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Permit (f CITY OF TIGARD MASTER PERMIT PERMIT #: MST2005 -00028 469I(1‘ DEVELOPMENT SERVICES DATE ISSUED: 2/25/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12455 SW WINTERVIEW DR PARCEL: 2S110BC -03200 SUBDIVISION: THORNWOOD ZONING: R - BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: DM714 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.210 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.350 sf GARAGE: 450 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 tiiRtt sf RIGHT: 5 VALUE: 249,637 00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,560 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVaFDR: 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 +amp6-1000v 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: Owner: Contractor: This permit is subject to the regulations contained in the DON MORISSETTE COMMUNITIES LLC DON MORISSETTE HOMES INC Tigard Muniapal Code, State of OR. Specialty Codes 4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100 and all other applicable laws. All work will be done in LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 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. ATTENTION: Oregon law requires you to follow rules Phone: 503 387 - 7538 Phone: 503 387 - 7538 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Reg #: LIC 35533 952- 001 -0080. You may obtain copies of these rules or TOTAL FEES: $ 10,139.17 direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : ---- - )4 r Permittee Signature : C Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. i Building Permit Appli 0 FOR OFFICE USE ONLY Received City of Tigard � E DateB : ` `Q — j` PermitNo.VS'�� 13125 SW Hall Blvd., Tigard, OR 97223 � Plan Review - ,• Phone: 503.639.4171 Fax: 503.15p61/ a 2O Oc. � /,,,,,,.....,,,,,L. �,i Date/B : 4 A _ - - Other Per mt:3 I y 0, _5— Inspection Line: 503.639.4175 1V !�i' f'__„ Date ReadyBy: Tura' ® See Attached Checklist for Internet: www.ci.tigard.or.us fT' ail° Notified/Method: - ere / -"1V Supplemental Information ; 'u - �V' 'ON'r.WQRK . ,,S 1 .,f., .:; „ VgP.IR E b ,OD' 'PA: :V.♦''7�rD,2=•FAMIL• D /ELLWG •: - -. . , � ,: t'•a.: ._. r ,!•- .a9,v „C \ - '�K: ?�,ari� ?<�~ •cr •��7 �2.1 :.t. •em g ; ' 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 ;r . ,.7N,•.. ..,.'''''d ./ .i ;:ii - • . ..a •.' on this a A'', --n• '-' . : k ; . ,i,, _ r',; work mdica ted thi "CATEGORY �UF. ST C 2I 0 1 't - R�• r, �.= n;.t >`� application. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: . f (Z ' i . - �- •. •,;•, Total number of floors: ';1m 0: i . ; '';; .; SITE • INFUR]VIATION; A � ' � � pr� ' I? QCATION .,.` ' , 1 ' t "N ' "'1" o s: Job site address: T J ( New dwelling area: C� square feet 5 City / State/ZIP: Garage/carport area: q 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 ' 1R'EQYJIRF)D '4iUS`E1G$ECKJ IS' i, = .ft 3,T . e .l;.ni' �� -.. ii ... .'C. ..' ' .. d` "Ir f. 1'.'[;:l .. . �, .1. Subdivision ht5f)\ I 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 equipment, materials, labor, overhead, and the profit for the :rt A - ' • ' • work indicated on this 's ,; r• t ' ; v' ''DESCRIPTION'� OF % a r `to ; :;• ' ;"°' • '• application. Valuation: $ Existing building area: square feet New building area: square feet t.'