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Permit t' CITY OF T'GARD MASTER PERMIT PERMIT #: MST2005 -00010 )f' DEVELOPMENT SERVICES DATE ISSUED: 2/9/2005 ��� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14991 SW GREENFIELD DR PARCEL: 2S109DA - SR042 SUBDIVISION: SUMMIT RIDGE ZONING: R -7 BLOCK: LOT: 042 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: DM172B STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 21 FIRST: 1,910 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 910 sf GARAGE: 400 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 272 230.20 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,820 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: lst W/O SVCJFDR: 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: Owner: Contractor: TOTAL FEES: $ 8,391.36 T DON MORISSETTE COMMUNITIES LLC DON MORISSETTE HOMES INC Tigard permit is subject to the regulations contained C o i the ard Municipal Code, State of OR. Specialty Codes 4230 GALEWOOD ST # 100 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. Phone: 503 387 - 7538 Phone: 503 - 387 - 7538 ATTENTION: 'Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 35533 rules are set forth in OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies of these rules or • direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS g Z---_- Issued By : e.. / Af/X � Permittee Signature/ •ll Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day I i I! Bu ilding Perthit Application `FOR OFFICE LSE ONLY ' 'City of Ti RECEIV Received Date /By: O5 � �' Permit No.: �S�b� - Odd / Ji G 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review - 7 Phone: 503.639.4171 Fax: 503.598.1960 .' O Other Permit //narnlHl�"YP I' � I ' � '� Date/By: / �{�J 2 $' S a �57. agOd ' Inspection Line: 503.639.4175 JAN 0 1 7 I �;; �� . Date Ready /By: � luris 0 See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: r �� � Supplemental Information CITY OF IGAR _,,. - Y S� a )0z. w ����� r`Sf?'- r,`f:- -` , 1 11•- `., .".`, . <>;. i 7t: „-i,{_, , .{t .:�' . Aif.: ;s,�, � �a.. •,� r x -° ; t- is } ;^t ; :, �zREQUI DATA :,,1- :A1VI),2-FAMILY DWELLING,,. `'�r. "�w .. ,._ - -- -- , _. ,: . ..., :``54 i+i5%i. _ , .� a �;a�„ • t:_: +i' _ ..... .. ... ... .� ,.L,'?,'.. t_ „ +Y, a .. �:�;'�t`z:-irra + r / ., New construction ❑ 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 r "�,� �t= work indicated on this a n. - application. %:ih "r , J � ;r _ PP ''''�,: "ATE � RY�u . F= :'•;CONSTRUCT ON": �. r: '.�''''�` ° ;'- '� % c +? =• •.: -��„ ❑ 1- and 2- family dwelling • ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: 4 ❑ Master builder El Other: Number of bathrooms: S - ,`.Y+;::'.W ..b "- '.'1.zu :.iii �. y 'r.�..Jr;r i.!`•, i�1i" cY•!S*.. W c 4 ..v�rF -. 44., - ti'nik:: - ", . ='s "`' :N.;r?:y.. _ ° . :;: cl..,, Total number of floors: 2. ' t {. , ',l: _:':rte. 'rd "7>JO B;,SITE' ^INFOORM:4TION.� ,,,,„ iTA'C'ATI .-„,: ... :iir.c: =.,,.t �t.: ; -,s. =r a, ,;.�:�. ": <., ,. h; - ., ,,.r. :?�:r,r ^t`` =4Es� „•.,,.,_. ...!�r,. ,..,.;•:•_..:, .. :�!�'..,. d`' i •` �,, ,yr3•z� . . .u..,,, ......,,. ...:. _�'-+;,<:_ :.. .,. ......,- ..� ",u..r...n..., -. .r _ ,r.,.,.i,, ,y � ,,..,...r way -�s ,..,�....,..ar•� ". , ;:,�t.;� :�, Job site address: � Lgct i SW_ / �y,� . f Lt -3;04 New dwelling area: 21220 square feet City /State /ZIP: 11 i Garage /carport area: square feet Suite/bldg. /apt, no.: J Project name: mt Covered porch area:' square feet - Cross street/directions to job site: Deck area: square feet Other structure area: square feet • Tiff i : ..