Permit A • MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2004 -00409
lu t DEVELOPMENT SERVICES DATE ISSUED: 2/7/2005
�'I �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST PARCEL: 2S109DA -SR079
SUBDIVISION: SUMMIT RIDGE ZONING: R -7
BLOCK: LOT: 079 JURISDICTION: TIG
REMARKS: New SF.
BUILDING
REISSUE: DM199 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.730 sf GARAGE: 609 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 TURD: sf RIGHT: 5
VALUE: 321
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,300 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 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: 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: 6 201 • 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 +amp6•1000v MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 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: $ 8,780.06
DON MORRISSETTE COMMUMITIES DON MORISSETTE COMMUNITIES l This permit is subject to the regulations contained in the
4230 GALEWOOD ST # 100 4230 GALEWOOD ST #100 Tigard Municipal Code, State of OR. Specialty Codes
PORTLAND, OR 97035 LAKE OSWEGO, OR 97035 and all other applicable laws. All work will be done in
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 162512 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
Electrical service /recor Foundation walls Interior shear walls Crawl drain Storm drain Mechanical rough -in
Electrical rough -in Post/beam structural Framing Post/beam plumbing Plumbing final Mechanical final
Low voltage Underfloor insulation Insulation Plumbing rough -in Sanitary sewer
Electrical final Shear walls /anchors Approach /sidewalk Water service Post/beam mechanical
Footing Exterior sheathing Final inspection Rain drain Gas line
Issued By : Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
I • Building Permit ApjligtU IVED FOR OFFICE USE ONLY
ity of Tigard , Received
Date/B : ,, --„. , (1 . Permit No.k ... "O / y iei
13125 SW Hall Blvd., Tigard, OR 97223 DEC 2 7 2004 Date/B
Plan Review
Phone: 503.639.4171 Fax: 503.598 OF TIGARD .411141t Date/By: Inv Other Permit .,,i gc
Inspection Line: 503.639.4175 0 Date Ready/By: 41 2 , // , • -lurk: El See Attached Checklist for
Internet: www.ci.tigard.or.us BUILDING DIVISI e ; 77' --' Notified/Method: 1 k ----- J Supplemental Information
. 4 0 ,
— • dr • _.■ -- V
.!;: . , .. " • 7 .:' % : :::: .:::.: '. '‘: ' ;icit.#014tg f, :1'''', ''''':' :::': , 40.P . 4 1 ,AtiO4 1 .:.,:;;tt.. 1 4 1 `:100•A *.,1e4 08:vkixiNg
New construction
X 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
'''' . ': ''''''''':'''''''''• 6k7fidicaA,, f.a.'lecii■iiiiilerizHi(*;!;::-;.,;,zP,3,.:=;:,,•,,,,,.•:;,-,--;:-;:,:::.ii.,;:v:,,,,,, work indicated on this application.
and 2-family dwelling 0 Commercial/industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms: 14
0 Master builder 0 Other: Number of bathrooms:
', i e/11' c ' •:., • ,''''. '-i--''' .. .4011,Sflt.' , 11■IFORMAT I;
ION: AND LOCATION ' ''''''''' "'I'i -''' ' ':' '1 '-' Total number of floors: 2-
q q
, .,,::.,,!.-- ;,' t ' ,,:::.i. -...:,... .:,t . , c I.. 1. ;,L,:..., 4 A ;-.- ■ -•:, t , ;' • .. - :•,'•-:,-'' .` ' .: ',,, ;,11 .' 1 , ?ArCi t., !Th";. , ','
Job site address: 1 2_ -2, Svj Ain
or tm a0 4.1. in t i gie. &t, , New dwelling area: % 120 square feet
City/State/ZIP: ITUG Garage/carport area: square feet
Suite/bldg./apt. no.: ' Project name: mo ot -p Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
. REQUOLlaktiAThiiCOMMERCIAIAJSEIGFIEGICLISfr:'
Subdivision: Lot no.: 19 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
tig ili
' ;l work indicated on this application.
: ' ..:•`,.... ' ': ‘ ■; 1 (1 '', :, ... _ . .
