Permit 1} CITY OF TIGARD MASTER PERMIT
CIT
PERMIT #: MST2004 -00407
. �II DEVELOPMENT SERVICES DATE ISSUED: 1/31/2005
s 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15049 SW GREENFIELD DR PARCEL: 2S109DA - SR044
SUBDIVISION: SUMMIT RIDGE ZONING: R -
BLOCK: LOT: 044 JURISDICTION: TIG
REMARKS: N
BUILDING
REISSUE: DM199 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,610 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,790 sf GARAGE: 645 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 330,580.50
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,400 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 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: 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: 7 201 - 400 amp: 201 - 400 amp: 1st W/O SVOFDR: 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: $ 8,876.08
This permit is subject to the regulations contained in the
DON MORRISSETTE COMMUNITIES DON MORISSETTE HOMES INC Tigard 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
Ersn Cntrl 681 -4444 Post/Beam Structural Mechanical Insp Shear Wall Insp Water Service Insp Building Final
Grading Inspection Post/Beam Mechanical Plumb Top Out Low Voltage Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Gas Line Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Rain drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Water Line Insp Plumb Final
Issued By� ..",',_ .,/i/Z) Permittee Signature : . 2----
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
•
P B>u(ildin Perm,�,, o 'r 1 � 11 ® FOR.OFFICE USE ONLY
R e ceived
Cit of Tigard / Permit No.:
' " • . • . r y g Date/By :��� �`T ��JI — S� � --(/6 yo7
T: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
'Phone: 503.639.4171 Fax: 5031D 912 't 2004 toatlipi ` �'1 hh\ Date/By: 41 V - 3 /— U S _ Other Permit:5� 1 5 j,_,l�
Inspection Line: 503.639.4175 � Date Ready /By: Juris: El See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: j. Supplemental Information
BUILDING DIVISION
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New construction ❑ Demolition Permit ,':
are based on the value of the work performed.
VVVVVVT \\ Indicate the value (rounded to the nearest dollar) of all •
❑ Addi tion /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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:: ; , work indicated on this application.
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'CAT GORY,:OF • "iCONSTRUCTIONc,,, f;;,` , -
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�l- + and t 2- fam il . y ' . dwelling ❑ Commercial /industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: Z 72.*
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E 3
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Job site address: I so>aoi /I �,12 s � e 4 la New dwelling area: 3� q square f
City /State /ZIP: — Ti, i ee� Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: V M4 i ei dgie Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
• Other structure area: square feet
ItOR CO M'M E R ,
C WE 41 :1 SE ' GHE CKLIS TP
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Subdivision: Lot no.: 44 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
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, 9 - , > : 1 work indicated on this application.
, ,.
:;��, " ' ..*, +DESCRIPTION'�OF',sV , ;: . r „n �,�,.�a.,,,.: , �.t,.,,.
Valuation: $
Existing building area: square feet
New building area: square feet
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: , , ” ',` $ , .,w, f . p , ;,,,,i ? Number of stories:
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Name: " 1\..\ - 4U - -i 5 • Ca �?h1�vh, $ Type of construction:
Address: I—f 3 (, ) GT.. (2- !CV Occupancy groups:
City /State/ZIP: L-b 4 c -_ p , � q70 345 Existing:
Phone: ( ✓I '20 /2551 Fax: ( 13) .3 d7 , 71 / 5 New:
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Business name: 5 KA- 1 E f �--� P� l2 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:
sCO =, "i `
Business name: & -1/1 r/,, \ (w� as;:` . +•': _a,:r ;,K. a„': r.
' ':� ,, jf UI _ G 4PERiVII FEES
- ..:,,,. ,;
Address:
•
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB tic.:
Date received: ..,,
., •
Authorized signature: ibj' _ gyp, rz j i - This permit application expires if a permit is not obtained
�,/ � /t r within 180 days after it has been accepted as complete,
Print name: 1 �� (6 Date: / 2 12 t oy * Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermiiApp.doc 12/03 440-4613T(1 I /02 /COM /WEB)
/ , Plumbing Permit Application FOR OFFICE USE. O
City Of Tigard Received
Date/By: Permit wU
No.: /0726 ,n �/ _ co y
13125 SW Hall Blvd., Tigard, OR 97223 Piau Review / J7
Phone: 503.639.4171 Fax: 503.598.1960 / /yulli 1 I +'1\ Date/By: Other Permit No.:
24- Hour inspection Line: 503.639.4175 e I .
