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Permit : CITY OF TIGARD MASTER PERMIT i - : COMMUNITY DEVELOPMENT Permit #: MST2010 00049 �TEOARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2010 ;',:....4g , Parcel: 1 S 135CA09300 .Jurisdiction: Tigard Site address: 11476 SW 96TH AVE Subdivision: SOLERA Lot: 2 Project: Solera Project Description: New SF BUILDING Floor Areas Required Setbacks Required Stories: 3 Bedrooms: 3 First: 663 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 24 Bathrooms: 3 Second: 871 sf Garage: 242 sf Front: 20 Smoke Dwelling Units: 1 Third: 325 sf Right: 5 Detectors: Yes Total: sf Value: $200,774.71 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 Tubs /Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains. 0 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 Furn <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =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 VV/ Svc or Fdr: 0 Ea addl 500 sf: 3 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) GREENBURG TERRACE LLC EVERETT CUSTOM HOMES INC 1 MST Ersn Cntrl 503 - 681 - 4444 735 SW 158TH AVE #180 735 SW 158TH #180 BEAVERTON, OR 97006 Beaverton, OR 97006 PHONE: 503 - 332 -7167 PHONE: 503- 348 -5602 FAX: 503 -726 -7106 Total Fees: $14,231.84 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 ug • • R 952- 001 -0100. You ain -a -co• • the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By. �/ w Permittee Signature: LL ' 1 Building Permit Application Residential RECEIVED ,, "` F O ff IG LU S L O NLt i �sr x j Af I A ; • ^�. t'#.,.;e � At n�. .1t -exi, tied$} ' '" ..A5,, .s if�xc u Ys sr f._ e3? z r_ , fir; ix Received perm No.: �^ �' Cit of Tigard APR 0 . ?UiO .y o ho O j'� „/ „ 6 i v b DateSt: r i 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review , �1 /� C i ' Phone: 503.639.4171 Fax: 503.9 6 DateB ': `- "; Other Permit20 1 « X u F TIGARD - . t I t G A t l Inspection Line: 5 03 . 639 . 4175 Date Ready /By: Juri El See Page 2 for eta i.!:A^'`,i Internet www.tigard- or.gov BUILDING DIVISION Notified /Method: S w . 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 application. Valuation: S x 1- and 2- family dwelling ❑ Commercial /industrial L�� r �' 7 ( ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: l ( 4 47 4Ci 5tA j 11" ' kV'- New dwelling area: IB square feet City /State /ZIP: — flLrrA '!• QK, Garage /carport area: 2_4 square feet L% Suite /bldg. /apt. no.: Project name: 'ijA Covered porch area: square feet 8-7( `]„ Cross street/directions to job site: Au Deck area: square feet 64 Other structure area: Z ( 0 ( square feet "T �,� REQUIRED DATA: COMMERCIAL -USE. CHECKLIST Subdivision: a t/rb � Lot no.: 1 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 DESCRIPTION OF WORK work indicated on this application. '''t Wortrot `t:f l `l ( 10f i[`/7 6- Valuation: S 1 Existing building area: square feet New building area: square feet PROPERTY OWNER I ❑ TENANT Number of stories: Name: 1■^I'e"' Type of construction: Address: 41k.! ' 1~ 4k I Occupancy groups: City/State/ZIP: 1 1 L DIQ or.... 45 1 - 70D D 6 Existing: Phone: (�7 3 Fax: ( 503 116 6 Pe /ID 6 New: 17,APPLICANT . CONTACT PERSON NOTICE Business name: peardel ayJ Ifs ` (p...1 C. All contractors and subcontractors are required to be {./� licensed with the Oregon Construction Contractors Board Contact name: 1,n S under ORS 701 and may be required to be licensed in the Address: '7 J ) 1.08e~ '* !O jurisdiction in which work is being performed. If the y � D ye / applicant is exempt from licensing, the following reasons � City /State /ZIP:J 1 �- h i tL /0 apply: /� � '�(� S4)4 Phone: (� 7) 2 I � 11D a 1 Fax:: (i 3 1 � r 1 (�� d 1 �=—� E-mail: agk& evVke,f itom,anli✓. cool to ITT612—(Q0' CIO CONTRACTOR Business name: v tit C sjs. S A. v.,., \ r „i BUILDING PERMIT FEES* (Please refer to fee schedule) Address: 5 S g t v. 7 `$(] Structural plan review fee (or deposit): City /State /ZIP: (3 „,,,Qr, - Q Z q 1 00 FLS plan review fee (if applicable): Phone: (SO) ) 3 isi_ c c Fax: ( ) l Total fees due upon application: CCB lic.: I g f M L d^ ®0 Amount received: ifif 73D Authorized signature: i � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: f ru., s Y Q,tn Date: 4, (Z (to * Fee methodology set by Tri- County Building Industry ( Service Board. I: \Buildine\Permits\BUP -RES PermitAnn.doc 10/01/09 440- 4613T(11 /02 /COM/WEB) r . • Building Permit Application Checklist y 3 �� "" '' , ;: 'f'+'J ."t!'P. .