Permit a CITY OF TIGARD MASTER PERMIT
11 14 a _ . COMMUNITY DEVELOPMENT Permit #: MST2012 -00269
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/14/2012
Parcel: 2S112BD06700
Jurisdiction: Tigard
Site address: 14750 SW 80TH AVE
Subdivision: BRITTANY MEADOWS Lot: 3
Project: Brittany Meadows, Lot 3
Project Description: New SF
BUILDING
•
Floor Areas Jteaulred Setbacks Required
Stories: 2 • Bedrooms: 3 First: 1245 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1120 sf Garage: 380 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2365 sf Value: $262,927.20 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 5 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 3 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: 4 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 adds 500 sf: 4 201-400 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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R - 3 2365
"Owner: Contractor:
BRITTANY MEADOWS LLC ALAN NATHANIEL GOFFMOORE Required Items and Reports (Conditions)
BY WESTLUND, MORRIS R 13950 SW BARLOW RD 1 Ersn Cntrl 503 - 639 -4175
16615 MAPLE CIR BEAVERTON, OR 97008
LAKE OSWEGO, OR 97034
PHONE: 503 - 781 -1981 PHONE: 503- 664 -6423
FAX:
Total Fees: $19,284.95
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 w• . is suspended for more the 180
days. ATTENTI • • • =gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. • ose ules are set forth in OAR
952- 001 -001 • + rough OA • 52 -r • 1090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 •r .:00 j .23• .
Issued By ` � � / Permittee Signature:
Call 503.639.4176 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 F012 OFFICE USE ONLY
FIC �/�
111 City of Tigard RECEIVED Received MEW, Permit No.: H1 ��� / aO
a
1 3125 SW HaII Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 a-
Date/B : iia/►�� Other Permit: (904,912:),09/ 7
T 1 G tt:D Inspection Line: 503.639.4175 C T 2 3 2012 Date Ready / Juris: EI See Page 2 for
Internet: www.tigard - or.gov •� �p� No /'� 3� � Supplemental Information
�CIT / OF 1 `GA D ��� 44- s0/ C �ClCdQ+�v
TYPE OF 1&GIRDINGDIVISION r 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: $ �(p ( 2v
❑ Accessory building ❑ Multi- family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 14750 SW 80th New dwelling area: 2365 square feet
City /State /ZIP: Tigard, OR. 97224 Garage /carport area: 380 square feet
Suite/bldg. /apt. no.: Project name: Brittany Meadows Covered porch area: jib 'are feet 1i. Z c)
Cross street/directions to job site: Bonita Deck area: 0 square feet 23—
Other structure area: 77 square feet 2_3
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Brittany Meadows Lot no.: 3 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New home
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Brittany Meadows LLC Type of construction:
Address: 16615 Maple Circle Occupancy groups:
City /State /ZIP: Lake Oswego, OR. 97034 Existing:
Phone: (503)781 -1981 Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Pacific Evergreen Homes (Please refer ro fee schedule)
Structural plan review fee (or deposit):
Contact name: Alan GOffMoore
FLS plan review fee (if applicable):
Address: 7410 SW Oleson Rd Ste 133
City /State /ZIP: Portland, OR. 97223 Total fees due upon application: y �
Phone: (503) 664 -6423 Fax:: ( ) Amount received: t`+ 766 ov
E -mail: alangoffmoore @gamil.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
• Commercial an, esidential prescriptive installation of
CONTRACTOR roof -top mounted ' .otoVoltaic Solar Panel System.
Business name: Alan GoffMoore Submit two (2) sets o .of plan with conne • . details
and fire department acces , . long wi • 2010 Oregon
Address: 13950 SW Barlow Rd Solar Installation Specialty Co. ecklist.
