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Permit • ,II. MASTER PERMIT A , CITY OF T I G A R D PERMIT #: MST2004 -00405 1‘ DEVELOPMENT SERVICES DATE ISSUED: 1/31/2005 ^��" .'- I � 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 SITE ADDRESS: 12797 SW SUMMIT RIDGE ST PARCEL: 2S109DA -SR034 SUBDIVISION: SUMMIT RIDGE ZONING: R - BLOCK: LOT: 034 JURISDICTION: TIG REMARKS: N BUILDING REISSUE: DM139 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,580 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,490 sf GARAGE: 688 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 TKRO: sf RIGHT: 5 VALUE: 302,478.00 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,070 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: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 • 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: let W10 SVCIFDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HWSVC /FDR: 601 - 1000 amp: 601 +ams- 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 8 STEREO: VACUUM SYSTEM: AUDIO 8 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: $ 8,650.05 DON MORISSETTE COMMUNITIES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the 4230 GALEWOOD ST # 100 • 4230 GALEWOOD ST, STE 100 Tigard Muniapal Code, State of OR. Specialty Codes LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 and all racer with approved laws. s . This permit done in accordance with approved plans. This permi t 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 Cntrt 681 -4444 Post/Beam Structural Mechanical Insp Shear Wall Insp Rain drain Insp Electrical Final Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insf Storm drain Insp Mechanical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Line Insp Plumb Final Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Service Insp Building Final Foundation Insp PL /Underfloor Framing Insp Insulation Insp Appr /Sdwlk Insp Issued By :CC�;r ,lam _�.vcai / /61, - AL9 Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day a • , Bujildinn Permit a lie t l/ FOR OFFICE USE ONLY CI of Tigard E 'Jt 1 `r ED ® Received � j � (� �j permit No.: `J g Date/By: /94.. r �CI) 1 "c29,O0 — Ve,c. 13125 SW Hall Blvd -, Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598. } 2 r t 2004 4�a�' k l ' � I + I , Date/By: (\/� J/ /— 3 )- G S Other Permit& 02 5 -co 028 Inspection Line: 503.639.4175 LL�1 CL'... I r.._ Date Ready /By: Juris: ® See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: ` v 7 Supplemental information BUILDING DIVISION _ ' ORIC , ; >, `5.1 r ,' v . ` . t "BE .UIItED'iDATAf- FAIVIIL : .DgrELT; ., _ �� ,'! " = , I ,:^ ; - ,. • .:',9,; :- ' :. : : :r , ‘y': .; r, ,v .E 7 J. .. . - _ r : � . D$ . :. ,•. 7:''. `. �[J New construction ❑ Demolition Permit fees* are based on the value of the work performed. VV �� Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ,. - "� Y ", 4' 'f+•+^"'":;' -' "�`• -- --- • work indicated on this application. ' CATpGURY:)! QF: iC© NSRUC TIQ'];F; ^' f: : ' - '.'.'`!%: - , ./ . '•c , .! ,; r ' ■ • Vii" �; ' "• - , ��-•a ; �ni � 4'r :' , , . .�.c <; .. ... ..,x -, 3??..-- ' ,.. -, : -: .. ';::+:r•. +'!;`•�::'. �1:Y`.Y .i ; ^!! Y�t._ '� l `and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: 5 ❑ Master builder ❑ Other: Number of bathrooms: 3 ,: •, } .; _ ;bi ' �4 ftV!":.4 F, - _ "•YQ'.• . ii :' • a , n r ., - .,i ,;,.,,, : -: v ,:a Total nu _ 1 , ' ,�. r e 4- g . ' ; . , :'fl. .. CL --, ,): '.' JOB; SITE' INFQRIVPA'TI©N''zAND .LO I ( , :h :. ?t:< ' h",, number of floors: 2 � �7..,. :�.: _ f +; gun` :i 1, c.. ..._ 1Y:. rtl4' -sr<:, `1''.•.. , - �'f ;a'.,. �.J':�,_.y,'';edr,11-0,',,,...1,2r,,:,:(14; R Job site address: 1 L.q7 W S i 'edge. 