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Permit CITY OF TIGARD MASTER PERMIT . PERMIT #: MST2005 -00097 7._ DEVELOPMENT SERVICES DATE ISSUED: 5/4/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109 DA -S R2_111 SITE ADDRESS: 12998 SW KOSTEL LN ZONING: R -7 SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 111 JURISDICTION: TIG Project Description: New SF BUILDING REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 772 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 317 60 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,190 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 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. STE. 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: 50 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: $ 10,660.30 1 -800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Engineered soils Issue : l -_ ' 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. w=9.,r. C 11P Buildrn' PernutA o. 1 FOR OFFICE USE ONLY City of Tigard AA 9 1O(1( DateJBy7 e 4 Permit No.:�� Q 13125 SW Hall Blvd., T OR 97223 UU J Plan Re -,,,A // Phone: 503.639.4171 Fax: 503.598.1960 ///414 yp = )1 \ Date/By: / L4 I a --G S" Other Permit: �w/� .7q � , o v a ) Inspection Line: 5O3.639.4r1i75 OF TIGARD ,, �. Date Ready/By: . i 4 . , J Ei See Attached Checklist for Internet: www.ci.tigard.or.us Notifed/Method:47 - "6 ) ?G f Cr Supplemental Information BUILDING DIVISION ��^] (/A - ; s ✓�� h"'°" ..'?G.A §§A,y +, . "3x ; Ec � ^� ;•_,�. 1R�. , ;t ,: . !,a�« : +; ti-A. � ue�rX .., .r a.?1`o _, ^+kc ,._ �s b ;s ue - = * ; F' ' ° 2,� r.; -uTh ,:x; ^_. �. ���s��z '<.:w:'.�. - > . 'r r„& `� r �' ,= , p 04 .t s4' ^3' ; <_s; „ G;". s ue` fix. ° ' -� ` >a .V� ,RE 2 . , IRED D'T I7.0` R 2 - EAMILY_DW.ELLING x ,, 114 --« v4e: ' t 4s a YPE O F � wkt o.r` , >, • , h � , , .o' f � ;3• ark , m .u,,w : �;s :,aiii , ,,,. »eyes New construction 111 Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ty .;.' :. .-.,,- ,. ar�-_ge e's?tr�,.a�. mom: ;:, l5fiwruc �^,. -; .:.. :, a=.� -.fir *xi"a ' ` @4; x� . ifg work indicated n � � f Itt N R O ; F CONSTRUCTI M r s" �o k on this application. ❑ I - and 2- family dwelling Ill Commercial /industrial Valuation: $ j 5 i GJ (DO El Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: 2 . 5 r xr ' . - s: , .' :.' = = a. M , mow =;, "r : 'Yr. .. S M, ,t.: . " " ' , . OB S PTEtINF QRM TI©N�ANDy,, ' O Total number of floors: `` Job site address: I D g 3L� K L, New dwelling area: 3\ G c square feet City /State /ZIP:)0(Z i Garage /carport area: ' Z square feet I. Suite/bldg. /apt. no.: Project name: ` � .) (/1 \ 2, 6 Covered porch area: square feet Cross street/directions to job site: • 7—... Deck area: square feet Other structure area: square feet ° ,174, 't m44e :i 11 . ,,., - n sss if i aka'i - ::%; 1REQ.UIREPIDAT A COIVIIVIE v ;;mm USE CIIECKLIST' l - ::s�.;vx'�".�_,� .z4,+� �r�, �i-.- ���r�, z��ve�: �u., �Y�,< �= �i. �:,: tear;; Subdivision: Lot no.: \ \ \ 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 n . I r e fi E y { 4 W„ equipment, materials, labor, overhead, and the profit for the • t . s NV.OF ARA . '. DESCRIPTION s OF W,ORIC t f , 4� .. r �_� work indicated on this application. Valuation: $ • Existing building area: square feet New building area: square feet • °,; MA - , C ' - . scgt h„ + � iJ'; X:: �'.