Permit CITY OF TIGARD MASTER PERMIT
IIIII C COMMUNITY DEVELOPMENT Permit #: MST2012 -00173
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 2S 102 DCO5800
Jurisdiction: TIGARD
Site address: 13773 SW 90TH AVE
Subdivision: GERTZ HOMES AT EDGEWOOD NO.2 Lot: 7
Project: Gertz Homes at Edgewood No. 2, Lot 7
Project Description: New SF. Demo credits from BUP2011 -00091 applied to this permit.
' BUILDING
Floor Areas Required Setbacks Regulred
Stories: 2 Bedrooms: 4 First: 1557 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1692 sf Garage: 609 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 3249 sf Value: $365,993.44 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories:- 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 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 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
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: 6 201 -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 8 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 3249
Owner: Contractor:
GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC Required Items and Reports (Conditions)
19200 SW 46TH AVE 19200 SW 46TH AVE 1 Ersn Cntrl 503- 639 -4175
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: 503 -692 -3390 PHONE: 503- 692 -3390
FAX: 503- 692 -5433
Total Fees: $9,412.87
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. 0 01 NTIO : regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 0 through 0 952- 001 -0090. You obtain a copy of the rules or direct questions to OUNC by calling 503.23 . •87 or 1.800.332.2344.
c
Issue y: • Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection • e.
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.
Dec 07 12 11:30a BRIGHTEN ELECTRIC 5415497213 p.1
Electrical Permit Application RECEIVE r I OR OR OFFFI E t SE ()NIA City of Tigard . vim /2 I d / 1.1 Permit No : M5r2012 -00173
'
• 13125 SW Hall Blvd., Ti ) : rr �
Tigard, OR 97223 DEC (� 1 0 20 � 'L Plan Plaa Review Other Permit:
s Phone: 503.718.2439 Fax: 503.598.1960 C 1, Date/B
Tic 1 RI) Inspection Line: 503.639.4175 _ Date Ready/By: Juno ® See Page 2 for
Internet: www.tigard- or.gov CITY O F (! IG Notified/Method: Supplemental Information
TYPE OF w jLDING DIVISION PLAN REVIEW
E New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems 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
E I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑Multi- family D Master builder ❑Other ❑ Fire pump. ❑ Installation of75KVAor
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor bad of ❑ "A" "E', "1. T' "1 -3"
Job no.: Job site address: 13773 SW 90th , IOOHP or more. occupancy.
❑ Six or mom residential units. ❑ Recreational vehicle parks.
City / State/ZIP: Tigard, OR ❑ Health -care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg.apL no.: Project name: Gertz Construction ['Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Dneription I Qrr. I Wee. I Thiel I •
' New residential single - or multi- family dwelling unit.
Includes attached garage.
Subdivision: Edgewood Lot no.: 7 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft )
• Limited energy, multi- family
* *CHANGE ELECTRICAL CONTRACTOR ONLY ** residential (with above sq. ft.) 75.00 2
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
401 amps to 600 amps 200.34 2 ■
Name:
601 amps to 1,000 amps 301.04 2
Address: _ Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation
Phone: ( ) Fax: ( ) 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 to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits u•irh
above service or feeder fee.
❑ APPLICANT ❑ CONTACT PERSON each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included) _
City/State/ZIP: Each manufactured or modules 67.84 2
dwelling, service and/or feeder
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 circu it(s)or limited- energy '
Business name: Brighten Electric, LLC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: PO Box 2236 Additional inspection (1 hr min) 6625/ hr
City /State/ZIP: Sisters, OR 97759 Investigation (t hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: (541) 549 - 7210 Fax: (541) 549 - 7213 Inspections for which no fee is 00/ hr
specifically listed ('Yrlu min)
CCB Lic.: 132222 , Electrical Lic.: 34 -483C Suprv. Lie.: 4667S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required :crG;(;1 6 Subtotal:
y.-- Plan review (25 %ofpermit fee):
Print name: Larry Young Date: /6/12 State surcharge (12% of permit fee): .
TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
1 !Dui tdineennitriELCPamitAppdoc 07/01 /10 440.46tS4ItO5 /COM/WES
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
: . II . Request Permit Action
4.,,:;,,,,, I r 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ® Owner ❑ Applicant ❑ Contractor ❑ City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State /Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL /VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
® REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: MST2012 -00173
Site Address or Parcel #:
Project Name:
Subdivision Name: Lot #:
EXPLANATION: Change Electrical contractors
Signature: Date: 12/6/ 12
K e i
Gertz
Print Name:
Refund Policy
1 The Director or Building Official may authorize the refund of
a) any fee which was erroneously paid or collected.
b) not more than 80° /u of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. .