City /State /ZIP: Beaverton,OR. 97018 Permit Fee (incl • p lan re w $180.00
a. . •ministrative fees):
Phone: (503) 664 -6423 Fax: Stat :. rcharge (12% of permit fee): $21
CCB tic.: 187268 Total fee due upon application: $201.60
Authorized signature: 'i�r This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ‹ms v1te Date: 10/23/12 * Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits \BUP- RESPermitApp.doc 02/24/2011 440- 1613T(1 I /02 /COM /WEB)
•
Mechanical Permit A lice. ' EIVED ro 1, 0,,,,, I 1 3 s r . o i v
1,11 City of Tigard /0 A3 0. - "
° 13125 SW Hall Blvd., Tigard, OR 9 T 2 3 2012 Plan Review / ' ',
0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit � j f ; -40 ,2/
T 1 C A R D Inspection Line 503.639.4175 � A p D fl Date Ready/By: tarn: ® See Page 2 for
Internet: www.tigard or.gov CITY OF i iutu Notified/Method: Supplemental Information
BUILDING DIVISION -
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._;,..._. - : � Mechanical permit fees* are based el New construction ❑ Addition /alterat ion /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
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C5 I - and 2- family dwelling ❑ Cornmacial/industrial ❑ Accessory building For spedal informmian use chee/dist
❑ Multi- family ❑ Master builder ❑ Other Description 1 Qty. 1 Ea. 1 Total
u sr u -, = -_ :�_ _- - - - Head coo
- ' ,: y . - I�!Y .... L��._.:. S. 3/' ": ::95
^ 1s -= - .t�` =, : {:Sl.,,. flz < :3 t: = -
l - ?( SL'..., e iirci °�_.�a :__:L•.Es�_ > z_..... •�1= '+ ;t.:___ - ci .�.r:,:Y. 11 ___:, .,,t:�_'= .Z;':c�.i ,. :it gs2z
_.. - - - - -- A i r cond
Job site address: N -7 So W _ j kh (requires site plan showing placement) 46.75
City/State/ZIP: /� eV/
Furnace 100,000 BTU (ducts/vents) 46.75
.� �fk� -� - , 1 `7 7 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJapt. no.: Project name: • Alp ,q„J al Heat pub
(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
Subdivision: ' r i # & , - Qdo WS Lot no.: r j Flue/vent for any of above 23.32
Other 23.32 _
Tax map/parcel no.: Other fuel appliances:
l .- C _..- --'; - � + Water heater I 23.32
kc1:r =z • :- .._,�F__._•
Gas fireplace/insert 1 _ 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fire placelmsert 23.32
:e: _ - 1; - e - c :•fre- ii= ' -1c = -,,, m - , C /linedflur/veut 23.32
- °_ --- - -__ - _ .__ _ _
:.::. ._ -.:I - Other: 23.32
Name: 1a •.R Its .- 4 • u - Environmental exhaust and ventilation:
Address: 7L4 10 (.4) • i . � 1 other kitchen 33.39
City/State/ZIP: • • / A • 0 ° '1223 6 �1 Clothes dryer exhaust 1 33.39
Phone: (503) ( j) 20 3 f 1 toilet , utility rooms) s, )
Fax: y ' 23.32
�� f.T b 1 ' ' ... 7 --`� r c i 6 ' J1 ` :, ...: I Attic%tawlspace fans 2332
�.......,.._ .,, ,., other 1.014 l
23.32
/ • ■ • Fuel piping:
Contact name: A d r a► • $14.15 for fast four; $4A3 for each additional
Address: / Furnace, etc. t 1
- • ` 1 � �' • ' Gras heat pump
City/State/ZIP: f r r I/ AO . 1 7223 Wall/suspended/unit heater
Phone: (503) (e(y • 23 EMILPlig.W411111M11 ' Water heater (
Fireplace 1
E•mail at ctrl 0 0 , V oore@ 0 ma. . Co
Y r , , '%''P',./:----:-'72 �� F- ` 2.0 ` r Range Re
p3/, - I ;' t 1 `t 1 • Cel , 4 1 y1 rP, - ` 1 -'' •3 Barbecue
L -S. .,: :t.� -1 .L .. .w.. �.'.._n
Clothes dryer (gas)
Business name: • am H-__t•.• :. .. •..
- Othex
Address: 9409 NE Colfax St. •> ` i 1 1 E : ,, 5A , < ! r M r , q {,
City /State/ZIP: . o an., • R 97220 Subtotal
) Q Fax: (� '7 : 3y 3Z Min;mym permit fee ($90.00)
Phone: (
1 O to q 2 Plan review (25% of permit fee)
CCB lic.: 6Ct 3g 2. State surcharge (12% of permit fee)
TOTAL PERMIT FEE
signature: y U /�f
This permit application expires tie permit Is got obtained within 180
Authorized si
l;n - C days after it has been accepted as complete.
