Permit CITY OF T I G A R D MASTER PERMIT PERMIT #: MST2004 -00406
lt DEVELOPMENT SERVICES DATE ISSUED: 3/16/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S109DA SR048
SITE ADDRESS: 15147 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: SUMMIT RIDGE LOT: 048 JURISDICTION: TIG
Project Description: New SF.Phase 2 of 2
BUILDING
REISSUE: DM255 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 28 FIRST: 2,515 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,685 sf GARAGE: 686 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 406,210.60
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 4,200 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 5 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: 8 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amts- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
DON MORRISSETTE COMMUNITIES DON MORISSETTE COMMUNITIES LL and all other applicable laws. All work will be done in
4230 GALEWOOD ST # 100 4230 GALEWOOD ST #100 accordance with approved plans. This permit will expire
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 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
952 - 001 -0080. You may obtain copies of these rules or
Reg #: LIC 162512 direct questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 9,506.55 1 - 800 - 332 - 2344.
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Iss ed By
�i if �� �� Permittee Signature : �� mi.
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. •
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
If •• : ., _
• (h Building Permit Application F O USE.ONLY
•
R ECEIVED '
City of Tigard DateB •
y � , w � •` PermitNo.: ` d / -age-) o6,,,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.59 60 effigt + `\ D ateB : ,Other Permit: r/� +
C 2' 2004 y.' •1 , �,, l l C, • S l v � i s
Inspection Line: 503,639,4175 , . c W - - Date Ready /By: � luris: See Attached Checklist for
' Internet: www.ci.tigard.or.us Notified/Method:, // lI 5 1 6 4....\ Supplemental information
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New construction ❑ Demolition Permit fees* are based on the value of the work performed.
V \ Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacetnent ❑ Other: equipment, materials, labor, overhead, and the profit for the
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,:,.;; ;;'+� :;I #;- >:/ work indicated .;_ «a� cited on this application.
PP lication.
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sGi1TEGQI2Y.'OF.2;CONS RUCTIQN ,� � , Zi
Valuation: $
' ❑ I - and 2- family dwelling ❑ Commercial /industrial
CI Accessory building 1:1 Multi-family Number of bedrooms: A
❑Master builder ❑Other: Number of bathrooms: S /�
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, O '` '" T ,4 Total number of floors: 'y
, Job site address: 11,.t” 1 V w cejecRe Id Dry New dwelling area: at, 6a. square feet
City /State /ZIP:. \ T ' )C i ' Garage /carport area: square feet
Suite/bldg. /apt. no.: J Project name: Evi 6 4 ` Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
• Other structure area: square feet
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Subdivision: Lot no.: �O 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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;,; =,;n r,',,,,,, .,1<•_.- work indicated on this application. ::� >:�DESCRIPTION��'OF�rW,ORK.. ,`rte +is,.t.,. ,
Valuation: $
Existing building area: square feet )
New building area: square feet
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Address: r�
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Phone: 1. ✓/ Ct)7 '� 5� Fax: () :6 •7 L4 S New:
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Business name: All co ntractors � 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:
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ICON ����_ : -
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Business name: ..„ .�- _ .. ;
',, . UILDING:;'P RIVIIT'FEES
Address: . - _._... .a . .,, ? � r a i:._ °'.
City /State/ZiP: Please refer to fee schedule.
Phone: ( ) Fax: ( ) Fees due upon application
• -- Amount received
r' `
fi l ^ (i Date received:
Authorized signature: � V/C/:?/[9(-1L4116-/ This per application expires if a permit is not obtained
l �� � within 180 days after it has been accepted as complete.
Print name: �J 1 . z r . r to Date: I a'� ov * Fee methodology set by Tri -County Building Industry
" Service Board,
is \ Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T( I I /02 /COM /WEB)
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•
s P1 bing•Permit Application = '
� -, FOR OFFICE USE •
t
,, • Received w'`''�_ `` t - v� �y�o&
,, ��"
r • City Of Tigard DateBy: Per / ' Permit No,: �J L at q -co
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �r
Phone: 503.639.4171 Fax: 503.598.1960 Atillip r ,r\ Date/By: Other Pemut No.:
24- Hour Inspection Line: 503.639.4175 • _/ I Date Read /B Juris:
Internet: www.ci,tigard.or.us w Notified/Method: Supplemental See Page
Supplementt for
Information
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Al New construction ❑ Demolition For special information use checklist.
Description [ Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
".