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended
e) not more than 80 of the building permit fee for issued permits pnor to any inspection requests
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds ,
' ' FO OFFICE USE ONLY i i
Rte to S s Admin: Date v !��. 1-' Rte to Bid: Admin: Date 647AMIllQrille j
Refund Processed: Date B Invoice Processed: Date B
Permit Canceled: Date B Parcel Ta : Added: Date B
Recei.t # Date Method Amount $
1:\ Building \Forts \RegPemutAction.doc Rev 05/25/2012
Building Permit Application
Residential
i ', _ _ . ;- ,i
4 ll — I --‘ .' ..... ■ 1-- '' h
11 ' - 2 . .-- •i• • FOR OFFICE litil.: ON 1.1
1. City of Tigard JUN 2 3 201? R W i0., Permit Nqt/S7:2 .....do / 73_
• 13125 SW Hall Blvd. Tigard, OR 972'23
' gi Phone: 503.718.2439 Fax: 503.598.1960 ;-. • A - • Plan Ren •,,..,‘ , ..,, A, .1
Other Perrnitjtd fi 3
• ,,u ,1 7, ji ;-. . ..,', 4 41-
T I G A RD Inspection Line: 503.639.4175 i
,,.„,, ., ,, „ , : i, . Date Rea. - y: d o,, A EM kris: ic....... 0 See Page 2 for ,
Internet: www.tlgard-or.gov LVALL', '..,, ',..,ljl. i41 4 eth°d: ° Supplemental Information
.,t New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
' :' '' ,.• -' 4i.T .'.... 714 ' •"-: C.._,A:.••-:'(i'"-:Zi'i:t6:1:::.•jiiitiiii • ::.-•,=,;7:-.7.t.-i.,.-.:;.:.:1-.,!:.:;i:.,::.:;,--: work indicated on this application.
Y4Ff"-Aiiii: .:s.: ......‹. -., n A 4V I:.1 • .• ...-;':: • . •'::?• -
0 1- and 2-family dwelling 0 Commercial/industrial $
industrial
Number of bedrooms:
p Accessory building 0 Multi-family f
0 Master builder 0 Other Number of bathrooms: 3'
:-::••, -..,_,,,,,,_.____,,,,, - - .„::3..,,1:f,.-...:.:7k-..7:-..4,,,F217-,-.?.,L--"I'-',-!.,.-,
t",,i!,:1,,,,.,s1Wfill.-..,..i.,',.VA,FOW,101.(4-****MilY4cW0.1A -::',-'j.A='!':3..fei'..-1'.4.41.-.-...-:#7':-•:.:' Total number of floors: --.2..
-
Job site address: / 3 2 3 S c.-1 4,0 New dwelling area: 32A square feet .
City/State/ZIP: Tigard OR 97224 Garage/carport ai (cat square feet
Suite/bldgJapt. no.: Project name: Covered porch area: zzo square feet ( 66i 2- -
C r o s s street/directions to job site: 0 A 4 A-Aii• 7 C Deck area: square feet ( 6
Other structure area 36, square feet 74..
::
Subdivision:. : C,, e f c,. de Z__ Lot no.: $ 7 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.: s a jo goo equipment, materials, labor, overhead, and the profit for the .
... work indicated on this aplication.
Valuation: $ ..
_AL-6-ex..)
Existing building area square feet
New building area:. square feet.
i \ ' ' ..':',: • • . Number of stories:
Name: 6. 71A.,( Cf€'1 43 4 e— . Type of construction:
Address: /f2.- <',a) C il If.--. Occupancy groups:
City/State/ZIP: -1 cr , ‘..e.... Z; T2 062-- Existing:
Phone: ( 5z)3 ) • F i_--js t _ ...Fax: (,a . 3) 6?2.-s 3,3 New:
. 1::'=',-,:::'::'$2,46-241-dialgrii;cripamew aumwmagoimairtsg::,:f::::::1474
,,..
Business name C7e /Zrikie 4‘,4„,
•
Structural plan review fee (or deposit):
Contact name: e 4, ‘ — _
MS plan review fee (if applicable):
Address: /1 ZOO - 14-1 4 6G
Total fees due upon application:
City/State/ZIP: 17 ..., Of4.... 97 2 —
Phone: ( 5 ) 4,012.-33 fee Fax: : (SC13)412,3- ,e3 1 , . Amount received:
E-mail: X-e or CP arer4 .C.17
,, -...). - ...:7Y,d - dd - - .- .7. , : . ..!..T.:444 dd.! 'd , - , -• d • d ,d.v.i.6::;d1 d: d, _.;:: , ,d.... ..,,,,,,...d..;.: Commercial and residential prescriptive installation of
:;r': ' ' • ' roof-top mounted Photo Voltaic Solar Panel System.
