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Permit &Val /o6 -2 31-e., o2Q Ale_ 1 � 1‹...__ !. �-Lb . � C I OF T' G A R D MASTER PERMIT PERMIT #: MST2005 -00007 ; ,, In DEVELOPMENT SERVICES DATE ISSUED: 2/16/2005 .,�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 109DA -08600 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST ZONING: R -7 SUBDIVISION: SUMMIT RIDGE LOT: 080 JURISDICTION: TIG Project Description: New SF. 4/27/05: Added (1) sink & (1) A/C unit. BUILDING REISSUE: DM162 STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 18 FIRST: 1,665 sf BASEMENT: sf - LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 430 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 110t0: sf RIGHT: 5 VALUE: 166,702.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,665 sf REAR: 15 PLUMBING SINKS: 2 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: • OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 VENT FANS: 2 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: 3 201 • 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: 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: This permit is subject to the regulations contained in the Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes DON MORISSETTE COMMUNITES LLI 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: $ 7,509.73 1- 800- 332 -2344. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued : 1 _ _ Al i�L..:.L. Permittee Signature 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. • - ....____, D ON - MORISSETTE OBE: 3546 HOMES INCORPORATED n : 11111 4230 GALEWOOD STREET LAKE OSWEGO, OREGON 97 (503)37-7538 FAX (503)387- 7 5 LOT: 80 : 1 3 13 5 DATE: 12/17/2004 PROPERTY: SUMMIT—RIDGE CITY: TIGARD SCALE: 1"=20' - PLAN No.: 162 OPTION-2 ELEVATION S , W. Sun Ridge Street 506 l • 506 0 b "1 _ .. ... :: : .,:':......:•:,. H. _ _ ..... 4. — 504 — '0 1: Concrete •:1 6' P.U.E ‘ 1 EI\153 b I:Driveway .'.! Z REC N I p 21 2 05 • I : :-..'.. e . .: , ,:.'• .; :I FTIGNCICI .. ... . .:, GO ° vIS101 1 : 444 sq. ft. 0•00:1114"1 2 car gar. - F.F.E. 507' 0 1°1)(11114j - 05 0 4. . 1 g . 1.665 sq. ft. / 3 bdrm. 2 bath F.F.E. 507.5' .•.. 506 1– 1 1 r: I i la 1 L ..1 504 /1.11.1111111.1 502 1 1 10 ev e immillallEleggel_ _500 500 5 W.E. !..;_■.:,s'i; Ir.; TO !do!. r..,■:. -.N. ,......• -.-.. •:-.... 7.. 7-- 7- ',..' -...." • rig' ',6 • 491' 50.00' . . : 488 , LOT COVERAGE LEGEND :, 4 , : i:,:•::•:.:‘ ,?, :•-• , :,:_:, : : —!:::-:::-! NOTE: LOT #80 • 5250 sq ft. • : .' -r .: , i•:•.: : s •::::: ,.....!. :::i . ": 1 ' ' • • "." : ''': :..s. ,,..,• , ,,. :1. .:: ::::i::-.: : • 1.. ..ss • •'••.; ----mom■Niii,,mmm.b. ,. A CITY OF T I G A R D MASTER PERMIT PERMIT #: MST2005 -00007 VII; DEVELOPMENT SERVICES DATE ISSUED: 2/16/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST PARCEL: 2S109DA -SR080 SUBDIVISION: SUMMIT RIDGE ZONING: R - BLOCK: LOT: 080 JURISDICTION: TIG REMARKS: New SF. BUILDING REISSUE: DM162 STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 18 FIRST: 1,665 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 430 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 166 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,665 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 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: 2 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 FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 - 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: SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps - 1000x. 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: $ 7,494.61 DON MORISSETTE COMM UNITES LLC DON MORISSETTE COMMUNITIES I This permit is subject to the regulations contained in the 4230 GALEWOOD ST # 100 4230 GALEWOOD ST #100 Tigard other Code, State of OR. Specialty Codes LAKE OSWEGO, 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 rules are set forth in OAR 952 - 001 -0010 through Reg #: LIC 162512 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued = : IL i// _ x Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day , Building Permit Ap lic4t ' .' ' i fll < I 1 , 1 ' �til t► � % . "tD City of Tigard Received - _may ,/ `,� g Date/I3 i 61.