Permit ;
CITY OF TIGARD MASTER PERMIT
411‘ PERMIT #: MST2005 -00024
i DEVELOPMENT SERVICES DATE ISSUED: 2/24/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST PARCEL: 2S109DA -SR033
SUBDIVISION: SUMMIT RIDGE ZONING: R -
BLOCK: LOT: 033 JURISDICTION: TIG
REMARKS: New SF.
BUILDING
REISSUE: DM169 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 21 FIRST: 2,110 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,070 sf GARAGE: 400 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 11016 sf RIGHT: 5
VALUE: 305,046.00
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 3,180 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 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: 4 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 SVCIFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVC /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: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,735.43
DON MORISSETTE COMMUNITIES LLC DON MORISSETTE COMMUNITIES ( This permit is subject to the regulations contained in the
4230 GALEWOOD ST 4230 GALEWOOD ST #100 Tigard Municipal Code, State of OR. Specialty Codes
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 and all other applicable laws. All work will be done in
accordance with approved plans. This permit will expire
if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 387 - 7538 4 Phone: 503 387 - 7538 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
Reg #: LIC 162512 952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -6699.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Engineered soils
/
Issued By : .. .-14i—e. ._ _ - . _ —I Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
. Building Permit App1iali. .
A FOR OFFICE USE ONLY
hp
AR,
City of Tigard Fern
R .... ...-
_05 -- D-- Peit No. \
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598i0 2 8 2005 ,,,m47:4101,,,,. Date/By: JA \) ' .4-1 ,f- Other Permit: ta.. j
Inspection Line: 503.639.4175 , A i Date Ready/By: . , „ Ed See Attached Checklist for
TV TIGARD
Internet: www.ci.tigard.or.us iftecVMethod: ' , r Supplemental Information
G OF Loa. 0
• - - - . -, "0 tiptts1C,PIMION-- . .
' ' -• ''-'- • .!-: ,',. • .:7"1..•woikk-,- .,L , ;,,,:-.,- , :.'::,,,'!': ii'::' ,; -iiii k ;4 , i . .;, r' '*.. • , •
New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
,• .,' ' • • • , . '': ',.' ; ... .. '0- ' AiliEdiry0.'76V664iiii&deili i ' f . Z ; , .• ' f; " ' ,'‘;i 77 , - ? ,! l'; work indicated on this application.
Valuation: $
0 1- and 2-family dwelling 0 Commercial/industrial
Number of bedrooms:
D Accessory building 0 Multi-family
D Master builder El Other: Number of bathrooms: i il
7is..*•;f:Ircs'i;'''.4-'''aTv-d,'.'.:r.-iiiiiikiiiiii#,tiiiikik0:Iiidtii•51,'..,.0.61'4,"11',,rp'! Total number of floors:
:;: rlIt .. .f•,;:i'' .;".•ki:..- ,-.',!!.. 1-,..,t..Va-,1 t4.■,1,:..", -;T 2:; ,: rr,m:, ;,7 ; v''' • "::."31* e , k
Job site address: gytiN
I sym e.., 54 . New dwelling area: ‘.. 1 square feet
City/State/ZIP: - 11 TA, i MC., Garage/carport area: HCV square feet
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
!;4 1Rti,:61, 4 ,,•&1 0 filipo. o .* 4 14:eu4 i gki iii , 6„, , • - , 4§ . 1 • 6i4
Subdivision: 6 v I Lot no.: 27 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.:
equipment, materials, labor, overhead, and the profit for the
!, work indicated on this application.
. • . ,. ...', ,,,,..... Al: ,,, -7,t!';', , '". i' . :.,,, . r .... :. . . ':;., .•.:%,:■.;',.;?,:;'''•:;;- ": 4.:.U , .., - g.t . `.i1.- ',1
Valuation: $
Existing building area: square feet
New building area: square feet
'i — • iiidkiii:fiji6ifi,•3 1;i14ki,i,i.,1/4.:.r.,,Y.::,:;.1:.!..,\,.,; Number of stories:
li•,r t'.,..;:1 ,,..,.:•.,,,, A. ■. ‘.•'1 .v, ,, I.:- , ' .;I'7 ,r,
Name: vor _ t .c., 5 ... c; ,0,,,,,,, , ,,,... Type of construction:
----' r
Address: qaw (i ) sii c ic,it Occupancy groups:
City/State/ZIP: LIkre (y-- oc ci - 20 3, Existing:
I
Phone: fl . 7t2 - 2 --7552) Fax: ( .37---7 1, 15 New:
: ti•:-. :':` „.., ,,,,.. . .., ..,....,...„....- ..