Internet: www.ci.tigard.or.us • ---� Date Ready /By: ]uric. See Page 2 for
g Notified/Method: Supplemental Information
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INew construction ❑ 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)
/,,:._ - CATEGORY OF CO ;7 en s;. , ; SFR(1)bath 249.20
1- 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
`- `- t.JOB INFORMATION,AND�LOCATION'1' ',t`, ,i Site utilities
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Job site address: ' t5o L 1 Si& C�,yeL�6e� 'r. Catch basin or area drain 16.60
City /State/ZIP: ° �ie l e kt e r k 0 l � � o X 912 1 Drywell, leach line, or trench drain 16.60
'i6t n • Footing drain (no. linear ft.: ) Page 2
p M h
Suite/bldg./apt. no.: Protect name: f 14 'L
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: Lot no.: 1t
Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
;:,as° .._ �¢; ro ,,,:' :.< , Absorption valve 16.60
c ` ,,i, � >:r.JrEjft:: %DE` 1''OF VU + .,,,,, ;2�.� _,s >:, , s-r "t".,rr.,,:,,,
';;:ti z Yt s` '':r SC TIO .,.... , a. O ;,'; .., a •.
._ .,,... _,- ..r_.. ..:�..,.. � xcet °.Ji:w„x ... _.. o� ,:. -.�. �..,'`zL£,.i .��. „.yt,3;- ,..r „3b -..hr Backflow preventer ..: �z .,r, - :,._.... -.: > - ,:a »ca w pr Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�.,4:,,, •,r..=. ,,. ' ,,, ;�,fe .� i ::;.;- Drinking fountain 16.60
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PROPI r.,:if W W -: „ri '•::;, ,,. ; . ' i `❑ 1P-n NTi�:. p4:;4 <=
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Ejectors /sump 16.60
Name: 00 \4�r /,Ad 9 Coyh Expansion tank 16.60
Address: .L .2 . • � G `,` J ?., I co Fixture /sewer cap 16.60
City /State /ZIP: a C p ) :� iiL�� � , Floor drain /floor sink/hub 16.60
Phone: j�) ..92 7 Fax: ( )� 0� (a1 Garbage disposal 16.60
7.s:: ;,, .;�,: =f� •. __.a:'' :,�.�..> ;. +,; -�,; �,�:•�;,�<;,k .;t;; „ ',:;. . �,.� I-Iose btb
°' a., "1'R -..1 x s,;.._ r.
_r. t t ' <
eiA�EPLICANTt;� �,��` , C
N., =�
G Ice maker 16.60
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
n�, S .h t3 ,
A5:`'"
1� ,.,T
,.tt
a -
- t e
. , , Water closet 16.60
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Business nom /u',� . /,, ^ „ ] t Lt1 . y ,^ \ �n(,,t Water heater 16.60
Address: l Q t L�l-1 , J , ✓\ Other:
•
City /State /ZIP:.,+(,. Subtotal
�
( Minimum permit fee: $72.50
Phone: 7 )(,9 / ` L'L 3C� Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lie.: L j 7 _f - 7 v ^himbing Lic. no.:.. /3 P0 Plan review (25% of permit fee)
Authorized signature' State surcharge (8% of permit fee)
...•••" TOTAL PERMIT FEE
Print name: .� ) 3 -- I .1 v /� Date: ' Z /� t' This permit application expires if a permit is not obtained within
I l 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ Building \Permits \PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM /WEB)
,,• Electrical Permit Application FOR OFFICE.USE ONLY '
City of Tigard Received
I,. Date/By: ermit No.:AL yo
1:,125 SW Hall Blvd., Tigard, OR 97223 y
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y y ,.. 1 4 � 0 � p�w1'1 II! DateB y: Other Permit:
Inspection Line: 503.639.4175 c-}r� Date Ready /By: Juris: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
,- .. . -, .,. TYE'E - OF W O RK,,:.,, ,..:
,.
