Permit 0
a CITY OF TIGARD MASTER PERMIT
o COMMUNITY DEVELOPMENT Permit#: MST2010-00017
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/25/2010
Parcel: 2S104AD05900
Jurisdiction: TIGARD
Site address: 12918 SW SEVILLA AVE
Subdivision: WALNUT CROSSING Lot: 6
Project: Walnut Crossing
Project Description: New SFR.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 2078 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 19 Bathrooms: 3 Second: 512 sf Garage: 460 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: sf Value: $286,550.06 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0
Drains: 0
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100
Bckflw Prevntr: 0
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/ Svc or Fdr: 0
Ea add'I 500 sf: 5 20 1-400 amp: 0 201-400 amp: 0 1st W/O Svc/Fdr:
Limited Energy: 401-600 amp: 0 401-600 amp: 0 Ea add'I Br Cir:
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
CASA TERRA LLC PAHLISCH HOMES INC 1 MST Ersn Cntrl 503-681-4444
PO BOX 1082 63088 NE 18TH ST #100
CLACKAMAS, OR 97015 BEND, OR 97701
PHONE: PHONE: 541-385-6762
FAX:
Total Fees: $15,976.26
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0111000. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: e 1 ~vY l 1/ 1 1 VJC ~/L>~ Perm ittee Signature:
r is
Building Permit Application RECEIVED
Residential ,
FEB 0 2 t
Ci of Ti and 2010 Received Permit No.: 00
l
" ° 13125 SW Hall lvd., Tigard, OR 972 Pan Review
o Y OF TIGARD Dat 2 l0e* t: 0.006
Phone: 503.639.4171 Fax: 503.598.1
Inspection Line: 503.639.4175 BUILDING DIVISION Daze Ready : 13 See Paget for
Internet: www.tigard-or.gov Notified1Method Q ID Supplemental Information
TYPE OF WORK REQUIRED DATA: I- AND 2-FAMILY DWELLING
® New construction ❑ Demolition Permit fees' are based on the value of the work performed
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other. equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this appl ion.
Valuation:
E l -and 2-family dwelling ❑ Commercial/industrial '
❑ Accessory building ❑ Multi-family Number of bedrooms:
❑ Master builder ❑ Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 12918 Sevilla Ave New dwelling area: 2590 square feet
City/State/ZIP: Tigard, Oregon 97223 Garage/carport area: 460 square feet
Suite/bldg./apt. no.: Project name: Walnut Crossing Covered porch area: .444 ZI(p squarefeet - .2
Cross street/directions to job site: Walnut & Sevilla Deck area square feet . C
Other structure area: square feet ci
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: Walnut Crossing Lot no.: 6 Permit fees' are based on the value of the work performed.
Tax map/parcel no.: 2SI04AD05900 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Construct new single family home on lot.
Existing building area: square feet
New building area square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Pahlisch Homes Type of construction:
Address: 63088 NE 18th, STE 100 Occupancy groups:
City/State/ZIP: Bend, OR 97701 Existing:
Phone: (541)385-6762 Fax: (541)385.6742 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Pahlisch Homes All contractors and subcontractors are required to be
Contact name: Jason Spence licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 63088 NE 18th, STE 100 jurisdiction in which work is being performed If the
City/State/ZIP: Bend, OR 97701 applicant is exempt from licensing, the following reasons
apply:
Phone: (541) 385-6762x101 Fax:: (541) 38S-6742
E-mail: jasons@pahlischhomes.com-
CONTRACTOR
Business name: Pahlisch Homes BUILDING PERMIT FEES*
Address: 63088 NE 18th, STE 100 Pfmsereerto eesckedule
City/State/ZIP: Bend, Oregon 97701 Structural plan review fee (or deposit): $750.00
Phone: (541) 38S-6762 Fax: (541) 38.5-6742 FLS plan review fee (if applicable):
CCB lic.: 42067 Total fees due upon application: $750.00
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Jason Spence Date: 2.2.10 Fee methodology set by Tri-County Building Industry
Service Board.