�"�I ASe41t T° �a' i ' �): G �t . One- and Two-Family Dwelling , :. � .. r ,:�: � , -4 •,q.,,,x .J 44.0 '61x-7P' City of Tigard Re eive Permit No.: a 131 25 SW Hall Blvd., Tigard, OR 97223 I ll g I u . Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑ Mechanical k ❑ IpLU'n•Ill) Other: xoax v�rt Internet: www.tigard- or.gov .4i ` l HutFO LLOW1NOFFF-N1S A R PkE UF F612' I A NRCN I ^ ' �`` UR 4• 4 '.' " FS IK'N I. Al; :•�R� F _._...s-_F.r- ..._ __.... OFF . -. :.�' ....,i. _. .._. �_ I12 I ....- ...t n...,—.- '..L.. -. J-. . Arbri'ard r -. ' C I F ,, 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑ . . 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat /lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ , 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing confoiin to pp licq � ile'localartd state _ ' • , ® ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or or •separgte full•siie f ; • sheet attached to the plans with cross references between plan location and details. Plan review t'annot be completed if ' copyright violations exist. :1)4 .1 t • 11 Site /plot plan drawn to scale. The plan must show lot and buildi set dimensions;irrovert, cg'nes.jevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines aY2 =11: inter s), of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction • indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 11 • 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, yetit size -C❑' ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches_above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes Arid spdc;fp snob' y 1 orbeams�tea ;ders►joists,'stib -❑' 9 �,A' � � • floor, wall construction, roof construction. More than one cross section may be irequired to'clearly a po4 1 1. 1 J' aw6 � 14 .` rtrty construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ 0. ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. - Full -size sheet addendums showing foundation elevations with cross hef4yerlces al' h gtbte: 21 ' WI; ;.; -) : 4. 0,,_.* x 1: . 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indieatt dgtads and IooNljpnsi for nop- t ' -, LI t • ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standard's. 17 Floor /roof framing. r ovide plans for all floors /roof assemblies, indi a fi' citertib rsizin acin • ' I ❑ ❑ g. p G 4t 6 , , g> P 8 > �tg j '' . locations. Show attic ventilation. ; a, •I • s t or • 1..,;. e` -• i•. .. v. 18 Basement and retaining walls. Provide cross sections and details 5howing'plac'ement: of rebar. For engineered' i ' • `❑ F�' — • ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current.code •design xalues.for all laeams gntl• multiptsjois(�- . y '.d E over 10 feet long and /or any beam /joist carrying a non - uniform load: . • " r r •:' A / a / J' . -•A -,r ✓'• • 20 Manufactured floor /roof truss design details. :� ± . / f I, ❑ ❑ •, : i r Q 21 Energy Code compliance. Identify the prescriptive path or provide calcula'61dns. A gas `s't tiemati 1. , ° • .C'' ❑ ❑ • for four or more appliances. • - !. . 1••. 22 Engineer's calculations. When required or provided, (i.e., shear wall,'rooPt'ds) shall-beitamped b anieng [; • ❑ ❑ architect licensed in Ore•on and shall be shown to be a..Iica1 le tb•the 11 Frd'eat Undefreview. • t' •.. r °. g * • • 1 4` t J h� �r 5 S ', �c li' In i f t f , i µ! i7 Y C - y t 1 ,w { R s+G ir, . IURISD[ C ,T IONf1L SPE , ' %..a ".,g4 ,.� ,:.. 31 4._. 4 Nt>sy ; 1 € _ -., n- s 7,T . r . x . �gl 23 Three (3) site plans are required for Item I 1 above. Site plans must be 8 -I/2 "'x•11 dr %M" le l7'.. F ' , A ' . ' .0 4 ■ � '-'❑ t ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. . ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplincs, . ❑ ❑ ❑ and protection measures must he drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required lin- all building additions, ❑ ❑ ❑ including flecks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I \l ijIdin \Pennilx \11111'- Ill {ti -I'a•, mil A doc 01/21/06 4•IO -•161 T1'(1 I /02 /COM /Wlill) , • 20 00 / 04 /2 01 0 08 :07 21 5035981960 503 - 651 -35 OF qu phase electric pAGE 2 ' ?/02 Electrical rar it'�Qp�Gattfi■ y I ,) I:..1 , 1 . 1 ,, tl 1 - � a, City tr W. N l3 of Ti sw Habl Tigard, oR 97223 .. , � a. . Permi No :11. . L ��, • 5 Phone: 305.639.4171 Frac 503. 598.1960 . , , f; , l7lho► lar nlr. Inspection Line: 801.638.4175 i..,, Ready/By: sorb: -• Page 3fee Internet: v ww.tigard- or.gov reffest hfethodt Soyglarowital laeartastlia t ? - ,.... k: `. �.•M1 -,er {r _.. ‘ � - ,t• r" „ '∎ New construction • ■ AddltloNaltel prtl0Nft3plltot:mtlrlt mow r fin that apply (oink l ace ot�]m� wrrta� dEedoea edaw ■ Demolition so v os er fender doe amps or roam O Bella* over ]Iasi emits. 0 Other: where the ardiaWa fah mom ❑ Marima and boatymth. k F ,.. , . , -a � , ., , ._r', r I Unto greed, le epru s14,0 volts ar 0Cce ce ia m e, and 2 family dwelling • ComtllerclallhWustrial 1 Al cesuoty building Unto m an o er ins ia,000 p b b ldogs. uawaaAdoalalrAl it 1 amps for an other fortallatiorm. � bulldogs. ❑ Multi Ibmil 0 Master builder 0 Other" 0 Yes AMP- 171nitetiatiee of 75 KVA ce Emageory eye (leaved grim ... - i e- .,r_ -r, , :.1f ; 4r- ..v' 0 Addaiea of row (Maier1Md of Ow. "E, "1.2",°1 - r. • Job no.: Job site address: , I 5y J i '' r, lac e, er ores. oempaaal• • El SM or more residential min. 0 RsarrationsI velnete pads. Cityfate/ZIP: • `l 2 21, 0seera -care AWES* GI 8apply voltage for don ®e 011to desslesatiana. . 600 volts nomiml Project Hume; In Services to dodo 600 or loam - eekactlona , .. „ Cress st t/d • tts job ttiM: � • 1 , pn eAadee lit '■■J TaW • • Now residential 1itast& or motel- family dwelling unit. fndttdes shacked garage Subdivigt00: 4 r Lot no.: 2.. 1,000 sq. it. or less 1 16834 0 Taxm.. • I no Ea_ adds 5OO sg, n. or portion I,.., 33,92 1 { — r Limited energy, taidomiei ; 67,84 2 Limited messy, remit,- fsemiy III 67.84 _ © rased. R. .; '1 {; a n . • btAtaileti . a • • • , • PP#er rdeatlea 200 mope or ten X 100.70 2 111 l 011'i-1i t 400 ultra 13 ' 3.56 2 '€ 5 •';'''.: 'e`8� „n• 1 ,h,k. Pi, i.� r _. , .s • 1. • r. '' 1 c•', ' . i • 401 amps to 600 amt's 200 34 � Name` - 601 amp to 1,000 amps III 301.04 Address: Over 1,000 et volts 552.26 El Temporary ee vtees or feeders Iastallatian, 'Menthol, and/or City/Stair/ZIP: reloeatioa _ Phone: ( ) Feat: ( ) 200 amps ar legs 6136 1 Owner Inst Harlon; This installation is being made on property that 1 own which (a net 201 ova to 400 sops 123.08 intended for sale. lease, rent, or exchange, aecording to ORS 447, 449 670, end 701. 481 imps to 599 amps 16854 minimi Breath demons- Pew. altenida or eatenoton, per paael Owner signature: • Date: A, Pee ibe• bond circuits with t - :', --, , , t ,. .•!, , y :7 above service or Seeder fee. 7.41 , , ,. L ` :! <} 't s t .. +., o . '. •6 se eaahbranchaimit 2 Business name: 4 Le , a _ .. 6. • h. Pea Sbr bunch CIKUhI widow Sepses or Seeder fee. Silt 56.1 A 2 Contact name: v� branch circuit - Each ad01 branch circuit 7.41 2 Address: - 1 S W . ; r a M1ssallaneees service er header not tat:lo - modular Bash aoetediattt r d or mod City/Staxe/ZIP: ¢ o Q�� N Saab ono Bloom and/or od r l 60.84 IIIIR Phena: ( S ) 7t' - c z t:e only 61J4 mmmmil;!!!!!!!!!!!!!!!!!!!!!!!!! 6o Pump or Nngaian asok 67.84 ilI► �► Y >r • , . 7 ' z 1. : { , . - -.