Permit r
' C I . MASTER PERMIT
PERMIT #: MST2005 -00092
u .�l�, DEVELOPMENT SERVICES DATE ISSUED: 5/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DB 03600
SITE ADDRESS: 13018 SW HAZELCREST WY ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 074 JURISDICTION: URB
Project Description: New SF detached
BUILDING
REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,600 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: V
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,670 sf GARAGE: 625 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 322
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,270 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: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS 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 /FOR: 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 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: $ 10,268.92 1 - 800 - 332 - 2344.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Issued By : , ■Lz., 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.
Building.Permit Appal catiQniV E D FOR OFFICE USE ONLY .
Received
City of Tigard DateBy: � /�� (J S � Permit No.:fr/��5'
13125 SW Hall Blvd., Tigard, OR 97223AR 1 7 2005 Plan Revig
Phone: 503.639.4171 ' Fax: 503.598.1960 °' ��NP �'`� Date/By: lj9T , �� �G - o S O r 'ernut•. N V r-.
In Line: 503 � .639.4175 ��' JI Date Ready/B7: Juris 0 See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: V 7'cSi Supplemental information
BUILDING DIVISION :s o ' - .;ar<: TYfE' WORK vs . - ? w RE ' : UIItED DA.T
,r�cB:y. ,,�: .s` .k�...
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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
work u3dreated on this application.
���� +" �• }4 ��, 1 ' �tCATEGORY t OF GO STRiJCTION° ,� �> :. �_ �' u �,
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ G Exc
❑ Accessory building ❑ Multi- family Number of bedrooms: l�
❑ Master builder ❑ Other: 1 Number of bathrooms: J
Total number f floors oors:
Job site address: 1 ?I ' ` �7 Q.,\ G �e � t , �t I , New dwelling area: `� 1� (3 square feet
City /State /ZIP:�� „"', Garage /carport area: ��L� 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
,REQUIRED: DATA. COMMERCIAL= USECHECKLIST
Subdivision: �L}rn�1��'\ („ Q Lot no.: _ Lj Permit fees* are based on the value of the work performed.
Tax map /parcel no.: ^ V` Indicate the value (rounded to the nearest dollar) of all
a e t equipment, materials, labor, overhead, and the profit for the
a k CRIPTTONOF "WORK•'k9yp `� work indicated on this application.
Valuation: $-
Existing building area: square feet
New building area: square feet
�: ;; :;�;xe ;,:�t'�;,:>_',� �. =u'r.4 ;x .:t: ;s:r.;r• �5 - atr6:v�ear - t >:�"aa` �.�a� r?,�kt- �c-n">r� - � bra
;' PROP ; ERTaY�OWNER k L. TENAIV I T s Number of stones:
Name:' t 55 c'..�. r, t-.' j ( Type of construction:
f ,�
/ -('' �� a
Address: 12 () l � j �1 - t �� tl� � Occupancy groups:
City /State /ZIPP: �6.� �� ! (.Z.. —7q 70 Existing:
Phone: �� ✓J !�7-7S Fax: ( ) / 7 L [ ,
`G / New:
. : �• % , �s�* ,��. �:;,1�:�:,2r � „ ;, ��{�� � ar,s¢; .p�:t4ag }?arxtxrv°=1* ' �.;s�, ;> �-�sr, ttl
��, � � ��_ � �>���; ®APRL'ICAN'T�'t' �`,a .. �.�`'�` °��. ®t #CONTACTPERSON. �,r��_. � �;,.•• z,w �i��� t` ����x����,. •"�_ ;^ t���� I°� :r
�yr,�,.a �>,<_.'�.��,,„�,::;� ;,.:,�, � #�„ aarr��:,.rrtatw?: � f''� ;� ��> � �����+:�,•tv =. � w :;, zs»r. ,�st ,i' r xa nos ;�2�.�`�.' ���;�' ' ;�'+, " t`+ ,, �'. t: _,,.� t� �'�,,, r'�c � k;'
�1 \�
Business name: t! �� `•✓ �'`��tJVC�
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:
}: '*e�` -'' `,,.- :�;.:',�`�_'' ".�' '';t - A "::�i d; �. ,>i * ,, ��; .,.�a'�?„�,irr •,,��, . ,• ;��e� =tr„�a _i�': 1 �.� ^ � - ,'';�sjir
H y
Business name: l �� N?C V.