Valuation: $
Existing building area: square feet
New building area: square feet
;-2, , i, 11..;; TapPirj*„ Number of stories:
Name: tritor-i- . 0).....rfmunervics Type of construction:
es
Addrs: 4-fd.b( ( ) b _ c..-- ( k.
ix
Occupancy groups:
City/State/ZIP: LiNe -C-- U-34.4-3...10 OK. e1 7035 ,
Existing:
Phone: ( ftn, -7,cb--) ' 75 -.5? Fax: ().3)--7--.---2/As New:
';,.'.- ..: • .• - .c. .;-- } 'Ill 'APPUICAli,1;:'' ..i+. ,. --.',(t.':„ 1 i, itONTWOU'll i ZASON:' .:.' ; , ; p,,, .. .,,,,',. :v ,; ,,,,; ..; :',',.'. • •-•.‘ . ..-,' , .,. •;,_..,'
NOTICE
Business name: 5K-1-1,e iks p\--aNe 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
Cit y/State/Z1P: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:
E-mail:
, .. •-•,--:!%.'..••:': :.. , ;' • ,'- .; , .c , :,.' CONTERACFOR"..c.'' ,-,.. , .n..-.:': :•• ' , :,:;1.,;zs' `:•:.s.?..2;•xi..,.;::.
Business name: 51-4C. ...., PC PC159\fe, : .':' - '.': -::,, ''''''-'r - , L'' .. Y ; ;''':'131J11611■16TiiiiMii .. i?Ei,,i': '; . . ' . . —
Address:
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
. Amount received
CCB lie.: , R•2
Date received:
Authorized signature: Ala This This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: -,_)e iNi F-ITZ: 01:)C2K, Date: illul04 * Fee methodology set by Tri-County Building Industry
Service Board.
i: \ Building \ Permiis \ BUP-PermitApp.doc 12/03 440-4613T( I I/02/COM/WEB)
____
r sracio % -
I ,Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard ve
Receid
Date/By: ecve Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 //Naa + '\ Date/By: Other Permit No.:
24- Hour Inspection Line: 503.639.4175 ' I
Internet: www.ci.tigard.or.us Date Ready /By: Juris: See Page 2 for
g Notified/Method: Supplemental Information
- : ,TYP•e'OE "WOR:ieg: -, :: - , ,:•,'` ��" E • iCHEDULE.:
I�New construction ❑ Demolition For special inforatation use checklist
i _ 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`CONSTR'UCT.IbN „ ....: 4i ' +y;i' :- .:ai:i4:-- 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
'i ` JOB,, SITE _"INFORMATION „ _., . il \ ?j) s;:.' . !
AN D "..LOCATION , I' ;l •,° �, " , '1 Site utilities
Job site address: SW Sv M 1Z Catch basin or area drain 16.60
City / State/ZIP: 11171 tiia O R a 12. 2q Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: + I Project name: 1 . __ Footing drain (no. linear ft.: ) Page 2
SV rY'stlAw.rf �� s --,, j 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 ICI
Tax map /parcel no.: Fixture or item
: ,
4 t i .; " ..i
ar r� ,., ,, .. ...- - " ' • , ' + ; : .., .';
:',,!';'31..,‘...':', -;'r.h:,L g,' 'DESCR'IP11ION <OF. WORK'•` ,., , .1 " " Absorption valve 16.60
,
:w, ,- 1 - .' : ‘ :' E:x ... '` . ` -!" ' ?,:': \' ';t 4'7:';c ! Backflow preventer �,. p Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
,. .. ;,;,:. `.. _.. t:::,1 Drinking fountain 16.60
"® iPROPE,RTY'OWNERY' ,y ,. ^;' i '' : :, IIII ;TENANT '`';',;:';
Ejectors /sump 16.60
Name: VON`?7ft 9 .4 ,km Ini v n' a I Expansion tank 16.60
Address: . g 1' $y_ [ Fixture/sewer cap 16.60
City /State/ZIP: et c. 4 Floor drain /floorsink/hub 16.60
Phone: U.27) �7 7 Fax: 699 ?�(aI Garbage disposal 16.60
c: - Hose bib 16.60
r ...... .. r,�„ ^4s t , ! °3 '; '. CONTACT,':PERSONu'.t,
®;:APPLICANT. t , ;; ® , ;'.