Submit two (2) sets of roof plan with connection details
Business name: Ge47 ./crl dr ......or
and fire department access, along with the 2010 Oregon
, -I
Address: / ? 2....CM, 5 (.:(...) Le (.. Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee (includes plan review
ty/State/ZIP: - 17 ( iG 4 ,4_ , -) 6 C 2 — $180.00
and administrative fees):
Phone: (T% ) lei.g7,2 -3s ''IS Fax: ( .) ) ‘,? 2 - 5 Y 3 3 State surcharge (12% of permit fee): $21.60
CCB lie.: 3 3 sn
Total fee due upon application: $201.60
Authorized signature: / .........si This permit application expires. if a permit linot obtain ed
within 180 days afterithas been accepted ilicompiete.
* Fee methodology set by Tr-County Buildinglndustry
Print 11111IIII: /9e,„J Trhanar Data pirt(2--- Service Board.
IABuildinipPermitakBUP-RESPermitApp.doe 02/24/2011 440-46 I 3 T( 1 1 /MCCAW/BB)
robing Permit Application ... •.
pplication .
USE �
.lding Fixtures Rig,c,,71 , I OR OFFICE ;1•: ONI.l
•
am ∎0 :f ! a
•
1 City of Tigard • Rec Reeeeiveive Permit �l silo /V- zy
13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 3 2 012 ' Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
■ 0 Date/By: Other Permit No.: -
Inspection Line: 503.639.4175 CITY Y an TIG p D Doti Ready/By: lure. it See Page 2 for
171
Internet: www.ugard- or.gov s 1 a t to �, Notified/Method:
- _
Sop Information
•
,.�L:�•;:.' :ai: e . ''n' :gT ox - •:3> : :i:ti:J f' ' ^� "'.eT` +'L'!'...',..;,...1.-..,::..?... `��i'' ) rl �:�'.;.
Y1 _ r _: _ _ :2 �!: tl I }• µ ;.,. ?„ : - .-
construction + ❑ Demolition • For special information use checklist
Description I Qty. I Ea. I Total
dition/alteration/replacement 0 Other • New I- 2- family dwellings (includes 100 ft. for each utility connection)
n.,,:• ..__ .., Fsx •:Y - -;,€ .- SFR 1 bath 312.70 •
'�Lnp�. ie L ..:r •jt .�•. ..YSi. I' •: � _ ":4 ✓,r. f \1i_ � CI . = 1 Y. }L- ,c,..� ✓�' ..y ( )
.-a0.'{ �..^sr . i c 1 n1�K w „ i : .e. :\. 1 r . ' : , ;t "S .✓'3ei
SFR (2) bath 437.78
and 2- family dwelling ❑ Commercial/industrial SFR (3) bath 500.32 £ ,/,'37._ •
cessory building ❑ Multi- family Each additional bath/kitchen 25.02
aster builder - ' ❑ Other , Fire sprinkler (_ sq. ft.) Page 2
. Q}Sy] ��� { � [ � - ' y .��,�� r .�„� ••,.: ...:,:,:_,,a Site M C • 11 - [ ''i •;� .i ti^ ;�.`'.�..'. , ';' , •r.••:.. . "
18.76
:e address: / 3 7 y . ?3 0 e,el Q f' � . Catch basin or area drain •
Drywell, leach line, or trench drain • 18.76 •
tate/ZIP: . s C7L y7 2.2 . y Footing drain (no. linear ft.: - Page 2
bldgJapt. no.: // Project name:
Manufactured home utilities 50.03
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.: _J Page 2
Water service (no.' linear R: _) Page 2
vision: ‘-'( S . .0 ,r6 ,i Z.__ Lot no.: ? Fixture or item:
J Bacldlow preventer 31.27
nap /parcel no.: •_ ..,:..;_: :.• •'- Y: . 'Wr Y. .;=r : :. Backwater valve 12.51
a ir ..�.. ... :-•g -.ft' .. • ..y- ••:`-'- .'.-'•r' r�2 I:ifuk-.n °, .V.',ei..:: r• '
A '��'Lr�'S�".�:L�F7a�:v -`.!F A94iM•o► a .. .,....•,_,; _Y�: ,�.
„r. N ®H ,e. ' -1 , -,:' ,'..u.r � .: Clothes Washer 25.02
-e er} �00•04.. Dishwasher 25.02
• Drinking fountain 25.02
Ejectors/sump 25.02 .
