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Permit
CITY OF TIGARD MASTER PERMIT 0 . COMMUNITY DEVELOPMENT Permit #: MST2010 -00128 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2010 Parcel: 1S135DB13300 Jurisdiction: Tigard Site address: 9254 SW NORTH DAKOTA ST Subdivision: HELLWEGE PARTITION Lot: 0 Project: Hellwege Partition Lot 2 Project Description: New SF. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 926 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 23 Bathrooms: 3 Second: 835 sf Garage: 528 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $193,735.83 Rear: 15 PLUMBING Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0 Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Tvpes Air Conditioning: N Vent Fans: 3 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 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: 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! 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) SEAMAN, MARK TIMBER PROJECTS LLC 1 Prcl Pin BEFORE FINAL BUILDING INSPECTION 8407 SW 58TH AVE 8407 SW 58TH 2 MST Ersn Cntrl 503- 681 -4444 PORTLAND, OR 97219 PORTLAND, OR 97219 PHONE: 503 - 789 -5349 PHONE: 503 -246 -9890 FAX: 503 -245 -8507 Total Fees: $14,749.08 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 . es a• • -ted by the Oregon Utility Notification Center. • e rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of I _ -- - •r. •irect questions to OUNC by calling 503.246.6699 or .800. 32.2344. / Issued B % /L / ! Permittee Signature: �� — a � i—. /, - Building Permit Application A. \ \f • Lq� t. PA --r LP S -_c,ct Residential v^ s A FOR C)PFICI: LSE ONLY City of Tigard i ` Received e ei iv ved 3. t Permit No.: . t _ r , q CO Dat (7 a #i11 Per do T �'0 • , 7 13125 SW Hall Blvd., Tigard, OR 97223 �avie �6 / Phone: 503.639.4171 Fax: 503.598.1960 .t\ ^ r < ! : Other Permit: P ,C �. �i��T � S - a r i G A RI , Inspection Line: 503.639.4175 QZ k o . e Ready :y: Juris: ® See Page 2 for Internet: www.tigard or.gov � '� .G� Notified/Method: i I r Supplemental Information TYPE OF WORK V y REQUIRED DATA: 1- AND 2- FAMILY DWELLING ,0ew 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. �, '- and 2- family dwelling ❑ Commercial/industrial Valuation: $ ( 7-&5 ‘ S._ El Accessory building 12 Multi-family Number of bedrooms: ` ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: _ ?A 5 o' o�fi � / r New dwelling area: \ 1 tQ , square feet City /State/ZIP: % �..„_. n "..,� Garage /carport area: sZce square feet Suite/bldg. /apt. no.: I Project name: / k/ ' j ' / yrf j' Covered porch area: '1 b square feet - , Cross street/directions to job site: . e `R ,,, CSJ - x - " -r c, ca t2. W` Deck area: square feet eigt Other structure area: 22...5 square feet 2 ? ) REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision:' c('1 - S cd'. act 04,4 T 1 Lot no.: Z Permit fees' are based on the value of the work performed. Tax map /parcel no.: 1 5 l S Q a ‘3,3pp 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: $ C-. Its v.t % - t - tfiV C.-T •. tJ 4.4 r.J S v.J & • us. C .4-1. i="01.4.1. `Z - S T t91 tiL.S k 6 S Existin building area: square feet New building area: square feet Q-PROPERTY OWNER I ❑ TENANT Number of stories: Name: Wl r+4..�•,k. S �trhir it••■- trJ Type of construction: Address: . 14 S ■ L>J ■ T 54: Occupancy groups: City /State /ZIP: C-1- 1__.40 ( yam_ c Zli, Z Z 1 Existing: Phone: ck S- Lr},,c.k Fax: (gjj, W6-k, S q S New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) 1 Fax:: ( ) E -mail: CONTRACTOR Business name y "-•- IN $ ` J a- -T S LA,_. C---, BUILDING PERMIT FEES* Address: .