£ �q r- ;ux��_T .;,7".tit:��S.kx`�`i s ..' {�.3r. , � .� .,.: w,&; �' n1�.. �;;M „aa;y-«.'*.",',3" ��s:;'? -„ � -: - �� .. I�,:i P O WAV Il i, , •TE ' ` , Number of stories: Name: 1404r--1 55 l i c¢i -• -- _,- (-J- -f � _. Type of construction: J Address: `t7 21,E ( I) ST lC 10 Occupancy groups: City /State /ZIP: (--"EAU J - j, � ! � ' O” ' - 20 3--'5 Existing: Phone:.) �,yL� y Fax: () Cii7'" 7 /071 New: _ ,',,,,,,,,,,,,,-,,.0*:, ^ "nf i 4:`3.'= :�✓: saro`; 9t ^.�: & „ ^ ii.':",u`o`SC' ;ii ' `h±', %:i4;,"mkl i 2'.�' 'd'dr:' . :t r {N;x k. ,i;” ..- 4i j'. a dv'ti �„ ' {". ' 3r .,.*'1E;.i:£#�� 'N*z : 4 . , ECV:`.,z"�' -�•� r: Y 3? . A PPL'IC.ANT• `, r ® CONTAC> ,PER - ;° ..S , 4 W , . ` , , .- „' sm };.+�' ^dxr..c. °'... Yr �. �s.,.. v�. �a�r .�e,.lfr7:ha�`� �k"�Iw r+, .. T' r: $$�� �r',; ,. �5 ��3:,,�,�.,�s.5� 3,� ,a k *�,^. ,ri >_k ,�., :'�, x ;,.. ," z -. - _ `z vtw-: x k'u ':.:' .. : „^�:Fr ,.;v,. ..s:.i iaa ' '::` ” 4... * ,A....It`4.a.€1,4'". :v'`• 04 ,I,,o,:, `4.l.�?% "'�; ^.. .,..',', t,''4,4, Business name: No. e f cs p\ 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: f ,,, ,�yh;.k:•fgT* x r i w +``.bf'^ „ ' , .`. <?:.J!t' ".,"fil .:: „ �kFp ,,,, ,y a ��e c ik'°vs�3. , ,- tacyNI ..- :,kt� 4 '#a . ' i .,1*Wa,v"vw,, ;4148 CANT 7C .OR)� ,k { MAIS : i,tiAS`u" {, , ?TRItt I z`a'x� Business name: 50\1-4 1 PC-FINE 1,„"q131 v y a n r� � z s N mac.. � j ,, , r B>t1ILDIlVG PERMIT F, ,-' , , Address: Please refer to fee schedule. City /State /ZIP: Phone: ( ) Fax: Fees due upon application ( ) • — Amount received CCB-tic.:— - , 2- "l Z F Date received: Authorized signature: 1 I �/l �i,' 1'/( This permit application expires if a permit is not obtained , , within 180 days after it has been accepted as complete. Print name: I! IT �^ , � Date: * Fee methodology set by Tri -County Building Industry Service Board. ¢:,iti'.v is \Bu ilding \Pei mils \ BOP-Permit App.doc 12/03 440- 4613T(11/02/COM /WEB) a- ' Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard R h n 2 (� It�� 1\ /J {� ® Received /W / lj V /f Date/By: Permit No.: 131 25 SW Hall Blvd., Tigard, OR-97223 Plan Review � Phone: 503.639.4171 Fax: 503.598.1960 //,1 r I I ,I Date/By: Other Permit: Inspection Line: 503.639.4175 f AR 2 2 2 �. Date Ready/By: Juris: y El See Page 2 for 4 L U _ Internet: www.ci.tigard.or.us Notified/Method: • Supplemental Information fli,TV !'i -yrra,Amr. �,r.R.:§ t;uj '"l ac ., • 'S -._ s 4f°• S-dew.i$9: r+:m= o.+xr.* y n US.:r,.:a Wa�; r�s 9 r, , ,p;i.. " ?x; * + pp?s� ;; �s •. r z a !�s - c „ m; a ak " -- '•£„�,= *mx�q,n�d:r..a: c s < n. m.�r.:xse:,aaenvo-..s: c>s --w� .t"k -.1 z e r i t 3 d .roar t, 'a+.'.�'ajt5/r.. P T ,, i 4Sr. 1""ui#XER 4: - P O s x C =F SCHEDULE U SE CHECKL x y wr:�+a.�x construction »&`�s� �a4ran sn >; r .�"�s,�t.w- .�.;..�,e- ;,,.�..a�. , ` : .. , ..„ ni ..OA..:e« er.: u.T : , , New cons truction ❑ Ad dition /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. - 'ZU =�; =eai+, 3.g, ..,d�r�° »+ {;c. , :3 gas%. , r' rr:: t:- :a.M - ,,,,,, ,...,s ..ro.srasA :`r ' r. .."'r tir,3 e, ztPR E �a ` ° CATEG o ltl OF A �° r �.P rr" ' Value: $ �s� , ��..g?ei ��'�"� ..