Permit CITY OF TIGARD MASTER PERMIT
IIIII C COMMUNITY DEVELOPMENT Permit #: MST2010 -00197
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2010
Parcel: 2S109DA17800
Jurisdiction: TIGARD
Site address: 15287 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 107
Project: Arlington Heights
Project Description: New SF. SDC credits for TDT & Parks from demo BUP2006 -00393 applied to this permit.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1155 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1548 sf Garage: 717 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2703 sf Value: $292,636.80 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
0 Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell- Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Tvpes 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
Fum > =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 addl 500 sf: 5 201 -400 amp: 0 201 -400 amp: 0 W/O Svc/Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
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:
NEW SF VB R -3 2703
Owner: Contractor:
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC Required Items and Reports (Conditions)
16869 SW 65TH AVE #505 16869 SW 65TH AVE # 505 1 Ersn Cntrl 503 - 681 -4444
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503- 387 -7577 PHONE: 503 -387 -7577
FAX: 503 - 387 -7615
Total Fees: $7,903.16
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 ' co ante- 'th 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
day ATTENTION: Oregon requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR : • 001 -0. • r You may obtain a copy of the rules or direct questions to OUNC by calling 03.2 or 1.800.332. 4.
Issued By: �� `� '� / Permittee Signature: ( j
/
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential RECEIVED FO,Z OFllCI; lisi•: ONLY
A �(��
City of Tigard 0 C T 2 8 2010 DateB Receiv / / r Permit No.: p —do f q 7
. ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ► .
Phone: 503.639.4171 Fax: 503.598.19�q,,,.�, OF TIG Date/B �`
: '/�/ rim Other Permit:�ji, r 0 r 5 1
Inspection Line: 503.639.4175 Ll l i ARD Date Ready 7 El See Page 2 for
lZ° Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: 1/ () t0 'f7) i_ Supplemental Information
t t_✓vn ¢rw- Qty
TYPE OF WORK REQUIRED 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. �
®
1- and 2- family dwelling ❑ Commercial/industrial Valuation: 2.1z 5 ?O f2 ,80
❑ Accessory building ❑ Multi - family Number of bedrooms: i
❑ Master builder ❑ Other: Number of bathrooms: 2 t
JOB SITE INFORMATION AND LOCATION Total number of floors: .
Job site address: 15 2:21 o - VL New dwelling area: 2,103 square feet
City/State/ZIP: Tigard, OR 97223 Garage /carport area: 1 1-i square feet
Suite/bldg. /apt. no.: Project name: Arlington Heights Covered porch area: 5..i square feet 158
Cross street/directions to job site: Deck area: square feet I (,j
Other structure area: 3 ! ` square feet-
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Arlington Heights Lot no.: 10 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 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, Single Family Residential Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 16869 SW 65th Avenue #505 Occupancy groups:
City/State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616 New:
❑ APPLICANT _ ❑ -C CT PERSON NOTICE
Business name: SEE ABOVE O All contractors and subcontractors are required to be
Contact name: Gayland Forsb �') 1.061— t'7 (0 licensed with the Oregon Construction Contractors Board
C 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:( ) Fax::( )
E -mail: gayland@stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: 173318 Total fees due upon application: � OB
Amount received: P7,56
Authorized signature: Yhtac,L... YP ^- This permit application expires if a permit is not obtained
�" 1 within 180 days after it has been accepted as complete.
v
Print name: 1Vr tALK lyNot.awctobr, Date: * Fee methodology set by Tri- County Building Industry
Service Board.