�A 1 s ` .3 . Sie T (Please refer to fee schedule) r 1 City /State /ZIP: Q .r Q \ 1 Z ` G Structural plan review fee (or deposit): Phone: (S�� 1. e, S3 �c Fax: ( SQN * .�S 8 SO FLS plan review fee (if applicable): - CCB Iic.: l _ ' Q Total fees due upon application: 57). `C: 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: v-N " 0�,4_ S {. wl.i0%Y'J 1 Date: 1 4 I , ll * Fee methodology set by Tri- County Building Industry Service Board. IABuilding\Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(11 /02/COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling rOlt OFFICE: USt: ONLY City of Tigard R eceived Permit No.: l ig 1 3125 SW Hall Blvd., Tigard, OR 97223 Associat C ' Phone: 503.639.4171 Fax: 503.598.1960 Associated permits: 24- Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical imARD Internet: www.tigard -or.gov ❑ Other: T 1 - 1F. FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ' " t's N11 N/A 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 conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -11. intervals); location 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. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ 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 and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray 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. ❑ ❑ ❑ _, 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 references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ • ❑ ❑ systems, see item 22, "Engineer's calculations." • 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore. on and shall be shown to be applicable to the •ro'ect under review. JURISDICTIONAL: SI'IC-II 'ICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 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, driplines, ❑ ❑ ❑ and protection measures must be 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 for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. 1.\ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB) Electrical Permit Application, r• • - 1 O IZ (4.1. i is i.: ()NI. 1 ed ceiviv City of Tigard Re Re e : p y p 4 Permit No.: N.f rlj /D .gyp is $' I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �•, • g Phone: 503.639.4171 Fax: 503.598.1960' Date/B : Other Permit: 6 464 A00_49/0 i 1 ` Ic i - � Inspection Line: 503.639.4175 Date Ready/By: kris: 65 See Page 2 for Internet: www.tigard- or.gov • t •- 2.J: Notified/Method: Supplemental Information Ti- . ' r' 3./'k � J k•.: .(.i. sl TYPi b b PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit i sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition 0 Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", 100HP or more. occupancy. Job no.: Job site address: C tS' x t o ei ..,k tl - €3,, ❑ Six or more residential units. ❑ Recreational vehicle packs. City/State /ZIP: 'T� , __.� C l 0--...._ ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: c_e_ � czzV___ d \ S Description 1 Orr. I Fee. 1 Total 1 • ^ �__ `` n New residential single- or multi- family dwelling unit. -- c — YV 'Q .k j < A- Y , j . L Includes attached garage. Subdivision: Lot no.: Z— 1,000 sq. ft. or less 168.54 J�. 4 Ea. add'I 500 sq. ft. or portion 33.92 1©1,76 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) ( 75.00 2 Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ ,PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 l 401 amps to 600 amps 200.34 2 Name: M ✓- �..-. Sk t% V"■ rx) 601 amps to 1,000 amps 301.04 2 Address: L 6 2 J , � Q-K- ..se - Over 1,000 amps or volts 552.26 2 , U Temporary services or feeders installation, alteration, and/or — City/State /ZIP: .