Print name: • , i -J '� y a ( Date: Z • Fee methodology set by Tri -County Building Industry Service Board
I:IBuadmg∎Pamit MEC-PamitApp.doe 03/07/12 440 (11/02/COM/WEB)
Plumbing Permit Application
•
Building Fixtures ME wED Received FOR OFFICE USE ONLY
of Tigard Date /By: p , Permit No.: '� /� apad
7 •
V 13125 SW Hall Blvd., Tigard, OR 9722
C : Phone: 503.718.2439 Fax: 503.598.1 T 2012 Plan Review
T Date /By: Other Permit No. /240/„V. .A/ 7
T I G A R D Inspection Line: 503.639.4175 c`w�a Date Ready /By: Juris ® See Page 2 for
Internet: www.tigard or.gov TIGARD Notified/Method: Supplemental Information
TYPE O„ FEE* SCHEDULE
® New construction ❑ Demolition For special information use check list
• Description 1 Qty. 1 Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New I - 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION - SFR (1) bath 312.70
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath I 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SUE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: 14750 Shy V
Drywell, leach line, or trench drain 18.76
City /State /ZIP: Tigard ,OR. 97224
Footing drain (no. linear ft.: _) Page 2
Suite /bldg. /apt. no.: I Project name: Brittany Meadows 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.: _) Page 2
Subdivision: Brittany Meadows I Lot no.: 3 Fixture or item:
Tax map /parcel no.: Backlow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
New Home Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Brittany Meadows LLC Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
• Address: 16615 Maple Circle
Garbage disposal 25.02
City /State /ZIP: Lake Oswego, OR. 97034 Hose bib 25.02
Phone: (503)781 - 1981 Fax: ( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Pacific Evergreen Homes Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Alan Gofflloore
Roof drain (commercial) 12.51
Address: 7410 SW Olseon Rd stuite 133 Sink/basin/lavatory 25.02
City /State /ZIP: Portland, OR. 97223 Solar units (potable water) 62.54
Phone: (503) 664 - 6423 Fax: : (503) 208 - 7127 Tub /shower /shower pan 12.51
E - mail: alangoffmoore @gmail.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: EDWARD MULLEN PLUMBING Water piping/DWV 56.29
Address: 1601 SE River Road Other: 25.02
City /State /ZIP: Hillsboro, Oregon 97123 Subtotal
Phone: (503) 640 - 0113 Fax: (503) 640 - 4483 Minimum permit fee: $72.50
CCB Lic.: 92689 Plumbing Lic. no.: 34 - 260P6 Plan review (25 % of permit fee)
State surcharge (12% of permit fee)
Authorized signature: , ,g,k. TOTAL PERMIT FEE
Print name: Ray Mullen Date: 10/18/12 This permit application expires if a permit is not obtained within 180 clays
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
•
I: \Building \Permits \PLMU - Permit App. doc 10/01/09 440- 4616T(10 /02 /COM/WEB)
•
Electrical Permit A lication EIVED 9, .oa o E u E Y�
T{"" EIVED Received - -_- '""'';•
spi - City of Tigard Dale /B O //2. Permit No.: D
., J`_`° 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
r.0-- ° ° ' ; .; . 1 1f" T 3 2012 Other Permit:
_ [Bone: 503.718.2439 Fax: 503.593.1 [CfI�I 2 ,. 1 3 L Date/By: OI � - 417
� 1 i' Juri5:
T;I Inspection Line: 503.6 Dale R ead y /B 0 Scc Page 2 for
* '"- 'i Internet: wow tigard or.gov c rr ^y i' 'G 1 D Notified/Method: Supplemental Information
11 n� ) t j ll 1f1111WW
v ` _ -:;- _ TYP, QFTITH DING DNISI ,:, , _ _ ; PLAN REViE _
® New construction ❑ /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 11 Other: where the available fault current ❑ Marinas and boatyards.
,C4TEGORY'1OF-'- .CONSTRUCTIOi' exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
:. . _ -. less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
® I- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: Installation
❑ Firc pump. 01 75 K\ n or
❑ Emergency system. larger separately derived system.
�,.
-_- _ ____ JOB SiTE ,_iIVFORD•IATIONFAND:LOCO - - - - •I -s'•
- --- : �w = „ �.._.
_._;_- _,.- _,... -.. - -_ :__ .. , 0 ❑"A ". "E ","I - -.
Job no.: Job site address: 14750 SW 80 Stt looslP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR. 97224 ❑ Health -care facilities. ❑ Supply voltage for more thrum
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Brittany Meadows ❑ Service or feeder 600 amps or more.