•'-:t•,' ` , '• PROPERT] '�U NER;: • ', > ,l. ,u :,� • F eft 1 - r- ,. , - "''' .: , - rti • i,:!�•. r, r' -� : �: � : u.,. rv .H;2:;..a - t.. • � •:2/r', : ItgN.t - "' ;a .,�1., , �� Number of stories: Name: 4Uf`% • l' ,^ rr l. Type of construction: Address: , C -- (i P�j E S ' T tom. � Occupancy groups: City /State/ZIP: LIP ()3 + OK q - 2 0 3 y, -- / j Existin g: Phone: ✓) .2eiji' 5F, Fax: � (�r�j) 3 / '7(.�[ 5 New: ,,',11.,,‘,-,2••,,,':-,,, ;Y ' , /r "t. �ti - ,I fl A. 'TS •' y Rii , :i' . ' , r' i ® °APRL ,` ;;:' c.• \,•y �2,, . " � '1 j 1 '' * PE ON; -. a =t7 p, ti ":. , ,,, , ✓, i 'i' ; , :' ' Y'. :d•S , ';:c •`l.i '7 .1 :4r:i "rl' •, ". i � 0 r. ,. : : i . ar• : • L , • . , p l n fl. i w ' i ` , • f i ,t, w /..,.... r. 1F;.,:,i . 's -.�.' �1, ; „ ' 1: v i .1 ,.t IC E • `ti ., o i , -1' , ► ^ter ^l ,, ,,.:.r , ,.. • � �- • : r..r' +.,.. �„ •: .. • " `e .. • f '& N1c l :�• I r s uni. ; subcontractors ,•••• c o . ei • wire ., , Business name: 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: :,CONTRACTOR ', .c, ai'. Business name: J P _ e:.;•. i j o i 'BUILDING, PERMIT, ,FEES* ` ' Address: -- • • • -- Please refer to fee schedule City /State/ZIP: Fees due upon application Phone: ( ) I Fax: ( ) Amount received CCB lic.: Date received: Authorized signature: ihe 1719(j....4 This permit application expires if a permit is not obtained kb within 1 days after It Itos been accepted as complete. Pr1nt name: 1 I TZ Ai I ) 12:) Date: • Fee methodology ology set by Tri -County Building Industry Service Board. i•\ Building \Permits \BUP- Permi1Appdoe 12/03 440.4613T(Ii/02/COM /WEB) Plumbing Permit Applicat 'eV FOR OFFICE USE ONLY City of 1 Tigard too Received Date/By: ulNNW;2603 0 27 13125 SW Hall Blvd , Tigard, OR 9 Y1 r t0 C' A Plan Review Pent No. Phone: 503.639.4171 Fax: 503.598. 960 % ,x 9, Date/By: Other Permit No.: ..: 24- Hour Inspection Line: 503.639.4175 Wt P- .-41-';' Date Ready/By: iwo EZ See Page 2 for 0; „ . ,,n Internet: www.ci.tigard.or.us Notified/Method: Supplemental information -..;•:. :?, ,":,: ,': TYPE ,'"" t..) .10 ‘,.;i171 ;'F;: Sex gPII Ig e w ' , of.' 'Demolition .7 For special information use checklist. Description ( 0 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection) ' '. ''• '''' '''' CArigdolcei'deeariiiiiiiiielifeSW, SFR (1) bath 249.20 0 1- and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00 0 Accessory building 0 Multi-family SFR (3) bath 399.00 . Each additional bath/kitchen 45.00 0 Master builder 0 Other: , Fire sprinkler ( sq. ft.) Page 2 ''''' ''''''''' Ion . SITE INFORMATION `:,..r■iflii'tkiloiii::'1 Site utilities 1:' ,. ,., ..,,..,... ,. ,. ,.. ,,, „ „ . ,... .., ., ...; .......,...„.„ ., .,.. ., .,..,.„ ,- , .„...,... p., , ,I , A ,,, , ,, !-,..-- , Job site address: a r5 kk4Yv-6), icetAl IX . Catch basin or area drain 16.60 City/State/ZIP: Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 I 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 Lot no.: Water service (no. linear ft.: ) Page 2 Subdivision I Fixture or Rem Tax map/parcel no.: Absorption valve 16.60 '`'' °.7.1') '`" ; likiti101C0 - 1? :. 4 - 6 - Rii,W ; V .41 =. - gi' sP, 41:1 - '; ,, ':' - !'