� t___„ l c� l 'Z \ \ relocation 200 amps or less 59.36 1 Phone: ��) ' b �1 5 3 4.k. � Fax: (Sts') ?„4,..1 S 1 6 S () 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 _ 2 Address: Miscellaneous (service or feeder not included) Each City/State /ZIP: dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: T --1_4 c L . b; r A.4 panel, alteration, or extension. Page 2 2 V h � / Each additional inspection over allowable in any of the above Address: 1 3 g ( _ • M t „ t v cru Additional inspection (1 hr min) 66.25/ hr > Investigation (1 hr min) 66.25/ hr City/State/ZIP: M 6 L �.. 4 L a 4` 0 3 e Industrial plant (1 hr min) 78.18/ hr Phone: .. , Q I f 3 Fax:.1 ) 8z C Z2 Z Z Inspections for which no fee is 90.00/ hr 11 specifically listed (Y. hr min) CCB Lic.1 8 rags Electrical Lic._ (¢ 3 c Suprv. Lic.: /.4qp U S ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: o otal: `? • d Plan review (25 /o of permit Subt fee): Print name: Date: State surcharge (12% of permit fee): 4( 44- 0.-4. TOTAL PERMIT FEE: s n 180 Authorized signature: T his permit application expires if a permit is not obtained within 180 - � v „. �, .,) Date: V • days after it has been p accepted as complete Print name: N t 4 f2 I 0 t � � • Number of inspections allowed per permit. 1:\ Building Tenons \ELC- PennitApp.doc 07/01 /10 440- 4615T(I1 /05 /COM/WEB Plumbing Permit Application Building Fixtures City of Tigard R eceiv ed .� • 13125 W Hall Blvd., Tigard, OR 97223 Date/By: t 0 Permit No.: M /G - �/?g Plan Review . . P hone: 5036394171 Fax: 503:598.1960.._, , - i+ .'' Date/BY: Other Permit N o.: t9�GY0 Q �O/0 i 1 i ; \ i c 1 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 FEE* SCHEDULE New construction ❑ Demolition For specia[ 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 CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 dwelling SFR (2) bath 437.78 and 2-family g ❑ Commercial/industrial ❑ Accessory building ❑ Multi - family SFR (3) bath ' 500.32 rx 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: G a-5 - Catch basin or area drain 18.76 �� I v� ' _ Drywell, leach line, or trench drain 18.76 City / State/ZIP: V)"'� '( 1-i--- Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 _Qf a_ ` 1 ,-, . , W Q Z V• 4 Rain drain connector 18.76 --\.\ ` , t� fl Sanitary sewer (no. linear ft.: ) Page 2 'v Storm sewer (no. linear ft.: ) Page 2 k? �� L- Water service (no. linear ft.: _) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 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 Address: Floor drain/floor sink/hub 25.02 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: Medical gas (value: $ ) Page 2 • Contact name: Primer 12.51 Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units (potable water) 62.54 Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: eL 3 \ vJ t.,_ C v,i L Ej rt Water piping/DWV 56.29 Address: P Q. \3 ‘ 0 &p t, Other: 25.02 City /State /ZIP: C t. �A L 4 . � � d tP-� 'N l t. t Subtotal �)�, 32- Phone: 4 $ $.-S Z3 'Z Fax: (S 04.s--b D Z S Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: CV - I 5151 _ Plumbing Lic. no.:1* 2et3 - State surcharge (12% of permit fee) ( O , 04- Authorized signature: - TOTAL PERMIT FEE '�[). '3fp Print name: 1 i.e 1 CZ, -e..... >� ,,../ pate; \ This permit application expires if a permit is not obtained within 180 days J t C after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:\BuildinglPermits\PLMU- PermitApp.doc 10 /01/09 440 - 46167(10 /02/COM/WEB) BUILDING DIVISION Mechanical Permit Application roR OFFICE is IJSI: ONLY