>s �, , :ir.�',��. : - ;� - ., .� . �' �: " � �� ,R p ari:O Ifi EQUIPM NT /SYSTEMS FW,7 ❑ I and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: ,: ": ..:. =, ,s:: r,.� : , . x . •- Description Qty. Ea. I Total yr. I; 'y p s abli i IT aANDraE OCATION ' r ; , k Heating/cooling Job site address: �9 5�Pl Ai re g wifires res s s ite plan pl an sho wi ng o n g p tpump lacement ) t / 14.00 City /State /ZIP: _�i ��1// y . I Of.-- Furnace 100,000 BTU (ducts /vents) 14.00 J� Fumace 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: awl 1 1 t.... ac�Lot no.: 1 =' I ` Flue /vent for any of above 10.00 A Other: 10.00 Tax map /parcel no.: Other fuel appliances '«r } 4 s. it 4 (..r, t n x Nr a - a"-a e ;.r, . ,,..s�11t ;*I, ¢: , , a DESCRHT OF r W r .4 ; rs 1 vo qu , s Water heater 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 : " : : -- .:w .sazra ` tea >>,,: ° a a a :� s s= `. Chimney /liner /flue /vent 10.00 ',c 7 r4 k7iieRTY . P OO ,I ilai NAPiT WNI x Other: 10.00 Name: \ �JY 1 . '� �, y l t - Environmental exhaust and ventilation Address: t/, , e7 t l l/ L� - Range hood /other kitchen "'` equipment 10.00 V City /State /ZIP: G f v I 'TQ Clothes dryer exhaust 10.00 i Single -duct exhaust (bathrooms, Phone: � j f --) t Fax: ( €22 - 7 - 7 (Ci toilet compartments, utility rooms) 6.80 Y'7•syis «, T:r „;a •.i 4fi ;t, "' �.. ` ",,t 'x „ - : .a :,. ,;v:= =1I W,,•Ws;6'"'_ tv t two ".. aa re;;er r,� s= °.. ,x� .±r a, ; u, " = �: . ;ai,; ,, - �-" t 5 APPLICANM i „ , V " � CONTACT. PER � � Attic /crawlspace fans 10.00 Business name: Other: 10 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 m•Urfx.•gil }i� • X .'v t6:�,jy., a? r, ;ti,*, '_: i;n. :..; ;°nuz *..�, ;"saa ?tai." WI 4 . °"' . „ ;, AK ; " " "-,. - �tMI ,'- ,i1s:;`at i- I4 "', CONrT RACTOR wa ,�' �",e Barbecue Business name: d Clothes dryer (gas) Other: Address: r,vM . ... Q � 1 � .L.I ,��° � 1( � � � � *: � *_ �, f (�� ����jj `^ ) � 1 - = ME'C•H RERIVII,T >iF�EES ,n t Y "' K.J \ �� Y (V- > � r ",l��.. .�"ak? '�:.�,..�t', ��.a r,,:...zr... ..t'r xx �s�s+,�..�:.z��. =;�;a- -:,�.�.,:°a; ;a�!4Y.k�:��4��:4�,"���'. City /State /ZIP: el 7( lY L0 Subtotal r t Minimum permit fee ($72.50) ' Phone: (� �. _. 1` Fax: ( ) Plan review (25 %- of_permit_fee)_ CCB lie.: 507) 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: 2 _Q 'e ' \)' .4[ � � . Date: ' t [Co I * Fee methodology set by Tri- County Building industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (1I /02 /COM/WEB) r. Electrical Permit Application FOR OFFICE USE ONLY City Of "Tigard = CE �p ()(�(� !E . \�� I l l�li Permit No. M6 •/ � �(lU 1h25 SW Hall Blvd., Tigard, OR 97223 r �" ✓! U o _ . Phone: 503.639.4171 Fax: 503.598.1'9'60 4n�Mip�l" t Date/By: Permit: Inspection Line: 503.639.4175 n � O^IJ � L .i� �'I Date Ready /By: kris: H See Page 2 for G Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information a s = �?e: "?`�?e �: >� ..., -, '�rs�, •. �- s... �," w�.z���,�.'x;:r, us,,xsx:,,; •sn- �+t a =�-� - e.-_ * v; a s r nr� _- _ - a-' � _ Nic O W 5K ' ,, i. - t,.,` : ` .` ' ' 4r _ .gas • �.,c s,� � � .3 �,- �+..ir^ rz� ��;a��,e��4��,�a��+�n�x��r�:� �.