Address:
Please refer to fee schedule.
City /State /ZIP:
Phone: Fees due upon application
( ) Fax: ( )
CCB lic.: Amount received
Date received:
Authorized signature: � • •'
4 ..•�,/ , \1Git /` � This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /\ N f < )C.4 Date: 3 I O� * Fee methodology set by Tr-County Building Industry
J Service Board.
is \Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T( I 1/02 /COM /WEB)
•
P t m l
bilria P ermit= v i FOR OFFICE USE ONLY •
u b L u v ICU Received (1,61-;-_-73-
y g Date/By: Permit No.: UA-- - 10651/
13125 SW Hall Blvd., Tigard, OR 97223
� n
Phone: 503.639.4171 Fax: 503.59M601 / 2005 //�nna+hi ', Plan Review
Date/By: Other Permit No.:
Inspection Line:
24- Hour Ins 503.639.4175 . I�
p �' W Date Ready /By: Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental
r`tTV rtc TI(_`rion PP
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�', ?m, 'who' `)b,?' ,�•t;����, „� ".� - :�,:�" ��}` � �^k ��ar,: &�:wrm,.w�:esza.z.�*w'.. < -�. � xF,. ;.W.^,r .��
,,:. 4,� i :, a ; `�t m. � " 411 ;' r t =.• it; t "FEE a,SCHEDULE �°`a= A
� � ��: r a n€ ��� � � r j�`aYPEt OE WORK � s". � a �� ,t � � �- >; ,r�
!ts x* R == + -1 e��; .`.1;.n§'�kr t�.� �9.= .:�u'. 113, �wtr�� :,Y:2�+a+sraurs•�c�r,�'�ae ... :�:�fc'•,`�_xa,n -.r c� �� ,r.,:L;"�ela�i:��'v. �.as3.3'S�rrtM.t�ac.,r : a�- ,r,>,.a•�>�- .r- . >�:.,''::�'. .,1,• .���•:a•.,r • ,?.
New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
k i t h ; -J'. ..s:;s�e`' � xz���; �. :.�:�.,eta„4�..s�•;xw ors:. �:= a�. �,. �_ ��� :�w,z�s;;g;�- u �"t'"s�;���.���; p: -,���. �'�', '��:a
A ;� , �t' F ,• r a ' CATEGQRY -OF�-CONSTRUGTIQN iLL. ,.• . ' :-nsr
.wAttA4#.:1; : -£ ^ 't.._.• .,, •:,, .,,a sx.4,.., %,..s tt41 . to:A4 .4 rtt), t.i.4... -' . SFR (I) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
F , s . ' .. Yf , ,, Fires sprinkler s ft. Pa
=� st¢ � , r� n { �°h °rs of a�' P ( 9 ) Page 2 .