• -- y �, t ..0 , , ' Sign OrOurlusa it 118 67.94 • . - - f - •H; Sirs] OTC1111(3) 0r limdtedtner j' Business name: - IF r c,4 e It /. L:-L of etaatadan. t ` •' . Seek additional b ropietloa over allowable in soy of rite above • • Additional irspscpon (1 hr min) 66. k City State/Z1P: t O e 7' ) r lmeaeiodion (1 hr rain) 66.931 hr note: ( 6 ) p 4,4 1 Floc ( 563 )161_ -• . l R 7I ilifht II Electrical Lin.: 1C.... r -"+-^ arp cb 'mike is ■ 90 001 hr . Suprv. Electrician Signature, red: /04 0 listed li is min K Print Mc: ` • •� i \ Date: Subtotal: Plan review (25% of permit foe): Authorized signature: ap.4 — State euretmraa (1291 of puma fee): ' Date: TOTAL PERMIT PPE: rIlalldlatemetteate.senaltalegeae 1191,09 mewe,am1ro5/Comiw>ta Plumbing Permit Application • Building Fixtures : 1 OR,, OFFICE USI. ONI l . IN . - , .. ,. City of Tigard Received Permit ee <""" g DateDate/By: i ;(5/ 7- � qt; •-/ WV q q 13125 SW Hall Blvd., Tigard, OR 97223 C - Phone: 503.639.4171 Fax: 503.598.1960 an Review DateBy: Other Permit No.: Inspection Line: 503.639.4175 Date Read B le ns: ®S Pa e 2 for Tj GA,It'p Ready /By: g :; ." Internet: www.tigard - or.gov Notified/Method: Supplemental Information -. ; . , .. TYPE OF WORK - FEE* .SCHEDULE • c aNew construction ❑ Demolition For special information use checklist Description 1 Qty. 1_ Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) ,CATEGORY :OF; CONSTRUCTION , SFR (1) bath 312.70 p lr 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB ' SITE, INFORMATION AND LOCATION Site utilities: Job sit . address: 1 \ k.3 "I S, S W . Avg_. Catch basin or area drain 18.76 City/State /ZIP: 1- G Drywell, leach line, or trench drain 18.76 ,, ,, 0 \F A\ 22 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: G. 0 , " 1A . Manholes 18.76 Rain dram connector )( 18.76 Sanitary sewer (no. linear ft.: _.(N, Page 2 Storm sewer (no. linear ft.: ) 3 b Page 2 Water service (no. linear ft.: --) 0 Page 2 Subdivision: Lot no.: Fixture or item: oor Tax map /parcel no.: Backflow preventer 31.27 '.DESCRIPTION 'OF WORK Backwater valve 12.51 Clothes washer l 25.02 Dishwasher i 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ~,❑ 'PROPERTY 'OWNER , ' ' 1 2 " ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 1 25.02 City/State /ZIP: Hose bib 2- 25.02 Phone: ( ) Fax: ( ) Ice maker t 12.51 ' "® APPLICANT , ,'• ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: E v Zv A L y, \ 0 -\r^ \'( Q Medical gas (value: $ ) Page 2 M \ 1 " 4 Primer 12.51 Contact name: I t { v Roof drain (commercial) 12.51 Address' 5 5.AN) . 1 C �, v `^ Sink/basin/lavatory 25.02 City/State /ZIP: \7 e s_-' Solar units (potable water) 62.54 Phone: ( , -j ) J L', _', t • Fax: : ( ) Tub /shower /shower pan Z 12.51 E -mail: Urinal 25.02 . , Water closet 25.02 'CONTRACTOR' Water heater t 37.52 Business name: U c!, `C U V \ tN.%INN7 "IV\� Water piping/DWV 1 56.29 Address: '.k0 1 s W , ask.. , ,av Co \.r.r. r tq \ ' ,silt . iA`ai Other: 25.02 City/State /ZIP: -\-- i µ,v Q 6AR 01 0 b C Subtotal Phone: ( s t,, ) ((V7 `Z Q ` Fax: ( -) ) r � U ,ck I C t, ' Minimum permit fee: $72.50 CCB Lic.: k f; Z-.c) tl Plumbing Lic. no. : Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: C i i • (°!' 6 VJ 0 V` - t -- J.V( V) TOTAL PERMIT FEE Print name: J ti Date: 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\PLMU- PermitApp. 10/01/09 440 -4616T(10 /02 /COM/WEB) Plumbine Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: (minimum charge - 1/2 hour) Site Utilities Qty. Fee (ea) Total Subtotal: Footing drain - 100' 50.03 Footing drain - each additional 100' 37.52 Residential Fire Suppression Systems: Square Footage: Permit Fee: Sewer - 1st 100' 1 62.54 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Sewer - each additional 100' 37.52 3,601 to 7,200 $233.20 Water Service - 1st 100' ` 62.54 7,201 and greater $327.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm &Rain Drain - 1st 100' 62.54 Valuation: , Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to Other Inspections or Fees Qty. Fee (ea) Total and including $10,000.00. $10,001.00 to $25.000.00 $148.50 for the first $10,000.00 and $1.54 for Inspection of existing plumbing or for each additional $100.00 or fraction thereof, to which no fee is specifically indicated 90.00/hr and including $25,000.00. (minimum charge - 1/2 hour) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspections outside of normal business 90.00/hr each additional $100.00 or fraction thereof, to hours (minimum charge - 2 hours) and including $50,000.00. Reinspection Fees 