L\,Building\Permits\BUP-RES PermitApp.doc 10/01/09 4404613T(I 1/02/COM/WEB)
t~
• f Mechanical Permit Application 0- %'l
Received
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
C Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
h., Inspection Line: 503.639.4175 Date Ready/By: rurin: ®See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
TYPE OF WORK COMMERCIAL FEE; SCHEDULE - USE CHECKLIST
® 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: $
EQUIPMENT / SYSTEMS FEES"
® 1-and 2-family dwelling El Commercial/industrial ❑ Accessory building RESIDENTIAL For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ia. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12918 Sevilla Ave Air conditioning
(requires site plan showing placement) 46.75
City/Statc/ZIP: Tigard OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100 000+ BTU (ducts/vents 54.91
Suite/bldg./apt. no.: Project name: Walnut Crossing Heat um 61.06
Cross street/directions to job site: Walnut St. & Sevilla Ave Duct work 23.32
H dronic hot water stem 23.32
Residential boiler (radiator or
h dronic 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Subdivision: Walnut Crossing Lot no.: 6 Fluelvent for any above 23.32
Other: 23.32
Tax map/parcel no.: 2SI04AD05900 Other fuel a liances
DESCRIPTION OF WORK Water heater 1 23.32 23.32
1 33.39 '7j3~
Gas fireplace
Install new service for new residential single family home Flue vent for water heater or gas
fireplace _ 23.32
Lo lighter as 23.32
Wood/ pellet stove 33.39
Wood fire lacelinsert 23.32
® PROPERTY OWNER ❑ TENANT Chimne /liner/flue/vent 23.32
Other 23.32
Name: Pahlisch Homes Environmental exhaust and ventilation
Address: 63088 NE 18th Range hood/other kitchen
equipment 1 33.39 33.39
City/State/ZIP: Bend, OR 97701 Clothes dryer exhaust 1 33.39 33.39
Single-duct exhaust (bathrooms,
fJ
Phone: (541)3856762 Fax: (541)3856742 toilet compartments, utility rooms "5 23.32 l`4t
® APPLICANT ❑ CONTACT PERSON Attic/crawls ace fans 23.32
Other. 23.32
Business name: Pahlisch Homes Fuel piping
Contact name: Jason Spence $14.15 for first four; $4.03 for each additional
Address: 63088 NE 18th Furnace, etc. 1 14.15 14.15
Gas heat tun
City/State/ZIP: Bend, OR 97701 Wall/sus nded/unit heater
Phone: (541) 3856762x101 Fax:: (541) 3856742 Water heater 1 14.15
Fireplace 1 14.15
E-mail: jasonsQpahlischhomes.com Range 1 14.15
CONTRACTOR Barbecue 1 4.03 4.03
Business name: Pahlisch Homes Clothes dryer
Other.
Address: 63088 NE le MECHANICAL PERMIT FEES-
City/State/ZIP: Bend/ OR/ 97701 Subtotal -30-5
Phone: (541) 3856762 Fax: (541) 3856742 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 42067 State surcharge (12% of permit fee),
TOTAL PERMIT FEE Lt i , b
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Jason Spence Date: 1.12.10 ' Fee methodology set by Tri-County Building Industry Service Board
1: Building'Pa itsVNEC.Pe itApp.dm lo/01109 440-4617-r(I1/OZtCOWWEB) I/A/A
Plumbing Permit Application
Building Fixtures
City of Tigard i -7
1 it u'H Permit No.:
ZOO' 1
13125 SW Hall Blvd., Tigard. OR 97223 P1anaievr
is Phone: 503 639 41 71 Fav 503 598.1960 FEB n (.)they Peanut No.:
Inspection Line: 503"639 4175 2010 Date Kc.A;By: Jens Ea See Paige 2 for
Iniemet: w~vev.tigard-or.gov Nc»ilitecL'Meihot Supplemental Information
TYPE OF WORK .(°y,t FEE* SCHEDULE
® New construction p Demolition ' ad For special ln ormarion case checklist.