�s� -,��� - s?� ��.x.�- f5��..���„�.�ku..'�..m, �r:�s, «�� ° =x =` �is�':. N ew construction ❑`Addition / /replacement Please check all that apply: rU CL LMI' I. Lit c t .uuat ❑ Demolition ❑Other: EService over 225 amps, comm'l ['Hazardous location k ° ' T ` = 1 n' °? ' "� , .:. ,mfr , z , :s ue �' =j i.; 1 : , -M r. EService over 320 amps — rating ['Bulldog over 10,000 sq. ft., : = t s CA OF CON `� c - --„ X : r , 4 of I- and 2- family dwellings 4 or more new residential ❑ 1 - and 2 - family dwelling ❑ Commercial /industrial ['Accessor building ❑System over 600 volts nominal units in one structure El Multi - family 111 Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more p3 ° : , ,: v . ,: -. -, z . y,a <;. :,, «4 ,•s t o °, lr % - ^ A , . ['Occupant load over 99 persons EManufactured structures or " ,. t 4 5 01,9B I ., IN EORMATION � P. L ,RW.ION ,I i4 ❑Egress /lighting plan RV park Job no. 2 -`32 Job site address: \ C �W tit ) i ❑Health -care facility ['Other: L �! t r l�y 1 Submit 2 sets of plans with any of the above. City /State /ZIP: -- ti C ( The above are not applicable to temporary construction service. Suite /bldg. /apt. no.: (Project name: � _. � _. -_ ���... �,�.� Description I Qty. Fee. I Total Cross street /directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision n \._ � J Lot no.: ` i Ea. add'1 500 sq. ft. or portion 33.40 1 y ` 1 Limited energy, residential 75.00 2 Tax map /parcel no.: ,, „ , , , Limited energy, non - residential 75.00 2 i .,� I , l, Y D . E S CRIP9�TION OF WORK iV , £ r Mit ` � � ..,.��, ,w_;�V��,�.- .,�...,... �.I�,.. „�, �i »Fab: �s,� ,�,:,,,n2.�,, 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 y :m /' PROPERTY iOW, ,v, to a� r: � . f; t ° TENANT ; ' 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: 11 ih' 0 � '' C.-c. ,,.,� , ,:- +r ,' a $ LL C _ 601 amps to 1,000 amps 240.60 2 Address: 2-0..W ', , e ,., ix Over 1,000 amps or volts 454.65 2 Lo �b � (, _ !,, Phone: ) r ya ql. " 7 c' Reconnect 66.85 2 City /State /ZIP: v U� C Temmpoorary y services or feeders installation, alteration, and /or , 65,) 9J 7 _ ., 4 relocation . ' —? Fax: - 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 a'r.'ar,a i %+.:J:; - 'e.:a = =are^a: a;,:�:d =., ..:,„, . 5;:9±' ; v i ^ > �.4 e ^:r;5,; > a..,aso-':.r: .r..q:.,.� �K;v.�_� ,F_ 4,0 * APg T s A " .' ,) , , , C® Mf- PERSON t- � r A. Fee for branch circuits with . service or feeder fee, each Business name: branch circuit 6.65 2 B. Fee for branch circuits Contact name: without service or feeder fee, Address: each branch circuit 46.85 2 Each add'I branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or in circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - ��- :,r` ^ts:a'"",e € (',,� a .ns;:�'•- =s.•�_ . - ,•t a, .a ,, r•.. M ,'” CONTR "' n SS : ' gy panel, alteration, or �,a .., '.���a��� � . �., � �- r -s. � � . =i � � "a ever ,«.t. :.,'.... � � ��k� �.s i'ts 1*��., �� ,: ��IE. >.#,t°,`r91�i*'.';� k extension. Describe: Page 2 2 � r Business name: C L/ • Address: ff sV v ,,,,c e .. s . ) , `c -� Each additional inspection over allowable in any of the above �•�/ V Per inspection 62.50 City/State/ZIP: [i 7I (44,4(j, ID.