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Additional plan review for revisions 90.00/hr Urinal Other Fixtures: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Quantity, by (Fixture) Work Performed Plan Review for Plumbing Installations Fixture Type: Replace Plan review is required for any of the following. Previous Capped Added Existing Please check all that apply. Baptistry/Font pp y Bath - Tub /Shower ❑ Any new commercial building with water service 2" and - Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" 4 " Isometric or Riser Diagram Car Wash Drain Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial that meet the qualifications above. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor *Note: If the fixture work under this permit results in an Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Macintosh HD: Users :WhitePony:Documents:Microsoft User Data:Saved Ittachments :PLMF- PermitApp.doc .} R OAF CAE U Samty � : vo Mechanical Permit ApplicationRE V jl , v "� .c: S.. v eT � �Zd7R- tc�� ^iiiRi4 .h-0srtu2 %}� uks dY A�eo �2: 4 �a�.....1 't"' [ oi'k ° ca City Of Tigard , t Received (� g 2, C 1 @ Date/By: T ? A, - / Permit No.: . O Ols �= 3 �'± pp pp F • 13125 SW Hall Blvd.. Ti ard, OR 97223 H�R �� g Plan Review Q `% } 1 . Phone: 503.639.4171 Fax: 503.595.1960 T p p� y� Other Permit: g ( 90/6 -r VA l;l av a CITY S I G t t h �. �1 DateBy. - CAR D; Inspection Line: 503 C1Th OF i a r Date Ready /By: _tuns: El See Page 2 for )i: xz tu ,, T, Internet. www.tigard- or.gov BUILDING DIVISIO Notified /Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* 'SCHEDULE- USE CHECKLIST Mechanical permit fees* are based on the value of the work New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT /SYSTEMS FEES* I1 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating /cooling J/� Air conditioning Job site address: W ....1 '4%%) aq 6� � (requires site plan showing placement) 46.75 City /State /ZIP: - D cia ` �f 7 a 3 Furnace 100,000 BTU (ducts /vents) 46.75 , 5' 6e3, r Furnace lP Q00 BTU (ducts /vents) 54.91 Suite bldg. /apt. no.: Project name: ,. Heat um 61.06 Cross street/directions to job site:l _Duct work I 23.32 Hvdronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Flue /vent for any of above ! 23.32 Subdivision: Lot no.: a -. Other 1 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 1 23.32 7s3,3 1 .e ` ���_ �- , _ Gas fireplace l 33.39 RV �� tvf `,� � Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 %PROPERTY OWNER ❑ TENANT Other 23.32 Name: GyV r4 leL L- u. Environmental exhaust and ventilation 7 s w l � ,, Range hood /other kitchen 4p, Address: equipment 33.39 �3 J / City/State /ZIP: ¢j�'�j�J co?... Clothes dryer exhaust 1 7.7,:31 33.39 7.77.7,:31 VV Single -duct exhaust (bathrooms, Phone: ( 503 ) 7.■• 1_ Liii Fax: (5 ) '?t4 .. °i ( cog toilet compartments, utility rooms) 23.32 I U .60 APPLICANT . ❑ CONTACT PERSON : Attic /crawlspace fans 23.32 Other: 23.32 Business name: Gtie- r Rama, (1.1C... Fuel t io P�P g Contact name: tA„a( E $ 14.15 for first four; 54.03 for each additional N �� O Furnace. etc. 14,(6 Address: 7 ' ,� St.1 15 S� Gas heat pump City /State /ZIP: F yAiV tQ)J O P2_ i ll co G Wall /suspended/unit heater Phone: () 32 1 (61 Fax: : (5(J3) TA W i 11 ag Water heater 1 ✓' Fireplace 1 E -mail: !i �,�,k a eva iN home s env. Co", Range l 1'-' `• CONTRACTOR Barbecue • Business name: SUI,..iDtU AL-) tINC- Clothes dryer (gas) Other. Address: gLO.Q' F NO MECHANICAL PERMIT FEES* City /State /ZIP: hr-fi Iv / diZ �% -7'J -1 (4) Subtotal �3Q�; 7 . cu p-1 Minimum permit fee ($90.00) Phone: (sn3® Fax: ( ) Plan review (25 %ofpermit fee) CCB lic.: �ir /( State surcharge (12 %ofpermitfee) �6C.,i 2,,, TOTAL PERMIT FEE 3 l t ( k : /I a T his permit application expires if a permit is not obtained within 180 Authorized signatur : days after it has been accepted as complete. Print name: is Date: ' Fee methodology set by Tri- Count' Building Industry Service Board Mechanical - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: TOtarVialuatliWf7Y. Permit Fee . . $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and • $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.09 rit . ; $2.54 for each additional $100.0 or • ow • • , fraction thereof, to and including 4 r ' $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,0b0.00 and ' • $2.49 for each additional $100.00 or �LU '4Y fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof Note: All new commercial buildings require 2 sets of plans. r . , • • % • I • '"" • , ; • A e"1 " •••• 7,*•/• • /." • , ? • 1 s.r '4f 1 4 A ; * ,! r •** 4 4 * C.