Received 0 !o /0 /�./ City of Tigard Date/By: '1� Permit No.: f 6 ,, O,_ txl I 13125 SW Hall Blvd., Tigard, OR 97223 V E Al Plan Review Phone: 503.639.4171 Fax: 503.598.19 Date/By: other Permit. tQ Q -000 - r 1 t; A RI ) Inspection Line: 503.639.4175 Date Ready/By: runs: la See Page 2 for Internet: www.tigard - or.gov A U G 0 6 2010 Notified/Method: Supplemental Information TYPE OF w6117EY OF TIGARD COMMERCIAL FEE* SCHEDULE - USE CHECKLIST New construction ❑ Addition /altgatMeWa 1�i�ntlSlUN 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: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total JOB SITE INFORMATION AND LOCATION Heating/cooling "' Air conditioning Job site address: cR5 L i St-.) • t— - 1 '- r _ (requires site plan showing placement) 46.75 AA ,, City /State /ZIP: � \ \ L�.P!- �� ` -12_ Furnace 100,000 BTU (ducts/vents) 1 46.75 ''i10. � ` 1 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: O It wr lJ��� I r`qN Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 vJ Y./ Hydronic hot water system 23.32 C� di +v a 0--- N7 S. \/..N - � ^ Residential boiler (radiator or - ,^ -) `(� hydronic) 23.32 `r W Unit heaters (fuel -type, not electric), � ` TI " in -wall, in -duct, suspended, etc. 46.75 Subdivision: ` Lot no.: Flue/vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater ‘ 23.32 23. - . Gas fireplace 1 33.3937 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 ❑ PROPERTY OWNER I ❑ TENANT Chimneyniner/flue/vent 23.32 Other: 23.32 Name: ■f‘r1 ,A,- JL_, St v4 %Net uN d Environmental exhaust and ventilation _ © t 1 T Range hood/other kitchen Address: U `C� 6-1 S ,, �7 . ,' ¢ equipment k 33.39 ?3 City /State /ZIP: C k--A4 4"), c27_ S" L l C` Clothes dryer exhaust t 33.39 ?j Single -duct exhaust (bathrooms, / q , Phone: ( j' 2_rk( - I 'act 5 yck Fax: (9 ?J Z 4 S b Q ^ 1p ( toilet compartments, utility rooms) 3 23.32 1 c 1k ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Fuel piping Contact name: $14.15 for first four; $4.03 for each additional Address: Furnace, etc. ` 141 h Gas heat pump City /State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CON CTOR Barbecue Business name: IA. 6, lJ C LoA3 C - � / t Clothes dryer (gas) _ Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal 2. -, ` Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: State surcharge (12% of permit fee) [.),!j2,_ TOTAL PERMIT FEE 234 0 1 This permit application expires if a permit is not obtained within 180 Authorized signature: �� Print name: M �� - �4 �/✓1 ,A ix / Date: r days after it has been accepted as complete. 1 * Fee methodology set by Tri- County Building Industry Service Board i I:\ Building\Pmnits\MEC- PermitApp.doc 10/01/09 440-4617T (1 I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: 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 $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or 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. I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 2 10/01/2010 11:52 5036503898 CENTRAL AIR INC PAGE 01/02 Mechanical Permit Application t• ott OFFICE USE ONLY City of Received III a A 1 11�7tf al r � I j roY : ti t C� • • 13125 SW Hall Blvd., Tigard, OR 97223 1 r_ , N ��' p Date PtBn Review Phone; 503.639.4171 Fax: 503.5981960 DatJBy: Other Pennjt T r C ,\ R n lnspoction Line: 503.639 r 1 . Date Ready/By: IA See Page 2 for Intemot: w*w.4igatd or.gov u T Supplemental �1 Ma . Information ( v F • 6 • S fir" { ,ti f w. y t i.r � .. v 7 . � ` ] ii RD TON � p ,..- .