.';'.'; 1 - , Ft . .",;" 1, ...':LN i '''-:;:' , ' -, ,,,, s -,. ,,,', ..„ . . .,:.,„, ',:..., %,.„ ....' i•I Le ri:,,KV.: ...-1: '..',, - 1.f.;'‘..-,..:% , ,V Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 . . ' - '' ' '. ' ' . ' ''''' ' '''''''''-n 71i,' '...,,•!- : Drinking fountain 16.60 ... ; .,_ ,.., -~11„' '-' - •. -0 . - -',-,'-• -••• ‘- ',' '-'' - . ' Ejectors/sump 16.60 Name: 9 KoN4 Expansion tank 16.60 Address: 1/1 , 5?-, I a, Fixture/sewer cap 16.60 City/State/ZIP: 66, a ,,,,a 3 ,, a..._ (-7 ,,,,,, Floor drain/floor sink/hub 16.60 Phone: ) ei'fi 7 0.1 Fax: 6 ."i---7 t s Garbage disposal 16.60 1 16.60 . ,, ,=.: :'. • ...-.."' ', ' 'icr,„,;,&..e,1".,,,,=,.. t „,.. im 0 eei,.. s'i \ i. - ,,. z. v , Hose bib , ', .:' . ,■ ii's.V'-"; .;'-',_ ..;:., ' Pit.","-tl'.i•-.,',.,1.-t... 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 Sink/basin/lavatory 16.60 Phone: ( ) I Fax: : Tub/shower/shower pan 16.60 E-mail: ,,..._ Urinal 16.60 Gs5iiitAtijibif-';'' ,. ' _ • , . w„.„.',, t, 7 , .\: , s_ ,t ;lir Water closet 16.60 Business name: ( -- k kt. ry‘A9 iNc\-5 Water heater 16.60 ./ Address: PO ' , 1,ca, S L1/4)..,‘ Other: City/State/ZIP: G-ArAzetifit& ( C ' Subtotal Fax: ( Minimum permit fee: $72.50 Phone: 52 „.2-. ...i 31 ) Residential backflow minimum permit fee: $36.25 CCB Lie.: 1 C) .- 7 vipp lumbing Lic. no.: '? -'• ...Z.)12E') Plan review (25% of permit fee)_ , State surcharge (8% of permit fee) Authorized signature. t TOTAL PERMIT FEE a :-„ ■IP- Print name: i p4-1 3 , F..._. -. i\ig. Date: 1 t E ki- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tn-County Building Industry Service Board. i %BuildingWermitsWLM-PcnnitApp doc 12/03 440-4616T(10/02/COWWEB) i - Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No V1 - ‘ 900 " 13125 SW Hall Blvd., Tigard, OR 97223 „ LV Phone: 503.639.4171 Fax: 503.598.1960-o' 4 '44. /r I , '\ Date/By: Other Permit. Inspection Line: 503.639.4175 j , �� �� ,„ , I Date Ready/By: lurk: ® See Page 2 for Internet: www.ci.tigard.or.us m WI e COS L ` - Notified/Method: Supplemental Information ^/`,, - .rtY.�>, ,,,,;•.- ` - ? u•a; r:.f,'i c - ��; uii. :'. r , }�,,. .•_+7,', !"fk`j�;a,r, r•, . v-- - 'OHEC )8' ;a, , TAPE ;O `# IC r , :•;.;.,.' • CO1*4 #CIAL �FDE = 'USEKLIST . . _, ... ,,,�d i n u•., .,1; _..: ., �+i.•.''; x .. .i�')i,., h'S der, �- , , =„ .�`l'ie,� a,.- ..,•.in,. New ❑ Addition /alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. _ ' , '1T ; I''T -, r : .;, ... , "' Tii 41 � ' r`, %.• td'r' I Value' $ CAT•EGORY GUNSTRUGTIO - 4,' res - , :'1z R ESIDEN TI AL;E Q 1'JIPMEN T e /;SYSTEMS FEES *• ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB ' SITE INFORMATIONS r L OCATIONg r, , • " > ' - ''' rte "�'` • . ' ,, ,, ,, a...,- l„ nt.,, • : 1 a•.�,,, 1,.,, . •, ,..� ,, . , -' - , - 0 Heating/cooling,, Job site address: .43' Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State/ZIP: .il l Of-- Fumace 100,000 BTU (ducts/vents) 14.00 I r `� 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: Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ;, -..N•: ; s a _7t i 4 n� . •••,gA ".15 ,, e. r �,,s, '' ; ' "4"( 1".;i . ,s ;ws .on'e,., ,. r'i; Water heater 10.00 ' "A �:- L b ii ' . ,.,`��� " a - .D F • iS'C TICI NJ' " © FAC9RgI� v AC .,i,, a, ai••, =44 P - , .,l ai ?.y2,'C.