• . 1,‘ • k 4) - 4 Yorif f: '. 4 4 t > f. • 0"... • • 0, t• r A ft 1: \Buildineermits\MEC-PermitApp doc 10/01/09 2 ; .; Plumbing Permit Application t " � �,.��� r� �� �C N �':�'�'' � t of {ri;'.G� -, .14�# -t F ,tj�v�, � r;�-s RECEIVED V ED ORim" CG l SE ONLI ` m ` -; • � `- Building Fixtures �A' �. '" _,*. $ .� � .. �� �.�- tom,,- �,s�,_�.��r�; �'�'s'=�,..�'>ht� ��� Date/By 7 " " C' d/ A R eceived + I ( i t City of Tigard / pp o 1 p Permit No.: /�J�� �,y� t' , a APR R f t : j` ' t �� _ Ono R/ ® 13 125 SW Hall Blvd.. Tigard, OR 97223 ® �' ' Plan Review !, .`s C 4 Phone: 503.639.4171 Fax 503.598.} Other Permit No. �0 ,/ aI 1T ,> °v"*,"•w = ' i Inspection Line. 503.639.4175 IT OF TIGARD Date Ready /By: luris ® See Page 2 for 11 � g g CITY DIVISIO1�! pp 4,.1.,N.1:-;NW' I t Internet wwti.ti and - or. ov Notified /Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE gNew construction ❑ Demolition For special information use checklist. Description Qty. j Ea. Total ❑ Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 1- and 2- family dwelling El Commercial/industrial SFR (2) bath _ 437.78 SFR (3) bath I 500.32 • ❑ Accessory building ❑ Multi- family ' Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 • JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 1 l 1 ( 7‘00 itel, k u Catch basin or area drain 18.76 City /State /ZIP: f� WLII/ . q " 7-5 Foo leach line, or trench drain 2 � ,,per Footing ng drain (no. linear ft.: _ ) Page age 2 • Suite,/bldg. /apt. no.: Project name: s� � IQ.pt Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 • Ram drain connector 18.76 Sanitary sewer (no. linear ft.: 40: ) Page 2 Storm sewer (no. linear ft.: y(„) Page 2 Water service (no linear ft.: 1(") Page 2 Subdivision: ,t/e1"-i61 Lot no.: A. Fixture or item: Tax map/parcel no.: � JVV Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer \ 25.02 'f..) Ll '- Dishwasher \ 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 PROPERTY OWNER l ❑ TENANT Expansion tank 12.51 Name: '-re - Fixture /sewer cap 25.02 Floor disposal sink/hub 25.02 ss Addre: /'' Garbage ge dispsposaa l \ 25.02 City/State /ZIP: iA'v 1 PJ r 066 P Hose bib z 25.02 Phone: ( 5 332 61 Fax: (93 )1 Z6 71 ®6 Ice maker 1 12.51 tit APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: 'c JV6,,// i 3 1 � ,.t t�L . Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Y � °lr � �1 ig. te ` Roof drain (commercial) 12.51 Address: i 6•- K " 1 4 ab Sink/basin /lavatory 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: (sbt 332. 1 ( 4,1 Fax: : (9)1) b 11 p6 Tub /shower /shower pan Z 12.51 E -mail: WI 44,k Q.v # ? k e re - isive3p v. c • Urinal 25.02 C • Water closet 25.02 CONTRACTOR Water heater I 37.52 Business name: 1I a)1 v i pN6,- Water piping/DWV 1 56.29 Address: e0 S4 ‘41- Other: 25.02 en Q City /State /ZIP: �,Lt h4. e ,4... - l / l� 1 Subtotal Phone: (Sp) : p°] 4 s5 Fax: (9,3) 663 vets? Minimum permit fee: $72.50 CCB Lic.: 6Cal, ® C Plumbing Lie. no.: 3 - 5e2 T b Plan review (25% of permit fee) State surcharge (12% of permit fee) 60 t Authorized signature: �� /I��' ,J(' TOTAL PERMIT FEE 0t3 C.,+.04,15 c lott) This permit application expires if a permit is not obtained within 180 days Print name: �� ;J Date' after it has been accepted as complete. 'Fee methodology set by Tri- County Building Industry Service Board. rtn,a,ti„t,`PPrm„,tPl 11 A*, VI I-Pprrntt Ann tin', I (O1 /09 440- 4616T(1 /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities • • - Qty• Fee (ea) Total , Square Footage: Permit Fee: - - '4 Footing drain - l" 100' • t 50.03 0 to 2,000 X $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 1 62.54 7,201 and greater $327.54 Sewer - each additional 100' y 37.52 . Water Service - 1st 100' 1 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 1 62.54 $1.00 to $5,000.00 Minimum fee $72.50 '." Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for -Other Ins eetions' or Fees Q • Fee (ea) Total each additional $100.00 or fraction thereof, to l� and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) " ' + Vii''"' t ' and including $25,000.00. • Inspections outside of normal business 90.00/hr t•-• t $ to $50;000 $379.50 hg fir §t $25,000.00 and $1.45 for hours (minimum charge - 2 hours) • •,r each 4t1djFiosial $1 10,06 or fraction thereof, to Reinspection Fees 90.00/hr ' " N and including $50,000.00. Additional plan review for revisions 90.00/hr . • $501tX 1.00iandrup ' , $742.00 for the first $50,000.00 and $1.20 for • '"eaeh atidijional $100.00 or fraction thereof. (minimum charge - 1/2 hour) . p,i�: ..- • h Subtotal: Commercial Fixture Work: t 4 v Are you capping, adding or replacing fixtures? If "yes", . _ _ Plan Review for Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. 1. . ' Quantity by (Fixture) Work Performed ❑ Any new cdmrfiergaf Ddilding th;wdler seGvice t "tared;. Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped. Added Existing engineer. Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure Bath - Tub /Shower as defined in OAR918- 780 -0040. - Jacuzzi /Whirlpool Q gprinklei' sy5tett , . : ! Medicalgas.and vacuum systemsfor health care facilities. Car Wash -Each Stall ©• Any firei e . ! , -Drive Thru Ill Any ce∎tbrgox, sit Vt ure.a defined id OAN i $ 780 - 0040. Cuspidor/Water Aspirator •• . • Dishwasher - Commercial t ' 1 • •' t� -Domestic . - ' • ' 'Submit2 sets of MIaW wrth'ady m tide above. A t ■ .- !. ...., rc • • r Drinking Fountain Eye Wash Isometric or Riser Diagranw Floor Drain /sink - 2" , , ' I yc riser diagram is.yequi1 d,for laew buildings . - P "th f rrfeet the qualifications 4bovt . - r . • Car Wash Drain • •• • Garbage - Domestic ��rr w " Disposal Commercial • i.1-,Olnments regarding•DRtu) i wok' - Industrial Ice Mach. /Refrig. Drains . �, ' ..'. . Oil Separator (Gas Station) • Rec. Vehicle Dump Station • =Y •- '' - Shower -Gang -Stall • ! - • e, . , • J Sink - Bar /Lavatory / , ', "i," - Bradley " �, •• - Commercial *Note: !lithe fixture niorii under4is permit results in an - Service increase of sewer EDUs,'�► sewe1 pe' rrmrt w ilfbe issued and Swimming Pool Filter !.. , ,, .• . • .. ' • • .. :feeg•assess for the sewer irierta a must be the Washer - Clothes „ ,. Water Extractor •'', w• . , •p permit can be issued. • •.• 0 .4' Water Closet - Toilet Urinal Other Fixtures: P r , ,, t. ' i 4. • I: \I Ittilding \fern its \I'I.rvll'- PcrmiIApp.doc 2 This form is recognized by most Building Departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. BUILDING DIVISION T I G A R D TRANSMITTAL LETTER TO: I' DATE RECEIVED: DEPT: DING DIVISION RECL1VED MAY - 42010 (FROM M \) CITY OF TIGAR'P P ' ON COMPANY: v 'ere C v.s' IA0 vv\ BUILDING DIUI PHONE: 5 U - 3 ��b- 5 6oz By Af RE: 1 1476 AA) q6 40E- t -& ao/o- aa (s4 z 9 (Site'Address)3 (PermitlCase Numbern " olect n. e'or subdivisiortbame and lot number) ATTACHED ARE THE FOLLOWING ITEMS: p�i Copies: I Description: Copies:. Description: Additional set(s) of plans. Revisions: I „ Cross section(s) and details. Wall bracing and/or lateral analysis. U \ Floor /roof framing. Basement and retaining walls. I ; Beam calculations. Engineer's calculations. Other (explain): L REMARKS: FOR OF IC USE ONLY Routed to Permit Techn� '•'' Date: � f(, 10 Initials: !y' Fees Due: 111 Yes LJ'N o Fee Description: Amount I ue: Special Instructions: Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: Date: Initials: [:\ Building\ Forms\ TransmittalLetter- Revisions.doc 4/4/07 ---Vt_t):,Laj,6) L LEGEND , 4,1 I S D - - RIGHT-OF-WAY Aa! r o RECEIVE Z n CURB OFFICE COPY — — — — — CENTERLINE SURVEYED BY: JUN 1 2010 0 N ii LOT LINE i SUMMIT LAND SURVEYORS,I .oFTIGARD m o N o SETBACK LINE P BOX 230149 BUILDING DIVISI ( Q a- SS SANITARY SEWER 20 .. _ ° '� 40 TIGARD, OR Q < EE w xx SD STORM DRAIN LL a0 l U— r fjQO:� ) O W . WATER LINE 1 inch = 10 ft. CITY OF TIGARD - OF FIB CO Y • ® WATER METER (SCALE 1 " =10' ON 11" x 17 ") BUILDING PERMIT NO.: MST /O —(�' ` U (SCALE 1 " =5' ON 22" x 34 ") PLANNING DIVISION: + ) STREET TREE • Required Setbacks: Approved Q Not Approed : J CITY O TIGARD -SITE PLAN REVIEW Side: St pi Sid L3 J w / v3 Front.