:,• u• 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: ( ) Fax: : ( ) Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E-mail:
''''8::-:', •,i : •(' `, .yc% ; - =huh ? :,, ,..; yi ir ,; ; �,i,ca,r, .t {; '„r
Urinal 16.60
:.: CONTRACTOR :,r ,' .}' <bl. I
� ... •., ��' •:r•. Water closet 16.60
Business name: /vV_ n ? I� Water heater 16.60
Address: PO ,� L Other:
City /State/ZIP: �� C� Subtotal
( Minimum permit fee: $72.50
Phone: )�) `•� 3(.. Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: I O - f4 • inmbing Lic. no.: 3 •- 6 Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature � TOTAL PERMIT FEE
Print name: J N-1 1 • i\1 e Date: l��Icy This permit application expires if a permit is not obtained within
V I r 180 days after It has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
is \Building \Permits \PLM•PermitApp.doe 12/03 440.4616T(10/02/COM/WEB)
4467 —av yo9
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/Sy:
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /�,,, r iPglf)1' '\ Date/By: Other Permit:
Inspection Line: 503.639.4175 1. 61 Date Ready /By: luris: 121 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
• TYPE • OF 'WORK : '!; : .... :. PLAN REVIEW . . • •
g 0 Demolition ew construction ❑ Addition /alteration /replacement Please check all that apply:
❑ Other: Service over 225 amps, comm ['Hazardous location
- ft.,
< - ,..,_ .,•,.,,.... amps rating ❑B ngo sq.ft
.. - : ...- , -.•.::
CATEGORY '''OF - CONSTRUCTIONrf`. ' and dwellings residential
Service over 320 a rati uild over 10,000
���.i�=�:. •, : , . ��'j, of 1- a d 2 family dwell'ngs 4 or more new resident'
❑ 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';`INFORMAT ION. = • AND:' LOCATION = „- +!? ~.y; 1i; " ` ' , ; Egress/lighting RV ark
Z 1l !r ] ❑ a re facility ❑Other:
plan park
Job no.: Job site address:1�q [ - r Submit 2 sets of plans with any of the above. •
/
City /State /ZIP: 1 - 1 / The above are not applicable to temporary construction service.
Project name: -` �Af R . � , , c' ...;`;,`. , ' . : C ;'F < � • • 'EEE *'SCIiEDUtiE }'�.?�f; =ai � - ;, , -, �`�•`.`
Suite /bldg. /apt. no.:
V V �ti C Description r I Qty. I F. I Total I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. R. or less 145.15 4
Subdivision: Lot no.: "q Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: I Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
,' - '
,: :(' ' t
:, DE
:SCRIPTION' OF .WORK : . >:: ' .
;_,; ,., ' : ''
. .. ... ' ,' r ' _ . 'Y' , r r( 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 }+,;: 201 amps to 400 amps 106.85 2
'`;r�. '. Y_OWNER ?' 't:;d;� ° I.a�,.'.`,:. -. : ❑ ": `'. .
` 401 amps to 600 amps 160.60 2
Name: �� �� 1� }l �s 601 amps to 1,000 amps 240.60 2
Address: —1 g`w VY� v lam'►" , �^ ' , t Over 1,000 amps or volts 454.65 2
i� n w / , Reconnect only 66.85 2
City /State/ZIP: La, _ U, c /V zoS Temporary services or feeders installation, alteration, and /or
Phone: ) no?'-? Fax: ).) - '7& S relocation
v 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
;; a � ®' APPLICAN� :w'. ` ".'''` :.U',:;�, ' %u •: , "0NTACT,' _ � �; . :::. '
.: •;; A. Fee for branch circuits with
: A
;,'i ^ ; . . �+ + , i 'PERS :,,: c .