N ew constr uction ❑ Addition /alteration /replacement Please check all that apply:
❑ Demolition amps - rating over 225 amps, comm'I ❑ Hazardous location
❑Service over 320 am g ❑ Buildng over 10,000 sq. ft.,
Other
CATEGORY OF CONSTRUCTION -;;_- - ;:', 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 Ill Feeders, 400 amps or more
,a ;- _'.. ::.. ;: ; =z +r:,., .:........... persons structures or
❑Occupant load over 99 e' EManufactured stuct
;_; „at';;J4ki- SITE_;: INFORMATION- A1.W..00ATIONh' .- , RV ark
�.:....,.:,.:_ -,rt',. i.�;: %' ❑E /li plan P
Job no.: u Job site address:,5oliq SW ('. „� ,i ❑Health -care facility ❑Other:
` ''+ ► " t c , � ��� ✓ Submit 2 sets of plans with any of the above.
'� City /State /ZIP: / /Jn \ O V The above are not applicable to temporary construction service.
f nrtt �:� ... : tty:Y ��E �': �•��",4J ;hliitit - .*J,,f' ` �+ ": -.:5::. _
Suite/bldg./apt. no.: I o ......: ,';,..T,_.....,,...•...,.,•..._ Qt;. .....,,- . , -.:.' =T otal .
... •. i.,
Projectname: hw �;.,,� EEE.vSGH ULE + "'
�V 1►L � R I0 C Description " " I Qty , P T -
Cross street /directions to job site: J New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: 419 Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
.: ,. - Limited energy, non - residential 75.00 2
; > R - , _
,.
.,3. SC IPTI F'.
'h�� ON`�O WORK...
. ,, F.. -.. ,� 3.,.., x .. , ,_„ � „�... ,.. -,.. . �. _ ... r Each manufactured or , :.:•..,�, :.. <.. ,_spa., _�w ,...... �,' , : rF
�.: ._. ,._. ,. .,.,,�,v,_._ ,<. o modular
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
':' x.:.-,z° ' "'tr= i "'' ,t. 201 amps to 400 am s 106.85 2
`,:
1.4 = TR'OPER, � •T'''s` z , ,�. : rra',t::�lr.. : ='1 ,.�. , ;� tr. _n..,
;,y._ T. OWNER .0 ': ` N` -- CEI!TA1V' " _ `s.. {.,, 6 . „
-. ,.:..,'3` _«w .;u�:s;,�,,,.. ,� ;;,,, ,, ,,,,, ,�,.: .5 :".`; 'S h• 'sN }Fi:,�.....,: : ,•K._. t .. ,5n::',•4 401 amps to 600 amps 160.60 2
�.:��: . --. :... ,., �_ .�.�� :�'. - =�sH-.P.: �& .... �.. ` � ��
Name: 1 A �t ♦ . ._ GOr►'11-r cE 601 amps to 1,000 amps 240.60 2
Address: L,a.W ' .1 (.1) e to Over 1,000 amps or volts 454.65 2
v Reconnect only 66.85 2
City /State /ZIP: L�, ef- oo ff . q "70 '.5 � Temporary services or feeders installation, alteration, and /or
Phone: 3) ? 5 7 ' -75:. Fax: 6) i 9j 7 7(01 S 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
,�..t ., .�., s' ;.r.. '. � was
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°= ° °'� .� ®`AP- ,ELICANT - �t ®QGQNTAC�T'�PERSON:•, 1 - A. Fee for branch circuits with
•'� r-' ?, �-.`'. ' - ", ,. �.,.,.- _ . ,, n,., -, L. ..ut.. -4 .. ,fi v..�: b,r k. Ofd ,.,..�. ,.,-t ,. .. ,. .�.. •i- .
service or feeder fee, each 6.65 2
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 -
' • energy alteration, or 3� panel,
:'CONTRA . T ,��J;ic`x-',
extension. Describe: Page 2
Business name: c ( �-' -(. �Q X7,6, `� / --�
Address: v S , Ltirhl \ c� e.:04 C 4 , Each additional inspection over allowable in any of the above
2
1 Per inspection 62.50
City /State /ZIP: Ti (. (dd_. / t .7d-3_ Investigation per hour (I hr min) 62.50
Phone: (5\y3 l !V I t . Fax: ( ) Industrial plant per how 73.75
v 4 { rAic i:,, i ET ECTIgOA ..