'fit New dwelling area: a p O square feet • City/State/ZIP: Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: CUM AZ t Agile Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet "V iii)IRFiD' ATA:iCO1VIIVIER GIA1. U 1G ECIfI?ISJT''� . ';' J,+•s:K •;r' -: •' Feu• +.' - «",. ,�:.as:•d..,. :.. _, ,. •'• „r':r.•.rt' r;.�:'.u,r,,:�,n•. ,;,., .'ii Subdivision: Lot no.: 34 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 ,,;' sr ; ^i .`.,,� so ;':: h ,1 : ,,,,I^ equipment, materials, labor, overhead, and the profit for the : ,. '•' s , . t ` ':,r': ` . -' ••, DESCIIPs , +OF:a ' �;' :; . i X s .; . r .7 '1- work indicated on this application. , ,... - ,' -• ,.•u a. . ,, ,...;,-- -,,a, ' :v _.,.,u -. , ...,,,•a:,., ,,. .rt -:V1� . .. ... . : ... ..•,,.,..:,'.t..'1-1''. .:. . ,■r' Valuation: $ Existing building area: square feet New building area: square feet `'; �`i:4:' . :PROPERTX O�.� ''N'ER ,};> ' ' :1 1 -.* T;� :i ' -” : -. 1 Number of stories: '. '4 : 4:: 4: ' ' ' :. • ' ''. -- ''•1.:;., �?��` - _ ^.- ..h••r .i�..�:. aT t'�- r.:- ..�];: 1 ! 4 "'�.:<��3'�I "! +' �rTr.: w : `•'nt!5�. ,... �_.� �•-- ' "�''�:' :�' - i Name: 4(I � CD ( mwutiGS Type of construction: Address: 1 -1 ) ( 9,.�JC7 ( ) �`r c (ri.- IX Occupancy groups: City /State/ZIP: L e �� , ((x. q -70 ! Existing: Phone: (5);b) 9 2 0011) -' l� � Fax: ( pj) - ? -- '7 Csp, I5 New: ®+ APPL'I � ' l � `1:;., , . CANT: '=:•7 '!t . ��';,," tr t,, . a? :,,I,,,:-..., i ® xCONTAC'I?':'I?ERSON ' . . , '� , ,.; .,Ii 'A,,.. ;';;, 1_ ,.. �f - ar.,'.r:' ., ;.. 0 ., \ �x. ,. ..I, ,..a .,. .. .. 7:I:,.� i:4 +: �,.. . 1• •;H•.:.. t��. '.,, .. 'fr. .Yi'.; . -.�. i, ?S -: '. v, o�. , ._ ., .: I .,x '�,. ;`� . , • s7; + F "f; • r, „i..,'PT � , ' _ , , ; , 5 <:, , _ ° , Business name: S f AU 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: _ `i CONI „ '' : . :v,;: ;,:'_ . ,. .. Business name: 1 Move ,. ; ^ BUIL , DING :' • . ... T :FEES *., Address: Please refer to fee schedule. City / State/ZIP: Phone: ( ) Fax: Fees due upon application ( ) A CCB lie.: '-35- • mount received / Date received: Authorized signature: jjk�/l �p ,/K� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: D � e i Tz. tr l ' Date: al 22. joy * Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Perils \BUP- PermilApp.doe 12/03 440.4613T(I I /02/COM /WEB) iti sraarl q - `Plu Permit Application FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Alyee,m5..$1,& Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 f,.' � Internet: www.ci.tigard.or.us . Date Ready/By: �°� See Pena g Notified/Met/Met hoo S d: Supplemental l Information i v4, e•t`tli.`.. :, - ,1r, _ :_v;, - . YRE�.:OF..cWORK�' "':' ,;•,;•,,. -,. . ,..: r.�� �� , I;' _ r:.,; ' T ' - ' �`FEE,�:SCIiEDUT;E� I gN ew 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) CONSTRU IQN ^,,�.;`�;; ,t ,,.?` �1CATEGURY_'O'F:� I • ��� ; SFR (I) bath 249.20 jeI - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 SFR (3) bath 399.00 ❑ Accessory building ❑ Multi - family - Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. fl.) Page 2 �I. � � y .. .. � .... .- .. t.t...;. "ud t tl ::i. JOB;: SITE::'INrtORMATION; 'AND::LOCAflON ; a;�;•, "..i';, ;. •,_.,., ,.. .. ... _ ....... rn•., _... :.,.. y ....l:e' • ... , .• +:; i te ut • • i tes Job 1 j 74'- W SV t it i ll Job site address: S � S ` Jlif• Catch basin or area drain 16.60 City /State/ZIP: 0 1 / 10,1 a 0 R i''ia y Drywell, leach line, or trench drain 16.60 ' Footing drain (no. linear ft.: ) Pa e 2 Suite/bldg. /apt. no.: Project name: Svwk �,.r Rrdg g 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.: 3y Water service (no. linear ft.: ) Page 2 • Fixture or item Tax map /parcel no.: .. , ; + ' :,,. _, J ,..: a: : Absorption valve 16.60 . , `3 ,•rY. u • r , .. . t.. ''�;, - „,, . .. B)PIQN. UF-; W ORK „; • : : d , a, r,,,. 