i .' .r „s
•. � r i' (
9va t 1 u a . 5- .4. 71 7 � - _
�r c ...z Expansion tank 12.51 -
0_ 1 ±.7, :-.'_?.' r ■ . nr S 61f =:... ... r..m f r n $ _ :1e}Y7S!a Fixture/sewer Cap 25
e: 6 4 G°i,tt r{ G * Floor drain/floor sink/hub 25.02
:ass: / 9 2.0 a sr...) Air: • _ Garbage disposal 25.02
'State/ZIP: T.4 41(4.2 4.A 92 2. Hose bib 25.02
lc: (Se3)G42` Fax: ($41)G 45.33
Ice maker 12.51
77"4 Y ... .. . ; . . r ' +r ear Y+S9 Interceptor /gnaw VIP 25.02
" :' °1 "� ° '" A ` Medical gag (value: S ) Page 2
nem name: eAe . 'E Q' ltic_ Primer 12.51
tact name: / G_ Roof drain (commercial) 12.51
•
,rase: fq Z a a / CO. y, G 4 Sink/basin/lavatory _ 25.02
r /State/ZIP: 4. C 4 , 1 4 r 1, Q 4 . q ) d4 2_. Solar units (potable water) 62.54 .
ne: ( 5 6 3) 4 92 - 3 3 4D Fax:: (5o3) 4 ?2- $'f{ 3 3 Tub /shower /shower pen 12.51
Urinal _ __ 25.02
tail: (9).‘ r` d Gd �+ 25.02
m•i a:i,,,..,.•�.wu.:::yd' ' r . '-' _F• -. ::r W ater c
"--1 00 0 10 :Ek.` n
of 144 8'' 7.4.
F „ Y : 1 � : r r .� I. � > ..,. ' Water heater 37.52
tines name: it....4F A`4k i i, j , Water piping/DWV 56.29
Q 2 7c1. Other. 25.02
y /state/ZIP: {,v e s - f 4 ;;Noy 64 17 o(r8 Subtotal. •
num ( 5 S 7- 77" 8 r Fax: t Sa 3 )L,1111-8 Z! Z . - Minimum permit fax 572.50
Plan review (25% of permit fee)
:B Lic.: I b3 7/2- Plumbing L i u no. :.•2T 1 Pe • State sure w (12% of permit fee)
tborixedaigaanle: i•-•-•----a,,z;.;. _TOTAL PERMIT FEE -
l'Ids. pima appileselerespinsif a. vault tulip. obtaissiiwltldatgadge
M nataa- Date: ~it bsrbrraOapMd.•soa-p s
•Feemsdlodoiog) se try Tri- CousayB eldieslodnsp "Service ie rot.
milillarPormitAPLIAMosnoimpurn 10101109° 440a616Tt ocurCOMIw®)
•
1
Fee Schedule:
•
N y st, - ,,a :.;,;;;, :.v. ; _, .-;'• Residential Fire Su ression S
... � .. :7' f `xr.w. _ : — it'll; ^ ."� xrirt C Y , ;� } y 'iStems
Footing drain " ... i ' rf a ll \ - -t - 4 t j,J�
g - 1 100 50.03 0
�= 1to3
Footing drain -each additional 100' ,k r �
� $121.90
2,001 to 3,600
Sewer - 1st 100'_ 3,601 to 7,200
Sewer - each additional 100' 7 20 l and $13
MEREONI MMINIMMOMMIMINI
Water Service - 1st 100' �
Water Service .each additional 100' � Medical Gas S stems:
®
Storm & Rain Drain - 1st 100' a t _ ; r _r ? :i_. ;:e Y- >:.w:.; . r: =• :.
Storm & Rain Drain -each additional 100' ®_ • $1.00 to $5,000.00 Minimum -- fee . $72.50 r, ?_. ° 5
;.._ . _
- , . ®_ $5,001.00 to S10,000.00 $72.50 for the first $5,000.00 and S 1.52 for
- - -� - S5 0010
s: , Ri '� .. �, ., , , . .: _ each additional $100.00 or
Inspection of existing plumbing or for and includin_ $10 000.00. fraction thereof; [0
which no fee is specifically indicated 90.00/hr $10,001.00 to $25,000.00
minimum ch.:e -1R hour) ■ $148.50 for the first $10,000.00 and $1.54
thereof for
each additional $100.00 or fraction thereof; to
Inspections outside of normal business 90.00/hr and includin: 50 fo $25,000.00.
hours minimum ch. of - 2 hours $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Reinspection Fees 90 00/lu each additional $100.00 or fraction thereof
and includin: 550,000.00, to
Additional plan review for revisions 90.00 $50,001.00 and u
minimum ch.:e -1/2 hour P $742.00 for the fast $50,000.00 and $120 for
Subtotal: _ each additional $100.00 or fraction thereof
Commercial Fixture Work: •
•
Are you. capp adding or replacing fixtures? If "yes",
please - indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees *, '
•
'.
. FhttoFe3 • for. ' : • ' ; .' eP- :;1 i1aas
TXIx. _ �,��
�I �rt�i:e.+aYl�Y�r 3 ~ .: �'udT. naL.d.. f • ..s,-.-,-, ) .ti
CaPPac .: , :MOW:: a Plan review is R
_B _Font required for any of the following.
• Bath Please check all that apply.
