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Permit CITY OF TIGARD MASTER PERMIT > a n COMMUNITY DEVELOPMENT Permit #: MST2010 -00008 TI'GATED, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/23/2010 Parcel: 2S102DC04300 Jurisdiction: Tigard Site address: 9206 SW HILLVIEW ST Subdivision: MCDONALD WOODS Lot: 16 Project: McDonald Woods Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 5 First: 1157 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 1496 sf Garage: 427 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $288,040.55 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: 4 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 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders 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: Y HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: Y 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) GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC 19200 SW 46TH AVE 19200 SW 46TH AVE TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: 503 - 692 -3390 PHONE: 503 - 692 -3390 FAX: 503 - 692 -5433 Total Fees: $16,052.19 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.24 6699 or 1.800.332.2344. ro Issued By: v )A .( Permittee Signature: Building Permit Application Residential RECEIVE 1 FOR OFFICE USE ONLY City of Tigard Received _ Permit No.: •'1 l 20 . 040s; q 13125 SW Hall Blvd., Tigard, OR 97223 JAN 1 3 2010 Date : 111 I Plan fB Review '� Other erm' • Phone: 503.639.4171 Fax: 503.598.1960 Date/B : u r' er : � • iota. T I G A K D Inspection Line: 503.639.4175 CITY OF TIGAR D Date Ready/: i ' age 2 for Internet: www.tigard- or.gov BUILDING DIVISIt otified /Method:.2 /71 � t�� o Supplemental Information a TYPE OF WORK REQ R DATA: 1- 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. .55 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ a 0'410 ❑ Accessory building ❑ Multi- family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: 3 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 9206 SW Hil View St New dwelling area: ,2861 .2463quare feet City /State /ZIP: Tigard OR 97223 Garage /carport area: 427 square feet - Suite/bldg. /apt. no.: Project name: Covered porch area: 53 square feet Cross street/directions to job site: 92 " off McDonald Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: McDonald Woods Lot no.: 16 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2S102DC 04300 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. New Home Valuation: $ Existing building area: square feet New building area: square feet 0 PROPERTY OWNER ❑ TENANT Number of stories: Name: Gertz Construction Co INc Type of construction: Address: 19200 SW 46th Ave Occupancy groups: City /State /ZIP: Tualatin, OR 97062 Existing: Phone: (503)692 -3390 Fax: (503)692 -5433 New: 0 APPLICANT ❑ CONTACT PERSON NOTICE Business name: Gertz Construction Co Inc All contractors and subcontractors are required to be Contact name: Ken Gertz licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 19200 SW 46 Ave jurisdiction in which work is being performed. If the City /State /ZIP: Tualatin, OR 97062 applicant is exempt from licensing, the following reasons apply: Phone: (503 -) 692 -3390 Fax: : (503) 692 -5433 E -mail: Ken @Gertzco.com CONTRACTOR Business name: Gertz Construction Co Inc BUILDING PERMIT FEES* Address: 19200 Sw 46 Ave (Please refer to fee schedule) Structural plan review fee (or deposit): City /State /ZIP: Tualatin, OR 97062 Phone: (503) 692 -3390 Fax: (503) 692 -5433 FLS plan review fee (if applicable): CCB lic.: 34350 Total fees due upon application: 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: Kenneth Gertz Date: 1/12/09 * Fee methodology set by Tri -County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB) 02/13/2017 21:53 FAX 5036939445 0 002/002 Ele___EWEgaerinit A app Ca ECL.,IVED 1 ,. I ,, , „N. , City of Tigard Received JEW hnsilr Mo.: . 