1. :: l �. . �., ..,.... ._ , . ,., . ., . , .. ..�„ ,... .. ., . _.. , ,. • ..., . ,. .■ e B ac kfl ow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 r_ f: .01.z-;,t. r ' = _;'. Drinking fountain 16.60 ,;. c` ®= PRO Z}RT7G ;Q •.,� r; . 5 ,,, 7,4 �.1::;_:'t �; vroi'ANT ,, ,t,,:..,:,;,.,,,:,:1,-: i %' ,._,� :a• .•,.,,,...- :.,. ; , -, " , _ _ - ''' Ejectors /sump 16.60 Name: w \7-,:)5t , ' Um n it K1 tici Expansion tank 16.60 Address: ' 1 , • / , . • - GI , S�. 1 '� -y� Fixture/sewer cap 16.60 City/ State/ZIP: . / C� (p r Floor drain /floor sink /hub 16.60 Phone:) ?j .... 7 0. � Fax: ( 9y ��Cai Garbage disposal 16.60 . . . ., �,', , .. ", :,, , •: Hose bib 16.60 i e ,:AEPLIC•A - '' . ;c: �µ °hR' " r ! ®' ' ' ' I ? E RSON�', ',+ .. s w• ': ..v, _... ..; ., . .. , ...,... ..... , . .. ...."i' 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 CO :f1t;.t ti .,,, ' t�• = . ,} . : i' • , � ; • ' " Water closet 16.60 Business name: V Water heater 16.60 Address: . Other: City /State/ZIP: �,e' C e Subtotal • 3 j ( Minimum permit fee: $36.55 Phone: (5:))G9 �' Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: tttmbing Lie. no.: Plan review (25% of permit fee) Authorized signature State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: J I J 1 1\ Date: i Z 1s, 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 \Building \Permits \PLM- PennitApp.doc 12/03 440- 4616T(10/02/C0M/WEB) Al 5 T oto27y_ d •oc fa S Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 4 lA. lr'lj ' Date/By: Other Permit: Inspection Line: 503.639.4175 f a1�. F__� Date Ready /By: Juris: BI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information New construction ❑ Addition /alteration /replacement Please check all that apply: El Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., - CATEGORY' OF. CONSTRUCTIONr. :. .;... ' of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi family ❑Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more ['Occupant load over 99 persons ['Manufactured structures or • J , OB' ; SITE II F.OR1 %L OCATION .: -;; ,, . ❑Egress /lighting plan RV park Job no.: Q 1Q Job site address: fi ❑Health - care facility ❑Other: �7� 47 , address: l � G Submit 2 sets of plans with any of the above. City /St ate /ZIP: ` t-i c 6 U [ac\, ( , r , The above are not applicable to temporary construction service. 1 ' , k L #. : f'1:" Suite/bldg. /apt. no.: Project name: • ■ t . •``. FEE -:' SCHEDULE;' ". - i.` - ? : • Svn. war lz �9 Description I Qty. I Fee. I Total I *• 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.: ty Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ''„''•: ; 1;: _ :D .ORK:i(;- ", : °: , ; ' +t't=; :.• Limited energy, non - residential 75.00 2 ,. ;;. -„ .n., ,;,'hey �„ ., ,...,.. rk.'Y, -,.. '. .. ,4 ; 1 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` .' ;,: ;:'', iRROPE,. RT y(^Q .ND., • R „r,,,..,: w.,,,„...:,1"s , ` - pN ':r, ,, ). , 3 201 amps to 400 amps 106.85 2 .r- ;': ... _ �E'.:"'`i. .:' '; . �t_ : - -/PEN ,,,.(--;,t'... ,, _.i . . t4 ” 401 amps to 600 amps 160.60 • 2 Name: Qy'\ � . Lo rig M l • of 601 amps to 1,000 amps 240.60 2 Address: L i 1 jJ l�,Va / l a x Over 1,000 amps or volts 454.65 2 f Z . _, Reconnect only 66.85 2 City /State/ZIP: l� l 01 q - 0 Temporary services or feeders installation, alteration, and /or Phone: 06) 5 Fax:) ;r? — "7bi5 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 ," :, 1 A. Fee for branch circuits with '';`i; � v ^t ° .. i; "` "y ® ^CUNTACT ' t service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, Address: each branch circuit 46.85 2 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 - s:: ,, ,'CUNTRACTOR;, .:.,s, 111- ,: :.?. ! , Nelpi , , ;: T,, .; energy panel, alteration, or ,i .., ..,. :.. : .,. ;. • : .F• , .:. . ..:' .. ..Y S;F �.,:..::Ji� . 