g
41 a z 0 SITE I N FORM ATION ANDr LOCATII a ^ ;T -'� Site utilities
Job site address: ' '' 12S Q ' l F-1-0,2(21- A r i- '1/4.)..)--� Catch basin or area drain 16.60
City /State /ZIP: T i 1 O 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: SUM v�A ` f- ra Lot no.: --1-(--i Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: " 1 "v�/`' Fixture or item
i h< " , s; , m ;; r3 F .I# fit p, Absorption valve 16.60
0,° Aa " ` ' A � , DE9C WORK Ai t t,g , Backflow preventer Page 2
Backwater valve 16.60
• Clothes washer 16.60
Dishwasher 16.60
a ti n `a �u�,, E - -r e t : - , gi a , I r » - Drinking fountain 16.60
al'A tN � „P OP E R s T,Y OW �� � , .: a , ,, ; MVit _ . -
`��. ? t . t Ejectors /sump 16.60
Name: l 4M" -Jf . -„ "r ` t - : _) I - Expansion tank 16.60
Address: 1- u, ....;
.. ( j � v 11 GI . s?„, / I Fixture /sewer cap 16.60
City /State/ZIP: ' Ki / l •) •_ _ )` = Floor drain /floor sink/hub 16.60
- 7 7 ` I' Garbage disposal 16.60
Phone: C-1) .�jq - 7 i 0 . Fa ( C1 ) � ��(a s
^ l.<; �uf .,.,, s . a 1z° '" "_r °_;{ :.:fix. ._ sag a s b 16.60
Hoe ebi
R Oa . ,, r, . t® APPL . W . € U � ea'A ® .Vra C P
_a,.. r �, �.. s 2�,_.0 �,� „z w d€ 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:
° t 4erzr .,i c r a . r. z r Urinal 16.60
u
A,'� ° �u �� V VCONTRAf � ,a»' � t.M . r Water closet 16.60
Business nam U� Water heater 16.60
Address: I Q �,!� ........Y AS Other:
City /State /ZIP:. Y. �„�'� / Subtotal
/ / • (� L Minimum permit fee: $72.50
Phone: ��) (r2 � �l ,Ur Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 1,0 C 1 /` 7 y ^tttmbing Lic. no.: 2 , 7 , - x Plan review (25% of permit fee)
Authorized signature' V im ,
� State surcharge (8% of permit fee)
TOTAL PERMIT FEE •
Print name: ' 3 N- cl 1 , 4 Date: 3 1 i r i b s This permit application expires if a permit is not obtained within
l 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(I0 /02 /COM/WEB)
Electrical Permit Application, ,'i_ r � FOR OFFICE USE ONLY ;
Clt of Ti ard'° w LS J u ("2. Received
y g Date/By: PermitNo.:11\5 r, 10 06 -62.04q 2
A
13125 SW Hall Blvd., Tigard, OR 97223 ",''
n, p Plan Review
Phone: 503.639.4171 Fax: 503.598.19.'60 i t 1005 / 4tm1 N'Yl '� Date/By: Other Permit:
Inspection Line: 503.639.4175 f 4., Date Ready /By: Juris: El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
;';�'.``: �'S5`,'-` F, "e �+,� . -..� �- `'.ty.'n ° .c,a,.znF.s ' , �vs.rrrw7u „�:z � "g j..' r Y; . ;:2� �;;t f � ,.� „ ._�; - - - , s:
:.�� :`ate": � '�� . ` ~.n :-.�f S :sc:z� �RC� rte.= ;?,' �Ys �'F::, s"," -,'i<: �,�"V ,' iX::�a.- ; �•y.,. ni�..�m•...x '",.t =�Ye"= 4 - ` - :z��" *; ac
_ Zi. -- a t` ,,.i f -PE tMg5 Z ;r )., *;, PP ,A , u . ?3 ,. `:" 1 EV IEW' W =�-
. kx: �`..z. � -�r �__. n,R... ��.�.�,.xxi� r.�:.�.�x� =s ..���,�..�_a._.as�,t. '. � �� .. u . �„��- �,,. :� n..=�5•�. ,_�0,<.� -,� �.�.'�.,.a�?.,;%�s~��
New construction ❑ Addition /alteration /replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ❑Hazardous location
f`$3 , , ::a; ; k. � < mss..,. ..a , .:'tf._ ,,- ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
* mi i ;,' „ C A +TEGOR *Y4`, G®NSTRUCTION liiof i,1P A a . t of 1 -and 2-family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
E1 Multi family El Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more
_ r ,„ x - l ['Occupant load over 99 persons El Manufactured structures or
si` �w" r k',555g 1011454Mki ON ilTal5 TTON `3g , ❑Egress /lighting plan RV park
❑Health -care facility ['Other:
Job no.: 3 Job site address: ` SW L . 0 . L +1 it - Submit 2 sets of plans with any of the above.