° :ti�::in �r�.a „n - -� # ••r'a=,t.r . 11A��� h* �', �.'- „fi "`a • f :��;..p.fSwl�1 ° '.•i ' 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 = s-:: ," ,,,. ., Chimney/liner/flue/vent 1 ',: - ; PROBER� • ; OWNERS .sa'` ? ` a•r , , ,,,. - .1 y' , . , :; ;• �'.x }.FI, n v _ Y _ 10.00 $ . : .,lus d ' `I :, q •' r , 3_ ti »tP ie r o';rl; Other: 10.00 °; . •, �•: - .. • .. _... r - " v re c ..- " - _ 7.1 }eo ... t., 1;f mod:'` =: , Name: . + � other: V eh Environmental exhaust and ventilation l./[J" - . (�,(� ' � /D Range hood/other kitchen Address: (,/'� -' VD equipment 10.00 City/State/ZIP: /,j �(p - q )0 S Clothes dryer exhaust 10.00 v "� ` i Single -duct exhaust (bathrooms, ::!' -?.6t) Fax: ( I toilet compartments, utility rooms) 6.80 L ,y +-.,.ura C'" itiZ431 iJ' ;r ; - i+vi � "a %V., ;, h Attic%wls ace fans LICrmSr "' ' € � ) �F'; , � ;COMA' • P , t<•r1 P 1000 .I, . , f.,,, , , , .....- , . s .6- :Yt•i$�;xN�I:sa},t;' l� ,., ,•v�.t�,��RSONfx,$.w; <;:'r;:' Business name: Other: 10.00 Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State/ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E-mail: Range ,,, - . :CONTRACTOR; , 's : '': • _ ,. ; ,' Barbecue . ; Business name: d Clothes dryer (gas) Other: Address: p f) �� 1--y---( /] 7L / (, }] ,, *, ;e `. - I . I ERMIT'FEES! . , ;',...;,;2:, City /State/ZIP: `f , &?.? 1 ` V ` c/ 1 /`��J ` `l� 5 ' V` Subtotal Phone: 0 'a e Fax: Minimum permit fee ($72.50) `� i ( ) Plan review (25% of permit fee) 2, State surcharge (8% of permit fee) CCB lic.: . 5 � TOTAL PERMIT FEE Authorized signature: , I �/ J 'cif This permit application expires if a permit Is not obtained within 180 days after it has been accepted as complete. Print name: Om morp ,,t Date: , Ir • Fee methodology set by Tri- County Building Industry Service Board i:\ Building U'ermits \MEC- PennitAppdoe 12/03 440.4617T(II /02/COM/WEB) Electrical Permit GEA/ED ., FOR OFFICE USE ONLY City of Tigard Received Permit \o ,/� 131 Tigard, OR 972 SW Hall Blvd , TI Date/By Vrxsr-r. �(JO� g Plan Reviess Phone 503 639.4171 Fax 503 598 R 24 2005 A A Date /Be Other Permit Inspection Line 503 639 4175 Date Rcady,By I Jars 0 See Page 2 for Internet www ci ugard or us OF TIGARD Notified/Method Supplemental lolurniation BUILTVW ! SION PLAN REVIEW y New construction ❑ Addition /alteration /replacement Please check all that apply ❑ Demolition ❑Other: ['Service over 225 amps, comm'l Hazardous location ['Service over 320 amps - rating ❑Buildns mci 10.000 sq n . CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or mote nos residential r■ I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one siructuie ['Building over three stories ['Feeders, 400 amps 01 note ❑ Multi 0 Master builder ❑Other ['Occupant load over 99 persons ❑Manufactured structures of JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park I , I /f U.■ H ealth -care facility ['Other Job no.: gg Q Job site address a /� t�� SW W ��� V � Submit 2 sets of plans with any of the above City/State/ZIP. �4Y 6 e I `/7 The above are not applicable to temporary consuueuun set vice Suite /bldg /apt no 3 Project name: p6,vree,655 ph FEE* SCHEDULE a illl. escnptmn Qn I Fee anal Cross street/directions to job site: New residential single- or multi-fancily dwelling unit. Includes attached garage. 