` ' rL y s Garage: Rear: ,.f. ' l OIIIIIII CATCH BASIN BUIL► NG M1TN0: Visual Clearance: [ Appr ved ❑ Not Approved Q Street Trees: ,, �f� pproN.ed ❑Ida Approved Maximum Building Height..... feet Appt�6s+e�d, ❑ N ot A pproved CWS Service Provider Letter Re qu i re d : ❑ Y es ❑ N cv g Protected Trees: I \° ° d. I .: , ) Q / ' V — I te'. ® w� _ p ❑ / AeCe1VQd O I- I I ° \ ° ° i d e _° � a Nn a i t I \ \. ® ® � �j ;�, ` J Date: / r ‘ �� I 4 WM I.° 1 i �'� (j. i? 7 „...,1 iij`, fe ENGINEER DE PART MENT: J O Nil I a d. ° a \ ° e II I �Tr N A ctual Iope� % Approved ❑ 9tro ' t Approved I i a ° \ d : S ite PI `APF t'oved 3 2 1 — _- ( , . ° By: i D ote: g . I I I , ER Pi ' • ..g: . i Notcs 2007_ 00,`� ? F�efh 4d� r� 12-.75” -� �® C VAZ- 0.10 6 7-pis3b /4 , �F,b -- / 3 .F0 Z El- . N 86 ° 0 1'52'W \ I o ul OS WM a , N 91.07' � ' fir% \ `p �, I e d � I r1,13'13. � \a \ \1 �1 0 I \ r - - 1 \ tit w 8'PUE \ \ �N5 re • 37 , \ a 216,E t o \ __ D a . ao� 12.75' - -�., „, g I \ I . ,-,,, I . I CV —a-- ° ° w SAN LAT \ \2j 0 o W `,.a ' s ` - LOT 2 \ \ ° ^° w cr) ;74../L NON Q I ft a N 4---- \ d ;° $ ° \ 3,123 SF \ \ ”' N CO G a zl ° d •d, d a e 1 FF216.2 `"; \ °� A 5 - \ � 21 , �' ° d . Al ° ° \ 24.00' \ ° I - - - '. 31.5' \ \ N \ o \ \ \2j6 (/) N 87 °04'47 "W 81.80' i f,;‘,. . 21 I \i \ - - - - - - - - - - - - - - - - - -- - -- _ \ ?,6S SHEET \ - - - - - 7 I 7 --- d I 1 • I ° Plot; Jun 10, 2010 — 2.24pm, P; \124 -003 5dero \dw9 \Engineer \Lot PlonS \124- 003- 1-0T2.dwg / Oregon Residential Specialty Code N1107.2 AST 206 66o4-15 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: 2 I a U O WI Jurisdiction: .1 VO Site Address: I I, "'TTib 5 - k. b +r. Subdivision/Lot #: '(- and /or 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: / 0)! 9 10 Owner /General Contractor /Authorized Agent Print Name: M 0 e 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- HighEfficiencyLighting.doc 07/01/08 Oregon Residential Specialty Code R318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, / t>.L u QV\ , am the general contractor or the owner - builder at the following address: Site Address: I " A City: 1 Permit #: 2 -0 `b —006 4 o\ Subdivision/Lot #: 1 cl S a1 C I >` - Q\ lr and/or Map and Tax Lot #: To conform with the 2008 Oregon Residential Specialty Code (ORSC), Section R318.2 and OAR 918- 480 -0140, I am notifying the building official that I am aware of the moisture content Requirement of ORSC Section R318.2 and have taken steps to meet this code requirement. [Section R318.2 is provided for reference]. R318.2 Moisture Content: Prior to the installation of interior finishes, the building official shall be notified in writing by the general contractor that all moisture - sensitive wood framing members used in construction have a moisture content of not more than 19 percent by dry weight of dry framing members. Signature: Date: 1 0 / � �j J It General Contractor or Owner- Builder / 1 l:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 STREET cER TIF ICATION TilEE . ..., ..,..z!g...?..,,, ............... ,,. , .)..z.+?...q.1.•,4:,,L. 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'; , ',^16 kl, :^.^1 ' 4;5 , ^ r "kf t, ^ - ,•.'',.,. .:,. 4",:.:.. , .,.:.;*4 ,1,,'?,,,' - d=',;,,,,,,,,..,,4,,,, ‘T;' SITE ADDRESS: ' ' , - z _ ,,,,_. • • ..,.,,,,,k2,4,.. •-, - ,,,, z ,_ ::,,A .= , - • . ,„ „ , , .-',,,,-, .--...,,, -.. G 0/0 , 606(49 \ ( 1 -ti 0 - b. "' ,... SUBDIT/ISION: 5 % osr c LOT #: 2 SIGNATURE: DATE: 1 D I V 10 (OWNER/ AGENT) 7"..te-- RECEIVED & VERIFIED BY DATE. (CITY OF TIGARD) • e• Tree location ver per approved site plan. 1: \Buildiri g \Fo \StreetTreeCertificate 07/01/2010