City /State /ZIP: l'i �f� /� j The above are not applicable to temporary construction v o service.
Suite/bldg./apt. n W; M »i * r s.,
no.: Project name: bz�,� r= =rte F�,EME S�C_ ;HEDUIE� � �`- "�'�,ti.�; ,�,
Description I Qty. Fee. I Total I **
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: W \ 2,dIC41 Q Lot no.: 9_ U \ Ea. add'1 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: "� Limited energy, residential 75.00 2
ws ?': °' *-; < *; sc -wm: . }. �:,,�,:;. ,.n... -.. .. m „ }, :r s ,.' Limited energy, non- residential 75.00 2
* „ +iltr t ESCwitiONgoF W, . g ffi �� ` ?
,�r: r���,a f � . ter- � �.. ��?;���, �, � ._ ,,. � � fir _ .�- ,rG,�bSt k ; 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
`?'rL;.iii i m°_ a ., a �° +'+ 4 _;� 201 amps to 400 am
I/ PROPERTY`,OWNER g � " i � TEN' N` '� s 106.85 2
P P
w�=.�,a �r,4��. . ;. .� � a n.,� '' , n _ '.. �_ �` v , - 401 amps to 600 amps 160.60 2
Name: ikk _, '.., - ( _ . _ . ; , y ` .�S 4_4.C., 601 amps to 1,000 amps 240.60 2
Address: - .,,,,(> Over 1,000 amps or volts 454.65 2
�� , .( Reconnect only 66.85 2
City /State /ZIP: La, V /�� I N � ( 70 I� Temporary services or feeders installation, alteration, and /or
Phone: ) ��'�? Fax:c )3) - 2 - 7(0/S 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
`x L,l: , ' ;' k'$:t' os 9 . ". f6 4 , .xr,= . ,* r -. l rt (` .., ,. .c ; °-�: o ,.-kv�r :Hm prefi Q Z,at
,... „'.K°s-
rn . 't APPLIC r 3 ' ' „ C ®NTAC „ T PERSON A. Fee for branch circuits with
= �s?s�'��..�.;'�,r�:�;,.,. a. 4��.:� «ate. �r��. _, 4 r 3� �t h.�1;.� It....�.� ��a��a. x. t��a°, �F.,r+�z rz+
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address:
each branch circuit 46.85 2
Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
;' &. .Ga•` - .a'3�..$�,z::',u,'�p - ":e;;; '.:' �' �65'':'ti:.. ? ,. f .., �.4 it�t♦?5w;',.ret,,,ey,'r';;rr'` �`r'�'2;s.S "jd,4.,. ._,.:ass ,�: . r,
r.; „x ,nom CO ever panel' alteration, or
., > "`;��s` y: ��; n€eka "%'w- . t _ 'r x..:� �`. err � t , °`�,r gY P
extension. Describe: Page 2 2
Business name: f( L/
Address: ?IV SV v u.rhhaify\ 'S4 - 7 Each additional inspection over allowable in any of the above
' Per inspection 62.50
City /Stat /Z [ l aij / q'' ;X..3 Investigation per hour (1 hr min) 62.50
1
Phone: _ '(y2 D ` Fax: ( ) �c� Industrial plant per hour 73.75
�//� (S .. l;. , ELEC_.. -- 'PER_1VIIT ?EEES:, `� k J;
CCB Lic.: - I r l �'g- Electrical Lic. ., Suprv. Lic.: -• Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
i ii ++ ^(( State surcharge (8% of permit fee)
Print name:
��AC� r '.e6en I Date:'3 I1.0 IOS -
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.doe 12/03 440- 4615T(I0 /02 /COM/WEB
Mechanical Permit- per pl j FOR OFFICE USE
City of Tigard + Received I
y g . Tigard, O
Date/By: Permit No.: I / 7 �
y
13125 SW Hall Blvd., Ti R 9/72'23 2005 I �'
g � {!M ( Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 - Ganr di t Date/By: rm
Other Permit:
Inspection Line: 503.639.4175 11II� Y
Date Ready /By: Juns: ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method:
Supplemental Information
BUILDING DIVISION
_ ��..,.:� ° _ - � ° - ^,s� ��• "' r� =��. °. � r+: �xw �:.. damz�i :aa.; ;�ra- r:+ "_:+� .A�, -- •.�.g. ,�^�8 �.� r.�u:, r -- arse ��;p�..n- ..:_, �w�.*v.. - � • - r,c
' , a a +' " f : �' ' a `" �, '•, i ::c _ x 4s l'1 . e `. Fri= 4 . ' r 3, c . iii c p ii -h s r ,.