-- Permit No..S-�� v a � t! 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review _ 3 ItiL Ai , Oth Pemut:^ .�� / / / / / d Phone: 503.639.4171 Fax: 503.598.1960: ,,, ,, t 7 a i 1 ,T ` ,', ; '' Date/I3 : M /t ✓ - - S Inspection Line: 503.639.4175 -t • ;; _ '!!ii , , ?'._ Date Ready /By: Suns: ® See Attached Checklist for Internet[ www.ci.tigard.or.us Gip( 01- Tlu »s �' l Notified/Method: : � � Supplemental information V f,.: + fIV1SION --r _ �"'= ?' ;F:. `�xN , ••. .i =.. r:.•,,..j,::;utig, . k; - ;:k ;.+ ,,„•, .•r �vS(, gy � per( F y, • New construction 1 ❑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 /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the >~' :;::. , ,,._e... work indicated on this application. ❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ — ❑ Accessory building [3 Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: ::fi • "+' ' i i1 ,. ,�; r •w, - s' .T. + i'•. r .,..a-,, k '! I � � . , � �[�1 . � y ((�y ♦ 1r � ]J It„,� I ' t Total number of floors: f ,. . -, i : . .:r.'St1 - 0`.>:,...1 •Tr 1u�n' 0 . : 41 1` .1,1*ifv , + > � • i'1M �— Job site address:/ 0 7 0 s- an P S - u - New dwelling area: It /�'- square feet City /State/ZIP: j ,)� ( - Garage/carport area: `� square feet Suite/bldg. /apt. no.: J Project name: aj, m m} "1 ' Covered porch area: - square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet fit t at$l !.:1 �'i�)fyy .-6biTh • . ,. CIs G ty ' nlsT i 4 41 ' - JLi - r Subdivision: Lot no.: 8'(' Permit fees• are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all fax map /parcel no equipment, materials, labor, overhead, and the profit for the i'v s . - k . 1e ?1" '' ; LJ k. V 4 P " :: ; ` • .,,. t . ' , indicated on this application ;4 CRI>ltti . :.. • work i . - _ Valuation: $ Existing building area: square feet • New building area: square feet r `�ri a- s syx r i� i � _: '. a"' f , ..t', , ...t Number - a a u iy :,� h� 5: w e of stories: Name: 1'1 1 lei Co rn Ur des Type of construction: r &tress: � ( 1 a I , AO GT. cJ ( G . i. Occupancy groups: f. t■• /State/ZIP: Li, • _ 1 . 0 7O Existing: -_ I , ,ne: ;' � 7 � 5 I Fax: ( e3) 3i)7._ '-7 / o _1 New: g -- - -- ( � • s .: s Y.� 8i Qlli�` - �r�:aF,�.�,, �, K....4,. , v ,.. • ,,. 5 ) 1 ► E NS ket5\ v 5 ' 11 t.:ra rs } a sub :c a does are e. ' ? ' t Ii ,,siness name: All contractors and subcontractors ae required t be -- ,, o itact name: licensed with the Oregon Construction Contractors Board - under ORS 701 and may be required to be licensed in the Ai ;dress: _ jurisdiction in which work is being performed. If the C1ty /State/ZIP: applicant is exempt from licensing, the following reasons - -- apply: P,..me: ( ) Fax: : ( ) `- L-mail: ypp`y��,,\ - -- Business name: i �� • . . ';r. . •.. ,. . ,B'UIir FEES* Address: — Please refer to fee schedule. City / State/ZIP: -` Phone: ) --1 -� Fax: ) - Fees due upon application - P - -- Amount received CCB tic.: °I �r "7 Z - - - -- - Date received: Authorized signature: ` ' ` `1 • , ( ta, % This permit application expires if a permit is not obtained r within 180 days after It has been accepted as complete. Print name p " f- a AM Date: Z iiipq • Fee methodology set by Tri- County Building Industry Service Board. , \ Building \Pemuti PermnApp.doe 12'03 440.4613Tt I 1/024COM/ WEB) ./14657 t 7 Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / � artr t\ Date/By: Other Permit: Inspection Line: 503.639.4175 1 J. 1 _ Internet: www.ci.tigard.or.us _ Date d/ o: Juris: See Page for g Notified/Method: • Supplemental upplemental l Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST X I 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. CATEGORY OF CONSTRUCTION Value: $ and 2-family dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES* l y g ❑ ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. 