1 I: \Building\Petmits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB)
`Y~ RECEIVED
Electrical Permit Application 1:0 14 (11:11( ' I; l s i; ONLY
City of Tigard OCT 2 8 2010 naffed �a �� 1 7 /D
Per m it No.:
: . • q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review W��O —OOl$
Phone: 503.639.4171 Fax: 503.59>�1 OF 'I IGARD Dat : Other Permit: a
t I c 1t D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: fur s: la See Page 2 for
Internet www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ 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",
Job no.: 141$ Job site address: (t 2_151 �' cum I't /V C w T�f • 100HP or more Recreational ,m elf J t ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SC
Cross street/directions to job site: Description 1 SCHEDULE
Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
O , 1,000 sq. ft. or less ( 168.54 4
Subdivision: Arlington Heights Lot no.: Ea. add'I 500 sq. ft. or portion Cj' 33.92 b`3. (C> 1
Tax map/parcel no.:
�� Limited energy, residential - 7501 1 6: et 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family
67.84 I 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 turps or less 100.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State /ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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
0 APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits
Contact name: Gayland Forsberg
without st bran service or feeder fee, 56.18 2
Y � first branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: gayland@stonebridgehomesnw.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: City Electric Signal circuit(s) or limited -
ty energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /ZIP: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (971) 404 - 1714 Fax: (503) 625 - 3052 Investigation per hour (1 hr min) 66.25
CCB Lic.: 42422 Electrical Lic.: 26 - 289C Suprv. Lic.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 4 ('?) , 14—
Print name: Chuck Friesen Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): et ,-sEs
Authorized signature: j TOTAL PERMIT FEE: i - 7
Print name: Date: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
• Number of inspections allowed per permit.
l:\ Building \Permits\ELC- PemutApp.doc 10/01/09 440.4615T(1 r/o5 /COM/WEB
Mechanical Permit A lication IOl( off lc :l: USE ()NI.)
City of Tigard CEIVED Received /0 ° to A Permit No.: ff Pao% -oo /97
1111 • 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
C
Phone: 503.639.4171 Fax: 503.598.1960 2 8 Date/By: Other Permit: ,5� Q po/•0 ce/
T I G A It 1J Inspection Line: 503.639 our T 2 8 2 10 Date/By:
Ready/By: raris: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE OF W
uA t,DING DIVISION 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*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description i Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 152:2n 31,A/ Air conditioning
J(s OUP MD- ( yft(, ) ' U 111('t (requires site plan showing placement) 46.75
City/State/ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) % 46.75 , t�'�
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Arlington Heights Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic 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: Arlington Heights Lot no.: 1
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 23.32 73:
Gas fireplace 1 33.39 n•
New, Single Family Residential 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 , Chimney/liner /flue /vent 23.32
❑TENANT Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation
Address: 16869 SW 65 Avenue #505 Range hood/other kitchen
equipment l 33.39 .j.
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust I 33.39 .
Single -duct exhaust (bathrooms,
Phone: (503)387 - 7577 Fax: (503)387 - 7616 toilet compartments, utility rooms) 6 23.32 1( ,14
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: same as above -
Fuel piping
Contact name: 514.15 for first four; 54.03 for each additional
Address: Furnace, etc. 1 14
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
)
Phone: ( ) Fax:: ( ) Water heater
Fireplace 1
E -mail: Range
CONTRACTOR Barbecue
Business name: Comfort Zone Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Troutdale, OR 97060 Subtotal `33Xo.1
Phone: (503) 667 - 5595 Fax: (503) 491 - 8252 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 110091 State surcharge (12% of permit fee) ?.1
TOTAL PERMIT FEE 7. 1
This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
Print name: David Heldstab Date: • Fee methodology set by Tri -County Building Industry Service Board
I :\ Building \PennitsMEC- PennitApp.doc 10/01/09 440-4617T (11 /02/COM/WEB)
Plumbing Permit Application RECEIVED
Building Fixtures
City of Tigard oc i 2 8 2010 Received I7aicBy: !o P6.1° �� Perr,�t \ o. tf yfdOlO - �(
il
13125 SW Hall Blvd.. Tigard, OR 97223 t'tan Rcvi �►
Phone: 50)6394 7) I Stl3 :598,191r1►C 0?TIGARD ,�, otirerpeerai1 Flo $e J»/e, -t / 5�
1 C A D Inspection Lint: 503.639.4175 B UILDING DIVISIO Read hail! 62 See Pane 2 for
Internet: www.tiird- or.gov �Ioei ethud: Sapplemeotat:latarmalian
TYPE OF WORK FEE"= SCHEDULE
® New construction ❑ Demolition For special infonmatlun use checklist
Description 1 OI_v. 1 Ea. 1 Total
0 Additionialtcrtitionircplacemcnt. 0 Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY .OF - CONSTRUct1ON, SFR (1) bath 31230
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath C 500.32 45CSGt
❑ Accessory buli iing ❑.Mufti family
Each additional hath/kitchen 25.02
❑ Master builder 0 Other: Fire sprinkler t sq. 114 Page 2
JOB SITE INFORMATION "AND.I.00'ATION Site utilities:
Jolt site address; 19 2.$1 3W $UN11v t .'vtc w `>i,Ve- Catch basin or area drain 18.76
City/State/ZIP Tigard. OR 97223 Drywcll: leach line, or trench drain 18.76
Footing drain Inn. linear 9.: ) Page
Suite/bldg. /apt. no,: I Project name: Arlington Heights Manufactured hone utilities 50.03
Cross street/directions to job site: Manholes 18.76:.