'd ".. \, 'S_h...Jr: . - �y.., 4. vrro o extension. Describe: Page 2 Business name: r) . cA Address: - 1 v u.rh S1 ' . �� Each additional inspection over allowable in any of the above , n^/ 1 ' Per inspection 62.50 City /State /ZIP: -' ] G t ' 1 , / q ') ' rte{ Investigation per hour (I hr min) 62.50 Phone: LH — IQ t D._ Fax: ( ) v � J Industrial plant per hour 73.75 J ' c/ `�' :` : ,r� r. ,Y.. ELECTRICAL ;,PERMIT• " • CCB Lic.: L / 21, ry Electrical Lic. K.,1 Suprv. Lic.: e .5j Subtotal Suprv. Electrician signature, required: — / Plan review (25% of permit fee) C��C-„ . en State surcharge (8% of permit fee) Print name: I Date: TOTAL PERMIT FEE Authorized signature: This permit application expires if n permit Is not obtained within 180 t _, �/� - 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. is \B ding \Permits \BLC- PermitApp.doc 12/03 440.4615T(10 /02/COM /WBB /45 To2 dv y - Mechanical Permit Application FOR OFFICE USE ONLY .' ' City Of Tigard Received Penult No.: t 1312S'SW Hall Blvd., Tigard, OR 97223 : Plan Review Plan Re Phone: 503.639.4171 Fax: 503.598.1960 /c,, i ! A Date/By: Other Permit: Inspection Line: 503.639.4175 ,.11� Internet: www.ci.tigard.or.us _ Date Ready /By: ions: li3 See Page 2 for g Notified/Method: • Supplemental Information ,TYPE'OF: ,C-0.. f' , Y�',. • \!!•:`' 'COMMERCIAL:•FEE. ;SCH �USE'C IQ,I T. • New 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. ;1 , ,,,.... �.,•;;'r fic' =, : :•`;; .,•, -,.,. ,, _ _ "C'ATE97 /1t %O: : :CUNSTM7CR ••:' 1.;.; , .•. "` Value: $ .''. RESIDENTIAL,EQUIPMENTI SYSTEMS FEES* J 1 - and 2 - family dwelling El Commercial /industrial ❑ Accessory building ID ❑ Master builder ❑ Other: For special information use checklist. Description I Qty. I Ea. I Total JOB 'S ITE ' ;INF ORMATJON;?;•AND IIiOCATION i . i3;; i; = �. "; °:;:: `. Heating/cooling Job site address: 12'1°11 $ Rte. SVm A Air conditioning heat pump �� (requires site plan showing placement) 14.00 City /State/ZIP: a, ! TAJAI)g- Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: } VVVui11 1 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 BLI Other: 10.00 Tax map /parcel no.: Other fuel appliances ;t .;,•;. = . *_p,,..} o i , rD z - , - 4. . .:::=`li l,,; .% s ; :.r; ,; �,,,* } f �> �, • ,., -, iR - .. ESCRIPTION UP? WURIfs�. ^' : ti.' . ".�} t,. ! Water heater 10.00 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 PROPERT :- , ' 4?' - R' , , . 4 , - . •F Chimney /liner /flue /vent 10.00 F,'a;�tr:: . L,T,ENANT - � �' 4 .`' ;' 7 '': ,.. Other: 10.00 Name: \ s - A5 t / OM V fr Environmental exhaust and ventilation r� � Range hood /other kitchen Address: VSJ" / 1 L �(((��� equipment 10.00 City / State/ZIP: i Int a')O ?7 'E Clothes dryer exhaust 10.00 ( // Single -duct exhaust (bathrooms, r Phone: -� � Fax: (".6 1'- toilet compartments, utility rooms) 6.80 • ` - i s ` `'; 't r'-``I: `r ` , . f`•, ;: -' • " °:' Attic /crawls 10.00 ace fans „i ,; y.:. ®. k L"IC:4N`C' . ' ,•,, i !.:..1 :. 7 ; '...'''.:.•,.`..,:.,. . ` , ', ON I1A RS ; i0 . ' . . -. Attic/crawlspace 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 •CONTRACTOR'';,. . ; .: , . :,� : : ;: ..... Barbecue _ (I _� Clothes dryer (gas) Business name: (1 � I- ( ii `�' Other Address: Po l �1 LI .'.' ', : `'. MT dielq*AL P FOO k' ,` : City /State/ZIP: \ i ' & . 9 - U r 1 ` 0)1(2-' 't -20t5 Subtotal Phone: 5 2 ii l Fax: ( ) Minimum permit fee ($72.50) �1 Plan review (25% of permit fee) CCB lic.: 5(22') _ State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: rmi',w�� This permit application expires If a permit is not obtained within 180 days after it has been accepted as complete. Print name: it� =�/ 1 w/ l Date: 1Z Mii , • Fee methodology set by Tri -County Building Industry Service Board i:0 a\Pem»1s \MEC- PcnniIApp.doc 12/03 440.4617T(11 /02/'SM/WEB) .11 44rz-oq-crogo.5 . ....,_ LA, AAAAAAAAAAAAAAAAAAAAAAAAAA.AAAAAAAAAAAAAAAAAAAAkAAAAAAAA:A.A ■ ■ • 10 1 , 1 l■ . - ■ . . 