�, r ..r - T - a; �{y . :. i :1. , 1'` .,, lZ , 2:'• F t ' :I 1 ;.,.;N.. J • �, IS —' � N� t : i.m, ) • n r L �: } j I;r . i 1 1;:':-.cF:Y i .:: New construction Addition/alteration/replacement Mechanical permit 6aesR 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 CS,. ^ ... . ' ° d: l j" S , ' -' r , v c 1 9 t � N ; , r I G i rjv"� � - ?.:. Value ..:.4 1- and 2 dwelling € rut r t , t ' I / ' ?` ' rr ^ Y B [ ] CommerciaVmdusiriai ❑ Accescery building - ... ... � For Multi family ❑ Master builder ❑ Other: Dest rtpuon ►mat/ 1 use Total or special in o on ' (c r t : i *,v r -1 tp '. - t t 1 . r`i ..._ ; t tv,1 �1 •, r -- __ Rmtitt Job site address: 9 2 5 � S W . N - l� Dc , An conditioning - (requires site >;'lqo showing placement) 46.75 City /State/ZIP: 'r, C 4. ,-e-4 ,-e-4 / G r / q 7 ' - Furnace 100,000 BTU tenets/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg./apt. no.: + Project name: ry r 't la.c.� PYD t (• ' Heat pump 61.06 Cross street/directions to job site: • Duct work 23.32 � [ 3 c,( • a S "6‘-A— A) ,-/-4 L D. L2; -s 3''d� - — Residential n boiler water adirem 23.32 $1 _,._..__. Residtil boiler (radiator or bydronic) 23.32 � Unit heaters (fuel - type, not electric), 17e, i lr-tA1, t 4- .1. t- �,� I 2_61 6 ! cD I Z- $ in -walk in -duct, suspended, etc. 46.75 Subdivision: Lot nil.: Flue/vent for any of above 23.32 Other: 23.32 Tax reap /parcel no.: Other Biel appliances fr r :... t c'„ ,.. n � rr ' 'S � � �l �y.�: ••;':;;;:,:',4 W flttr heater 23 _ 32 ., -- . • . ..a . . r" r, ■:ufr7i .9 %. ;,±!'' ..... ..� 71' : . " E_... .'J' :.. - �. • - - • i Gas fireplace 33.39 At t. — p i . . , ,jj Flue vent for water heater or gas fireplace 23.32 f 1 �,� ,�j ,, (( /� _ L . _ li ..ter _:: 23.32 U 1�l lw Cam" 1 Tit 1 _ VII() B,) . Wood/pellet stove 1111 33.39 Wood .. _.lac+e/insert 23.32 / V am ' • • �= ., -a Chimney/liner/flue/vent 23.32 • i j f;; r .4 . -. !: ' ,• ':' ;'. V7 ;: . . - •; = : ': :•• •e•-• ':!••• • • j • : ,� L :�. '' 1 3�'r -.� t1N itt:fl lr 7 , .' : :'- t • , . • ^•' other 23.32 Name: '17 viAbt..c Pr . e 4 -S L L,e., Environmental cabalist and ventilation Range hood)otber kitchen , Address: A ii b 7 5 V ti) "1 L V-e equipment 33.39 l 7U• 4j Zt vizt Clothes dryer exhaust 33.39 City/State/ZIP: / Q✓ Single -duct exhaust (bathrooms, Phone: ( ) Fax ( ) toilet comparttnents, utility moms) 23.32 :.`•= � .... _ h 4 c t 1 Y i -':.: ' .�r„ l w�+ il e a c/ : :: % .' , c Atnc/crawlspaee Bans 23.32 . Other -{` ', i., +" F : .zt 23.32 Business name:• C -0/V , Y CZ R \ 1 -Y1 t~, , — Fuel piping Contact name: r+ f-Ae c Q_,+ a - O S1415 for first fan /, S4.03 for each additional Address: ' o O. L. `' �' . Gas heat pu pump City /State/ZIP: 0,r_ ,_ C silt r... . • ( :, y WatVsuspended/unfthaatrx Water heater Phone: ( ( p ` z , — 19 Q.$ Fax.. ( Ci ((1 ..: ''',', '7 ;'S Fireplace roD E-rail �• .► t E4 O.:'i? Ran :e �R ,iAn -i o i , ga _r../ r r t r t ' '4' 4'1 . ; .,- Barbeouc Business name: Clothes dryer (gas) • t ■ _ Other: Adds ass' p ` ti 3 _ .v .) - r t�, l ( ` + ! { '. s , I City/State/DR a (CLC ri l0, 0 Q � fit ' ; : ' : Subtotal - Minimum permit fee (590.00) Phone: (59 6 f::-/ ..' 9 tp Fax: (5C)3 fi; . '?S — Plan review (25% of permit fee) • GCB lic.: J • ,1 • I ., —^ State surcharge (12% of permit fee) TOTAL PERMrr FEE - gpplirtationexpires it a penult is not obtained within 180 Authorized signature: .A . 1 ` ` / / • , _ j.' ; ,• been accepted as complete. Print name: ` s/^��1 /-� n A-e ,r Q ` / Date: /0 it / to Fes m ethod oro r -County Building Industry Serv Board e t:1BUildingT nits \ t C-- permitwpp.doe 10/01/09 - 4.1a4. rr i 1 On/CO /WM • Plumbing Permit Application CI��� Building Fixtures �V FOR OFFICE USE ONLY City of Tigard A. G1G Received �C Permit No.: ?