='i' RERMIT:;F`EES *A::. -.; ...:
CCB Lie.: ��1�'4,r1 Electrical Lic.40 � Suprv Lie.: '1 l Subtotal
e
Suprv. Electrician signature, required: � Plan review (25% of permit fee)
�a �,�� State surcharge (8% of permit fee)
Print name: l � D ate : y
r � I I t; / TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PermitApp.doc 12/03 440.46 15T( I 0 /02 /COM /WEB
„Mechanical Permit Application .. . FOR O USE ONLY ' . '
. City of Tigard Date/By: Permit No.: �n
l I3125 SW Ball Blvd., Tigard, OR 97223 y' /V! 5 r a h- yo
r Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Gst S Date/By: Other Permit:
Inspection Line: 503.639.4175 -,' ��^$ i Y•
ard.or.us ¢. t - Date Ready/By: Juris: S See Page t Information
Internet: www.ci.ti
g Notified /ivletllod: Supplemental Information
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w�;;} :;''- R,IAL_ FEE,n SGI�EDUI ;E:;;;'USE?CHECKIyISTA
New construction ❑ Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
!!!!ll��. performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
"�:i" _ �� %,, Value: $
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. £. ': t E':''i ):�
CAT'EGORY;;OF.; CONSTRU,CTIONli : =`;? i ;;''i 's'.
:` I' .''` :k:- RESIDENTIALQEQUIPMENT /- SY FEES * :
1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 111 Master builder Other:
Description Qty. Ea. Total
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ript'
JOB SITE INFO RM ON ATI AND LOCATION - ' 1 . S ' _ Heating/cooling
Job site address: 1 5tt..161 t� �� g Air conditioning or heat pump
f / �/, (requires site plan showing placement) 14.00
City /State /ZIP: - - Yyjd i V Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
vh T2 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
-:t :'- -- :g.: i': "- .;r +5 +� anco -,,.., .,s o .s- :a,1.::r-.d zre . ,,,�.,
? :ls•i 'fiT z; "':; s:�', : - , �,z . ., M1:' ;:,y F':.i
°. :�,:'� °'�'a';��;�at!:: Water heater
.$ i'...�,. .u"i.,,�.. s: 10.00
- ;;iDES'CRIP'TION, +'O ;TWO ,. �, x ,4,,.t -. �: :,�: ",:t..,
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...:r.,:.., 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
= ',:4 n _ " - : Chimne /liner /flue /vent 10.00
_
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` >PROPERTY..OWNEIi��' �=�' x:, ' =1•
-s_,- ;,° Y, 4;.®= ;T'E1VAlVT.,t- rE:�,6:':`.t ,x:';.
�._.��;a=.� =�x'� _ „< "- Other: 10.00
Name: \ ) Inovvi7la C0116U/1. Environmental exhaust and ventilation
Address: ] DA V, ood /other' kitchen
l V � °'W ✓ " S [ 1�/ equipment 10.00
City /State /ZIP: 4 ie", of. 6 1 ' �C� � Clothes Range h dryer exhaust 10.00
f l ` Single -duct exhaust (bathrooms,
Phone: -� & -- Fax: (E i 7 - 7 (? ( toilet compartments, utility rooms) 6.80
_`', _ - i, - ,,;:tali +;i1(�)1, ,,>i.. f,.�_tt. .t, „; tic /craw
®";APBLIC ,, :T...:,.,, �..,,�s ., �:x;.° :- `a;' s;'.:a.., ". _ At is ace fans 10.00
�',�'�,': .+- AN .� , _,t=,t a.:•. :x.,. ,:: •:< ,.��� >CONTACT;: =PERSON ,,. '.,� P
:. .. ....'CS`', -.- . __., .._.o_ ..:._ �.-,�- .�_'.: a;�.,.. >.,1.e;~_^tatr >= '�.,_d: „., '`)r,n:,,... ..:.St�,d;;,,....� s. �t.- �E: ���riaa, w:n:.v- sar>. �,rrc�i
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
GONTRACTOR?``` x« 1 _ Barbecue
Clothes dryer as
Business name: 1 �j/ i d y (g )
r . �� Eli C� ?` *� � /`L. 1 ( � Other:
Address: /'� .L-. ° : , - - �.