-- 4ii: � _, y . k ,,. .. N - ,, ,, .. ovr ., - v - wt .., -, •- -3w - . 4 = .D: . , DATA . : i CI CO MM .. E_ RAL. ,.. . ? . USE'CH : ECKL;IST , ;s v1A, t ),::,, , ki4' v: e.", , .. ..,.rrn ,,ii s';OW1_ +s ?`- ",..;- r.;�_Ci Subdivision: Lot no.: £4 '7, 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 s: pr } ,:d', ,`.f "r- :•`kit - - '-a�e. ' }fin � t �lA - ,:r,Y: - <<: rx�a�r=•� I,.. work indicated �. z ;`,� I) E S C RIP TIO N A � OF. W .ORIC;`� � z ' ; ,.: ,, >z Y . rk Indic on this application. Valuation: $ Existing building area: square feet New building area: square feet Occupancy groups: - - _ :!Hll'.!}trC�irtif`Af�. „iT' +' -:�) � i3zi.'i }' �n4..,- � ;t�l 'f::',r ": �... - ..;.: �,X,. `'r`t °` iPR E E12TYqq`.=0, NER` N53- =:rr`TE1V "� Tr,. s,';� ?3�.�. + +, ^,�,�r . bY O .,,s ;:`. -.W m �,zt- , 7'i� :� "' +µ ;y.; rn: ,'1:,.. .i .t4; µ: „�±5� '.F..,�i�. �s,.- w.. ,. ,r Number of stories: x. -. i J,' , - ., _ -� - Cet « - - -- z : Vih^.:: �'��� g\Y'"''_.':� ....... .. .... .e�,t:i�`3'�,;.. :dS,:. n u eb.. xtt. �N- �- x�x..l4s . 2'sf.:r'�7�,:.. ,, - v.w,. s<.:ti1k4. -x. Name: � vt 1 c �V ` Type of construction: Address: f� c---(--L..--, ' �� , 1 la) City /State/ZIP: l__.i t ��,C I q —20 ` 35 Existing: Phone: (.:21..5 ,67 y � Fax: ( ./3) .3c-67.- •7 L,,,, 15 New: ss , >A PPLLC' � Tip , :. aza N EE �.• r',� -: AN C O. TACT. RSON��`� E `S f ��� y All c , . : ,-: 7 : - t - „ ,:_ _ o Business name: ' onh•actors and subconntractoractor are s are required to be r Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and maybe 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: @ONSpRACTOR?' Business name:�y//���, I i _ - - -.1.: :i,BUII ;DING�I'ERIVIIT:.F�EES,. � + a$'r<` Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) ' CCB lie.: 11d, Z6 IL / � '� Amount received • 7 1 ��� \ ��4--- Date received: Authorized signature: 5 1 i' � ,p � Z � / This received: permit application expires if a permit is not obtained i `jL within 180 days after it has been accepted as complete Print name: . 1 " 7� ) C n ' Date: 1 2/i /J * Fee methodology set by Tri -County Building Industry f Service Board. • i:\ Building \Permils \BUP- PertnitApp.doc 12/03 440- 4613T(I I /02 /COM /WEB) / (t t, Plumbing Permit Application ;FOR Q FFI C E ` USE ONLY.: City Of Tigard Received Date/By: Permit No.://1 O _ tea /0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Uy�olh1 ' � Date/By: Other Pemut No.: 24- Hour Inspection Line: 503.639.4175 sal I� +$ i Internet: www.ci.tigard.or.us � - --. Date Ready /B ]uri � S ee Page 2 for g Notified/Method: Supplemental Information w .T. W RK y,. OF . O - ? FE E �.:5 "" ..<. _:. = , - ,yam ..., -� ......:.... ... •...:.,,... -.. ., . K New construction ❑ Demolition For special information use checklist. Description I Qty. 1 Ea. I Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION r r L 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: „ „ _ - Fire sprinkler ( sq. ft.) Page 2 JO SE INFORMATION AND LOCATION' ' , ' , , - . . , _... . B 3 ..... IT .. ... .� .� .., ..._, ,.: ,.... ,.. ,.... , .,. r t, t . 1 Site utilities Job site address: 'LICK' Sw .R• n Dr, .. ci1 ' Catch basin or area drain 16.60 City /State /ZIP: 5 1 ® R •111.2 q Drywell, leach line, or trench drain 16.60 Suite /bldg. /apt. no.: Project name: Su r �1 '� �e Footing drain (no. linear ft.: ) Page 2 1 D"� 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: I Lot no.: 42, Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: .,. r.0 ,..,kt ;x.; „` . +r> ,< ...;a,,a .,;:[ •Cr: t- s',, Absorption valve 16.60 t , +, `g ibESCR T IPIONitQF W R p ®K ° x s �n ' ..t . +a # %' - \- w1, Backflow preventer Paget Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 - u- :.;, ,...... - st iivNt. -_: ,4s: h,: :,, - < < �a.i;, - Drinking fountain 16.60 o- 3 • A n; eYx .. -,, t ••. .:;+ , `pi ", . - ��.