� l d .....0 1 31 25 SW H all Blvd., Tigard, OR 97223 (),1 ARQp Date/By: :� 17 Phone: 503.639.4171 Fax: 503.598.1960 F 1 1 � P+ y . Other Permit No.: I Line: 503.639.4175 1 i c.. A r �� Ct �1v 1 S RcadyBy: ]Bess: 0 See Page 2 for Internet: www.tigard-or.gov �1L�1NG Notified/Method: Supplemental Information TYPE OF WORK B FEE' SCHEDULE w construction ❑ Demolition For special information use checklist Description I Qty. 1 Ea. I Total ❑ Addition /altcration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Er: and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 0 Accessory building ❑ Multi - family SFR (3) bath 500.32 Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_ sq. 11.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: q a ry J E'bo Naga ptq.g Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/ State/ZIP: t-7C / CR. Footing d f. rain (no. linear : _) Page 2 Suite/bldg. /apt. no.: ° 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 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.: 50) / Page 2 1 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 � Clothes washer ( 25.02 td� (r) nth v l'} c )r Dishwasher / 25.02 P p�M 1 1(� ! I / Q Drinking fountain 25.02 , ) , Ejectors/sump 25.02 ❑ PROPERTY OWNER ( ❑ 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 a 25.02 Phone: ( ) Fax: ( ) Ice maker 1 I 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory (, 25.02 City /State/ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub/shower /shower pan 3 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 3 25.02 Water heater 1 37.52 Business name:-VII i'1-) 1 5 p1,,,.. lil. + ie,,, , . Water piping/DWV 56.29 Address: 9.• D t>x 1 dS3 Other 25.02 CitylState/ZIP: &O./2a i- , n q q-t73 Subtotal Minimum permit fee: $72.50 Phone: ( ) 5/8/ 7 Li / 9 a Fax: ($153 ) 42(0 q c Z Plan review (25% of permit fee) CCB Lic.: / a L' 1 t t Plumbing Lic. no. : - 6,/ y P!3 /f ,� ®� State surcharge (12% of permit fee) Authorized signature: "-- flV� ��.n�` TOTAL PERMIT FEE Print name: M. t_k.1/t -ttk. K a Date: q - . - o Tbis permit application expires i[ a permit Is not obtained within Igo days after it has been accepted as complete. •Fee methodology set by Tri- County Building Industry Service Board. I I26B- 699 -E0S I4e>1 1a dOI :IO OT TO 400 Dec 15 10 09:35a Lynn and Mark Seaman 503-245-8507 C�GI ,57 Z-8 I ' R ECE VEO I DEC 1 5 M • CITY OF TIGARD Oregon Residential Specialty Code R3182 BUILDING DIVISION MOISTURE CONTENT ACKNOWLEDGEMENT FORM I„ M. aII K Q, zi , am the general contractor or the owner - builder at the following address: Site Address: Q f3g-1.j S w re O City: -prc d Permit #: M S a OIL)- Ooi aD Subdivision/Lot #: � )1 kJ ev Pce4/1 i-I 'f. 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 83182 is provided for reference]. 8318.2 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: r> ti Date: — t 5-I G l Contracto or Owner-Builder [ 1Buildmg1Form1RFS- IvioistureSensiuveWood.dac 091208 L' 9Z999t79E09 11S8d1A1V0 NHOr egg:LOOL S L 0e0 • 0 5' . ? / 1 5-e .61-c) AJD,erh --- 7D4 Ao7 --- • p, p, 6 g co Al Tive.4 AS . , - 200 t ' . . • , . ' . . AUG 0' , . : • \ 96.50' ....,, ...:,.. . . ........1.......,•,....!.......wwww. • 411 ogim.MWARIlwrimms mir 4mo ., .. RECEIVED , i . ,cri-;:. c,i . . 2'7"---7.---77,...„14.--- N.8_9_,922, . . .• - • . • •• • • - --.......::- -....--------- . / • . , . . ....-- . 'AUG 06 2010 . CONSTRUCTION 'NOTES .....-- n-Ree ?AgrEc.7? •-•-, (9 ' _ - •',,:, ___. / --- •-.......... ...../ @ 1, • .