Tub/Show ❑ Any new commercial building with water servi 2" and
- laeuai ,. o ol
Each greater, except systems designed and
Car Wash - Stall
engines �P� by licensed
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor1Wem As as defined in OAR918- 780 -0040.
Dishwasher - Commpetal
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain ❑ Any multipurpose fire sprinkler system.
tare Wash ❑ Any complex structure as defined in OAR918- 780-0040.
Floor Drain/ai . y
- 3" Submits sets of plans wltb any of the above.
-4"
Car Wash Drain fir. 'n- r �+«: -;,. 2 f?eA i . :. ;fir ,: ,....i.,„
Gar; .Domestic- nan -food w....,.v..,:..1 �. .:.,_ l:' : i
Disposal .pompUO -food related • Isometric or riser diagram is required for new buildings
- Commercial - food related meet the ualifictstions above.
- Industrial -food related
•
Ice MachJRelrig Drains
(Jil Separaror (Gas Statio
Rec. Vehicle Dum Station Comments regarding fixture work:
Shower -Gang
-Stall
SinWLav - Non -food related
- Bradley
-Commercial -food related
- Service
swimming Pool Filter
washer-Clothes *Notes If the fixture work under thla permit results in an
incre
water Extractor ase•of sewer a sewer
water Closet - Toilers permit will be'issned. and
Urina feelassessed for the increase must be paid before-the
ewer Fixprre plumbing permlt.can be Tuned.
httpJ /www.tigard -or. gov /city_hall/ departments /cd/doc&PLMF- PermitAppjdoc
Mechanical ,Permit Application, 1 _, cn , 7 ,., „, ,,_ FOR OFFICE USE ONLY
I' Cit of Tigard i ;'-- i; ` i,ni Received
tl,-- . No.:,1 ...... o 7 •
• 13125 y SW Hall Blvd., Tigard, OR 97223 Permit Plan Review
111h ll Phone: 503.718.2439 Fax: 503.598.1960 JUN 20 2012 Date/By: Other Permit:
Inspection Line: 503.639.4175
TIGARID Date Ready/By: turn: Ea See Page 2 for
'k Internet: www.tigard Notified/Method: Supplemental Information
r .
. o'
:.11'.32:•:::.:'-';'-'niejitAjtFWORIC,W.!:E.?," ■•.:ri. .:'.;.:'' .. COMMERCIAL FEEt;:
. Mechanical permit fees' are based on the value of the work
New construction
Demolition 0 Addition/alteration/replacement
. .• performed. Indicate the value (rounded to the nearest dollar) of all
0 Other:
mechanical materials, equipment, labor, overhead, and profit
Value: $
...vv-,,,,-,7.i.},..-..,.,i:::Nr.,,qj40.070:.'70.W)Itte:OW'.:7':',I'..'...'.:"_'..c.r.:,-?;:,:-._ r, , r
p 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. 1 Total
' ' ' .e.-'---1,- Heating/cooling
-•.' . .....: :
sortmiiiisotiihififf*AiitY,LOCAclitUM ...- ....... ,,._ ,...-. -..;:i.....,.....-. . . . .
...,..,.„&„ , ,:.i. it- ..,.. r ,-, ■ ,. • -; -, " '., , Nt '-,..., - '',- -,-- ' • - " '' - " ' ' ' "" " '`' ''' '''''' '' Air condmonmg
Job site address: 1 5 7 3 5cf.) Ti.cf #41 (requires site plan showing placement) 46.75
Furnace 100,000 B71J (duets/vents) 1 46.75
City/State/ZIP: 77 47,......e o'f- T22zY Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: - Heat pump
(requires site plan showing placement) 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: El alcr:42 Z__ Lot no.: ?
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
_iii4§ai ,. .='.': Water heater 1 23.32
Gas fireplace/insert ( 33.39
At -eft.) /63'041/4-e- 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
- 4 0 . E..:01 i -,tr i s-;: - i ml - rftt;;-T,T.,,,,:,0 1 %... , ....:ri ,4 ;1 . ; - . 4 .i i r ■,.. . Lki4i*tk . Chimney/liner/flue/vent 23.32
.4f?V:i',,.r-5..f.'NL..-e.iri,4;'o.vi'za'liA,11 , ...7*-Ao. ,w ix- t'' - - • - ,--,-., .''', - -,,,,,-,...-.• o t b ar. 23.32
Name: 6 . _ C M 5-f del (-C.. Environmental exhaust and ventilation:
Address: IT Zerb 5 yG. '14 Range hood/other kitchen
equipment i 33.39
City/State/ZIP: -7 a ( f , Oft. q )c6 2-. Clothes dryer exhaust t 33.39
Single-duct exhaust (bathrooms, • 5
Phone: (14 ) 4, -33 - 6 Fax: (5 )49 2-- 5 -- V 3 3 toilet compartments, utility rooms) 23.32
.'1;Y ,41 1 3 i ,1 44:1' FA -tati AttickrawlsPann fans 23.32
. Other: 23
Business name: / i.1 d 2... _ erS o s. ,,- c 4,, Fuel piping:
Contact name: A.a.,,,J (44.-14z_. $14.15 for first four; $4.03 for each additional
Address: 7 zoo Se.c.)- (et "dc) Furnace, etc.