Business name: service or feeder fee, each
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: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
+'- �, , 'CON FR ",c� Lt.. ,:<< +�; ti s> iii ti energy panel, alteration, ;,;;;,,,, •.,,:��:;_ .� . .., . .t..., 'CI'l�R _ ,: ,,., , r . , .- tw ; t :, p� , Ip;•:�';::;.:'t•�.1t : •o';••,; gYP 2
.. extension. Describe: Page 2
Business name: ��• -
Address: ma) s v ' Lo ch E_ �� Each
additional inspection over allowable in any of the above
11 ' Per inspection 62.50
City/State/ZIP: ” - j C 4f t c 0 ;0:3 Investigation per hour (I ltr min) 62.50
Phone: (� .C/✓ L�'- ^ j Fax: ( ) Industrial plant per hour 73.75
t;''1.,? i;„ ';..; : % : ::
CCB Lic.: 1-0,1- Electrical Lic.KLI Suprv. Lic.: .Jl;95 Subtotal
Suprv. Electrician signature, required: — Plan review (25% of permit fee)
�l,���;� , , � /n I State surcharge (8% of permit fee)
Print name: / , Date:
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: ' 1 :yQ� , • Fee methodology set by Tri -Comity Building Industry Service Board
"• Number of inspections per permit allowed.
is \Building \Permits \BLC- PennitApp.doc 12/03 440- 4615T( I0 /02/COM/WBB
,/457 -vo Si-o
.Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit No.:
Date/By: 1 13 i 2 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /1+rz dA Date/By: Other Permit:
Inspection Line: 503.639.4175 N aJ,II t �4r / L Date Ready /By: Jura: 10 See Page 2 for
Internet: www.ci.tigard.or.us Notifted/Method: Supplemental Information
TYPEF.";W i40:;r; =,r ' COMIVI�ERG I
. ;, •. .. ,, 'O,, •+.. I, - ... ,, ...... ' ;Y.. . ....._ iia .. , i` ; IAL ` FEE. - CHEDUI:E:,,= 'USE'CHECICC,IST ;
g ew con struction ❑ 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.
, , ; Value: $
CATEGORY;tUF %'CONSTRUCTION,;; i.'i.; : s:'°
RESIDEN ;E /;SYSTEMS, • `',
Al and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building =
For special information use checklist.
❑ Multi- family 0 Master builder
❑ Other: P I Qty. I I
Description Ea. Total
JOB• SITE INFORMATIOPI;i; ` = ,,1a+" ,°':F :. : " '=r;; Heating/cooling
Job site address: V9't 2 c y� r - Air conditioning or heat pump
SIN 1►a1N/ � 1ts (requires site plan showing placement) 14.00
City / State/ZIP: d, ` U Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: S une , .E X 14c 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
s` ' :DESCRIPTION rOF: V e O ,- s ! ' ' :' ;° 'r ' 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
r. - „„ ; !; " T . Chimney /liner /flue/vent 10.00
; ,. . OWNER ,_!;; '.',;; {:u': ,:,...r'''';® T ENANT -
., , :• .. -. -: .: _. -,. . . . Other: 10.00
Name: E - 1 C Mnik i',4 Environmental exhaust and ventilation
Address:, /
p \ 6. Range hood /other kitchen
equipment 10.00
City/ State/ZIP: ; ' 1 i OP-- q - )CI Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone ) -7 Fax: (E0( - 7 tot toilet compartments, utility rooms) 6.80
' . ''• � ���, � :- 'S:'' "' � � '''" Attic /crawls ace fans
®• A.'" ' • -, T '• ' r?„ � . �+ ..,.. CONT'A►GT`'4P,ERS'ON'iis :" P 0.00
- ',�'� � � .;:'"s.`:-:.,- : �!• a - - - " : ,.� .f';t2 l ,d'N °. ..... ��: z. ..:.a�.: ':,, . "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
' : : CONTRACTOR" � ` . `, ; :' `••. ,' - .' Barbecue
/� � r r Clothes dryer (gas)
Business name:
�� [ �l �' r C�Y� "- 4�.� "� Other:
Address: pQ `�/� l i ,L f 11 „ . - .
l :': .� � ''• ri IE 'CAi,6ICAL ; `PERIVIITfFEES I" •' '
City /State/ZIP: V - T ` - ` v l2- 11 •7I L Subtotal
Minimum permit fee ($72.50)
Phone: 'a. e7 L1 Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 07) State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: �J'Wrif This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete.