F7csc;ri firm ( F,a. "1"oral
C3 Addition/alteration/rclpl icemen( p Other: New I- 2-tatmly dwellings (includes 1017 fl. t'or each (uility connection)
CATEGORY OF CONSTRUcrioN SFR (1) bath 312.70
SFR (2) bath 437.78
® I -and 2-lamil Y dwelling El 170mmercidTndustrial
SFR (3) bath _ 500.32
❑ Accessory building ❑ Multi-family
Each additional balh/kitchen 25 02
El Master builder ❑ Cther:
Fire sprinkler ( se), fl. ) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12918 Sevilla Ave Catch basin of area drain 18 76
Citv'StateJ7IP: Bend. OR 97223 Drywell, leach line, or trench drain 19,76
Footing drain (no. linear ft.: Page 2
Suite/bldg.lnpt. no.: Project name: Walnut Crossing: Manufactured hone utilities 50.03
Cross street/directions to job site: Walnut & Sevilla Ave. Manholes 18.76
Rain drain connector 18 76
Sanitary sewer (no. linear fl.: Page 2
Storm sewer Ono. liner ft.: Page 2
Water service (no. linear It.: i) Page 2
Subdivision: Walnut Crossing F,ot no.: 6 Fixture or Item:
Tax map/parcel no.: 2SI04AD05900 Backilow preventer 31 27
DESCRIP'T'ION OF WORK Backwater valve 12.51
Clothes washer 25"02
Install new work in new single family residence _ Dishwasher 25.02
Drinking t-ountain 25,02
Ejectors/sump 25.02
® PROPERTY OWNER p TENANT FNgxtnsion tank 12.51
Name: Pahlisch Humes Fixture/sewer cap 25.02
Address: 63088 NE IW" Fluor drain/floor sink/hub 25"02
Crarbage disposal 25.02
City/Statc/7,IP: Bend. OR 97701 tiosr bin - 25.02
Phone: (541)3856762 Fax: (541)3856742 Ice maker 12.51
0 APPLICANT p ('thNTACI' VERSON Interceptor/grease trap 25.02
Business name: Pahlisch Homes Medical gas (value $ } Page 2
Primer 12
.51
Contact name: Jason Spence
Roofdrain (wmmercialt 12.5)
Address: 63088 NE le Sink/hasin/lavatory 25.02
CityiSlate/Gill: Bend. OR 97701 Solar units (potable water) 62 54 -
Phone: (541) 3856762x101 Fax:: (541) 38%742 -1-ub/shown/showcr pan 12.51
I:-mail: jasons(a)pahlischhomes-com Urinal 25.02
Water closet 25.(}2
C.ONTRA(:TOR
Water heater 37.52
Rueinesa name- LIPPOLD PUIMRING Water piping/DWV 56.29
Address: 25430 SF. SUNSHINE VALLEY RD Oiler: 25.02
City/Slate/ZIP: DAMASCAS. OREGON 97089 Subtotal
Phone: (972) 404.7012 Fax: (503) 454.0624 Minimum permit fee: $72.50 2
Plan review 125% of permit fix:) __1i4l40*
CC13 Lic.: 1891142 Plumbing Lie. no.:
State surcharge i 12°/u of perntit fix) 53
Auttorircd signal Re TOTAL PERMIT' FEE ~
Print name: Date: 1.12.10 This petmtit nppliratian expirrra ira permit b not obtained within 180 dats~
er it has been accepted in eamptete. l~l Q V
"Fee method olopty set by'rri-County Building IndussirySsrviee Booar& +CUX
Sbtaidi,WkPemetslPi,MIJ-PemutApp doe 1tL01109 4Ml-4vlt~r(Ia.11L'1 •t).N+N`Enl _54,3(,q
Cd
FEB-25-2010 13:18 From:M 9 W ELECTRIC 5417541872 To:15035981960 P.2/3
I
flect>rical Pferm_itApplication m~mllks
City of Tigard Re coved 77 Pannit No • 0 1
11125 SW Hall Blvd., Til{urd, Olt 97223 Phut Itaview
Phone: SU3.639.4171 Fax: 503.5981960 nteln Other Permit:
Inspection Line 503,639 4175 lhuro Ready/try uric tlee Pepe 1 Mr
lniomet, www lisarci-or.gov Notifled/Mathod, 8u famanul Inrarmadan
L.rl"!'1G rah''W411tK,. „KAW4NIRW'
® Now construction Addition/alteration /roplacemont Irlcaao oho k all that apply (sulon t I aeu of plena w/ilema shacked belaw).
Q Somiee err fooder 400 amps or more Q auildind over throe stories,
❑ Demolition Other' where the availabla fault current ❑ Marines and hontyords
itTRf4QN . less
Q~ ❑ tai/induct to l10.000 udo amps at 150 von) or Q Floating builddnga.
qtr CONSI'NLICTIQN
lass to ground, or exceeds 14,001) ❑ C011101416111-11911 sgrioulruml
I. and 2-lhmily dwelling Commerc real ❑ Accessary building amps far all ether lnsallaiions buildings
❑ Multi-f tmil Muster builder ❑ Other: O Piro pump installation of 7S KVA or
r E3 tl,nergency system laraar raparatsty derived system
Jd0 ;N;T P+ (NIeOIIMATION' AND LOCATION D Addition of new motar load of [3"A", Job no.: Job site address: 12918 Sevilla Ave IMHP or more occupancy
Q Six m more rmidendal units. Q Recreational vehiula parts.