Rain dram connector 18.76
Sanitary sewer (no. linearfi. :) Page 2
Storm sewer (no. linear ti,; , ) Page 2
Water service ton. litwm'il.: _) Page 2
Subdivision: Arlington Heighlx ( Lot no.:. 101 Fixture or item:
Tax map/parcel no.: Rackfow• prcventer 31.27
UESCRIPTfON OE 'WORK' Backwater valve 12.5l
Clothes washer 25,02
New Single Family Residential
Dishwasher 25.02
Drinking fountain 25:02
Ejectors/sump 25.02
. 'a PROPPRTY'OWNER.- ( 0 TENANT Expansion lank 1 2.51 -
Name: Stone Bridge Homes Fixture {sewer cap 25.02
Address: 16869 SW 65' Avenue #505 Fluor drain?tltwr sink hub 23:02
Garbage disposal 25,02
City/State/71P: Lake Oswego, OR 97035 ' Hose bib 25:02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
Q APPiJCANT la PERSON intcrcgtorfgrensc trap 25,02
Business name: SEE ABOVE Medical gas (value: 5 ) Pttgc?
Primer 1231
Contact name: Gayland Forsberg
Roof drain (commercial) 12,31
Address: Sinktbcisinrla, atot • 25:02
Ciiy/State.2IP: Solar units (potable water) 6234
Phone;`( ) I Fax: • ( ) T'ubtshowtr /shower pan 1231
E- mail: gayland@stonebridgehomesnw.com Urinal 25,02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Legacy Plumbing Water pipingr'DWV 56,29
Address: 8985 Hazelvern Way Other: 25.02
City/State/ZIP: Portland, OR 97223. Subtotal 6C)0,,
Phone: (503) 816 -8887 Fax: (503) 297 -4587 Minimum permit fee: 572.50
CCic.: 159281 Plumbing.Lic. no.: 26 -Si7P8 Plan review (25% of permit fcc)
l31.
State surcharge (12% of permit fee) 1oO ,
Authorized signature: 77Z,, ell -.,..., TOTAL. PERMIT FEE 5 3 ,
Print name:. trine* NelSnn I Date: I Phis permit application crones if a p e r m i t oat nbraiord wtthio ISO way.
after It has been accepted as complete.
"Fee methodology set bird-County Building Industry Sevier Board -
tau±ldy;?Pmni,sJ•LSKI- ornitA +dor 1001,'11 +44- 0161tI04t:,63310W111t
STONE BRIDGE OBE: 1478
I30MEs NW T.T.0 LOT: 107
2.588Q 9W 815th AVE.. # 1505 DATE: 11/03/2010
L♦: s O s if i s O. O s s a O x Y 7 0 s
(503)387-7877 kECEIVED PROPERTY:ARLINGTON HEIGHTS
TIGARD
Q �� COUNTY: WASHINGTON— COUNTY
NOV
SCALE: 1" =20'
CITY OF TIGARD PLAN No.: 225
BUILDING DIVISION STANDARD ELEVATION
20
21' -3' iii
.ov L n
TN: 14.7 IF.