.,.....,,,-. k „,-,, ... ,,,, ., „.....;1,.„ ‘ N0 . 11 . ' :: '.' ■• i.'' ', !°/i ; . it.' ■'. •-• ?'■ • '• ‘'■ ■ ; !•••
' .'•••''''''''''' '' i''14 ,''. zi '> ,.. e •7•■2f , ` , .:•■h ...';',;■, 4 ■•■•• . , l'; ' . -.' "'::. '''
Business name: 51\--yt e Ns Nex.Ne 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
Cit /State/ZIP : applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax: : ( )
E-mail:
i. •-,'.!....,:',:;:,....,':. ;;_ ! `,;,:- n';';; ,:. •VZ,.•r' •••': ';`0•;,
' ' •'.' '''''' ..i •-■••":. ••:} ''',.. ,'::::::.':'' ., :,:.,:;::,',:',,;
Business name: 5 PC Mae,
Address:
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) I Fax: ( )
• Amount received
CCB lic.: ' i .7" -a 5 .).,,
Date received:
Authorized signature: ASA- This permit application expires if a permit is not obtained
Print name: Oe A ITZ: Air )C;K, Date: rilA hin wit 180 days y after it has been accepted as complete.
* Fee methodologset by Tri-County Building Industry
Service Board.
i: \ Building \ PermitABUP-PamitApp.doc 12/03 440-4613T(11/02/C0M/WEB)
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard R EC "IV A '; Received
Date/By: Permit No.: �/� c,/
13125 SW Hall Blvd., Tigard, OR 97223 ` "' �� /
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y � /4- -n � yl r�1'?' ti' Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 IAN $ ai r-111 1 1
.� I
Internet: www.ci.tigard.or.us mil Notified/Met od: hills:
Supplemental Information
; O.:. TYPE F'
" -Oi 1 ' �',? • ' :1; ; ,f�".�. ,,,. , t. '.i! .. , ' F EES ;SCHED UL'E';:,
I� New cons[ . .� iU ' P �' i lifit ®iii For special information use c
ruction � em checklist. Y Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
:CATEGORY ' CONSTRUCTION -t; -1•'•'; i S ° %',N's.+/ SFR (1) bath 249.20
❑ 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: -
i -. �- „ E I1■r �„ ,.:.a.r,:, LOCATI Fire sprinkler ( sq. ft.) Page 2
: JOB „SITVFORIVPATIQN::I ANDON> ctG i .1
; ;. �6. .• .:: _" N a_ : � ! ':.. S nt
Job site address: U j _�r�dj / c- 1 Catch basin or area drain 16.60
V12 VV �' Dr well leach line
City / State/ZIP: y line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
�� ft
Storm sewer (no. linear ft.: ) Page 2
u� Subdivision:e DlAyyt r Vb NLf 0 , I Lot no.: Water service (no. linear ft.: Page 2
Tax map /parcel no.: ` Fixture or item
;, •�•, :,.,,< ::, ,..,. N . ,,. , ... ! �; ? „ - , Absorption valve 16.60
4
•_ g ' . A :N : ^DE - ! .' , IQIV tiO.., ; ' ,
-, " tt ; : ' 7 _ - i, F
• i•; .•, . , . „ ,. .1: , . .