— Or— 4' '3 -2 investigation per hour (1 hr min) 62.50 Phone: _i_I _ I(�OJ Fax: ( ) vc� Industrial plant per hour 73.75 CCB Lic.. y-�J�' ° l Suprv. Li: �� - ..:ONOECr RICAN; fPErR1VI T„"tFEE5'OSVIV ' � �I> 4� Electrical Lic. � u prv. e. 3 -J( Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) - - - -- - -- -- -� -- +� — � I • Date l State surcharge (8 %of permit fee) — Print name: �( � ! j t� l 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 \ELC- PermitApp.doc 12/03 440.461 5T( I 0 /02 /COM /WEB Plumbing Permit- Applicati :o, FOR OFFICE USE ONLY u -Al tt u vl , City Of Tigard Eew Permit NoT�.,a9 / 13125 SW Hall Blvd., Tigard, OR r � 97223 Phone: 503.639.4171 Fax: x503\598. <1.960 2005 40 004/ +qty Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 AA .! I� Internet: www.ci.ti ard.or.u .. Date Ready /By: Jul El See Page 2 for g .ETV OF TiGARD Notified/Method: Supplemental information ,A.: &^ - - - :�'�°U'" _ - T >.��, _ "";= ±;e;F�<�'ts:�n. '...`,tip"'' �itg7a": ..� ". ""- ,.E:.: ?iF�` °" +,: �4�t!ti+y c .:i ,, a i" a,: �;. �:'sr',��.shxrfu^N�t:"s- ;: }�«,; - ',�'{'..`^ s� -.. ,;p. #� ,...� .ate. - ; ";.:f,� . . ��. - rs'�in.'N''w'- 'r� "3a.' k � � ���, �'f - vi . ' P : + ;4 OO 'WORK a , r a - i * . , , ,} xw - ,;;n} ' FENFer ED E £ �l 1 ' � lt7 5.4"-A,...: .r, '•a,',rvii,� ,,,-. ., :e:,' � - a. - .^ .9.°.r. , <ar &,,,,, ., `user 7x ,,,, .�Yttem,;,,Aa`L_ 4 ,, :...w, ,,. , . ,, vO4.t� z , 44 , Y,O..v.,. , s ::a r. 7,-a,x .,,,,,,,, ... iiZt$ *,L . •',,, : a3 741 -`0 NNew construction El Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) 'Y . " : ;n;-�... 1 r a.;'i:.,`x 5 ,i .,.. ;a{'z rGfNfl.;�ivF.w. I � `:5v��i ei t r ,; . i CATEGORY OF C ONST RUCTION %$ �w - 1, SFR (1) bath • 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 Each additional bath /kitchen 45.00 , ❑ Master builder El Other: ,, ,:ls r: «= : ar ; aar , - „r,.c a s a.. h r :;KK •a a, w.t'r ,s <�:„ Fire sprinkler ( sq. ft.) Page 2 t *': n 'JOB °SITE INF,OR n:,A1N AND tLOCAT =IONr ,Wirda < ki. .._,..,63f,a, ,s. , ,,, .s; :rax ,. .,x as,...aim a.awa,x. ,..t :fit .,.1. o n eU tll i tl eS Job site address: \ ' °1C � 1/<cy� -0.\ (-� Catch basin or area drain 16.60 City /State /ZIP: I I (, l' 1 01Z. , 1 ` Drywell, leach line, or trench drain 16.60 Suite /bldg. /apt. no.: ` � " J� ' �� 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: 1�x / k 2 e I Lot no.: l t 1 Water service (no. linear ft.: ) Page 2 Tax map/parcel no.: Fixture or item Absorption valve 16.60 a a v �� .sae � cam. �� a �.���a � � � � s. ,+ .r�, K ;� � N k � ,,t rigiFf r 0 ' DESCRIP 6141 itiM " L / . Backflow preven ter Page 2 Backwater valve 16.60 Clothes washer 16.60 • Dishwasher 16.60 � �;v , ; { : PROPER F TY wOWi`iER � 7 , tax,' 4 TENANT, � RI,,,1 k Drinking fountain 16.60 Ejectors /sump 16.60 Name: 1 ` Ccz*.,.,.,.. -�_4-i rS [_.LL Expansion tank 16.60 Address: �c7" ' GI • 5\e-, l CV Fixture /sewer cap 16.60 City /State /ZIP: L a�r Or..._ N `' Floor drain /floor sink/hub 16.60 a lr %t ' ' e , Phone: v Fax: Garbage disposal 16.60 :-. ?; c v � � a" ;hr z ry :mr,K7 Til c =:. t : 14168: P �Y Hose bib 16.60 ,. . ; z \ , ® stAPPL ICAN Tg t ' 6 1 1, 40 1 y CO PE R n, n , 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 t 'raan }am", ��. »;aF.. �; �ro��i ''�''k"S'�M;a"`.' P �' t .