a :_,6 TV 4
.- A � _ ,. . COM MERCIAL FEE S C , �HED ULE; = FU SE €CHECKLIST',
g _ ��� i�"�m4. -, f ir, °�FZ �- a`r � .;+€�, � � t� , - d. ,�w��.:�- 6 _ ��;i*savu�r =.a... ..wraw�.. xu>sd z�.r =r.��,. +. as�w�sk�.,. > - ����mss� >,�s
ew construction El Addition /alteration /replacement Mechanical permit fccs* 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°.'= 4`Sr'tp` ;,�. uy*,. €sansw pizr,;uc• r�+° ;.rc- r ar,r.,nce.ww m Value: ;ate i t , ' tk iiiree i alt � OF C ONSTRUCT I, ``'`t" �.1`� ,t Vl $
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. �, "n.,.sc�� � *r' �;T;�avx� ^'a�... zM;HV.�,era +aa.»�.0 - ,.u:: �.
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ID W, IDEN ^ T, I'AL EQUIPMENT` ;
S. EEES *
Commercial /industrial Accessory building - ' ^ 't " "� "c=,zur v b 4.sre•�•,Y, .:F >- , a� - ^«a- . ;;~'.•.,,.
❑ I_ and 2- family dwelling
For special information use checklist.
❑ Multi family ❑ Master builder El Other:
•r,.. r rw ;. , �.. xr:,� ,rf,,,:. u. , Description Qty. Ea. Total
r.,° ;-,., ?: �. „`?1;:". '`J6B . SITE )dNF,ORMAT • "f ` 4 coolin
' �� � t' �' ��t °e".�owiaaf�h» 3msw, aw: �. l- �'� �'�.�- '€�+ IIeatin� �i
Job site address: 13� 1 ti� (^ , , 5 . -„- k ,�� + Air conditioning or hegtp pump )
w C (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
Flue /vent for any of above 10.00
Subdivision: \ \, -L- - - 2 1.( j o n Lot no.: '7. L! Other: 10.00
Tax map /parcel no.: U" � I Other fuel appliances
:rai s.,.rar :' z "att. seAS467 -:k v,„s:.: ,,�,. , :k,. ?* x n ;: '''6 `. T' Water
` ti fit ;~`. �. i. ,F ,.. `'',YDESCyRI -4TI ,ON W®RIC °r � y � U. I t t eater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
. - ',,,,,,,,,.-,.= ; . ,t, : ,,, .,4.k,- ,,, ,,?N' * ., x 4 Chimney/liner/flue/vent 1
`" '... ` � ePROPERT,oNER , '" , " I 4 z 0 tkv, -' T EN . NT ; f `< ` y 0.00
�� - , Oth er: 10.00
Name: . J Y • . ' """-%- ✓ , F- + '`_S L. - Environmental exhaust and ventilation
Address: ,)- / .11 (' l I Range hood /other kitchen
( �/ equipment 10.00
City /State/ZIP: .2 ' 1 S ' q �OT S Clothes dryer exhaust 10.00
I Single -duct exhaust (bathrooms,
Phone: 4 7 -. ) Fax: ( 2 -- 2( 0 1 toilet compartments, utility rooms) 6.80
' ;. �`: '+ , , -- -. „rs,,,,,,,,, , �.a17,-: rrr, 31' _;,: ; - "-- ..m.::xa:s ,:, u :rss g :
Attic /crawls ace fans
?.. IMA APPLICANT � `#1 n ,19,? T egeg:RSON ,,,' P 10.00
Vv rttcflk y,g ��a ,.s . �LS :x3.5 Afi -3y�X.'4,v3b15 .; .k9 �^� &�:. �:, m. .:'71xs ka t�.u'2-r.� b:.�s:..,m,L.tiatz`. :�°
Other: 10.00
Business name:
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
; _ �%3.i.V4 _'}'. $ , 3 , µ 3y -, ^ IIei E-:r.s�.; a;„ : t..w,ttw-: t F, t g ` arV- ; :;.. ,. .�
F.,' :... �.. ": t ,COIVTRACTOR't4' � ?r M, h7 Barbecue
Business name: ('5 � _j, � t ,p /tr j /7 Clothes dryer (gas)