�C �` ^ �jl �1 f ` �� �
/ I /� / )) t 'ME CHANICAL PERNII T- FEES *t
City /State /ZIP: V j 5\ 1' lV �✓`, e 4 70t :::'.. 2' -t,,.: ' Subtotal
Minimum permit fee ($72.50)
Phone: ( g.. i3i2, "l.. J I Fax: ( ) Plan review (25% of permit fee)
CCB lie.: �c ) State surcharge (8% of permit fee)
g tii 'M TOTAL PERMIT FEE
Authorized signature: * fi This permit application expires if n permit is not obtained within 180
days after it has been accepted as complete.
Print name: 1 0 Mir,` riei I Date: I la. 0 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits \MEC- PertnitApp.doc 12/03 440 -4617T (II /0 /COM/WEB)
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ADDRESS: .
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CITY OF TIGARD -
l BUILDING DIVISION PERMIT #: MST2004-00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005
Phone: (503) 639 -4171 �r r�n ilit a il
Inspection Requests (24 Hrs.): (503) 639 -4175 :� `:_..
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 59
SITE ADDRESS: 15049 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 044 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSL11 E COMMUNITIES, PHONE #: 503 -387 -7538
CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 4t15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 004637 -02 503-209-4837 N
Corrections /Comments /Instructions:
PASS il PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL U CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A41.
-"ollillaubb. 2 /' Date: 15:0 Phone #: (503) 718-
CITY OF TIGARD \P '
E.
II BUILDING DIVISION ,, #: MST2004 -00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005
Phone: (503) 639 -4171 / � (i ll
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
1
INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7 :10AM PAGE: 65
SITE ADDRESS: 15049 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 044 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF,
OWNER: DON MORRISSLI IE COMMUNITIES, PHONE #: 503 - 387 -7538
CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503-387-7538
Inspection Request Scheduled For: Date: 4/13/2005 Pour Time: ,
Code # Inspection Description Confirm # Contact # Message l
199 Electrical final 004395 -01 503 - 209-4837 N
Corrections /Comments /Instructions:
# : /Y e s 4e.e - ct.ki-re.rI' , 6 -e _
J Q,F p r4 0 A N ci fie._ 4, a.1 p e c -94 S
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: / / 7 Of Phone #: (503) 718
ItY OF TIGARD
�
BUILDING DIVISION PERMIT #: MST2004 -00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005
Phone: (503) 639 -4171 �n
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/15/200, TIME: 7:08AM PAGE: 58
SITE ADDRESS: 15049 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 044 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUNITIES, PHONE #: 503 -387 -7638
CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503-387-7538
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 004637 -03 503 - 209 -4837 N
Corrections /Comments /Instructions:
dr"
272117
i n PASS II PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL a CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -
p V Date: I /6 : Phone #: (503) 718 -
CITY OF TIGl4 DY(
BUILDING DIVISION PERMIT #: MST2004 -00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1131/2005
Phone: (503) 639 -4171 i ,,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/15/2005 TIME: 7:08AM PAGE: 60
SITE ADDRESS: 15049 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 044 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSEI IE COMMUNITIES, PHONE #: 503 367 -7538
CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503.387 - 7538
Inspection Request Scheduled For: Date: 4/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 004637 -01 503-209 -4837 N
Corrections /Comments/ Instructions:
j� 'ASS n PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00407
13125 SW Hall Blvd., Tigard, OR 97223 �im� DATE ISSUED: 1/31/200'x,
Phone: (503) 639 -4171 m dl�n��y�mp 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/14/2005 TIME: 7:10AM PAGE: 32
SITE ADDRESS: 15049 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 044 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUNITIES, PHONE #: 503- 387 -7538
CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 4/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 004529 -01 503 -209 -4837 N
Corrections/Comments/Instructions:
Vr_ � � 41 I / /lam
❑ PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Q F_A_ IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: mil / Phone #: (503) 718-