�,: a +s ® P,ROPERTY ='i O. 11 x,t ,. - -~., , NAN �� `ri ,'k 141 - WN'E ;�i=.`sti \ +:��. srh:*�.. -�" „I�,, . +�� E T , �t�,z:• -:. ` ,.. " -, ` -,: e. :`t�. : a� r; :;1�9<, _. ��;.., _.. .:. ;.. - . x•��: a... , ,,,rd+ � S .,.�... n,. .a4 . ;; ; 'K"d, : i Ejectors /Sump 16.60 Name: ) ?jf „& ? 4tPY%I Rej Expansion tank 16.60 Address: 1 1 1 0 , ( V i e ' <ji , s�.,, I CO Fixture /sewer cap 16.60 City /State/ZIP: (.,(,,1`1 ChArapi 04 N Floor drain /floor sink/hub 16.60 Phone: C4' .2 7 0. Fax: ( 7 -7 ( Garbage disposal 16.60 F Hose bib . 6.60 A�P � T�'A_.a :rig:' rr.r'" ", ELIGAN, �, ;: C,ONTA�CT`�:EERSUN . -.: �,k .. .:. _ -^. c•` •ht!'- y5 :=. • �.- '.'�k; v'.Yt�2Y�l� . ... .. .. ... .... �.V ? 4•S:A ,.. �. . .r., .`.?v�v�- r j ' . -om 5 - :.: i� t - '.e`�.'_ , ;,� = r, . 3: -..., r , a�.Y� . ... ,�_,.�;..,,., . <ry � m�, Ice maker I k 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: ( ) I Fax:: ( ) Sink/basin /lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 1 �GONTRATOR` C.. . - .. . .r .. : �� -::; � ,. � 4 _ :., , a. ��t - . - ... ,. _;;�;�� `a,: :�..,a. i,,. Water closet 16.60 ` Business name: /,> ,�,.,\ .�Jt � \,( . Water heater 16.60 d" , J kp,, Address: po '� v Other: Subtotal 'y City / State/ZIP: ,(4, -. C � / ( ` Minimum permit fee: $72.50 Phone: f;)�j) (�, ) "" �l Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: 1 d` V ^ Lic. no.: ?7 `� pb Plan review (25% of permit fee) Authorized signature w State surcharge (8% of permit fee) - + TOTAL PERMIT FEE Print name:. I \ ,,� jI �� Date: I '. 2I This permit application expires if a permit is not obtained within �.J "'""""7111 p 4 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Pcnnits \PLM- PcrmitApp.doc 12/03 440- 4616T(10 /02 /COM /WDD) Electrical Permit Application . FOR OFFICE USE ONLY ' t* City o Tigard Received Permit No.:1 /3 90e5 0 1 `3125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 � / / "l '+ `� Date /By: Other Permit: c inspection Line: 503.639.4175 '/W '���m$ . ' f ar Date Ready /By: luris: RI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information . = PE.OF=W ` ORK :- , , _ .,: � TY. -. ` . ,. _ ., .t, „ .. , PL'AN`�REVIE , , N ew construction ❑ Addition /alteration /replacement Please check all that apply: TT ❑ �� ' Demolition ❑ Other: over ['Hazardous .,; ,.," :........... :.';.. -_.:.- . rating ft., Service r 225 amps, comm'l Hazard location x °r . =,, CATEGORY OF CONSTRUCTION,:: ";' of 1! and 2 -family dwellings ❑ 4or d mote new residential 0t ❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure 11] Multi- family ❑Master builder El Other: ❑Building over three stories ['Feeders, 400 amps or more ks " :• ;.,,,;<::.: *n;:;;::, r * -,., :,.::;.,,':.: ;:, -. cupar 99 persons ❑Oc rt load over 9 Manufactured structures or JOB i SITE:;; INFORM'ATIONcAND,, -LOCATION;': RV park E ress /li ht' P Egress/lighting plan 'a' - car g P ❑ Health e facility ❑Other: Job no.: b 4 us Job site address: 1 q i W r�, n li C 141 °) r/ Submit 2 sets of plans with any of the above. City /State /ZIP: "htf Q V �� �"� The above are not applicable to temporary construction service. gyp. .. Txt�. ...,..:. ; "s?.•. ,..,: `.= . "FEE_,;'SCHEDULE''t.. ,-• - n u.s; . Suite /bldg, /apt. no.: Project name: SV�hMlg1 'f i Description Qty. -, . .,: �.....o.,.,:._.,_....:.