Permit 4 I
C ITY OF TIGARD D MASTER PERMIT
DEVELOPMENT SERVICES DATE ISSUED: MS
ISSUED: 4/2/2005 00082
. 13125,SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA- SR2
SITE ADDRESS: 12968 SW KOSTEL LN ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 109 JURISDICTION: TIG
Project Description: New SF
BUILDING
REISSUE: DM199 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,610 sf BASEMENT: sf LEFT: 5 SMOKE_DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,790 sf GARAGE: 423 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 325,185 90
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,400 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 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 COMMUNITIES 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 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: $ 10,677.63 1 - 800 - 332 - 2344.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Engineered soils
Issued By : " £. -e t 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.
Electrical Permit Application ,FORoFF><CEUSE ONLY .
City of Tigard Received
}
Date/By: Perm t No.: s i OO5 �Oo 2 _
13125 SW Hall Blvd., Tigard 9i t 9'72 `y 1- Plan Review i
Phone: 503.639 4171 Fax: `�03. 1960 ,' i /A 1 ��l''�l Date/By: Other Permit:
Inspection Line: 503.639.4175 _ I Date Ready/By: Juris: B See Page 2 for
Internet: www.ci.tigard.or.us MAY 2 5 2005 Notified/Ivlethod: Supplemental Information
C,IT\FUE PLAN REVIEW
New construction BO Dti'dlifibQdi O r eplacement Please check all that apply:
El Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
Ki: 1 and 2 family dwelling ❑ 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 El Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
)� ❑Health -care facility El Other:
Job no.: 35 Job site address: i��t 8' SLR A E 1.- 1-411 / Submit 2 sets of plans with any of the above.
City /State /ZIP: I l /1{1 j OP, T ? 223 The above are not applicable to temporary construction service.
I / FEE* SCHEDULE
Suite/bldg./apt. Pro ect name: (�
no.: '� b� pion i £IJloJt4 7Z_3Description Qty. Fee. Total **
Cross street/directions to job site: 6 sss--.ff Q ,S-1 I 0 New residential single- or multi - family dwelling unit.
t7C�1 L'� Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision UM "a "r l -� e Lot no.: / Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/ dwelling, service and /or feeder 90.90 2
A) C/4.1 1 405 r to a.. - s , Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
Ui' PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name D z ^i /0r/45 F - 601 amps to 1,000 amps 240.60 2
Address: 423 6 GA., a oi ) 3v i IF j o Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: j t /< C 0 5 14/ E 7l O O '76 35- Temporary services or feeders installation, alteration, and /or
Phone: (5 _ 3 ? 3 " 75 Fax: ) 3 relocation
�1' (�p3 �G /� 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
�
- extension. Describe: Page 2 2
Business name: /i ri L. ( I ?l�i / C u. C
Address: �� D ✓ ✓ Q �X 3 3 /� Each additional inspection over allowable in any of the above
i 61 C/ Per inspection 62.50
City /State /ZIP: a -V7 7 5-6 Investigation per hour (1 hr min) 62.50
Phone: (5 ( 0) 35,--6,,. $ 8 Fax: ( 5 (3) (9 c/3 yz/�' Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: I 2a Electrical Lic.:3 ^ 3 Suprv. Lie.: Subtotal
Suprv. Electrician signature, required: ��4 TAW/ Plan review (25% of permit fee)
Print name: �� j` Date: , z y e State surcharge (8% of permit fee)
�� � ��( 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*
. [ I Burglar Alarm
Garage Door Opener*
I I Heating, Ventilation and Air Conditioning
System*
Vacuum Systems*
Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260) •
Check Type of Work Involved:
I . Audio and Stereo Systems
Boiler Controls
❑ Clock Systems
I I Data Telecommunication Installation
Fire Alarm Installation
HVAC
• I I Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
Nurse Calls
I Outdoor Landscape Lighting*
Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ BuildingPermits \ELC- PermitApp.doc 04/03
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CITY OF TIGARD . .
BUILDING DIVISION PERMIT #: MST2005 -00082
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/12/2005
Phone: (503) 639-4171 ° ,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/20/2005 TIME: 7.11AM PAGE: 31
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: New SF
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387.7538
Inspection Request Scheduled For: Date: 7/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 011791-05 503- 209.4837 N
Corrections /Comments /Instructions:
•
PASS ❑_PARTIAL APPROVAL - ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4r 2e
Inspector: Date: 1 l Phone #: (503) 718-
yp_
C OF TIGARD
BUILDING DIVISION
i PERMIT #: MST2005-00082
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/12/2005
Phone: (503) 639-4171
-Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME 7:09AM PAGE: 3
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: New SF
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-387-7538
CONTRACTOR: DON MORIS%.11E COMMUNITIES LLC PHONE #: 503-387-7538
Inspection Request Scheduled For: Date: 7/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 011902-03 503-209-4837 N
Corrections/Comments/Instructions:
C '5 - L--R:2,C1 OS 001 Lk 7 ) ri
•
. •
ip PASS 0 PARTIAL APPROVAL _ 0 CANCEL 0 NO ACCESS
[11 FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: O NVII... Date: 1 14 0 ----- Phone #: (503) 718- 2` •
.
CITY OF TIGARD
BUILDING DIVISION ir ' PERMIT #: MST2005-00082
13125 SW Hall Blvd., Tigard, OR 97223 D,(,'�:E ISSUED: 4/12/2005
Phone: (503) 639 -4171 � j +�
Inspection Requests (24 Hrs.): (503) 639 -4175 A. °'I ,
INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME: 7:09AM PAGE: 1
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: New SF
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 - 387 - 7538
CONTRACTOR: DON MORISSE(TE COMMUNITIES LLC PHONE #: 503 - 387 - 7538
Inspection Request Scheduled For: Date: 7/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 011902 -05 503-209-4837 N
Corrections /Comments /Instructions:
•
•
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: r Date: 7- #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005-00082
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/12/2006
Phone: (503) 639-4171 A*
i t t hitili
Inspection Requests (24 Hrs.): (503) 639-4175 ' ,-191- • LL.
INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME: 7:09Alvl PAGE: 2
SITE ADDRESS: 12968 SW KOSTEL LN CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 109 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE NO. 2
DESCRIPTION: New SF
OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 603-387-7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387-7538
Inspection Request Scheduled For: Date: 7/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 011902-04 503-209-4837 N
Corrections/Comments/Instructions:
•
. •
•
• . El PARTIAL APPROVAL _0 CANCEL 0 NO ACCESS
n FAIL /CALL FOR INSPECTION
A El ADDITIONAL FEES ASSESSED
Inspector: -' , Date: 7 — "2/-0 #: (503) 718-