1 STREET TREE CERTIFICATION . - , A i . .... I, ____ ZiADALf fri oef t( (PLEASL Pl?lal) , ()wild" Agent or 1 f Do-) 4 .6 (PERMIT !WIPER) • t I 1)0 hereby (6114 Wt - the ((M)wing location 1 1 meets City of '1'igar(l/WasItington County - • A I . A land use and development standards for street. tree installation. 1 . . ADD' RESS: i 1 1 -1 LOT: SUBDIVISION: 51A /44. &I ; si-• ii 1.7 I --- — .., • , 4 ItY:. A . MM.: 4_74P 135 [ 1 ikliCiiIVED BY:. DATI.: 1... APr"e-V--**Wf-fTYY•TYY*1"IVVVYVYTYYTVIrTIViiiinfirirT0i/M7VYYVYTTYVYTYTTYY1 CITY OF TIGARD BUILDING DIVISION - PERMIT #: MST2004 -00405 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005 Phone: (503) 639 -4171 U Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 58 SITE ADDRESS: 12797 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 034 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES, PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: Inspection Request Scheduled For: Date: 4/25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 005272 -01 503- 209 -4837 N Corrections/Comments/Instructions: PASS 0 `ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL . CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED e Inspect • r: / /- z. Date: v•hone #: (503) 718- 1 i 6 " d CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00405 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005 Phone: (503) 639 -4171 ova: i ' r Ef : { ;�I� I Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 57 SITE ADDRESS: 12797 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 034 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES, PHONE #: 503 -387 -753$ CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: Inspection Request Scheduled For: Date: 4/25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 005272 -02 503 - 209-4837 N Corrections /Comments /Instructions: LAr� , �-% - -- � i �! PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Th1, Date: hone #: (503) 718- CITY - OF TIGARD BUILDING DIVISION PERMIT #: MST2004- 00405 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005 Phone: (503) 639 -4171 J ' `et l Inspection Requests (24 Hrs.): (503) 639 -4175 - ' "f �� /0 INSPECTION WORKSHEET FOR DATE: 4/27/2005 TIME: 7:11AM PAGE: 58 SITE ADDRESS: 12797 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 034 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITIES, PHONE #: 503.387 -7538 CONTRACTOR: DON MORISSETTE HOMES INC PHONE #: Inspection Request Scheduled For: Date: 4/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 005458 -03 503 - 2094837 N Corrections /Comments/ Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �� Date: 0 1 7 2:7/d S Phone #: (503) 718- CITY TIGARD C_ BUILDING DIVISION PERMIT #: MST2004 -00405 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/31/2005 Phone: (503) 639 - 4171 �I�ti\ Inspection Requests (24 Hrs.): (503) 639 -4175 ! ��i '':_.. INSPECTION WORKSHEET FOR DATE: 4/27/2005 TIME: 7:11AM PAGE: 59 SITE ADDRESS: 12797 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 034 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSt I I t COMMUNITIES, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSEUE HOMES INC PHONE #: Inspection Request Scheduled For: Date: 4/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 00545802 503 - 209-4837 N Corrections /Comments /Instructions: 1 • / ' i c it /4 , / / er 7 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 14/I UtC. Date: 4 7 2-7 7 1C- Phone #: (503) 718-