+^''Aj��b• ii" S6's.; > #?w ;, i "t�, ° ssht'' . =ra }� P ". i*� {:c6 - 3'"'t:: - ii#:5 Water closet 16.60 Business nam =�'�: - . t ",1'4 �.,F y n '1CON i r,1 a � ,, F 4 J Y .,.. ..., f� c.11�,4 x�.��tx . :..�a,'�Fc�� . �''�S's ?�.�rtt�'„� '..ii.a��, e: V � t) � \ C ] L i ' y ( 5 Water heater 16.60 Address: Q ,� ��" 4�11� , ✓) Other: City /State /ZIP:.,�!exa Subtotal C �,( r ( Minimum permit fee: $72.50 Phone: ) ) (.C) l � J ✓ dy Fax: ( ) Residential backflow minimum permit fee: $36.25 _ CCB_Lic.:1 _ O G.f 7 - li pp,-"Ilimbin g Lic.- no.: - ' 7 2 - )017 - -- Plan review (25% of permit fee) _. . ' , t State surcharge (8% of permit fee) Authorized signature. t. / �, ; � � ii TOTAL PERMIT FEE Print name: N.--) J is„-Vt iv Date: �) 1 O This permit application expires if a permit is not obtained within 111 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. is \Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T(10 /02 /COM/WEB) r Sep,20. 2005 11:03AV1 CLEAN WATER SERVICES 503 6814439 No.9232 P. 8 • Perm it #: 05 - 002784 - 00 - PE ClcanWatcr Services our rOmmitilALIAl. 1<,;11'. nspection Request Line: 503 -681 -4444 2550 SW Hillsboro [highway 4 hour notice required for all inspections Hillsboro, Olt 97123 q - — A Ph: (503) 68I -3600 Project Name: SUMMIT RIDGE, LOT 1 l I Project Address: 12998 SW KOSTEL LN Issued By: Nichole Vanderzanden 'type: Sani /SWM Connection Issued: Jun 29, 2005 Single Family Expires: Dec 26, 2005 Project Description: THIS IS ONE OF 7 LOTS THAT TIGARD MISTAKENLY ISSUED PERMITS FOR, THIS PERMIT IS BEING SET UP WITHOUT FEES. TIGARD HAS ALREADY COLLECTED FEES AND THEY SENT THE CHECK COVERING WHAT WE WOULD HAVE CHARGED TO SUE REYNOLDS. Owner Applicant Cimtractor VENTURE PROPER'T'IES, INC VENTURE PROPERTIES, INC NONE 4230 GALEWCX)I) SI, ST 100 4230 OAL.h:WOOD ST, STE 100 LAKE OSWEGO OR 97035 LAKE OSWEGO OR 97035 Number of I-,q a iva lent Fixture Units (PI J).,.,...... 1( Number of Sq Pt 2640 Treatment Plant Durham Water District Tigard • TOTAL • • I HEREBY CERTIFY THAT TFIE ABOVE INFORMATION IS CORRECT. SIGNATURE: Date: vm rURH PROPERTIES, NC fr 57V0v9-6 \,. AAA A AAA 1:ii. AA AAAAAAAA a AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA q V 4 0- A , 0- - A 0- :-; STREET TREE CERTIFICATION A 0- S\ 1 , ,.., 0- 1 4 4-. , 0- I, 13/A .494:T6. , AO wnerr4gent for At/ i gor 7- 5"5 - e 9 1 di.4 ie m ,- 1 4- es I 2 C (PLEASE PRINT) i \ (PERMIT HOLDER) 0' ' ,, -1 i f A A i A r A i i , ),4 ,,,,:_, 0'. 1 44:1* gri , , ;z: ' 7"\ -of Do hereby ihattilif‘foltdwing location ,-4-1, - ' , '3.4,.."ril ;4 4,,V.4 ,._., 0> meets City OtTigard/WahlSon C ounty 00- 1 1 land use and development standards for street tree installation. A 0t- A 1 0 ,, ADDRESS: / Z996 5 k.i igesm L.— 0- i 0- I 1 LOT: /// SUBDIVISION: 54. imi" i ,q. 0- I 4411 BY: AN/ DATE: g--7 ,, 0,. i v 1 RECEIVED BY: ---,....