{:). EXISTING TEE(S) TO BE RE} 202 '. / / - .7 ------ `---,.. --- ----- , '2 LO srotizt . , In • ......,.. : vii EXISTING TREE(S)TO BE SAN ■, • / 20 IA/ Nal 24 a I • / • ..-/ • /- - cv / / Nc0 .- . CITY OF T•IGA.R1).- SIT.E'F1:01 REV. EW i • . ' ' BUCIILTDYI°NLTDIGIVALSRIDON:. .......: .... . . . :i,. . . .. ..---- 201 -/ / - . ----. J 10'X10 VUILQING PERMIT NO i.-14-rgemo.- ao / ;IA C32i . ,---- 200 I ...--- .;-> CONC I f. .... PATIO. .- • _.- --- - - PLANNING DIVISION: ...equired Setba5ks:. rp<Approved,- : a Not Approved ---- • 198.5' • ' 1..c: 198.5' ,. --..- -- - . • • ...-- .......-• • Side: • • ‘.) Street Side 2..._ ' \ 199 '- t . Ar3 font. Ien .:-.)t) • r; c1Li r / . 30.53' . 1,- 58. 00' Ar 10.. e. ' • 4 -,4i Crance,.. Ap 0 p rove d • :.. Nikit Approved . - '3X1Mtilll Builti.i.2,,, ,_...V. feet : . LL..1 47 PROPOSED SIN ." tV.: I >97 :Nki erviee Provider Letter Required: , - e 4 I _ ate . / • / , j • • : 5C Are < - 198 - - I PROPO - . . .. . .. :- O • -6 Pi ------- FAMILY RESIDENCE I NOINEER t- rigKWIMENT: -`.' • PLAN:1761A11 i• . • • . - z N 0 ,,,,, • /FF/:/19/9.5. • ,..ctual Slope i 4 ,%:. lApproved I . CI 14ot Approved. -I ite pl n: / ' • *Approved ." . CI it - 'proved . , . s: cieto ... ti _ e _d___ 4 ,... t.A. .... , ., - . • • 4 i 4 Se..0 . I , zo "=. re:01 - 196 I i - •,,_ f-- ' -. ) - 197 F- - „ 0 oi! 4fC, -70Yt-16- prit-fri .LA---T ". v Cn PROPERTY ,----1-1 0 , UNE ---______________ . ,Icer' 'X/ IT ..... - : - • • , .. - 2417 4 . ..." ; :. 1 - - -' ---- z ,__..„... 196' I A COVERED - -.... - .. , • •••• '. ..•-•••••--- . . ; / • -... : ., . I o - - P 1.0e4 . A g _ PORCH -., • CONCRETE, . . ..... .,... • • , eecove. ..4060. pet) ,L,..., - -Nit- . 4: . • - . . - DRIVEWAY ..._ ", a : . .,. 196 - ' la -........ ' I ' • '. ' • • • • & 1 • g- • -(44 5/' .2erere & 1 . • „....SI- DkLIALY..---. - . • • .. 0 ii . I ..- ,. ... ... . . , . 10 FIR RAIN AIN , I . , 4 AB, SCH40 -• 1 - I . - :-/. - • . • • - 4 . . - - 1 ''''''''' ,-, . :- : ..e.ritlft . . 4 . ..• • .. 4 .. • • • - • : I ,... .7 ....- .; ...:' .• • : • • - _ • • . di -. . 1 1 .4 D 4.:i.•-,y . ,-,... --, - •,.: 1 : • • • , ---11 ' . --..'-..:-.' *:- 4. -- .!.. ; 0 'EASEMENT ' ' '...::,.•••••••.:.;,.., ', :, ..... . . , ___ ....---- --....... I x.. -........ _____ ....,, WA-TER LINE, 1"0 PVC/ •_____4 ; - . .• 1 , - 1 ' " - 4 , - • ' '-v-- (SEE A :--- -7----: 195 -- 4.0' 0 x 5.0' . • DEPTH DRYWELL ____/ (CONNECT TO UP( WATER) ' ' - .- 7..-*--- ---a - • • 193 - • o I > -•--• • .. . : . . . . . ry • . TTACHED DliTAILS) ri . • . - f.- • -• 4 : 4 • .. .„ 1 ,,, .:. '4 : .. 4• • ..: . . : ' :a . • e 0 ''''R 311 iStWER LINE, 3"0 • 6"FIR ,...,--- ABS (CONNECT ...TO c•1 _.-- --- -____ a 1 • 4 - ... - .. • - .. •I- • • -: ... • : :. 4: 4 • , ' 6 I ----- - CITY SEWERY---_____A .. . • - ... . ' •. , • .1. .4' ..; . . • •'• . # - ' • •OITY or ricAsto SITE PLAN RtVIE - W re) 194 -- 7 1 I . • „, . . . • h. •• la t.. ..- 4 . 4 ' • • ••• • ... - . • . • • , • . - , A ilwi t m Rm. T NO: .. .. • - , . • 24"E1R- - ..... ._____ _.....-- -.•___.4.• .... i •. . .. 4 . 4 * - .4 ds91 , ,--- • . " ..- --•----- --AI.- ,.. 1 -'1 - - Sil Wiftelf.. ' E y. •:, . - 1 .... *. ‘4 Ret*Alej .• -.• . • 1'42. ---- --,-6 . 4pproved . 1..i - ot Approved . I 0 • ''''..... • ".:_4.• '. :-• .-- .. .. • AllImairrtees: • . ppedved KA ,' ._ mo d Pi) • F _____ ______. _ - i: 1 , 10 FIR - - . .. , . •• . • .. • ' • / Notes: I__ ----- n a- ---- 1 10"FIR _ .\ •• • ' ! ' -- ' . • . . .. • . rct .t.r 4 . .. " , . • 190.8' 19 .5' ,/ ix) 1 . 8 1014 - . - • • •• .. .._.... - ! -191- ......___ . . • ... ., , • , .. • • • 4 . alik. ; • • yyvtoia..., le: - ii- -iv 0., fa.. Y '''' • . ' N c :,.........