. „ _
Cross street/directions to job site: Description I Qn•. I Fcc. I Total 1
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Brittany Meadows Lot no.: 3 1,000 sq. ft. or less I 168.54 4
Ea. add'l 500 sq. ft. or portion li — 33.92 I
Tax map /parcel no.: Limited energy, residential
_ - -- 75.00
.g .-- __ - :;, ve ft
- - - nh abo s
- IP7?1 fVr- Fs
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
®:1 OWNER ❑,_TENANT= '' -. 201 amps to 400 amps 133.56
401 amps to 600 amps 200.34 2
Name: Brittany Meadows LLC
601 amps to 1.000 amps 301.04 2
•
Address: 16615 Maple Circle Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: Lake Oswego, OR. 97034 relocation
Phone: (503)781 -1981 Fax: ( ) 200 amps or Icss 59.36 I
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
,
above service or feeder Ice,
® ;APPLICANT •,'•, c ❑, CONTA_CT PERSON 7.42 2
r,_ y each branch circuit
Business name: Pacifice Evergreen Homes B. Fee for branch circuits witlioul
service or feeder fee, first SG.IS 2
Contact name: Alan GoffMoore branch circuit
Each add'I branch circuit 7.42 2
Address: 7410 SW Oleson Rd Ste 133 Miscellaneous (service or feeder not included)
City/State/ZIP: Portland, OR. 97223
Each manufactured or modular 67.84 2
y , _ dwelling, service and /or leeder
Phone: (503) 664 - 6423 Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: alangoffmoore @gmail.com Sign or outline lighting 67.84 2
CONTRACTOR=
,; " : w, -_ .. Signal circuit(s) or limited-energy
panel, alteration, or extension. Page 2 2
Business name: Garner Electrtic
Each additional inspection over allowable in any of the above
Address: 2920 SE Brookwood Ave Ste A Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Hillsboro, OR 97123 Investigation (1 hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: 503 - inspections for which no fee is
Phone: ( 503) 6484552 F ( 503 ) 7925 90.00 / hr
specifically listed (' /: hr min)
CCB Lic.: 12259 Electric ic.: )305p s ,Auprv. Lic.: 3707 -S : , r;ELECTRICAL' ;PERMIT$FEES
v,, "'',,; r;_5t� Subtotal:
Suprv. Electrician signature, require • : , "; :, _ / hr;, 2 _
p g 9 ,,,se _,, p �, � f� Plan review (_b /o of permit fee):
Print name: Chuck Garner Date: State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: "' This permit application expires if permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I:\ Building \Permiis\ELC- PcrniitApp.doc 07/01/10 440- 4oI5T(11 /05 /COM /WEB
e ° Building Division
Development Code Provision Review
T i c e Ei Residential Projects
Building Permit No.: .M or A6 - co 9 9 •
Site Address: / / 7 50 & ft0 Auf-
Project Name & Lot No.: 'h24 rT iY Heil A. 5 � L. r 3
CWS Service Provider Letter
Required: Yes ❑ No (tI
Received: Yes ❑ No la
Routed Plans: /���,�,
Original Plan Submittal Date: /�. 2 / Y`'� x`9
1st Revision Submittal Date: ❑ Site Plan Only
2nd 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 i approved. d
Planning Review (contact at 503-718- 2-)/ or @tigard- or.gov)
Land Use Ca e No. 3�LY9,��aa/.�
Zoning (' - '4. ► 5
i Setbacks:
/ Front 2 0 Rear ! Side J Street Side / 9 Garage s . O
ff Building Height: r40 Actual Building Height •
I ' Visual Clearance
E' Easements
QKSensitive Lands Type:
D"Street Trees
❑, Protected Trees
Notes:
Original Plan: Approved Not Approved ❑ Date: /0 i; W i, g-
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
•
Page l of 2
Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @ tigard - or.gov)
•
Er Actual Slope: S
Notes:
r Original Plan: Approved - Not Approved ❑ Date: / D (
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 Applica
Okay to Issue Permit: Yes _ No ❑
Date Routed to Building: / �� ; ////1---
Page 2 of 2
TROXEL'S HOME DESI
EIVE
1217 N.E. BURNSIDE STE. 303
GRESHAM, OR 97030 OCT 23 2012
CITY OF TIGARD
11 — 5256 • • — • — • — •
BUILDING DIVISIO
LOT #3
I
.• 43 5Q FT
I
-__
ao • ;
1- 1 — CONC. 1
. pA:1 1 10
PROPOSED
RESIDENCE >
• PLAN # I 2285
01.00
I 1
G.P.E. =100.50
1 I
// 3/9 mia41‘leXitivi
• \\:
1COvERED 1 \ •
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c‘, DRIVE
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E .:44t*Iv- • — • — • 7 E - j =•`11
LEGEND SiDE' AL.
3" SEWER TT Iv
I " WATER
GAS
POWER
--- PAIN DRAIN SW 80th AVE.
JANAF• SITE PLAN DA TE : 7-30-12 •
CALE 1" 20.00 PL AI PLAN # 1228B DF r NICK POVEY
An:7,1F-
• . . . . .