1 'li -
GAT 'EGORY''`'OF:,'CONSTRUCTION, r SFR 1 bat
- � %1 � ( h 249.20
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1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
1= s,. JOB`: S „ . IN I , 'ORI AND < rLOCATION /. � , -,.a:, .>. , , , ,
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Job site address: 15 t sw ot e d ,a4 D Catch basin or area drain 16.60
City /State /ZIP: ®12 4 1122 / Drywell, leach line, or trench drain o 16.60
• Suite /bldg, /apt. no.: • Project 7
ject name: s ` w } ' Footing drain (no. linear ft.: )' Page 2
14)4' 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.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
,:a :t:.;: -,a- :: ,,f r: r,l , -�:;,, . <xn:, :.^ : rt::, :,:'. Absorption valve 16.60
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Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
esr, „,•,:.. .> =,!f:: . : : n ,, ;r „ ,:� , ,:ti =t , a., .;,o,a Drinking fountain 16.60
3;I',I OPERTT''OWl:s .:et -n ,I,.`k :ri .I,. �.P.,,. •:_TEPTANT ':. .w.
h::�.: "c.. -� :_: ' .!4,:re'.',:rara.`r_;�Y'rss «. , ., �,va�a' :•,....,.�.�;., ,.�._ ^ , �. n,,, �€, 3 ra- s, �;,;,.^s..ir.;,,,.,.;<,.._ „sL:. Eje t /
'` � c ors sump 16.60
Name: a ��G,4 9 I CdW W Vr' "- F Expansion tank 16.60
. - Address: i-o i,,' , z • F ,P t Fixture /sewer cap 16.60
City /State /ZIP: W , - l Floor drain /floor sink/hub 16.60
Phone: Fax: Garbage disposal 16.60
. s^l„i=:' .:.i:t'.; ,;,15'.'x. "1�,a "F;fa�prs r:irAt . i c,: .•'w H ose bib 16.60
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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: ( ) I Fax:: ( ) Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
iq: :
tip tii-K
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_ - "�<;`:,,.,..: e 16.6
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Water closet - , _ ._... -�<> � .;.._�.•,-- ..,. -; :,-���• „ >,�,� :.,.,,,, , � ? ���;: ` '' -�'• =:tea ^ ';. , r ' •t'r:;. , :� ` �:� ,. . ,,,.,..r�_ >.
Business name: ,( c,1r ? A,A,YY\ 1(O Water heater 16.60
Address: '6(1). l,C `/ Other:
City /State /ZIP:.0,6C /� Subtotal
/ ( `- Minimum permit fee: $72.50
Phone: ;)6) ( � �l Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: [OC ^numbing Lie. no.: '. ,e3 T Plan review (25% of permit fee)
Authorized signature ‘` f w (8% State surcharge (8 of permit fee)
TOTAL PERMIT FEE
Print name: 1-- J I-
.. -vi Date: itigZ /0y This permit application expires if a permit is not obtained within'
" 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
is \13ailding \ Permits \PLM- PcrmitApp.doc 12/03 440- 4616T( I 0 /02 /COM /WE13)
Mechanical Permit Application F O FFICE USE - .
City of Tigard Received Permit No.:
I 13125 SW Hall Blvd., Tigard, OR 97223 DatelBy. ��T�
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Alt'
}'h Date/By: Other Pemit:
Inspection Line: 503.639.4175 , y
r
,A41.17:411. Date Ready /By: Juris: 10 See Page 2 for
Internet: www.ci.tigard.or.us W Notified/Method: Supplemental Information
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TYP F.W,ORK, _
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. , _ N ew construction ❑ 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.
,'r�� -i. { �. «:;,.'�� • �",;.� Value: $
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�: CAT 'EGOR,Y�`xOF- .GONSTRUCTIONt4)'�� _ - :,:�,�; -- =�t`•
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RESIDENTIAL EQUIPMENT SYTEMSrFEES *I 4s`
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
` JO 'B:: SITE;'. INFORIGIATION ';;;ANDriLOCATION...,•r -r" •;t.`-- s;.,•...,,�..,..,
�..., ,- .....• .........:...... :.:.:., -� -._. .,._., �r,._,.<- ,,•..,._..�. <•- .:.._ -... ,. _....;_ii;__.,.,..•,:,,_ -.._ earn cooing
Job site address: r ! ¢tes Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: , a, i ta Pe% Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg./apt. no.: Project name: Z Lip
MM I t t 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.:
T Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
ic „i•'; - '.5��' 7: rsL -n ;' {c:
;�, � : �;� `•• ��'»?. ,r .:A Water heater 10.00
r. - M CRIETION ' ': -�.., , �.:.. g.,., „sn
. - ,r. :.r. - ::s. . r�� "" =k.,, Syr : 1""':,'r'`': .t
... .. ... .. . a`ij4� `- 1$. -. n .n FU.. ., .,rr__.!de:!::. +, wc.,. � : °,T= A:::u..,'•,k�.Ci:Yf,.7... nJ y- _.`r:r,.�.: /.,..i =:'x5: ,.,'i:K •,,, -:, ., ,rs .; vli `.,'•,.,3,- s „'cn?��; +)a•x{.,.