Gas heat pump
City/State/ZIP: 7ia...4,..3 o A f 706 Z...._ Wall/suspended/unit heater
Phone: (SI ) (pq 2,..- 4 3 I+ d I Fax: : (S )6?2, 5 ill_ Water heater I
Fireplace
E-mail: .C.e A .) ‘,. 0 , eltsoa-7 Range .
t f . ;. 7 ,4 1 ..„..' -. ..4, 1 f7:4: -0 ,... 4 . '' . ... ,': , .'. ,•'-,. :...: :..,1.?..;,......,,, -„ B ar b ecue
, I4' , ..t.s.',T , vx , .'- f''' , - . :- . 'n• - - , •-•6 - ,. , :. -7- , 44miaiimpoomor.4.r; c: - ...., - ... ••• -$., •..• .., - • .1 ,
Business name: ipt6 6 CA( C 0 ,, s. ..rme -6:7 : Clothes dryer (gas)
Other
Address: A 0. 4 tr . g z 1.1(81( .. - -ritEariftilitioltiii***- 47 iiiM ,4 0
.. „ ...,...... __.,,,....._ ...
City/State/ZIP: V ,,, e authea. 6 , 7 I. s, ( 2._ Subtotal
Minimum permit fee ($90.00)
Phone: (S03 ) i S's .. � 2.2.( Fax: (G.3) h s.o - 21113 Plan review (25% of permit fee)
CCB lic.: 4/2 57 1 State surcharge (12% of permit fee)
J. TOTAL PERMIT FEE
,...,„...--
/
This permit application expires if a permitis not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: Date: 6. 7-- - (2.____ • Fee methodology sat by Tri-County Building industry Service Board
w Act.;Mino■Porm its \ MEC-PermitAradoc 03/07/12 440-4617T (11/07JCOMAVEB)
Mechanical Permit Application - City of Tigard
•
Page 2 - Supplemental Information •
Commercial & Multi-Family Fee Schedule: •
MititTatittaiMin
$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 $100.60 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: \BuildingWermits \NEC- PermitApp.doc 03/07/12 2
Electrical Permit Application rp, .. _ FOR of : i : I('l.. (ISE O\1,,
} .City'ofTigard . - � -, _ ' , Received Permit No/
11 1N •
X=04 : / X=0/ - h/ 7_3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 JUN 2 8 2012 Date/B : Other Permit:
T 1 ( \ IL D Inspection Line: 503.639 Date Ready /By iona: 55 See Page 2 for
Internet: www.tigard- or.gov •` �, N otified/Method:
el ' : 0:: � ;r- Supplemental informetlon
.. ,. Z'- .-Fw: � .YKtlJ,IilL1t. L.r"'.i).. 5 f: .. - . ,. _ ;i�q: - .1 k54. ;.1 .:p „y.
6 ew construction ❑ Addition/alteration/replacement Please check all that apply (submit a 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.
''''- ': 1. ,ry.. ._� •. :r; - _ • '
•
, ti exceeds 10,000 amps at 150 volts ❑ Floating buildings.
dwelling . -. , ., -.: / less to ground or exceeds 14,000 ❑ Commercial -use agricultural
] 1- and 2-family ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
] Multi - family ❑ Master builder ❑ Other: ❑ Fire Pump. ❑ Installation of 75 KVA or
-
f ': i, :. 4 Emergency system. larger separately derived system •
Emer • •
•,. .. -.-• 1 .9 . , ,` •: � . Z .�: _:, ' - ❑ Addition of new motor load of ❑ "A 'E" "1 - 2" ' 1 _3
ob no.: Job site address: / 3 773 5 c.) f o 100HP or more. oacatioy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
:ity /Stafe/ZIP: 77 + ■/) 0/t- 1 7 2 2 (E ❑ Health -care facilities. ❑ supply voltage for more t
( ✓ � 1 � K ❑ Hazardous locations. 600 volts nominal.
luite/bldg. /apt. no.: Project name:. • ❑ Service or feeder 600 amps or more.
"
:ross street/directions to job site: Description I on. I Fee. I Total 1
. New residential single- or multi- family dwelling unit.
Includes attached garage. '
ubdivision: . 6 /
�l 2- Lot no. _ 1,000 sq. ft. or less 1 ( I 168.54 4
t c ..J�•br Ea. add'I 500 sq. ft. or portion (,, 33.92 I •
'ax map /parcel no.: Limited energy, residential I 75.00 2
-r. «x.