Address: � t Other:
' - WiRaIAiNrICAI� PERa itifFEES* ,, x, t0
�.�r^,5.,:^ .;s � xs:. �; v:a.;��:m xs sk�. .s,..0 fi ? " .
"i?i*. ft•ro
City /State /ZIP: W 1 {�� OL "l 7(�5 Subtotal
Minimum permit fee ($72.50)
Phone: (`�. .�i'-, ") I Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 7 • State surcharge (8% of permit fee)
4, TOTAL PERMIT FEE
Authorized signature: , (/� ' if This permit application expires if a permit is not obtained within 180
1 \\ days after it has been accepted as complete.
Print name: ' 1 Or if (VIA I Date: 3 ( , OC * Fee methodology set by Tri- County Building Industry Service Board
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is \uilding Permits MEC- PermitApp.doc 12/03 440 -4617T (11/02 /COM/WEB)
� 1
Permit #:05 - 001596 - 00 - PE
CleanWate' Services
Our com,nitmea is clear. • nspection Request Line: 503- 681 -4444
2550 SW Hillsboro Highway 4 hour notice required for all inspections
Hillsboro, OR 97123
Ph: (503) 681 -3600
•
Project Name: SUMMIT RIDGE, LOT 74
Project Address: 13018 SW HAZELCREST WY Issued By: Cathy Lindholm
Type: Sani /SWM Connection Issued: Apr 21, 2005
Single Family Expires: Oct 18, 2005
Project Description:
Owner Applicant Contractor
VENTURE PROPERTIES, INC DON MORISSETTE HOMES NONE
4230 GALEWOOD ST, STE 100 4230 GALEWOOD ST SUITE 100
LAKE OSWEGO OR 97035 LAKE OSWEGO OR 97035
Number of Equivalent Fixture Units (FU) 16 Number of Sq Ft 2640
Treatment Plant Durham Water District Tigard
Fee Description Amount
Erosion Control Inspection Fee 88.00
Erosion Control Plan Check Fee 57.20
Sanitary SDC Fee (Connection) 2,500.00
Water Quality SDC 0.00
Water Quantity SDC 0.00
Sub Total 2,645.20
TOTAL 2,645.20
I HEREBY CERTIFY THAT THE ABOVE I FO ATION IS CORRECT. �/
SIGNATURE: j Date: 7 Z ( 't'
De MORISSETTE HO ES •
•
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S - � REET ' TREE CERTIFICATION
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® (PLEASE PRINT) (PERMIT HOLDER)
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y cer ify t- tit -he fot ;owing location r t'ttf3ii2i Id Mk \
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t st 'County
Bard /WashnW on
land use and development standards for street tree installation.
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I ADDRESS: /50/? Sci) /44 &57
AI LOT: i SUBDIVISION: 5ur ;T /2i4e_ , Pi-
® BY: / DATE: e- /9-05
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RECEIVED BY: D ATE: ®r d ?°
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CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: MST2005.00092
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005
Phone: (503) 639 -4171 7,40911111\
Inspection Requests (24 Hrs.): (503) 639 -4175 . -' __..