....- •...�' : r'l� ^.,. .. „ . .. , ,,.. .. .. ..:. ,�_� : r,....- �., .:., ._, - •# �� .' -, * Backflow preventer Page 2
Backwater valve 16.60
l
Clothes washer 16.60
Dishwasher 16.60
:e. r,. t- a �', -_ ,, ,. ,. „ ,r r.a.. Drinking fountain 16.60
' ''° ', A ' '•‘ '.;; ,.. %- ' '
! •ROP.ERT,3l,'0 R i r •. ®'.:TENANxR°"', t '
Name C' t(A7,-) E jectors /sump 16.60
, 1 �i r� LLn + {� t r,� 1.� L� i Expans tank 16.60
Address: o ( • � :- Fixture/sewer cap 16.60
City/State/ZIP: � F je , /� r2 Floor drain /floor sink /hub 16.60
Phone: 5�) .9 7 0•;! /
Fax: 69y 7 7 of Garbage disposal 16.60
= . $ ® : ' AR P IJI l *" T ::..i. , . ''' ' • ':5:!'"
. •' ' :CONT '. � ', � � -+ � •.,::, . , , .,_ ,{ Hose bib 16.60
:'' /h) , , 111[ a, \^ �.' ''- ., i -,. t) RS , ; ,
O .1,
I.} ` � i•,
�.. . - .: •,Lt. -,. , >.c -, +'• �y6 ... ) . ; , y .,.., . „, r ,el'. ''9
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
•
'i . , CONT C . :,,a ,. } . ;,,• °.,:>`
' •�
'''
. � .. , ' .., .. �� ..:,,: ' ,„ . "
.p''•=' . r.: Water closet 1 6.60
Business name: k ry00 Water heater 16.60
Address: `/O I Other:
Subtotal
City / State/ZIP: e ( /
" "ta ^ � f
I Minimum permit fee: $72.50
Phone: 619 5) `� ✓ � Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 1,0S � � ^Inmbing Lie. no.: �� � )1/� Plan review (25% of permit fee)
Authorized signature State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Print name:.. p4. \ t w Date: I (2 7 r'� This permit application expires if a permit Is not obtained within
V V 180 days after it has been accepted as complete,
*Fee methodology set by Tri- County Building Industry Service Board.
i:\ Building \Pc,nits \PLM- PermitApp.doc 12/03 440 .4616T(10 /02/COM/WEB)
Electrical Permit Ap i '` f ED FOR OFFICE USE ONLY
City of Tigard C tl G Received
Date/By: Pemtit No. : :290S- 10429
13175 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 2 0 1005 ��*' h t yl' � I +I� Date/By: Other Permit:
� ,►d
Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
- -- • ' � WIRP! , ,.:'S' - J ; ;PLAN•REVIEW - .
N ew construction ❑ Addition /alteration /replacement Please check all that apply:
❑ Demolition El Other: ['Service over 225 amps, comm'I ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
•, •' n 'tkil&oite'OF,CONSTRUCTIONi,`'`, _ „ + ? -;i; :r; : 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
❑ Multi- family ❑ Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
_�.
['Occupant load over 99 persons OManufactured structures or
_ .. . , _.., ,,• ,.:-:.,::.. : ,,, - ;,, ; a • �. •• :
' '' rJOB' SITE:1INi'olaiitio '• :t&ND` = h` ` _�• ,t,. -` ❑E ess/li htin plan RV p ark
Job no.: �H Job site address: 'ea r_ L p/�J II _ .Health-care facility ['Other:
1 �� " - Submit 2 sets of plans with any of the above.
City /State /ZIP: V.,( 6 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 1 Project name: t_ r: -. 'd.',;; i ' ` ... , - :,. . . . .. , ....V y ?� ±;;: ? . r t ; ,,,, : x,: : `.
„ I '
Description I Qty. I 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: )/+ V,A Lot no.: 3 Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: // Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
4;
DESCRIPTION•;OF ORK. t ,'2 . ", , ;
...r > +. „s� r ,��. .. t �� W , :�+ . t " ��:. k { i ' ,:i':;I 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
, ; ^,• ; r� 201 amps to 400 amps 106.85 2
( ; .' ?', ^t;•:�,f,`i'4:'1'�lign,ER Y9'11- 1VF_lR' t: tt +" • ',1, ''1k,;l' ;• ,•J ®';TEN °ANTt,i1;'%,.; H ,~ P P
r , _, -, i" ,, ,. �, .,.,.^ �,., .... .:. . ... ::: �� 'a!_- P -"e�=h ^ lt�� +, v., , ..l :.,, . , . r�. ,.. � ,. ,. r ` . `,
401 amps to 600 amps 160.60 2 • Name: A c. • 4. . _ i 52 (1 ,0 d 601 amps to 1,000 amps 240.60 2
Address: — l1` �tJ 'V l �� l 0 Over 1,000 amps or volts 454.65 2
���vvvvv Reconnect only 66.85 2
City / State/ZIP: Lot,,� GJv 0, c-. q�o �� Temporary services or feeders installation, alteration, and/or
Phone: ✓ !