13125 SW Hall Blvd., Tigard, OR 972 Mace : / Q � ` � Phone: 503.639,4171 Fax; 503.198,1 00106 19 't 1� Dori R° Dawn Other Pvrndt: t , c it n , Inspection Line: 503.639A1 7S Date Rose /p See cage 2 far Internet: www.tigerd -or,gov CITY OF TiGii. D Naiil.drn otbod: euttrrer anmr lafermso ® New Construction ❑ Addition /altertttlort/replacemcnt Placate alto 1 that apply („ul.oit 2 aots of puma *ROM ns Checked below)! ❑ Demolition ■ Ot:har: 0 seMite or feeder 400 amps er more in wen over three glories. C \�:'C.• ' ; -:'vi's'it; r >Zd'i t ^; where thy available Ptah current 13 Marina Bad bowtywds. :� .w., ,,,-- l ,p+!i �t! , '�1 .' .: i15 t t}ltll it i s— „, , , exceed 10.000 amps, at 150 volts e r .. � � : • • �'� ❑ Fleeting buildings. less to ground, or c;ccecds 14,000 a Commercial -use agrlwltmral El 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps fbralt uth. inttelluleta, build:no. ❑ Multi- t$mily d MRSter builder ❑ Other: El Fire pump. D Inttallation of 75 KVA or t{ ,. . r = ,b grit'l Xt' . t 7' 1 , ,.: , O Ennerpntly IMMO. larger separately derived tram. • ❑ Malle n er new motor lead of ❑ "'A" • "l.2 ", "1 -3• Job no., Job Site oddness: 9206 SW Flil View St 100HP or more 000apnncy, in 91x Or more resldontial units, ❑ Rear>tntronsl velnele park City /State /ZIP: Tigard, OR 97223 0 Hooltli.caro facilities. 1:1 Supply voltage ibr more than 0Hneardomu locations. 600 volt' non: . t, Suite/bldg./opt, no.; Project name: ❑ Serviss or feeder 600 amps or more. Ceti+ss street/directions to job situ; 42 "d off McDonald - : L::1.!< " rte 1 " .`." New residential single. or mniti• family dwelling unit. Includes attached garage. Subdivision: McDonald Woods Lot no.: 16 1,000 sq. it. or less MINIM 168.54 4 Tax map/parcel s,0,: 2S102DC 04300 • Pia, WW1 500 sq. ft. or portion 33 - 92 reran . , . - , ;',:vim' Limit • • energy, residential s's i;,' • , -t ..trrA ' , e ;'Ct►6iak r ,, .. wall • • ve :,. R. 67.84 67.84 El Limit nt , multi - Nullity 67,84 111111131 n tsidrnt wine slams • - ft, Services or At tars installation alters t , . and/or relocation f � 200 am • • Cr toss 100. p '��"' , n,. t= . `;••;i •: '' 201 r e to 400 amps Mil 133.56 IMIINEll Name: Gertz Construction Co Inc 401 am • 1 to 600 amps NM 200.34 111M© * 601 amps to 1 000 amps 301,04 Ell Address: 1t97.00 SW 46 Ave Over 1,000 amps or volts In 552.26 fl City/State/ZIP; Tualatin, OR 97062 -877D Temporary services or feeders Installation, alteration, and/or relocation Phone: (503)692-3390 Fax (503)692.5433 200 am • or less - 59,36 — - Owner Inatallatiod: This nstallation is being ttiadc on property that I own which is not 201 am.. to 400 am.a 125.08 Ell intended for sale, lease. lent, or exchange, according to ORS 447, 449, 670. and 701, 401 amps to 599 am s wE 111 Owner Signature: Date: Branch circuits - new alteration , r extension , r • a el A, Fee for branch circuits with ' : `' '� ' i- ' l ! �® above serrloc or feeder fee. II �.. r, 1•N °�e� each hr Oh circuit 7.42 Business nom'; Gertz Construction Co Inc 13. Fee fbr branch oircuita wrthoza service or fhodcr fee, 56.18 LI first branch circuit Address: 19200 SW 461° Ave A Miteelleneous mervtse or f. •.. • r not incl ed City/State/ZIP: Tualatin, OR 97062 Each rnanufacturod or mode yr mum is dwt:llia c, serve lather feeder Phone: (503) 692 i""ex:: (503) 692.5433 Reconnect onl, 1111 67.84 MIIIIEN Puri • or irrigation circle 11. 67.84 -- l"i; ;`'"' ,''' ' ?il r ,... :,, .aim R,fk _, Sie or outline lighting Buslfses9 name: Brighten Electric S pal cireuit(s) or limited- energy panel, altcratltm, or Address: P.O. Box 2330 extension. Describe: Page 2 City /State/ZIP: Redmond, OR 97756 WI additional ins leaden over allowable lit env of the Above Per inspection OE 66.25 MEN. Poona' ( /- I . _ 0 Pax; alrliell.41 ,S /" 1,4- — . - tnvcstigation , -• hour (1 lx min) 66.25 EMI. Emilminidmicsar Suprv. Lie,: - industrial , lent •erhour ��M r - .. - � ; : Suprv. Blaetrician Signature, required: /-wit✓ „A Subtoml: Q, - I :. IN ,may �r at 12/09 Plan review (25% of permit life : �, State slinkier UN Of permit fbo): ' f L�+at1�711'1� Authorized signature; y - .... = ; � a : � !j , 4 .i/ f � TO TAL P ERMIT ME: 6.0 