••'.itiN"'o:t+'1•.;r l �'}� r .. = r^°wR°=;. i .1: _ ' t'r't (with above sq. ft.)
�/ / Limited energy, multi- family 75.00 2
/ .e w / 'r - residential (with above sq. ft.) • Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
rk; �}. ~'i'• "'' ' '.,t,`.
r� , (. _ -. .. - • �,;.�.�iafR;i :. .,.' f9i�. :2�.=iJiii - ;; .. . ,. 201 am Ps to 400 amps 133.56 2 •
fame: �-ez 04744 t- e....1 t" ' 601 amps to 1, 0 amps am 30.04 2
60l amps to 1,000 amps 301.04 2 •
.ddress: / / izeb , 4,,S e {- Over 1,000 amps or votes 552.26 2
ity /State/ZIP: 4 . .C, y f, ,d• 02 4r ?O 6 a Temporary services or feeders installation, alteration, and/or
relocation
hone: (54) 4 72.-33 Y o Fax: (563) 6 v.-5-1/33 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Iwner installation: This installation is being made on property that I own which is not
!tended 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
•
'weer signature: Date: A. Fee for branch circuits with
~' x -. k.,, ,; :rr ,.., at i u . ti ,�,••��, . above service or feeder fee, 7.42 2
"` ' _ each branch circuit •
usiness name: t G z`z.C2r4. s /_ /�_ (�� B. Fee for branch circuits without V t� T �v service or feeder fee, first 56.18 2
ontact name: Ke w4, r; ri pe - L branch circuit
/ Each addi branch circuit 7.42 2
ddress: /' 'LSD 5.W Ai Miscellaneous (service or feeder not Induded)
Each manufactured or modular
ity /State/ZIP: , c„...6"; 04- '7 a dwelling, service and/or feeder 67.84 2
hone: (S ) 12_ z3 f 0 Fax: : (5 Z•,5Y3,3 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
-mail: Aid , • ‘417 - ' ^• , r. ' iv *- Sign or outline lighting 67.84 2
r „ �, ,.` t
"�S{ t rti1 r
t :. • r,:?Il'r11i :4 sw .tzi i c. // , ^ � L+ v 4t?. Signal circuit(s) or limited- energy
usiness name: R., 1; a r. c�eG fps � e dsT Oi4ep .) peel, alteration,
dds tion, l I extension. s Inspection P 2 2
VV Each additional Inspection over allowable in any of the above
ddress: Z el Z t'/ Se..i tistaem IL , Additional inspection (1 hr min) 66.25/ hr
ity /State/ZIP: s74 N d 64 ? 1 0 e r • Investigation (1 hr min) 6625/ hr
`/ ♦ Industrial plant (I hr mm) 78.18/ hr
zone: (SG3) g4 0 � `Vy/ tic) Fax: ( S 4 3) 4 48 - ii/1 r Inspections for which no fee is
`10.
s diced diced listed '/r hr min 00/ hr
CB Lic.: / g Li f2.. Electrical Lic.: C.5 Suprv. Lic.:Y4/33S ; :;.=
uprv. Electrician signature, required: Subtotal:
/ "�v�
A,F.L Plan review (25% of pamlit fee):
rint name: _� (4 r 4, -45-'12- Dat -45-'12- -45-'12- State surcharge-(12% of pmmit fee):
uthorized signature:
TOTAL PERMIT FEE:
nib parent apptleadae expiroolf a pendtfa not oUeiaadw'ltlria 1St
pint name: Date: - Z�_ Lr • dap..ainawa
ll po
Numbac of inapeotioos allodpar•patmit.
>ildhr{1fsnsi oa3.C.paronAppdoo 07N1110 440•61$Tt111OSICOMWWaB
rage z - Supplemental Information
LIMITED ENERGY PERMIT FEES
Fee for awl residential systems ms combined........ $75.00
Check Type of Work Involved:
[ Audio and Stereo Systems*
"Burglar Alarm
Garage Door Opener*
Heating, Ventilation and Air Conditioning System*
Vacuum Systems*
❑ Other.
Fee for each commercial
system $75.00
(SEE OAR 9 18 - 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication. Installation <.