„..:.,„ ,,.. . . • • - • 11),9 '::•:•:-. • • : . .. ...1._ 5.0' SIDEWALK -------_;•!Li •: 7 : ..• . . i ' 4. • .4 .---. 71 :- .. - - - ' " e--. - - .1 . '. CO PON ...... .. . . : 4 - • ... ' .. • . . 4 . i * • urciarroN . . 4: . ow.conow .• 4 ' ... • .. . .. ' . r. . 6,-- Liii+ erivrf Tp 4" 4 . • i% .. .. 4. • • • .. *. 8"COTTON ®.* - - • - . - - • • •• 8.0' PLANTER . .................... - ... • . - .... . ...... • ' 4 :. -.:- -' •• .............. ' ....... I ......... :-. • - • ' : 1 . 4 .'' • ..1. : .- ., 4 . . * . 4 . 4. .4. ............... • * ............ * . 4 . . ' - 4 , • : ..' 4... .• • . .. • 4. ' . 5' CURB -----., .4. 1 . • • ..il , 11 • 4 - .. .....- • ___--.------ i • . et I I 5 3 a- 4. ! Y Y '''5; Oregon 1 J on Residential Sp Code R318.2 co 0 T co a te. %,, `a erg MOISTURE CONTENT ACKNOWLEDGEMENT FORM/. I, I V a Sea mai , am the general contractor or the owner- builder at the following address: Site Address: gas s w Y 1_ /� p City: Tipa.td Permit #: MST A 5T a Did— 00 I a g Subdivision/Lot #: V -eItw Pcti-1i -- -o,, Lo+ a 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. 111 • Signature: r / Date: 1,2-/.5"-/O Ge •ral ontra- or or *wner- uilder I:\Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 H2OME Certified, Inc. Monitoring Report Customer: Timber Projects, LLC Street Address: 9322 SW North Dakota MC Goal: 18% Start Date: 11/9/2010 Sales Order It: 12675 Subdivision: Lot/Unit #: City: Tigard, OR Completion date: 12/20/2010 PO #: Cross streets: Site Supervisor: John PH #: 503-351-2332 Cert: Expected Date: Price $: $450 Date Moisture Content Readings 12/20/10 8:58 12% 12% 9% 13% 13% 12% 14% 13% 13% 13% 11% 11% 11% 12% 11% 10% 11% 10% 12% 11% 11% 12% 16% 12% 10% 9% 11% 9% 11% 12% 11% 18% 12% 12% 12% 10% 13% 11% 10% 12% 11% 11% 11% 11% 12% 11% 10% 10% 11% 11% 12% 12% 13% 12% 13% 12% 10% 8% 10% 9% 1.1% 10% • • Crawl Space n s ace E ul : 2144 2066 299 1751 2113 Pulled 2144 2066 299 1751 2113 1492 D277 556 1837 Equipment 1492 D277 556 1837 Crawl Equipment 343 Pre - insulation moisture testing (Frame drying): X Notes: 12/20/10 Still in Crawl I Crawl testing /drying: X • Floor testing /drying: Water Damage: Sheetrock drying: Stud scrubbing: Certificate of Moisture Content: Other: ' Electric heat: Visitation: 11/12/10 11/16/10 11/19/10 11/23/10 11/26/10 11/30/10 12/3/10 12/7/10 12/10/10 12/14/10 12/17/10 Contractor signature: Date: 12/20/2010 Customer signature: Date: 12/20/2010 Curt Kaupe A See terms & conditions on back Oregon Residential Specialty Code N1107.2 ,„. „ui , c, -1.11/ HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS''-?''p Permit No.: D �o -uw Jurisdiction: (��s Site Address: _ L l /� 7 f 2)73 �C aP Subdivision/Lot #: #e/htio_;y ,D 1. /`) - (rsi L07 D— 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) �1I p S ignature: L/jjleir � ��L Date: 02 - 1/ — `1 Owne G 7 ral Cep actor / 7 ut oriz- Agent ; Print Name: — 76 1 /1 / / 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. l:\ Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 YliJ a9,tD -oot9 d STREET TREE CERTIFICA TION I, -- 0)/10 owner / r agent o cam? /( g f (PLEASE PRINT) (PERMIT HOLDER) do hereby cert6 that the followinglocation meets , C .y ` do \1 C of Tigard eland use and develo merit standards 0 d : ?a for street tree installation eznd'is consistent ,' c; ,with the approved site plan. SITE ADDRESS: - - 3 , U l ' ,- Uk SUBDIVISION: /7 /to . 1 11( Lam, LOT #: a SIGNATURE: r DATE: J / — /( /D /AGENT) RE CEIVED & VERIFIED BY: DATE: (CITY OF TIGARD) Tree location verified per approved site plan. I: \Building\ Forms \StreeffrccCertificate 07 /01/2010