Print name; Ken Gertz " A P i te: l /) 2/09 WS permit application expires if a permit is sot obtained within 180 dare finer it bas bon .eeepted as eampIcte. • Plumber of inepcetieftS allowed par permit t:lertIdin Pert,ttFULC c tApp.do Io/01Ml 440461 Il/asrc-oNOVIR Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received g Date /By: ' r 10 , c s Permit No.: ' r 2010 n 13125 SW Hall Blvd., Tigard, OR 97223 2 ., Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit No.: Date/By: Inspection Line: 503.639.4175 T I G A R D Internet: www.ti and -or. ov Date Ready /By: Ions: Fa See Page 2 for g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE O New construction ❑ Demolition For special information use checklist. Description 1 Qty. I 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 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 building SFR (3) bath 1 500.32 6&0,30.-- ❑ 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 site address: 9206 SW Hil View St Catch basin or area drain 18.76 City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 92 off McDonald Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: _) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: McDonald Woods 1 Lot no.: 16 Fixture or item: Tax map /parcel no.: 2S102DC 04300 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New Home Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain /floor sink /hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Gertz Construction Co. Inc Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Ken Gertz Roof drain (commercial) 12.51 Address: 19200 Sw 46 Ave Sink/basin/lavatory 25.02 _ City /State /ZIP: Tualatin, OR 97062 Solar units (potable water) 62.54 Phone: (503) 692 -3390 Fax: : (503) 692 -5433 Tub /shower /shower pan 12.51 E -mail: Ken @Gertzco.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Threefoot Plumbing Inc. Water piping/DWV 56.29 Address: P.O. Box 274 Other: 25.02 City /State /ZIP: West Linn OR 97068 Subtotal 5 Phone: (503) 557 -7585 Fax: (503) 650 -8212 Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: 103792 Plumbing Lic. no.: 3 -259pb State surcharge (12% of permit fee) j Authorized signature: TOTAL PERMIT FEED j, 3 Print name: Marsha Threefoot Date: 1/12/09 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- Permit App. doc 10/01/09 440- 4616T(10/02/COM/WEB) Mechanical Permit Application FOR OFP ICE USE ONLY City of Tigard Received b Date/B Permit No.: 20 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit: Inspection Line: 503.639.4175 Date Ready/By: Juris ® 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: $ ® 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES* [:1 Multi-family F1 Master builder For special information use checklist. ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 9206 SW Hil View St Air conditioning (re uires site plan showing place ment 46.75 City/State/ZIP: Tigard OR 97062 Furnace 100,000 BTU (ducts/vents) 1 46.75 Al,, 76 Fumace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: 1 Project name: Heat um 61.06 Cross street/directions to job site: 92"d off McDonald Duct work 23.32 H dronic hot waters 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: McDonald Woods Lot no.: 16 Flue/vent for an of above 23.32 - Other: 23.32 Tax map/parcel no.: 2S102DC 04300 Other fuel appliances DESCRIPTION OF WORK Water heater 1 23.32 Gas fireplace 1 33.39.~j New Home Flue vent for water heater or gas fireplace 23.32 Lo lighter (gas) 23.32 Wood/ pellet stove 33.39 Wood fire lace/insert 23.32 ❑ PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 1 33.39 City/State/ZIP: Clothes dryer exhaust 1 33.39 Single-duct exhaust (bathrooms, p 1 i Phone: ( ) Fax: ( ) toilet compartments, utility rooms 5 23.32 1 l k~•b ® APPLICANT ❑ CONTACT PERSON Attic/crawls ace fans 23.32 Other: 23.32 Business name: Gertz Construction Co. Inc. Fuel piping Contact name: Ken Gertz $14.15 for first four; $4.03 for each additional Address: 19200 SW 46`h Ave Furnace, etc. Gas heat um City/State/ZIP: Tualatin, OR 97062 