G',t� l n ^-) - - -7 Fax: (f ,6`,5) - 7 j 5 relocation
�.� (L� 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
'.. , .. lA '''`" - -'" A. Fee for branch circuits with
- =:� ,,;,• '�APPLTCANTy:i y � !' , ;.1':e',..4.-',',1,-,1,.: • ®�= QONTACT �� ,,,
service or feeder fee, each 6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
` '; i,;' .;•: , : `CON`I AGTQR° r. ^;. ,-yyII n� ^
, i' , / i;:r. >: ':.� • ,,,r•„ `s energy Panel, alteration, or
Business name: ��( extension. Describe: Page 2 2
Address: sl ) rn s l , -e -7 Each additional inspection over allowable in any of the above
T .6 Or- q - 3 Per inspection 62.50
City /State /ZIP: 7 Investigation per hour (I hr min) 62.50
Phone: i.41-f I001 t D - Fax: ( ) Industrial plant per hour 73.75
:-N ,i',; 4.a: .ELE'CTRICAL PERMIT:FEES,'• :' :;'
CCB Lie.: —Ir _)-0,D__ Electrical Lic. �/I f�l Suprv. Lie.: 5qd / Subtotal
Suprv. Electrician signature, required: / Plan review (25% of permit fee)
� ���
Print name: LAC t O a-1 I Date:
State surcharge (8% of permit fee)
L •� ' � TOTAL PERMIT FEE
Authorized signature: This permit application expires if n permit is not obtained within 180
Vb7iu . Fee method days after It has been accepted as complete
Print name: Date: � methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Perrnits \ELC- PermitApp.doe I2/03 440- 4615T(10 /02/COM/WEB
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard o
® D E iew 63 2 c 25 SW Hal Tigard, OR 97CEI Y Perntit
Phone: 503.639.4171 Fax: 503.598. 9 �Cfy) $ ! / Date/By: Other Permit:
Inspection Line: 503.639.4175 Q ry -1.4 Ih J
Internet: www.ci.tigard.or.us 3AN . LO05 r- Notified/Method: Juris: Supplemental See Page 2 for
8
Supplemental Information
.., •• •'. Y' ,:r IGkirifW , "i: 1y;' r , '=Q0IVIMERCIAL FBE C •
g ew construct A�tit on a teration /re lacement 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.
.CATE rCQN T'1tUGTIO
GQRY,-OF-. S N.. -: , t, , Value $
! ' .RESIDENTI:A ;EQUIPMENT /SYSTEMS FEES* '
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
.JO.B:-' SITE :;INFORMAIGION!:AND1;,LOCAT1iON :: C._E ^
;P ;;;: +'' `, Heating/caoling
Job site address: 5111 e..-Ogg, 1 Air conditioning or heat pump
( (requires site plan showing placement) 14.00
City / State/ZIP: - 1V6, I Of- Furnace 100,000 BTU (ducts /vents) 14.00
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
Gy ��, „ _ f e t .2 Flue/vent for any of above 10.00
Subdivision: Y 1f1Ai Lot no.: ' J
Other: 10.00
Tax map /parcel no.: Other fuel appliances
;.:;,_.:17) .. . , R _. .. , ctv,: as ; , :A: i . s . Water heater 10.00
r ; L . , ,• D : WORK ' , t f:
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
® R'OP.ER '�
Chimney/liner/flue/vent 10.00
TY,_OWNERG; •':_,, ;1, 4. .; : ` %® �TE N'A NT ^l?: ' .'G Y
I'' ''' ' ' ' ' ,: ,.. : ': '
��' �. � . ,. y ,': � ». Other: 10.00
Name: \ 4 . �! ++ Th, r��-`e!•42 l Li 1C_J Environmental exhaust and ventilation
W r
Address: V 1.-. L "'� l���ICC L lX./ Range hood /other kitchen
�// equipment 10.00
City/ State/ZIP: ,( a �0 S Clothes dryer exhaust 10.00
` ' /,. Single -duct exhaust (bathrooms,
Phone: , '."�G /2 Fax: ( , - 7 O I? toilet compartments, utility rooms) 6.80
',0= :,_ r., ._I ®: � •1i °. ��,.-; :� ' '.t�4i;Yy ;::,i.. , / •, - .ti.,,!,,,r�, 'l:
'.,,.' ^! .