Gas fireplace 10.00
• Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Other: 10.00
Name
_.,.,.., : :,. r.a. .',E:.. Chimney/liner/flue/vent
;s .� N 6 .•�.. : , -`, ; i' ;, , � C y nt 10.00
"r7; - �' ' pax t ?� +:• - aU P -.
PROPERTY;`t'OWNER ;,_ 6 .'t::, -�, ®. T' ,, ' .W i i=K
.
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�J E�:,.; Co T _ N MVM�t� S Environmental exhaust and ventilation
Address: ,) , ' / e:. , lX/ Range hood /other kitchen
�( //� "�" r lll�����V// equipment 10.00
City /State /ZIP: ore.- -0,- . 61‘
Clothes dryer exhaust 10.00
Phone: '' n l/` Fax Single -duct exhaust (bathrooms,
C �1 / / _'7 �.1 � � ( . -2 �' 1 toilet compartments, utility rooms) 6.80
1r'.3' :r - ,c;i :' F,,.r,., ,,.;', - ��x° ,. r:, 't :sat
'+ "' ;'':�v� �S;ta�::.t • r =' ��{ Ss n .��;n:.- �:s:.•, . Attic/crawlspace fans 10.00
: `.- a. . r.0'` {'API!LICANT. N :' -i 'S ;,,- I n: --,CONTfAGT�<=P ..,„ P
, ..,...r_,. _..,-- ,..,ns•.. s.�:as,: =' k:. a. o-�$, i�' t r.` v. �'^; �l., l�' a).- �'^ t` �' tlul .':��r'y)�'`t� {.�':.,. rsua, x+ as,!:, r; a '- na,,;,_GN�?t•'�tr,P.k,.
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
: ..iia g.:+ 1.k: ;br�m, Barbecue
Business name: ( /) - p / t , iry /9 Clothes dryer (gas)
r'- L�l r v`L t Other:
Address: L r; _
�''';'fi a; ; i '�NIECAANi:A 4. * -0-#4. i '.
IBC? ^ �� ( l "� � f ( � LL z, . __ .. ,r_
w ow_ l� � T � ..... �<Ir� �a� = -_• t �. _ .� ...:.. �:� ::.:.... ..:.... LL, *RIVIIT._;. =r- .,s�s:�;.'. .. 'j:3
City /State /ZIP: V ` ( (Y - 't 7 ) L 5 ; Subtotal
Minimum permit fee ($72.50)
Phone: ( � g � ' j Fax: ( ) Plan review (25% of permit fee)
CCB lie.: J). 1 ) _ State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: • // ':jr This permit application expires if a permit is not obtained within 180
� 1 days after it has been accepted as complete. /
Print name:
V--0 I hi 1" 1 , n Date: 12/2 a li)1 * Fee methodology set by Tri- County Building Industry Service Board
'
'
i:\ Building Permils MEC- Per litApp.doc 12/03 \ \\ 440 -4617T (11 /02 /COM/WEB) /
\ \ n
Electrical Permit Application, <: '..FOR OFFICE USE ONLY '
City of Tigard • Ei\l 1 Received L / Air r
.�i� DateB 'J , �i Permit No.: r /�� t1 AO
13125 SW Hall Blvd., Tigard, 6 . SLID+ Plan Review
Phone: 503.639.4171 Fax: 513.598.1960 00 [ / 0I d�4 f� Date/By: Other Permit:
Inspection Line: 503.639.4175 ( 2 5 1, J to 1 Date Ready/13y: Jud ' , 0 See Page 2 for
Internet: www.ci.tigard.or.us �` " (� A pD
Ck1 PL ��, 5, Notified/Method: / ,., Supplemental Information
" PLAN REVIEW
r New construction 1 oi3/alteration / replacement Please check all that apply:
11] Demolition El Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps – rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
,s 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 ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑E /li plan RV park
� ['Health-care facility ❑Other:
Job no.: 39 59 Job site address: I ) (� 5 w � J_ftoJ F/ .Q B ' Submit 2 sets of plans with any of the above.
City/State /ZIP: – 1 – I D 0 1 e . 9 2 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: O„_, a FEE* SCHEDULE
+ � / � g " �" � Description I Qty. I Fee. I Total **
6
Cross street/directions to job site: - "E' Y U Q New residential single- or multi- family dwelling unit.
11 // F Includes attached garage.