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses. are required
for all :other •installations
\augain ,-p .aoo. o7/ovw
71 -
° Building Division •
Development Code Provision Review
T I G n R D Residential Projects ,
Building Permit No: "S /c — eV/ 7.3
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: lP /2/0
1st Revision Submittal Date: ❑ Site Plan Only
2 ^d Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (1) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact Chi( I Co.;ne.1 at 503-7184901 or Cile.rt( I ` @tigard- or.gov)
I Land Use Case No. $W3 a0c1 - 00013 Name G e . . 4 .. floMU of EC1 W dd. d
Zoning •P - 4 - S
Setbacks:
Front .20 Rear 1 Side 5 Street Side 15 Garage a0
p. Maximum Building Height 30 4 Actual Building Height .24 4
Visual Clearance
Easements
O Sensitive Lands Type: 0/ ft
Notes:
Original Plan: Approved 0 Not Approved ❑ Date: b -d9' - I a
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Engineering Review (contact Mike White at 503- 718 -2464 or MikeW @tigard - or.gov)
Actual Slope: s
Notes:
Original Plan: Approved Not Approved ❑ Date: 7/02,
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
• (Review Continues on Page 2)
•
Page 1 of 2
City Arborist Review (contact Todd Prager at 503- 718 -2700 or todd @tigard- or.gov)
l/ Street Trees
II Protected Trees
Notes:
Original Plan: Approved Q Not Approved ❑ Date: 7- } -
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
❑ Conditions of Approval Prior to Issuance of Building Permit
Notes :
Original Plan: Date Sent to Applicant:
Revision 1: Date Sent to Applicant
Revision 2: Date Sent to App • nt
Okay to Issue Permit: Ye No ❑
Date Routed to Building: 1/ .
•
Page 2 of 2
Jun 28 2012 3:37PM GERTZ OFFICES 503 692 5433 p.1
RECE
, Street trees Zelkova SW JUN 2 B 2012
-•• Serrata 2- S EDGEWOOD
EN
Street trees !ilia ST
Ameranana 2 /��� Cr! OF ;r10 . , tie ILDING IW
11V
Elev. 210 ?WAN 4.*
l sl cn
^ % 1117
Si/i nee Siltfence 20�`. S � 4
I Elev. 12 r .1 co
-§ 1
00 b.) 12 z......= . cit -1 ' ' M 1 i ll
4 lir
, ,,,,,,
(...
. v) 11 Ell
�.�Q Elev. 21 i 1 ?y '��
r III c I ,v' I
'� I
N .) zwitill g 1,/ \ 1 I 1 IT N I` 20 ' -0-
cy)
1 Grovel Drive 1
(..^1 L. — — f l 1 / �� ` ‘ 1 for Erosion N •
\ ...'
Elev. 213 0 ■ 8 2.8 5'
O In Elev. 210 I •
- Cfr.l
C1
Ci
1
G ER TZ "
COMPANY ZINC.
HOME SQUARE FOOTAGE BUILDING
MAIN FLOOR = 1557 SOFT.
UPPER FLOOR ° 1699 SQ. FT. CUSTOM HOMES SINCE 1977 / Zf
(503) 692 -3390
TOTAL = 3256 SQ. FT. 13773 SW 90th
GARAGE in 520 SQ.FT. Lot 7 EDGEWOOD 2
SCALE 1" = 20'
GERTZ CONSTRUCTION COMPANY INC.
PLOT PLAN 6/27/12
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13773 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
322 Shower pan
03/27/2013 00:00
MST2012-00173
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13773 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
199 Electrical final
04/16/2013 00:00
MST2012-00173
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13773 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
699 Mechanical final
04/16/2013 00:00
MST2012-00173
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13773 SW 90TH AVE, TIGARD, OR, 97223
Residential - Master Permit
399 Plumbing final
04/16/2013 00:00
MST2012-00173
PASS
Calling backflow preventer PLM for final approval
Violation Summary:
Inspector Contractor
tl
STREET TREE
TIGARD CERTIFICATION
I, 8, `R t.,i , , owner / agent for G c4.7 �'r� -- % s'
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certifi that the following location meets
City of Tigard land use and development standards
for street tree installation and is consistent
with the approved site plan.
PERMIT NO.: 2.o /z -
ST1 E ADDRESS: /3 773 _5 J 9D 7 / 4
SUBDIVISION: /E// za- LOT #:
SIGNATURE: $ ' DALE:
(OWNER /AGENT)
RE CEIVED d�
VERIFIED BY DA1 E:
(CITY OF TIGARD)
❑ Tree location verified per approved site plan.
I: \Building \Forms \StreetTreeCertificate 05/30/2012
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: J urisdiction:
�c� /7 / /7,43a / o
Site Address: 73 ? ?3 96 771- APt
Subdivision/Lot #: i /Gt/ 4 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 N1107.2)
■
Signature: � � r Date: � Z � ��
er /G Contractor u ortzed Agent
Print Name: EX14,--0
I ORSC Section N 1107.2. 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\ Fortes \RES- HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, ,649'O / , am the general contractor or the owner- builder
at the following address:
Site Address:
13 ?7} 96 77't ,e
City: 0 i 9?2
•i
Permit #: 2eiz , (310/7
Subdivision/Lot #: 7 �
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: ,72.--
n eral Con ractor or 'tiler
I: \Building\Form\RES- MoistureSensitiveWood.doc 09/25/08