� :.:"�'r,_:i�.:.:. > tal : ** Desorptio I Fee. To • n 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: Lot no.: 42. Ea. add'l 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 a ; ii, n "3Y'. L- s• , `:1)E RIPTI � E F:::... _. _ . :;_ _,,:., .�, :� ..,,,;�_.� ��- .�_ r, .,_..��.., �. �.:.�,;....:,��.;, .,..�..__„ •_�. °'����t�������,�;:isrh'a�;� 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 . i i i: ' ^f E: -t-kir - - :': \: - ;� r - ..:J. , }„ - to 4 �a'h, ,,:�;; , ,�,;�= t'.r, ,;:•m:, 201 amps t 400 amps 106.85 2 - .: 4x .- ;�,:�i4:rE, IY .� "� "- 1t -, � 4.'G., '::�°!?, r i �Gr ?��.; „- Z�:.,, _..;.�... �.��, �iPROPE"RTY', O. NER 4 ;•u :i .:r, i,•:.: ❑; TENANT.:,�,t. c; s.,,,.�.w. y, ni; ::..;::�c•�? .' -..r �f+:. vv k!d,s: -� - .•d �... .e ;s,:L ��tF B�, � .i.:};r;Sr U;,) :.... , �_*_.. , .. r......4.,.n'n`Y• }` -.�:M i�.,s4.;Jd� t..: ri.'.'1 =, ` 401 amps to 600 amps 160.60 • 2 Name: , 1/i/\ \ C orner K 601 amps to 1,000 amps 240.60 2 Address: L 11111L!��� ��`(.•n,`� Over 1,000 amps or volts 454.65 2 � — Reconnect only 66.85 2 City /State /ZIP: Lo._. ' , — cr J - ,) 02........ . ci . Temporary services or feeders installation, alteration, and /or Phone: - [ / �) j . Fax: t .✓l ,5,3) 7 7 ;G /��rS 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 ;r :<, >'.;; =1_ *" „.: A. Fee for branch circuits with :' t ; APRLICAN ,a., 'w,.: r m ®'CONTACT .: > - _\ .w,. , n, ,.r a }.. 1 - t service or feeder ee, each Business name: branch circuit 6.65 2 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: Pump or in•igation circle 53.40 2 ( ) Fax: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- :,ti "i - 'ei:;� „ i'r: > >1 t+ m ,is e xt t panel' alterati n or TRA - o , Business name: ... ;,.,,.�,�;��.;; ::: „.'- •:. extension. Describe: Page 2 2 Address: �' co 6- UVtch A i3 �� 64 , Each additional inspection over allowable in any of the above Y [. Per inspection 62.50 City /State /ZIP: 7 1 Ca/ ( ("K-- q-7:-30-3 Investigation per hour (I hr mill) 62.50 Phone: 0)5 `I'-1 - f( ']_ Fax: ( ) Industrial plant per hour 73.75 Iv v "'! u= ` ;i<; =1 " "`EL L:=PERMIT; *Y_ CCB Lic.: Li r ��� � Electrical Lic. � 3 J Suprv. Lic.: ( :" Subtot / Suprv. Electrician signature, required: / State surcharge (8% of permit fee) - r-t � Plan review (25% of permit fee) / �l�� C �u� Print name: .. L , Date: ' t> j 0 22.10y 2t0y L/� ° TOTAL PERMIT FEE / Authorized signature: This permit application expires if a permit is not obtained within 180 days after it ha 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( I 0/02/COM/WEB ,Mechanical Permit Application FOR OF ONLY = City of Tigard. Received pernut No.: A � / �y•- ff e'vo j(j 1 Date /By: /vr /J� I 3I L5 - S W Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /Gla i Date/By: Other Permit: Inspection Line: 503.639.4175 l_ ,, ., il Y inte net: www.ci.tigard.or.us ' Date e d /Met o: duns: Supplemental See Page l for g Notified/Method: Supplemental Innformation ,s.. ti -. ,_ ,. -- a. .. r r.:x. : y r_ .�. -. "- ._ .., ..,,.. _ ..... . ,,., ,TYP,E. OF:WORK ,..,� y „r.. _ �.-- .- ,.. ,.: . x . , .. � . _... ,. .., ._., .. � .. ..:.,, .,. - ; CIAI+i' �FE SGHEDUI;EUS CKLISTi' .._. ,.: ��:;.; OMMER- E :,...._ .... EFCHE Mechanical permit fees* are based on the value of the work New construction ❑Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. V lu a e ;: i , p ;cc r - r, 4 CATEGORY OF CONSTRUCTION , 111 1 -and 2-family dwelling Commercial /industrial RESIDENTIAL EQUIPMENT/SYSTEMS FEES* y g ❑ ❑Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea, Total , js JOB SITE'IN ,ORIVIATION, LOCATION x t r .N Heating/cooling Air conditioning or heat pump Job site address: ' 4 io, \ Sys/ ` c s ,. A J '�o. (requires site plan showing placement) 14.00 City /State /ZIP: — i A,/,(,I�a ( O — � Furnace 100,000 BTU (ducts /vents) 14.00 Suite/bldg. /apt. no.: !