INSPECTION WORKSHEET FOR DATE: 8/72/2005 TIME: 7 :10AM PAGE: 55
SITE ADDRESS: 13018 SW HAZELCREST VVY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: Q74 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF detached
•
OWNER: DON MORISSETTE HOMES, PHONE #: 503 -367 -7638
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387 -7538
Inspection Request Scheduled For: Date: 8/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014012 -02 503 - 519 -6452 N
porrections /Comments /Instructions:
•
p PASS % PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I♦ . L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: `� Phone #: (503) 718-
1
e
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00092
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005
Phone: (503) 639 4171 mypu�ii�6lf j � l �t`
Inspection Requests (24 Hrs.): (503) 639 -4175 �_ .
INSPECTION WORKSHEET FOR DATE: 8/19/2005 TIME: 7 :07AM PAGE: 41
SITE ADDRESS: 13018 SW HAZELCREST WY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 074 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 - 3B7 - 7538
Inspection Request Scheduled For: Date: 8/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 013918.04 503-209-4837 N
Corrections /Comments/ Instructions:
I
PASS % PA' .IAL APPROVAL n CANCEL n NO ACCESS
I FAIL IN ■ L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� o
Inspector: ` Date: ® / � p hone #: (503) 7187
N
'''.■
• CITY OF TIGARD
, BUILDING DIVISION
A , -
PERMIT #:
DATE ISSUED: MST2005-00092
13125 SW Hall Blvd., Tigard, OR 97223 5/3/2005
Phone: (503) 639-4171 goAliinAlit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/19/2005 TIME: 7 PAGE: 43
SITE ADDRESS: 13018 SW HVELCREST WY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 074 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF detached
OWNER: DON MORISSETTE HOMES, PHONE #: 503-387-7638
CONTRACTOR: DON MORISSE i 1E COMMUNITIES LLC PHONE #: 503-387-7538
Inspection Request Scheduled For: Date: 8/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 013918.02 503-209.4837 N
Corrections /Comments/ Instructions:
PA PASS 0 PARTIAL APPROVAL Ej CANCEL 0 NO ACCESS
fl FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: `9725: Date: i / V( Phone #: (503) 718
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 00092
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3/2005
Phone: (503) 639 -4171
AI y ��,� i � +
Inspection' Requests (24 Hrs.): (503) 639 -4175 . ' ''L
INSPECTION WORKSHEET FOR DATE: 8/22/2005 TIME: 7: •10AM PAGE: 56
SITE ADDRESS: 130.18 SW HAZELCREST WY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 074 • 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: 8/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 014012 -01 503 - 519-6452 N
Corrections /Comments /Instructions:
fi r: PASS ARTIAL APPROVAL ❑ CANCEL I NO ACCESS
❑ FAIL ' ■ L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: _— Da te: 8 Z2 0 = J Phone #: (503) 718 -
i
CITY OF TIGARD ..
BUILDING DIVISION PERMIT #: ELR2006 -00152
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U13/2006
/2006
Phone: (503) 639 -4171 u °b4po
Inspection Requests (24 Hrs.): (503) 639 -4175 .`•' � ..
INSPECTION WORKSHEET FOR DATE: 8/19/2005 TIME: 7:07AM PAGE: 44
SITE ADDRESS: 13018 SW HAZELCREST WY CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: am TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: Low voltage.
OWNER: DON MORISSL I I E HOMES, PHONE #: 503 -38? -7538
CONTRACTOR: GENESIS HOME TECHNOLOGIES PHONE #: 503.643 -1704
Inspection Request Scheduled For: Date: 8/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 013911.01 503-209-4837 N
Corrections /Comments/ Instructions:
Ala i&
IIIT
[PASS 1/) PARTIAL APPROVAL n CANCEL 1 1 NO ACCESS
I I FAIL / ' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ‘/..
Inspector Date: Phone #: (503) 718-
\