P 1,000 sq. ft. or less 145.15 4
Subdivision: S �� �/ i Lot no.: Li Q� Ea. add '15 00 sq. ft. or portion 33.40 1
, l( U Limited energy, residential 75.00 2
Tax map /parcel no.: 1i�"
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
A / _ dwelling, service and/or feeder 90.90 2
!/ LOUT C GdIJ /Q //AI & Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
tgi PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: ( JOB /. / o-/S rrr C o%2rwUU(7075 601 amps to 1,000 amps 240.60 2
ff Over 1,000 amps or volts 454.65 2
Address: L! 2 36 C BS l r r� -- Su;- S e - . ,6
11 L� Reconnect only 66.85 2
City/State /ZIP: xe" 657, j 6ga J ' ?CM Temporary services or feeders installation, alteration, and /or
l 5 ',_ 7 g 3 ` Fax: ('S 3 3a7— 7 �� relocation
Phone: (
r 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
El APPLICANT ❑ CONTACT PERSON . A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l 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: fill, k'roj latz Tp i C Lc c ,
Address: fI. 6 goy O Each additional inspection over allowable in any of the above
1 v Per inspection 62.50
City/State /ZIP: ,] M p � O (3J7 7 7 7S--10- Investigation per hour (I hr min) 62.50
Phone: (55 . `Z � s/ Fax: ( 3) LR 3 , t ei V -- i Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 1 5 222 2 Electrical Lic.: : -y 3 ‹ ...... Su / 4 Su rv. Lic.: /6 7 S Subtotal
Suprv. Electrician signature, required: T Plan review (25% of permit fee)
Print name: �� Y� 04 . 7 ate: , ` 2 O State surcharge (8% of permit fee)
"T TOTAL PERMIT FEE
Authorized signature: permit is not obtained within 180
g Th is permit application expires if a p
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- 4615T(10/02/COM /WEB
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:
n Audio and Stereo Systems*
Burglar Alarm
Garage Door Opener* `
Heating, Ventilation and Air Conditioning
System*
n Vacuum Systems*
Other: • -
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems •
n Boiler Controls
n Clock Systems
Data Telecommunication Installation
n Fire Alarm Installation
(� HVAC
• n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
I I Medical
E Nurse Calls _
I I Outdoor Landscape Lighting* - - -
n Protective Signaling -
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\Building\Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00406
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175 W
INSPECTION WORKSHEET FOR DATE: 6/27/2005 TIME: 7 :09AM PAGE: 14
•
SITE ADDRESS: 15147 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 048 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.Phase 2 of 2
OWNER: DON MORRISSETUE COMMUNITIES, PHONE #: 503- 387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 - 7538
Inspection Request Scheduled For: Date: 6/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 010228 -04 503- 969.9707 N
Corrections /Comments /Instructions: ,
i
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A(�. .,! 4 Date:& 2 7 "- Gr Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2004 -00406
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 6/28/2006 TIME: 7:09AM PAGE: 51
SITE ADDRESS: 16147 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 048 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.Phase 2 of 2
OWNER: DON MORRISSETTE COMMUNITIES, PHONE #: 603- 387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503.387 -7538
Inspection Request Scheduled For: Date: 6/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 010313 -03 603 - 200 -4837 N
Corrections /Comments /Instructions:
( ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: `v Phone #: (503) 718- 1977
CITY OF TIGARD \P
BUILDING DIVISION PERMIT #: MST2004- 00406
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005
Phone: (503) 639 -4171 �mniry91mUP� ° � elf
Inspection Requests (24 Hrs.): (503) 639 -4175 �! '! ..
INSPECTION WORKSHEET FOR DATE: 6/30/2005 TIME: : 6AM PAGE: 78
SITE ADDRESS: 15147 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 848 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.Phase 2 of 2 •
OWNER: DON MORRISSETTE COMMUNITIES, PHONE #: 503 -387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLG PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 6/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 010524 -01 503 - 209 N
Corrections /Comments /Instruction : 1/
te 1A. b� X7.5 4 ,145
PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r4 C' V Date: L #: (503) 718 -
CITY OF TIGARD
•
BUILDING DIVISION ` PERMIT #: MST2004 -00406
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/16/2005
Phone: (503) 639 -4171 ���
Inspection Requests (24 Hrs.): (503) 639 -4175 : `__..
INSPECTION WORKSHEET FOR DATE: 6/30/2005 TIME: 7:06AM PAGE: 77
SITE ADDRESS: 15147 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 048 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.Phase 2 of 2
OWNER: DON MORRISSETTE COMMUNITIES, PHONE #: 503- 387 -75538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7536
Inspection Request Scheduled For: Date: 6/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 010524 -02 503-209-4837 Y
Corrections/Comments/Instructions:
.L. v j .- - cam- ((WC'S' (y___G9 ` __-ss -
k CL-A S
W L £ .' / S v f -
G (IA( 1---- A., 0 e, ci.-/‹. 1 i a A ,..J 6-Ak- 4:7-v-Ire---9
c� , a- cr\r - - , -7 '► -c--A c /S
(e °. - n
0;41 '� `( ��2 a s o g - em u
1,/v\Ste_ . --"__11\ c_..C .
b N. 4.te
•
r: SS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
th---
Inspector: V U Date: if #: (503) 718-