City/Stale/LIP; 'Tigard, Oil 97123 Q Hoeltlt•cere facilities, ❑ Supply voltage for more than
❑ Harardeus locations 600 vales nominnl
Suile/bldgdapt. no,: Project name: Walnut Crossing Service or feeder Eno un s ar mu, a,
IrICIL RQIIRf1111,IL
Cross street/directions io•job sitc: Walnut St & Sevilla Ave. t
Now residential single- or multi-Ihmlly dwelling unit,
Includes -attached parage,
Subdivision: Walnut Crossing 1.01 no,: 6 1,000 a R. or leas I Ina 54 168 54 4
hu add'[ 500 s I) or onion 3 33.92 101.76 1
Tax map/parcol no.: 2S104AB05900 Limned energy, residential
Di clill"1loliii OF: Wc.1w. with ahova r A. I 67 84 67 84 2
Limited energy, muhi-liunily 67 A4 2
Install new service for single family residence residential (will) above 19. 0.
Nervicaa or famlortl Installation alteration and/nr relocation
200 UM PS or lose 100.70 2
'{$I A,RQPOIN 1'V Py►Nk111 i • U ITNANT 201 amps to 400 am a 133 56 2
Nume: Tahlisch Uomcs 401 amps to 600 amps 200.34 2
601 amps in 1,000 am es 301 04 2
Address: &1088 NT IAta over 1,000 amps or volts 552.26 2
City/State/71P: Band, OR 97701 Temporary saeviea or feeders Installation, alteration, and/or
relocation
Phone: (141)385-6762 Fax: (.141)385.6742 200 ant s or loss 5916 I
Owner installation: This instullatlon is being made on pmpcrty that 1 own which is not 201 bm 111400 am pa 125 e-8 2
intended for sale, lease, rcpt, or exchangS according to DRS 447, 449, 670, and 701, 401 am s to 599 am a 168.54 2
Owner signature: Dale Hranch circuits - now terallnn fir natension er anel
A Foe tbr• branch circuits with
APPhICAN'!; Q 'CONTAC11' I'S"SON above service or reader fee, 7.43 2
Inch hrnnch circuit
Business name: Pabliseh Homes B Foe for branch circuit,
Contact name: Jason Spence without service or feeder foe, 56.18 2
first branch circuit
Address: 630118 NE l8th Each add'] branch circuit 7 42 2
Iscellonroin eerviea or feeder not Inal dr
City/Statc&IP; Hand, OR 97701 Each manulhcturod or modular 67.94 2
Phone: (541) 385.6762x101 dwell in norviaa And/fir faadcr
Fax:: (541) 305.6742 Reconnect only 67.84 2
h'-moil: Jasonstal ahlischhomea.com drum or irri ,don circle 67.04 2
i'! CINII'ItA1~ i QR . Sign or outline li Iuin 67 H4 2
Business name; MW flocs is Signal circuit(s) or limited.
energy panel, alteration, or
Address: 29889 fiWY 34 SW extension. Describe Page 2 2
City/State/Z1P: ALBANY, OREGON 97321 Rach dditional Ins ecllon over allowable in an orthe above
Purina action 66.25
Phunc: (541) 754.6171 Fax: (541) 754,11 B72 Investigation or hour (I hr min) 66.25
CCB Lie.: 67362 Electrical Lie.: 2.61C Suprv. Lie.: 63045 Industrial lane per hour 78.18
1~1:1ar<n•al AI lrl1.'RAtr' ~IrlLr.ll
Suprv. Electrician signntura, required; Subtotal 330 14
Print.name: MICHAFLWF_AVFR Date: 1.12.10 Plan review (2fi%of unit fee) 8454
State surcharge (12% of permit fee) 40 58
Authorized signoturo: 'y 'row. PERMIT FEE 463.26
Print name: MICHAEL WEAVER Dale: 1,12.10 This permit application explras Its permit It not obtain ad rvlthln lea
days after It lies been accepted se- complete.
' Number of inapootinna allowed per peonlt.