1 Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling � � Air conditioning or heat pump Job site address: l il.A) n In t � lc i Eft • _ (requires site plan showing placement) 14.00 City / State/ZIP / U ✓✓✓ Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: SurtiniA ' c4 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 so Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK 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 PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00 yn'` r Other: 10.00 Name: \ `I �� 1ra Co h1Yht/i1 t - he 5 Environmental exhaust and ventilation / ',� / r r _'1_. 4'2\6' I � Range hood /other kitchen Address: (J�v �T equipment 10.00 City/ State/ZIP: / 'i at riO�S Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: -- )S -- 6 p Fax: ( 01 —2 (01 toilet compartments, utility rooms) 6.80 ❑ APPLICANT v ❑ CONTACT PERSON Attic/crawlspace fans 10.00 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 Business name: (j `Ltia ` r / � l `�' Clothes dryer (gas) ` /� Other: Address: PO ( 1 J f L ^ ( OW_ /� /�] ,, MECHANICAL PERM FEES* City /State/ZIP: `f Pi..9 1" \ ` �/I� CL --- ,a 5 Subtotal t Fax: ( ) Minimum permit fee ($72.50) Phone: a5 �) Plan review (25% of permit fee) CCB lic.: . )72 State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: k� eWI' M� This permit application expires If a permit Is not obtained within 180 days after It has been accepted as complete. Print name:,. EIDA Date: 1 z • Fee methodology set by Tri- County Building Industry Service Board i:\Building \Permits \MEC- PermitApp.doc 12/03 440.4617T(I1/02/C0M/WEB) , 457 - ge e5- OV`or97 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received Permit No.: Plan Re 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /4 '0 II Date/By: Other Permit: Inspection Line: 503.639.4175 . "IL Date Ready/By: luris: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK • PLAN REVIEW New construction ❑ Addition /alteration /replacement Please check all that apply: !!!!!! Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential t - 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 JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑ `k lu structures or ❑Egress/lighting plan P Job no.: 3lL11 Job site address: CIA) Axn '17 y ► S--, ❑Health -care facility ❑Other: � Q Submit 2 sets of plans with any of the above. City /State /ZIP: ' 't'1 O �Jt � ' U The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: S Project name: Q rD ' 1 FEE* SCHEDULE U>rl 1 f.1C9 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.: go Ea. add'I 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 DESCRIPTION OF WORK 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 PROPERTY OWNER __ ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 ... 6, � \ Cb rl)/ !�1/�11 l es 601 amps to 1,000 amps 240.60 2 Address: maw lJ� ) l� , l x Over 1,000 amps or volts 454.65 2 �/ Reconnect only 66.85 2 City /State /ZIP: Lam U Og- q r- )0 I DS Temporary services or feeders installation, alteration, and /or Phone: ) --- Fax: j�)0 — - 71 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 ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with Business name: service or feeder fee, each branch circuit 6.65 2 Contact name: B. Fee for branch circuits 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 - CONTRACTOR energy panel, alteration, or n , extension. Describe: Page 2 2 C Business name: ae. r Address: MOD SAN Wry 40] ' 1 .r�-7 Each additional inspection over allowable in any of the above J 7' Per inspection 62.50 City /State /ZIP: a/1(... /'r L 1 Investigation per hour (I hr min) Industrial plant per hour 62.50 Phone: Z-1,32-0g_ �,Crr Z-1,32-0g_ . ; v ` t D. FFax: ( ) J 73.75 �/ ELECTRICAL PERMIT FEES* CCB Lic.: � Electrical Lic40,� Suprv. Lic.: .a5 Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print C��C Z State surcharge (8% of permit fee) rint name: Date: 1 ' / n 2 �/ b 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 4615T(I0 /02/COM/WEB AL 57- -?rzo s -'7 ` Plumbing Permit Application FOR OFFICE USE ONLY City of Tigard Received y Date/By: No.: 13125 SW Hall Blvd., Tigard, OR 97223 // Plan Review Phone: 503.639.4171 Fax: 503.598.1960 10 1, �Il Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 �, '. Jura: ® B ., Date Ready /By: See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE I�New construction ❑ Demolition For special information use checklist. ` Description Qty. Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 141 - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 5tA) SuniYru t "P-15 11- Catch basin or area drain 16.60 City /State/ZIP: I I 1.1- I Da 47714 Drywell, leach line, or trench drain 16.60 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: SUn'I1n r t ( 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.: Water service (no. linear ft.: _) Page 2 Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 PROPERTY OWNER ❑ TENANT Drinking fountain 16.60 Name: /� ,.� ��7 Ejectors /sump 16.60 I" tfJV� )5 t�[�I� n! es Expansion tank 16 60 Address: � �' �, I Fixture/sewer cap . City / State/ZIP: �� /It �f 10 C � 7 �- Floor drain /floor sink /hub 16.60 Phone: ) )) 2P 7 70. � l Fax: 6-2 .. - S Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 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: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: f ` Y �� s? " ✓ k d u b6 - Water heater 16.60 Address: ' t, Other: City /State/ZIP:.Etleitt Subtotal C:05 )G9.2-ti „ L - 3 ` ( Minimum permit fee: $72.50 Phone: �1 )' � Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: f Us-7f1 tnlnbing Lic. no.: �� ,3j0120 Plan review (25% of permit fee) Authorized signature State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: J �J 1 - I 'v �j Date: 12 4 LAW 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. i:\ Building \Permits \PLM- PcnnitApp.doc 12/03 440 -4616T(10 /02/COM/WEB) • Sep.20. 2005 11:02AM CLEAN WATER SERVICES 503 6814439 No.9232 P. 2 Permit #:05 - 002778 - 00 - PE CleanWater Services Our i•ommirmenl r.IrAr. nspection Request Linc: 503 -681 -4444 Iii I0 SW O IORSbo 97123 o Highway 4 hour notice required uired for all inspection Ph: (503) 681 -3600 • Project Name: SUMMIT' RIDGE, LOT 80 Project Address: 12970 SW SUMMIT RIDGE ST Issued By: Nicholc Vandcrzanden 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. • Owncr Applicant Contractor DON MOH ISSE ruk HOMHS INC DON MORISSETTE HOMES INC NONE 4230 GA].EWOOD #100 4230 CIALRWool) #100 LAKE OSWEGO OR 97035 LAKE OSWEGO OR 97035 Number of N:quivalent Fixture Units (FU)...........16 Number of Sq Ft 2640 Treatment Plant I )urham Water District Tigard TOTAL • • • • I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS CORRECT. SIGNA7'UItE: Date: DON MORISSETTF. HOMHS (NC • I I AI L AAAAAAAAAAAAAAAAkAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAkA l' • F 4 ■ - A • 10 ,A ■ ' • -1 _ STREET TREE CERTIFICATION , A : ; 1 H . 1 I, _ owner/Aria for ..,--- ? ikto-i5seTre Cp..vt......14-4 tc_.',_/ , , (pLE/isi: /RIM) (PERMIT HOLDER) I I .., I ■ I .4) I I CIA y Cat i l'Y (It 1.11C 1(11()W11) 1; I( )Cal iffil 1 ' 1 meets City of Tigard/Wlshington Comity Al Ltnd use And development stintdards for sired I FCC 111StAlati011. I 1 ADDRESS: 12-9:70 Iv" LA.iv.vsii iel'olc s'i•-• . ,.. i LOT. /40 sithDivislori: ' kli.(EIVET) BY: FT-******---*TIVTYTTVTTIIVVITYVTIFTTIFVTTV*VTTTVTi-/iVVVYTIFTYVYTTYTIFTT1 ' CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 &00007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2005 Phone: (503) 639 -4171 4„u� �'I� 1� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 91 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 080 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. 4/27/05: Added (1) sink & (1) NC unit. OWNER: DON MORISSETTE COMMUNITES LLG, PHONE #: 503 -387 -7538 CONTRACTOR: DON MORISSE.I I . COMMUNITIES LLC PHONE #: 603"387 -7538 Inspection Request Scheduled For: Date: 4/29/2005 Pour Time: Q Code # Inspection Description Confirm # Contact # Message h 399 Plumbing final 005630 -02 503- 519 -6452 Y W - 'be Corrections/Comments/Instructions: t _a��.4J ) 'r v Ui•1 , q%/ I 1 1 NI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: cro6.4.A. 114 r..