1,000 sq It or less 145 15 4 Subdivision. die &N Weld j) Lot no . 3 Ea add'I 500 sq ft or portion 33 40 I Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75 00 , 2 DESCRIPTION OF WORK Each manufactured or modular N0V )16L115C w /i /Cr— Seis service and /or 90 90 '_ Services or feeders installation, •alteration, and/of relocation 200 amps or less 80 30 I 2 N PROPERTY OWNER 201 amps to 400 amps 106 85 ❑ TENANT 401 amps to 600 amps 160 60 I 2 Name V eN t 105 -- r r , zL Ne 601 amps to 1.000 amps 240 60 1 Address. Li 2 3 0 �7/.� -L s r7- Su I b� 0 t amps or volts 454 65 2 66 85 0 / Reconnect only IIM City /State /ZIP 3) 311LKr- 0,5 a 6 E . '70 :9 Temporary services or feeders installation, alteration, and /or Phone: 6B3) 3 F . Fax: (52!,3) 387_ 76/, relocation 200 amps or less 66 85 I 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 70I 401 amps to 600 amps 133 75 ' Owner signature: Date. Branch circuits - new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A Fee for branch circuits wah service or feeder fee, each G 65 3 Business name branch circuit B Fee for branch circuits Contact name 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 - CONTRACTOR energy panel. alteration, or extension Describe Page 2 2 Business name: B L-2 C ��'. Address. p. O Q Qx g� /� Each additional inspection over allowable in am ul the above d / J 3l l l Per inspection 62 50 City /State /ZIP: /�Q� a 477 7 f 62 , -- Phone: (s-a3) 3 ,57 0 ,62‘, 2 4 ,5. Fax (5- / 13, ? ''y• . 73 75 - � 11�y ELECTRICAL PERMIT FEES* CCB Lic.: Electrical Lic • — Lad Supry Lie 67 Subtotal Suprv. Electrician signature, required. Plan review (25% of permit fee) c., State surcharge (8% of permit fee) Print name. L p Y . Date: 0 1 aS TOTAL PERMIT FEE Authorized signature. This permit application expires if a permit is not obtained .. kiwi ISO days after it has been accepted as complete Print name Date • Fee methodology set by Tri- County Building Industry Sers ice Board •• Number of inspections per permit allov.ed i %Building \Permns \ELC- PermuApp doe U'0! 440- 45I5T1 100 /C0M. 0 EB 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* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ 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: . , • ❑ Audio and Stereo Systems • ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations \Budding \Pemios \ELC- PermnApp doe 04/03 .. M 5 - T —g C7C) 5 — o c9- 8 AAAAAAAAAAAAAIAAAAAAIAA./ , � . 1111,► eAAA® A®® A®® �► A® �►® �► �► �► A ®AA�.A�. ___ -__ - -- - - -- r A 0 C1.��Z �_I-� IC 1 4.44 STR EIJT TREE , i -!4 , ... ....,... 6l,"t"� - - - I )wiici /Agci)t fol. t O J 04 1 S rET� - 1/0■14E 11121111T I� ; 5 -_ - - _ - - - (1110I.I)lR) (PI E /ISE I'RINI) DO 11c•I CI)y ( t if)' that the following location Meets (City of 'I'il;alcl /Wasllillgtvll (.Cot111ty A i i I land use and development standards for street tree installation. i ADDRESS: .) g.. 5 5 fr.) /,✓INTig-to ea) Vl?. - -- fJ , . ; 4 Y ,. 4 . 