`r " B co _D TN: 414.7
h��` r- _____..2,_. 414 ia
EL •421'
412
� 1;� , -- --, - — €�-
4 11 g, 41 410' - • 1 i 14 .. .vas sq. re. 11i11 R
4
h i . : .4108' �' 111) 406 W 0$ ,� 1 , � %I WAS c•1
1 in I ._ .., 215' 1 yTO� r
409 in 409! ~ , , ,
,,, re V �11 .' 'i;A k.. 409 _ � �� V
I BC -,,
=.,r• _— r — I
n,� l 3 - 22.-61/4.
v 110 ♦ 404.6
EL•415 6��/ /_ 7--WPg1—
e e e
m� ss,P a V L. .t:.
VVV : 14.6
LEGEND
LOT COVERAGE STREET TREES
LOT AREA: 5,954 SQ. FT. j 0 — 2' CALIPER RAYWOCC ASH
BUILDING AREA: 1,924 SQ. FT.
PERCENTAGE: 32.2%
BUILDING HEIGHT: 21' -5' oI101
20% MN. LANDSCAPE: 1,191 SQ. FT. r e dr — RETAINING WALL
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS. APPROXIMATE FIGURES.
ALL DIMENSNS AND ALL RETAINING WALL HEIGHTS AND LOCATIONS ARE ESTIMATES. LOT •101
THEY MAY VARY AND BE SUBJECT TO CHANGE. 5,984 eq.
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES,
STREETLIGHTS, AND OTHER SITE CONDITIONS.
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: - 10 w MIT,
I,►
PLANNING DIVISION: Approved ❑
Required Setbacks: pp
Side: __S-- Street Side:
Garage: �_ Rear: _.L1 --
Front. Ince Approved ❑ Not Approved Appro
Visual Clearance:
Maximum Building Height .. feet
CWS Service Provider Letter Required: 0 Yes ceived No
Date: IS
ENGINEERING DEPAR MENT: Not Approved
Actual Slope: I� Nop
% Approved 0 roved
Not pp
Site Pls- : Approve ate: / " �
B : �6
Notes:
• TIGARD - SITE PLAN 95'""
BUIL) PERMIT NO' „ t �°t"► C)
Street Trees: AApproved ❑ Not Approved
Approved C� N App
Protecte Vf , Date: 1 f 0 3 3
Notes;
Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, A (iv am the general contractor or the owner- builder
at the following address:
Site Address: / S ZF C - yam -0 c- �►/
City: 1-7 ,CI✓ it—
Permit #: 2c./e) d U / CJ 7
Subdivision/Lot #: w
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.
Si
Date:
— eneral Contractor or O wner -B
•
h �LL
I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
� F
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.:
Gam` -57" 20/v UU / 9 7 Jurisdiction: 7jr. �r
Site Address: is , 7 s l„,..)
Subdivision/Lot #: l C� 7
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 Ni 107.2)
Signature: Date:/
Wier/General Contractor A orized Agent
Print Name: OpPi. V lc q
' 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
STREET TREE CERTIFICATION
1 , D pr vv V-e ; `owner/ a for B c 1:
(PLEASE PRINT) I (PERMTF HOLDER) Z_ 2-
do hereb' cei ' that the fbiidvi ngib cat ion meets
y . � ,
City of Tigard k nd use and *elopright standards
for street tree - installation and` =is consistent
z nIS the a r v ed to plan. Zc� : � - .
�� mac.
/A\
SITE ADDRESS: IS 2.2 `- r
SUBDIVISION: 4 IA^ vt: LOT #: k)
SIGNATURE. DATE:
(0 ►. •'AGENT)
RECEIVED &
VERIFIED BY DATE:
(CITY OF TIGARD)
Tree location verified per approved site plan.
I: \ Building \ Forms \StreetI'reeCertificate 07/01/2010