�� Project name: a Furnace 100,000+ BTU (ducts /vents) 17.90 � I a 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 1 2 . Flue /vent for any of above 10.00 Subdivision: Lot no.: ry Other: 10.00 Tax map /parcel no.: Other fuel appliances .,,; z� , z.. ="V, , �,,,� -. =i „. ' Water heater 10.00 � "DESG „ O e ,.r��:,�w,�: - �.. wXt, -t• pia• •,s•;� .. .7.I�t - , , „ as .,< , a •t t e4 .• . > ,. a • , ;....r.. .,..<m.. -. ,, 3,.... .�`�.:sdd -., ., �. �,- w.vfarnto.. 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 « - ;,-- - ,,:�• 1z .. �;,, -, - ,: ,, - Chimney/liner/flue/vent 10.00 PROP...... , :O.WNER :. ar;,.• ,,, ....,,,, ; ,T °ANT:. >,,..,.......a .. �,:- - ;,:...., :.. � Other: 10.00 Name: \ %.4 • ' . Dmn ” ' Environmental exhaust and ventilation Address: i ) bale; • ' '• e." \ e . Range hood /other kitchen equipment 10.00 City /State/ZIP: I X.P, q ` -)0- s Clothes dryer exhaust 10.00 - l . } Single -duct exhaust (bathrooms, Phone: F —7 Fax: (O O 1 — 2 (C? ( toilet compartments, utility rooms) 6.80 �::t>n-t R ',.: g - ro "'. q..`:� - _ "Y'F..' _ :•x'li a,lx _ , :; 'F'�• ' :.• ,:i. <Y•` . :i '_• i:r�:r 7 i - •°;Ei' : ;';{?� rN °aa °: = `i;�.: k „. ;�;; `_:� • l n' }: +,`� ... r ° + = �„ " l:`: r , . - ,-r �' Attic/crawlspace fans 10.00 , . _ ' .. ® c ;AP P,LICAPj , ; %, „,r, *, ga i, ,, ::6 P„,., ,CONTACT ?:I'r'RSO.N..,.".,,x. , P �.. .� >.,.,, „' .._., ,.� -. a _.., <.:, h., S ,. *.ts'tp{'';:,tf�;�,:`i�; Sb ai , +ry�Fy {(.,,.,r;'�,.�.,._ ..v „d. tcSr sa;.�.. _,.>-- 5 ,x- '�:.��;:kS s 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 ,_ CONTRACTORI,4; u.• ;.,., „ ..: _ Barbecue Business name: (lab ` , .j,- d 4 J t c/q4�. !7 Clothes dryer (gas) r ` Add' ess (�� Other: : /� V v'�� L %;1';_ /,;; M CHi *,.T O L i r - crwo.PERMIT FEES . City /State /ZIP: l T `V ` t I� ( - iota L0 Subtotal r Minimum permit fee ($72.50) Phone: (� `�.-� "� .1 Fax: ( ) Plan review (25% of permit fee) — 5 c.. ) ��� CCB lie.: ) c � 1 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: f • V / no , t I Date: )t z i- * Fee methodology set by Tri- County Building Industry Service Board / is \Building \Permits \MEC- Pe'mitApp.doc 12/03 440 -4617T (1 I /02 /COM /WEB) LAAAAAAAAAAA.AAAAAAAAAAAAAAAAAAAAVAAAAA -4 • ---.- , STREET TREE CERTIFICATION 4 1 41 `01- I 1 Oe" • • elAl'/4_ ()wner/Agetil [OF (Pi.tA sE Plill\l'I) (l'El?AlIT 1101.1)ER) 1 i 1.. I lierchy cerilly that the ((Mowing location 1 1 meets (_:ity of 1.'igard/Wasliiiigt0n (•otinty -411 10- i A land use And development sondard r s fo street tree installation. Ito- . 11 • ADDRESS: / . .1 [ Alif - • 1 MT:. , AV 6 'D " iqiCEIVFD B v - 1 r■-*TITYYTTIrifif TIFTY-TIIVIIWTYYTIfirl"ViiVTITIFYYTYYTYYTY*TYYTTTITITTY44116' ' CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2005 -00010 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/205 Phone: (503) 639 -4171 i�im Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7 :07AM PAGE: 78 SITE ADDRESS: 14991 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION:. SUMMIT RIDGE LOT #: 042 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSEI IE COMMUNITIES LLC, PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 3/25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 