; �.;'�; f� , , liTCe�P,IT.. - :;1�'� J';s� =� ; .+ dr ;C.RN� �.,,o: Attic/crawlspace fans 10.00
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
CONTFRACTORC. :L.; '_:. : ;, :i Barbecue
Business name: �p Clothes dryer (gas)
(� r �' "- `� Other:
Address: pQ ( "` L r
�l - l , ^ /� / �] �l: •' �;C " °i'- ' '1VIECHANCAL P
IERMIT'F1ES`) !
City /State/ZIP: V' &5 1 ` ` 01_ ` t �0L ,, Subtotal
Phone: `� _ •i Fax: ( ) Minimum permit fee ($72.50)
1 Plan review (25% of permit fee)
CCB lie.: .. ...3 '1'�) State surcharge (8% of permit fee)
� TOTAL PERMIT FEE
Authorized signature: •'M M17'1j1 This permit application expires If a permit Is not obtained within 180
- days after It has been accepted as complete.
Print name: ° , • iIIal1. ( ,n III Date: ��L • Fee methodology set by Tri County Building Industry Service Board
is \Building \Permits \MEC- PermitApp.doc 12/03 440.4617T(I1 /02/COM/WEB)
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44 l and use and development standards for street tree installation. 0.
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1 RECEIVED BY: DATE: c lo ^
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005 -00024
13125 SW Hall Blvd., Tigard, OR 97223 A A 0 0 DATE ISSUED: 2/24/2006
Phone: (503) 639 - 4171 °.a .
Inspection Requests (24 Hrs.): (503) 639 -4175 _�'�� `'_ ..
INSPECTION WORKSHEET FOR DATE: 6/13/ 6 05 TIME: 7:08AM PAGE: 56
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 033 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORISSETTE COMMUNITIES LLC. PHONE #: 503 -387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538
4
Inspection Request Scheduled For: Date: 6/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 009077 -01 503 - 209.4837 N
Corrections/Comments/Instructi ns:
F_e_ Pori C'A bc F )
Co ►--1 PC KPASS A TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 613- c) '" Phone #: (503) 718-
CITY OF TIGARD . A
BUILDING DIVISION r PERMIT #: MST2005.00024
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24 /2005
Phone: (503) 639 - 4171 :flit f I�
Inspection Requests (24 Hrs.): (503) 639 -4175 ^
INSPECTION WORKSHEET FOR DATE: 6/10/2005 TIME: 7:05AM PAGE: 76
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 033 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
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: 6/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 008966.04 503 -209 -4837 N
Corrections/Comments/Instructions:
PASS j1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL N CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:
p C �< ) • 0 S Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005.00024
1 . -- 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24/2005
Phone: (503) 639 -4171 /�m,�.ery� i � ll �,
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 6/8/2005 TIME: 7:12AM PAGE: 46
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 033 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
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: 6/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 008733 -04 503-209 -4837 N
Corrections /Comments/ Instructions:
//' ea JIL.i
f Lec. 1I�dt L .' 1 ) , Vie ai/ gA
KPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _____ Date: /D dr Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2005-00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/24 /2005
Phone: (503) 639 -4171 u ro l j
Inspection Requests (24 Hrs.): (503) 639 -4175 �' "I
INSPECTION WORKSHEET FOR DATE: 6/8/2005 TIME: 7:12AM PAGE: 47
SITE ADDRESS: 12785 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 033 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
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: 6/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 008733 -03 503 -209 -4837 N
Corrections /Comments /Instructions:
•
)4RAss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r iiV Date:,// Phone #: (503) 718-