�2,•? {=a7,. - ` v t i�:;{; :..y'�ea�l,l: i >:K''e>: { �i ;il t ,41 "k,l, �':: /vSl'r >�, e eft Tr `, }_,�,R :I T ; i ' _- ii ;:., ,_ - °:% ^:,- {. ,. sD SC1tIP2IO,- .OF.,:VE'OR,,, • i,tv"=,;. :. ,,r:..,c r.�,.: �,. :�,�'ti._., ti >�:.;_» Sr: hu<- �} `,��!sV<.:,,..,,. <r'�: , ��, �: , :,:,; �,,;: �, �* �?3r,;,. .>�t�ia;��:'4 = „"�- �i „�.,.,.,,�, Backflow preventer Paget Backwater valve 16,60 Clothes washer 16.60 Dishwasher 16.60 >, <, :, :'. :cn ,e�:s .,t:. <Y' i ac a f r,c_-, "; r, Drinking fountain 16.60 P ' =., ,.,t. , T E TT ;;Y, . >,, _ - - :';t'?4.:�'� 3 ti5�t .- .i1,h .ir -ks r. • 3'i "ac ... ., .�Y . ,. - ,_. ,..�,'.<, _._.,...�._,,. „<��, . �:�3 =� _ , :,.�.: � » . r•� . a. .,._.. _,:�N..r ,:'.,. »..::•. :rt�: < =, „��;..„ „� Ejectors /sump 16.60 Name:: VoV� � ' OMM ML l t'�)>�' LIP � Ex ansion tank 16.60 Address: Ti'� l�' �' , t Fixture/sewer cap 16.60 City /State /ZIP: (/),! ' Floor drain /floor sink/hub 16.60 Phone: j17) .3 •--. 7 / l/ . -b Fax: ( ) )7� (at S Garbage disposal 16.60 s,. „ ;4,rw�;: , tv , , .,Tv:3t:s•. n ,,,:, xf,,t., t,m ;1 ERSO -, , ` ,,:i., .;s Hose bib 16,60 i eft: > a , ARPT It A1VTs >:. ;; _ ' = ,4C .„, N.; >.,,.;':, - -,.._ . ..,._. _..... .. ,rs..,.:.., . ,R.,u_ ., ,.v:: .r -.... ,, e: t ,.._ . f ▪ 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: Urinal 16.60 :f:. - ';er : .pr ,ri;t: :a {:;: ,N'.C; 4:7•: ;.;t +e +.a,..2, <.e;;i: I - r . • IiiT =I ;+' -�., � • - - , i �.,...:r . ,.:..,,C > 'CT.QR� ,.i:t:;7 =` I ,rt'�,.,�, t :, _r -_ «��� ' ' < „k,`' - Water closet 16.60 Business name: '• ' ; � A -� ` `? rn �1 Water heater 16.60 Address: (� 1/ Other: City /State /ZIP: Subtotal ?t ^ � 6 :J r ( Minimum permit fee: $36.25 Phone: ) 5) `•� [4N✓r ( ) Fax: Residential backflow minimum permit fee: $36.25 CCB Lie.: web-744 ^lambing Lic. no.: 2 7 • �/'XPO Plan review (25% of permit fee) Authorized signature ..3X PO surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: J P4 --) ' - 1 i J Date 15' / U5 This permit application expires if a permit is not obtained within �J 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) Y Electrical Permit A' p rIV ECG ,. .FOR OFFICE USE ONLY .. p City of Tigard R eceived �V /o 0 PermitNo Date/By: daf 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: lII Date/By: 503.598.196 �,PR 9 2005 I' v \ Other Permit: Inspection Line: 503.639.4175 /± 4 Date Ready/By: Juris. El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGAR Notified/Method: Supplemental Information iiS9® PLAN REVIEW X New construction ❑ Addition/alteration /replacement Please check all that apply: ❑ Demolition [1] 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 ii,! 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure III Multi - family CI Master builder El Other: Building over three stories ❑Feeders, 400 amps or more ['Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park El Health-care facility ❑Other: Job no.: 3 C Job site address: 1 5 1 1', c� � J)47 g/ C ,,� '( Submit 2 sets of plans with any of the above. City/State /ZIP: &J 0 1 • `7 Q 223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: �• 223 FEE* SCHEDULE p d A/ / /f / er14•5 d Description Qty. I Fee. I Total ** Cross street/directions to job site: a Err 1.3 Q,l liP t New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 /- / q / Ea. add'l 500 sq. ft. or portion 33.40 1 Subdivision: • 5 Ui4yt7 i Lot ( Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK • Each manufactured or modular 6 dwelling, service and /or feeder 90.90 2 N X1) kifdLS E !Aug J ve, Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 X PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: /� LLC • 601 amps to 1,000 amps 240.60 2 Address: (23 O &A - LF e Aiod J/ S .�' ; 5 (Err / 60 Over 1,000 amps or volts 454.65 2 r !J� Reconnect only 66.85 2 City/State /ZIP: L kA L 05 W � Temporary services or feeders installation, alteration, and /or Phone: ( 5503) Ni.--7 7 7 '3 i 1 Fax: ( 5 D 3 76i relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 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) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or e... extension. Describe: Page 2 2 Business name /5 rl p�� 1 C [—LC, Address: f 6 ' j d Each additional inspection over allowable in any of the above J/ . v {� Per inspection 62.50 City/State /ZIP: VV /� ed „vet or, eit 7 76-6 Investigation per hour (1 hr min) 62.50 '`+� Phone: (563) r) '( z8' Fax: (5 ('- 3 .