280 Insulation 002843-01 503- 519 -6452 N Corrections /Comments /Instructions: • • I1" PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: A, Date: 3- 5-- dS Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00010 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/2005 Phone: (503) 639 -4171 i/ /tpu i, �1 � � Inspection Requests (24 Hrs.): (503) 639 -4175 , L U. INSPECTION WORKSHEET FOR DATE: 5/6/2005 TIME: 7:10AM PAGE: 57 SITE ADDRESS: 14991 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 042 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 60 3-3B 7 - CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503-387 -7538 Inspection Request Scheduled For: Date: 5/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 006285 -02 503. 209 -4837 N Corrections /Comments / Instructions: E PASS 21 P. RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL / r FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . <- '. Inspector: ` �. Date: v ° Phone #: (503) 718 - MP" ftill■ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST - 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/2005 Phone: (503) 639 -4171 / ' ���r�� �ND���mp�lt����l\ Inspection Requests (24 Hrs.): (503) 639 -4175 .. W `__.., INSPECTION WORKSHEET FOR DATE: 5/ 5 / 2005 TIME: 7:16AM PAGE: 51 SITE ADDRESS: 14991 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 042 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE 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: 615/2005 Pour Time: Code, # Inspection Description Confirm # Contact # Message 399 Plumbing final 006173 -02 503 - 209 -4837 N Corr ctions /Comments /Instructions: © 712_0 nA 1/0 _ ( 2 zt fee rv`- etLA - 113 -- t., C k. i 1 I 0 5 7J .-_19,,,- - 1 06 6 e /00 < [?rap c lea-re ©cii 4 ca fi )-e -e C � 4 ,- Jc pp - 4- _. ` or e �LJ ■ k 5 A- P"v3h L) : - PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V lam' Date: / Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005- 00010 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/2005 Phone: (503) 639 - 4171 JO iF'�I- Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/5/2005 TIME: 7 :16AM PAGE: 52 SITE ADDRESS: 14991 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 2 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES LLC, PHONE #: 503-38 - 7538 CONTRACTOR: DON MORISSE I !E HOMES INC PHONE #: 503 -387 -7538 Inspection Request Scheduled For: Date: 5/5/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 006173 -01 503-209 -4837 N Corrections /Comments /Instructions: PASS (l PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED s Inspector: Date: 5'.- Phone #: (503) 718- 7, CITY OF TIGARD BUILDING DIVISION n PERMIT #: MST2005 -00010 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2t9 /2005 Phone: (503) 639 -4171 , �t�dy�tIP ° �'I Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' NA INSPECTION WORKSHEET FOR DATE: 6/6/2005 TIME: 7:10AM PAGE: 58 SITE ADDRESS: 14991 SW GREENFIELD DR CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 042 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSE 1 I E COMMUNITIES LLC, PHONE #: 503-387 -7538 CONTRACTOR: DON MORISSE I I E HOMES INC PHONE #: 603-387 -7538 Inspection Request Scheduled For: Date: 516/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 006285.01 503-209-4837 N Corrections /Comments /Instructions: a ° St a i■f s c C _'NS U L -r - 7 Lr, ■1 ce—K--( • y i Aok_ss 2 P IAL APPROVAL ❑ CANCEL ❑ NO ACCESS El FAIL jam. LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED s c7 I Inspector: Date: Phone #: (503) 718- /