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Buyer Date Buyer Date Scale 1:10
Lot Sq. Ft. =6339 sq. ft.
Foot Print Sq. Ft.= 2667 sq. ft. J �� Subdivision: Walnut Crossing
% Lot Coverage = 42.07% Lot #: 6 .
Total Impervious Surface= 3242 sq. ft. •
PahllschHomes Address: 12918 Sevilla Ave, Tigard, OR
PLANT SCHEDULE _ `
SIRPFT TREES nTY 97F SPACING p nrANinu N WF (Y] N1NF
Plan Name: Rutherford
0 63088 NE 18TH STREET, SUITE 100
8 C u ,1,' nr GARPINI �nnus HG ,u BEND, OREGON 97701 Date: 12/15/09
t �AwNUS PH: (541) 385-6762 FAX: (541) 385-6742 Scale:1 =20
I / 2 OXYCARPA _
I 13 cu .3n n C. RAYwnno. RAYwicn ASH *DRIVEWAY, WALK, AND PATIO LAYOUTS ARE FOR REFERENCE ONLY AND NOT INTENDED TO BE I! IF EXACT DFPICII(I>: ()FOIE FIN \I. Plu>UUCI'
* ESACT UTILITY CONNECTIONS AT RESIDENCE. MAY VARY PER BUILDER'S DISCO I ION
e • , - '
. a
CITY OF TJGARD - SITE PLAN REVIEW
CITY 0 TIGARD SITE PLAN REVIEW
BUILDING PERMIT NO.: ri 2 01 0 •
BUILDING PERMIT NO:
PLANNING DIVISI01■1:
MIN til 1 MII ORM
Required Set.pcL_ , F1 7 ‘pproved . „— 0 Not Approved
Approved 0 Not Approved
, Street Trees:
Not Approved .5 si_•., „%,,,,• f›
____.... .... , .
Appsoved ! i4LA
• Protected Trees: i n Fro ,-*D 1 . - .X._. Rear:
B : I.
- o ila fro- ir Date: 9, . 0
1 Visual Cv;arance: u AH1,, , ..f Ti Not Approved
Notes: Maximum Lit:lkiing Ekig!ii Oa ;,..c
CWS Servi. - - ler Lettcr Requiw Ei . Y . CS 0 No
Li Received
13 \ : JA—L± Date: ,9--Lqj L6
ENGINEERiNg D -PARTMENT:
Actual lope:_t% Ei Approved 0 Not Approved
Site PI 1: IZI-Approved No Approved
By: Date: 2 --- 6 ---
Note: yfAX1 et_ cAtl'e-A,..._.
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: 1D ^ ` 1 Jurisdiction: y
Site Address:
Subdivision/Lot #: r \� ey-Osand /or lXJ l.�
Map and Tax Lot #:
By my signature below, I certify that a minimum of fifty (50) percent of the permanently
installed lighting fixtures in the above mentioned building have been installed with compact or
linear fluorescent, or a lighting source that has a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)
Signature: Date: --7,72.
. caner /General Contractor /Authorized Agent
Print Name:
ORSC Section N1107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
1: \Building\ Forms \RES- 1-lighEfficiencyLighting.doc 07/01 /08
PERMIT NO.
CleanWater Services
Our commitment is cicar. LOT
EROSION CONTROL INSPECTION REPORT
DATE la7,,4 INSPECTOR A
__®' SUBDIVISION // / /�4,, ` ,�,e s7S i'� ,
O WNER/PER MITES ,, �, �� �_ .,<
SITE ADDRESS
FINAL INSPECTION
THIS SITE MEETS THE POST - CONSTRUCTION
EROSION CONTROL gEQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
�
INSPECTOR PHONE•- /�
' �- - �-
. � e
STREET TREE CERTIFICATION
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I, Own er /Agentfor .
SE PRINT ,
,, r (PERMIT HOLDER)
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certify that t h o etfll ow i n g ction meets
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Do hereby a
Ci ty f ;T i g a r d an W a s hi n gt on County
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land use and development standards for str tree installation.
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SUBDIVISION: ClrC3 i L LOT: 6 G
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SIGNATURE: DATE: 7' 6
( 01 1 ' R /A CEA' )
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RECEIVED BY: ■ DATE: • j � —
(CITY'TIGARD) 1
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I:\ Building \I urms \StreeCCrecCer[ificate 01 /19/07
7 \