1 2 SIJ ISI NI: 7 . :., D A F.: 5- 19 -05 4 BY: ______4 -'------------------------ • A d RECEIVED 1; Y: I )n I F: - -- -- ---- - - - - -- CITY OF TIGARD • BUILDING DIVISION PERMIT #: MST2005.00028 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/25/2005 Phone: (503) 639 -4171 °4Rl „_,1,11- Inspection Requests (24 Hrs.): (503) 639 -4175 _ -� `-_.. INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7 :12AM PAGE: 38 SITE ADDRESS: 12455 SW WNTERVIEW DR CLASS OF WORK: SUBDIVISION: THORNWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: THORNWOOD DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC. PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503-387-7539 Inspection Request Scheduled For: Date: 5/19/2005 Pour Time: Code # Inspection Description / Confirm # Contact # Message 199 Electrical final V 007315-03 503- 209 -4837 N Corrections /Comments /Instructions: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: .1 i 1 • Date: 5 '-(�� Phone #: (503) 718 - P ) CITY OF TIGARD BUILDING DIVISION 9-7' .. PERMIT #: MST2005 -00028 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2005 Phone: (503) 639 -4171 gh ; hi l l Inspection Requests (24 Hrs.): (503) 639 -4175 `: _.. INSPECTION WORKSHEET FOR DATE: 5/19/2005 TIME: 7 :12AM PAGE: 31 SITE ADDRESS: 12455 SW WINTER VI EW DR CLASS OF WORK: SUBDIVISION: THORNWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: THORNWOOD DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -397 -7539 CONTRACTOR: DON MORISSETfE HOMES INC PHONE #: 503.387 -7538 Inspection Request Scheduled For: Date: 5/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 007315.06 503 - 209-4837 N Corrections /Com ents /Instructions: C1_,, (6. \- • S L:,,_ - `h ►tv-, h d &v2- rl R >Q • K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: d•C Date: �/\ 1� Phone #: (503) 718- 4. CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005 -00028 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2005 Phone: (503) 639 -4171 / e '' ��' l l'i � Inspection Requests (24 Hrs.): (503) 639 -4175 _�'�� s_ INSPECTION WORKSHEET FOR DATE: 5/20/2005 - TIME: 7 :11AM PAGE: 59 SITE ADDRESS: 12456 SW WINTER VIEW DR CLASS OF WORK: SUBDIVISION: THORNWOOD LOT #: Q03 TYPE OF USE: PROJECT NAME: THORNWOOD DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 5/20/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 007385 -04 503 -209 -4837 N Cor ctions /Comments /Instructions: _ e t-N- - -t c -- - . c o s--- ce* , SS A ce, . Cigta t/iii06:51„( 1 .z •F • AS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ve,A__________ Date: //hone #: (503) 718- , CITY OF TIGARD , 1 ` BUILDING DIVISION PERMIT #: MST2005.00028 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2005 Phone: (503) 639 -4171 :l�i °'n�v i Inspection Requests (24 Hrs.): (503) 639 -4175 - - INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7 :11AM PAGE: 60 SITE ADDRESS: 12455 SW WINTERVIEW DR CLASS OF WORK: SUBDIVISION: THORNWOOD LOT #: 003 TYPE OF USE: PROJECT NAME: THORNWOOD DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503.387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503-387 -7538 Inspection Request Scheduled For: Date: 5120/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 007385-03 503209.4837 N Corrections /Comments /Instructions: ri7.2. ,_, 7z9ugrez-e SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 27 - \ Date: ,)// t Phone #: (503) 718-