- `)L Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: J32222, Electrical Lie.: 311-- y8 C Suprv. Lie.: tit 1,7 t5 .,p //�� Subtotal Suprv. Electrician signature, required: T Plan review (25% of permit fee) Print name: f � � 7 I �+ 6 Sta surcharge (8% of permit fee) 1 � ✓ 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 12/03 440- 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: ❑ Audio and Stereo Systems* El Burglar Alann ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* I I Vacuum Systems* Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation (l Fire Alarm Installation n HVAC El Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* Medical El Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\Building\Permits\ELC- PermitApp.doc 04/03 /75 7 5 — ov 5 8 S TRF FT TRE E CERTIFICATION g . .. e f,, .' , 1 y t I, ' ‘,14-11. Pi 14-7 , . <° wner/ gent for Pop Mot, ; 5si c e I., rCe'S ac. . (PLEASE PRINT) . ./ (PERMIT HOLDER) i 1 ,7 I Do hereb;G yce`rt %fy t` atk��= r�1 e` � following location y b :Tigard / meets tash =ingtan County land use and development standards for street tree installation. 0. ADDRESS: / S1 6 S 'r,. , li49 z FLC.e.Fs i GvA LOT: 0 SUBDIVISION: SG, i,e. / ? 'loft- 0. I ® BY: �� i DATE: 6 --2/-05 IF 0- RECEIVED BY: ,---- DATE: IP /Z / o " (-- ,,.. ® VVVVVVVVVTVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVN CITY OF TIGARD , • BUILDING DIVISION PERMIT #: MST2005.00068 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/23/2005 Phone: (503) 639 -4171 h' fl/vsi.i I nspection Requests (24 Hrs.): (503) 639 -4175 „ INSPECTION WORKSHEET FOR PAGE: E R DATE: 6/20 12005 TIME: 7 :11AM 48 SITE ADDRESS: 15136 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 049 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE COMMUNITES LLC, PHONE #: 603.387 -7638 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 6/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 009686-01 503-209-4837 N Corrections /Comments/ Instructions: X 7ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ C , LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: fi ' ' Date: ! � � Phone #: (503) 718- CITY OF TIGARD v • BUILDING DIVISION PERMIT #: MST2005- 00058 13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 3/23/2005 Phone: (503) 639 -4171 /4000014 /y Inspection Requests (24 Hrs.): (503) 639 -4175 (�( 2 4 INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7:11AM PAGE: 91 SITE ADDRESS: 15136 SW:HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT-RIDGE LOT #: 049 TYPE OF USE: PROJECT NAME: SUMMIT - RIDGE DESCRIPTION: New SF OWNER:. DON MORISSO: I I E COMMUNITES LLC, PHONE #: 503.387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503-387-7538 Inspection Request Scheduled For: Date: 6/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 009756.04 503 - 209.4837 N Corrections/Comments/Instructions: �► ' Ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED \/ Inspector: Date: Phone #: (503) 718- CITY OF TIGARIO - . - qv , . . .. BUILDING DIVISION PERMIT #: MST005^00058 13125 SW Hall Blvd., Tigard, OR'97223 DATE ISSUED: 3/3/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . _ __. INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7:11AM PAGE: 92 SITE ADDRESS: 15136 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 049 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSE I I E COMMUNITES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 6/21/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 009756.03 503 - 209.4837 N Corrections /Comments /Instructions: • IZLI—PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: n1/ Date: / ' , • Phone #: (503) 718- 7 ' _ ..r CITY OF TIGARD 1- BUILDING DIVISION PERMIT #: MST2005- 00058 13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED: 3/23/2005 Phone: (503) 639 -4171 amnd�uyl,,,�ii�l� - Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/23/2005 TIME: 7 :10AM PAGE: 7 SITE ADDRESS: 16136 SW HAZELCREST WY CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 049 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF OWNER: DON MORISSETTE COMMUNITES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 6/23/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 010008 -01 603-209-4837 N Corrections /Comments /Instructions: • fc� DA/ Ai S - Ar•„ • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ' Phone #: (503) 718- .