-- ____.... DATE: G ' / - c? ilp, 1 Rt A r VVV '7' V VVVVVVVVVVVVY IF "TV v VVVVVVVVVVVVVVVVVVIT 'y VVVVVVVVVVVV1 1 i IF e. CITY OF TIGARD _ i BUILDING DIVISION 4 PERMIT #: MST2006- 00097 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: x6/412005 Phone: (503) 639 -4171 Ab �d n� l ( `` Insp Requests (24 Hrs.): (503) 639 -4175 ° ='!L INSPECTION WORKSHEET FOR DATE: 8/22/2005 TIME: 7 :10AM PAGE: 53 SITE ADDRESS: 12998 SW KOSTEL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 1•i1 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 50.3 - 387 -7638 CONTRACTOR: DON MORISSEI I E COMMUNITIES LLC PHONE #: 503.367 -7538 Inspection Request Scheduled For: Date: 8/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 014012 -04 503- 519 -6452 N Corrections /Comments / In /"--- ck -. ------ ( 4 1 , 1 . .-./ k Veo c (C,A) -- vSS s i- • • • rro. '.SS PARTIAL APPROVAL ___ __ CANCEL_ _ __ _ __U_NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED / 6 ( __ Inspector: 1, Date: / 1 " -2 7 (3 Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2005 000 7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 55/4 /2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 -__.. INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7:06AM PAGE: 16 SITE ADDRESS: 12998 SW KOSTEL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 1 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF OWNER: DON MORISSE1 I E COMMUNITIES LLC, PHONE #: 50,3.387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: 8/18/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 013839.06 503-209-4837 N Corrections /Comments/ Instructions: AI- // • • PASS n PARTIAL_ APPROVAL ❑_ CANCEL NO ACCESS ❑ FAIL . ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ri Dater / I j Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006 -00097 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2005 Phone: (503) 639-4171 . 39 -4171 a Iv ° Inspection Requests (24 Hrs.): (503) 639 -4175 �_'I INSPECTION WORKSHEET FOR DATE: 8/19/2006 TIME: 7:07AM PAGE 37 SITE ADDRESS: 12998 SW KOSTEL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 111 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF OWNER: DON MORISSL. i I E COMMUNITIES LLC, PHONE #: 60.3- 387 -7538 CONTRACTOR: DON MORISSEI I E COMMUNITIES LLC PHONE #: 503 - 387 -7538 Inspection Request Scheduled For: Date: 8/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 013918 -08 603-209-4837 N • • Corrections /Comments /Instructions: PASS _ a PARTIAL APPROVAL_ ❑ CANCEL n NO ACCESS I I FAIL a : % FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 6 Inspector: i — Date: /9 f eS � Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00097 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2005 Phone: (503) 639 -4171 / p�yhagivit Inspection Requests (24 Hrs.): (503) 639 -4175 `_ -.. INSPECTION WORKSHEET FOR DATE: 8/22/200f TIME: 7:10AM PAGE: 554 SITE ADDRESS: 12998 SW KOSTEL LN CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 11.I TYPE OF USE: PROJECT NAME: SUMMIT RIDGE NO. 2 DESCRIPTION: New SF OWNER: DON MORISSEI IE COMMUNITIES LLC, PHONE #: 5 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: Et/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 014012 -03 503-519-64U • N Corrections /Comments/ Instructions: o <71 0 '''. OS CC zSSv C s� G ®Putn P T6 _. PASS - % _P ' RTIAL APPROVAL- - -_ - - _ - CANCEL -__ � -- - -I . I NO ACCESS - FAIL ■ OR INSPECTION n ADDITIONAL FEES ASSESSED Inspecto s : - - &Z d – Phone #: (503) 718- \