Wall/sus ended/unit heater Phone: (503) 692-3390 Fax:: (503) 692-5433 Water heater 0 Fireplace r E-mail: Ken@Gertzeo.com Rana Pl CONTRACTOR Barbecue Business name: Oregon Comfort Heating Clothes dryer (gas) Other: Address: P.O. Box 190 MECHANICAL PERMIT FEES* City/State/ZIP: Eaglle Creek, OR 97022 Subtotal ZQQ, `n Phone: (503) 655-0221 Fax: (503) 650-2993 Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: 42519 State surcharge (12% of permit fee) TOTAL PERMIT FEE 7, 1 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Ken Gertz Date: 1/12/09 ' Fee methodology set by Tri-County Building Industry Service Board I:\Building\Permits\MEC-PermitApp.doc 10/01/09 440-4617T(II/02/COM/WEB) ,•' 1 p t - 010 ., .) , ,P7/3 2 1 I I B ECEWED AD • - ,� h T (\/ FEB 16 2014 a i ., Elev 220 4 1 00 �� �" CI OF �IGARD Area of O BUILDING DIVISION , Cedar I L - c----1 _ ♦ • �i °' - --��� 0 Trees <12" for Er. Gravel D ion ' e N v \ ♦ DBH. } 3 , �.���• Because he I - %� EXISTING is a nice I �_ _ ���� STREET guy and la I , ; ><,' i 1 5 11 - 1 -7 ----- 1-,, , I 4■Wir, TREES i 1 � 1E141 i likes trees, �__ � . ..,, - - „ i i r t Builder �tI • ;; -wow ` \ I II ` ‘ Elev 211 MEN �� 1 0 dead trees o;4, f— ' v and leave !I a Elev 211 cs, - 4 , r the rest b `� I i a alone . No O - WNW - WNW ' i - i . 1, • • protection is Q , required as p I / per 18.790 «0., w oe and slope ' mil a of tree area - Z \ lit fence Siltfence / 1 i ! ;ilk ; N • \ M LOT #16 r •' / 0 I• Elev 215 '\ /' 1 1011;11 rilill.PRI _ _ _ / ' r 10 66 - e 204 WARNING: El 20 • OBTAIN LOCATES PRIOR TO ANY 711 , \: , EXCAVATION l \ \ - GERTZ CONSTRUCTION HOME SQUARE FOOTAGE COMPANY INC. N\N MAIN FLOOR = 1150 SQ.FT. BUILDING ,'-_, UPPER FLOOR = 1450 SQ. FT. CUSTOM HOMES SINCE 1977 TOTAL = 2600 SQ. FT. (503) 692 -3390 GARAGE = 412 SQ.FT. 9206 SW Hill View St. Lot 16 McDonald Woods SCALE 1" = 20' GERTZ CONSTRUCTION COMPANY INC. PLOT PLAN 2/16/10 � c . �[LI !D CITY OF TIGARD - SITE PLAN REVIE BUILDING PERMIT NO.: r y , • / 4) _ a0p0,1 PLANNING DIVISION: Required Setbacks: Side: S Er Approved ❑ Not Approved Street Side: /S Front. Gja age Visual Clearance: Rear: L L� Rear: 0 Not Approved Maximum Building Heigh • feet CWS Service Provider Q.• c1nired 0 Yes ❑ No i Received B : 44_l , Date • ca-// , /v ENGIN RI eEPARTMENT: A Actual lope: % te P Approved ❑ Not Approved B : APPro pa e: z d • / Notes: �� �- , CITY O TIGARD - SITE PLAN • VIEW B _ LDI . G • MIT NO: Street Trees: �Q 1:1 Not A ved Protected Tr�s:, n o l Appro 0 Not moved Notes: " 0 Oregon Residential Specialty Code 8318.2 MOISTURE CONTENT ACKNOWLEDGEMENT FORM � , am the general contractor or the owner- builder at the following address: Site Address: City: .. , / Permit #: /0_ 0 6 Subdivision/Lot #: / , and /or Map anax #: • 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: �� / eneral Contractor or Own - - : uilder 1:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 -T -,-- • ........., ,_________--__.-- - _ _ _.. . _ . . . .: . _•- _ ________■•■• _ -.1, .. —s--‘*41.1111111.1111" -Pl"..--.' ---_________-------- _____ -_/ _ _ ------- Oregon Residential Specialty Code N1107.2 • HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: �� � cP 0 ^ 0000 K Jurisdiction: rii6 /J/"✓r.�_e_e7 Gdr.d, c Site Address: D ` 'Iv / y--;/,/v,-,-_, z ,, g--..--7 - Subdivision/Lot #: / and /or Map and 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 Ni 107.2) Signature: Date: l / /// O ner /General Contra • • uthorized Agent p , Print Name: 1 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. I:\Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 1 STREET TREE CERTIFICATION 1, /5l�a -D -� , Owner /Agent for • 6 7z_ (PLEASE PRINT) (PERMIT HOLDER) i f . Do hereby, certify that the 'following location meets v City of Tigard land use and .development standards for- street tree 'installation. { I I J 1 LC�r `i0 , ADDRESS: z a s D SUBDIVISION: - ,,,� ��,� LOT: SIGNATURE: //� DATE: /z/// / O INNER /AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) 1:A Building \ Forms \Strect1rceCcrtificatc 01/19/07