--a.- Date: yl2 C ja--. Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: AMST2005 -00007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1612005 Phone: (503) 639 -4171 �nma.Giidf {.IIh Inspection Requests (24 Hrs.): (503) 639 -4175 1 `__.. INSPECTION WORKSHEET FOR DATE: 4/25/2006 TIME: 7:10AM PAGE: 55 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 080 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITES LLC, PHONE #: 503. 387 -7638 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 699 Mechanical final 005272 -04 503209.4837 N Corrections /Comments /Instructions: 42 cq�- C+- v <rr-: ` - P14---t 9t t=c:7, ,z/ 6.ori",,?1 ,':r - �J'�Z:..__ /,- 4,„r i9 te„... 4 . a a 'tflu✓LT ( (-F-,,,,- rz 0_ Lh1v751-T . ap ----. 1.,,ic.fie--c..7-70 Ai - c 4- - ''Y/ PASS r " ' PPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 - zr 65 Phone #: (503) 718- CITY OF TIGARD - - BUILDING DIVISION PERMIT #: MST2005 -00007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2005 Phone: (503) 639 -4171 / ' i� Inspection Requests (24 Hrs.): (503) 639 -4175 , 11- INSPECTION WORKSHEET FOR DATE: 4/22/2005 TIME: 7:12AM PAGE: 66 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 080 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITES LLC. PHONE #: 503 - 387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 503 -3B7 -7538 Inspection Request Scheduled For: Date: 4/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 005168 -01 503. 209-4837 N Corrections /Comments / Instructions: j)ft ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 V Q Date: 1 - 1 4e Phone #: (503) 718 - CITY OF TIGARD _ . _ . g kj-. 13 24 . BUILDING DIVISION PERMIT #: MST2005 00007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2005 Phone: (503) 639- 4171��4w�p � I n s pection Requests (24 Hrs.): (503) 639 -4175 ''__.. INSPECTION WORKSHEET FOR DATE: 4/22/2005 TIME: 7:12AM PAGE: 65 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 080 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITES LLC, PHONE #: 503- 387 -7538 CONTRACTOR: DON MORISSti It COMMUNITIES LLC PHONE #: 503 - 387 - 7538 Inspection Request Scheduled For: Date: 4/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 005168 -02 503 - 209 -4837 N Corrections /Comments /Instructions: A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-44 `V Og Date: 4 105 Phone #: (503) 718 - CITY OF.TIGARD BUILDING DIVISION 411), PERMIT #: MST2005 -00007 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/16/2005 U '�� Phone: (503) 639 -4171 9a•�4; ii� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/25/2005 TIME: 7:10AM PAGE: 56 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: ON TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. OWNER: DON MORISSETTE COMMUNITES LLC, 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 1 299 Final inspection 005272 -03 503-209-4837 N Corrections /Comments /Instructions: PASS PROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 5-- Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION s PERMIT #: MST200&00007 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2005 Phone: (503) 639-4171 ., Inspection Requests (24 Hrs.): (503) 639 -4175 "__.. INSPECTION WORKSHEET FOR DATE: 4/29/2005 TIME: 7:11AM PAGE: 92 SITE ADDRESS: 12970 SW SUMMIT RIDGE ST CLASS OF WORK: SUBDIVISION: SUMMIT RIDGE LOT #: 080 TYPE OF USE: PROJECT NAME: SUMMIT RIDGE DESCRIPTION: New SF. 4127/05: Added (1) sink & (1) NC unit. OWNER: DON MORISSETTE COMMUNITES LLC, PHONE #: 503-387 -7538 CONTRACTOR: DON MORISSETTE COMMUNITIES LLC PHONE #: 603 387 "7639 Inspection Request Scheduled For: Date: 4/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message � / 1 II/ 699 Mechanical final 005630 -01 503. 519 -6452 Y o� Corrections /Comments /Instructions: I . AC ( n /T (4 � 12a�!* _! .-r�e 10 ✓ -v „4 _ i otree - ;0 ✓.1 dl IcIoC tk PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ^ tk■ w' Date: LI/2 q I of Phone #: (503) 718-