Print name:MMA!_.l I IC-,( Date: nu.; • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- Penni1App.doc 12/03 440 -46I7T (I I /02/COM/WBB)
SeP.20. 2005 11:02AM CLEAN WATER SERVICES 503 6814439 No.9232 P. 4
C1eanWah' Scrviccs Permit # : 05 - 002780 - 00 - PE
c>uf r.nmmitmoli i, �i,,.. nspection Request Line: 503 -681 -4444
2550 SW Hillsboro Highway 4 hour notice required for all inspections
Hillshon , OR 97123
Ph: (503) 681 -3600
Project Name: SUMMIT RIDGE, LOT 79 •
Project Address: 12992 SW SUMMITRIDGE ST issued By: Nichole Vanderzanden
Type: Sani /SWM Connection Issued: Jun 29, 2005
Single Family Expires: Dec 26, 2005
Project Description: THIS IS ONE OF 7 LOTS THAT TIGARD MISTAKENLY ISSUED PERMITS FOR, THIS PERMIT
IS BEING SET UP WITHOUT FEES, TIGARD HAS ALREADY COLLECTED FEES AND THEY
SENT THE CHECK COVERING WHAT WE WOULD HAVE CHARGED TO SUE REYNOLDS,
Owner Applicant Contractor
DON MORISSETrE HOMES INC: • DON MORISSE:TIT HOMES INC: NONE
4230 GAI.Y.WOOo #100 4230 OAI.1,WOOU #I00
LAKE. OSWEGO OR 97035 LAKE OSWEGO OR 97035
Number of Equivalent Fixtnrc Units (FU) 16 Number of Sq Ft 2640
Treatment Plant Durham Water District Tigard
•
TOTAL
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I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS CORRECT.
SIGNATURE: Date:
DON MORISSE - In HOMES INC:
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CITY OF TIGARD •
1 BUILDING DIVISION PERMIT #: MST2004 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/2005
Phone: (503) 639 -4171 ��m4J�4'`
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 53
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 079 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUMITIES, PHONE #: 503-387-7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 - 387 - 7538
Inspection Request Scheduled For: Date: 4/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 005272 -06 603- 209 -4837 N
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ` l ,4- Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/2005
Phone: (503) 639 -4171 :
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 54
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 079 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUMITIES, PHONE #: 503- 387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -387 -7538
Inspection Request Scheduled For: Date: 4/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005272 -05 503-209-4837 N
Corrections /Comments /Instructions:
PASS N PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: _ Date: Z� w "6 Phone #: (503) 718 -
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CITY OF TIGARD
u BUILDING DIVISION • PERMIT #: MST2004 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/2006
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Phone: (503) 639 -4171 ti..� I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/28/2005 TIME: 7:24AM PAGE: 42
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 079 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUMITIES, PHONE #: 503.387 -7638
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503-387 -7538
Inspection Request Scheduled For: Date: 4/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 005574 -01 503- 209.4837 N
Corrections/Comments/Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4- f-8 -46'" Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION #: MST200400409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/2005
Phone: (503) 639 -4171 li tl , ; , ,,;i i i i .: :
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/512005 TIME: 7 :16AM PAGE: 26
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 079 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUMITIES, PHONE #: 503- 387 -753B
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503- 387453B
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5/ 42005 U
Inspection Request Scheduled For: Date: Pour Time: a to
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006180 -15 503 - 619-6452 Y
Corrections /Comments /Instructions:
,:/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: \/6• v Date: /CA Phone #: (503) 718 -
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CITY OP TIGARD !
BUILDING DIVISION ■ PERMIT #: MST2004 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/7/2005
Phone: (503) 639 -4171 ;����.�,' ��
Inspection Requests (24 Hrs.): (503) 639 -4175 `'
INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 63
SITE ADDRESS: 12992 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE LOT #: 079 TYPE OF USE:
PROJECT NAME: SUMMIT RIDGE
DESCRIPTION: New SF.
OWNER: DON MORRISSETTE COMMUMITIES, PHONE #: 503 -387 -7538
CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 5(3'387-7638
Inspection Request Scheduled For: Date: 4/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 005680 -01 503-519 -6452 Y
Correc ions /Comments /Instructio •
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❑ PASS ❑ PARTIAL APPROVAL 1K CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED '
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Inspector: Date: `� v ' a Phone #: (503) 718-