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
14750 SW 80TH AVE, TIGARD, OR, 97224
Residential - Master Permit
199 Electrical final
03/19/2013 00:00
MST2012-00269
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
14750 SW 80TH AVE, TIGARD, OR, 97224
Residential - Master Permit
299 Final inspection
03/20/2013 00:00
MST2012-00269
PASS - C of O
Moisture content
Street tree
Lighting efficiency
Duct seal
All forms recieved
Violation Summary:
Inspector Contractor
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, ALA-.N) 6 O/-FM c 4'LJ. , am the general contractor or the owner- builder
at the following address:
Site Address: it' 50 Sw .D
City: T1(-7 4 rt,0
Permit #: ?OS"' 20 /Z 00269
Subdivision/Lot #: 6 -i�v 4/ G 44 3
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 inst lation of interior finishes, the building
official shall be notified in writing by the ge era! contractor that all moisture- sensitive
wood framing members used in construction have a moisture content of not more than 19
Aii
percent by dry w-':;t of dry framing memb rs.
S ignature: Date: 3l 3//-3
' eneral Contractor o is ^ er- Builder
I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: rls-r ZOIZ 002,0 Jurisdiction:
T -u,FlR.D
Site Address: l 8150 SW g0 /. C
Subdivision/Lot #: PITTA -r•{ mr,ocibovog col" 3
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 t - l as a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code Ni i 07.: )
2.4114
Signature: Date: - <3 -�
g �� 3 3
• wner /General Contractor 11" orized Agent
Print Name: 4,e)F-f"Mov'
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\Forms\RES - HighEfficiencyLighting.doc 07/01/08
® STREET TREE
TIGARD CERTIFICATION
I, A4 ke, , owner/ agent for Pc c L E„el,,e., NO rna ,
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certify 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.: 1 20l7- 00269
ME ADDRESS: / j o sw ,4
SUBDIVISION: g LOT #: 3
SIGNATURE: DA1 E:
(OWNER /AGENT)
RECEIVED &
VERIFIED BY DA 1 E:
(CITY OF TIGARD)
Tree location ven: ed per approved site plan.
I: \Building \Forms \StreetTreeCertificate 05/30/2012
• --'�`r ''- _ = = - - - ' : ia ` .: - !� =fir` •''> e 3 °iF i, ;z - -.r . , 1
DTC ., r t ' F+' — �� , .�h 'r `. _ .! I
}t t x. --z �•. 't � ti � ; ,- vFr �r .ard_v ,N- �I,-5 � � ' ^� "'t tr , �,� �;,3'"iiw .�,
2 ��
! : : , . - fi- ,,3 7: i1:1'- I T S 'f r f ry - Y R! ..
Performance Tested = a. " '• • _ 1`' � - at' .. :: • . ) e rn r •' i„, : E } „_— • •
Comfort Systems = - , _ _ ti
• PTC Duct Sealing Certification For ^` �
All sections must be filled out by a PTCS- certified Technician at the time of installation, signed and dated. A copy of the f
. completed form must be promptly submitted to the utility and homeowner in accordance with utility policy. Please
enter online at www.ptcsriw.com or fax to 877 -848 -4074. Questions? Call 800 -941 -3867 or email ResHVAC @bpa.gov.
Site Information (Please print clearly)
PTCS Tech Install Customer's • •
Tech # 10111 Name - "StV9eln; Ult k.o J Date • Electric Utility
Customer v Ramos L
Name Pk?_ E �QaQ -P.i;h t'I�OQS Site Site Address* ' 1 fl50 sW go fi Ave. L3 3
Site U Site Q Site Zip -t Customer
City* �� aR-d • States O 1 Codes 1 T 22'�i Phone it ( 503 ) 6 6 y - b 423
* If mailing address is different, record here (it, City, St, Zip):
Home Type (provide information for just one type, either a Site Built or Manufactured Home): •
Site Built Home: ❑ Existing (di New Construction Manufactured Home: ❑ Y ❑ N . .
. Site Built Home Foundation Type: # of Sections for a Manufactured Home: 01 ❑ 2 ❑ 3
❑ Crawl Space ❑ Full Basement ❑ Half Basement ❑ Slab Super Good Cents? ❑ Y ❑ N .
Year Built: 2,013 Heating System: ❑ Elec. Furnace ❑ Heat Pump ' Gas Furnace Heated Area
Energy Star? ❑ Y (I N ❑ Other: , Gas Company (if applicable): (sq ft) Required 2 3 S 4
Are at least 50% of the ducts in unconditioned space? ❑ Y '0 N # of supply registers # of returns
if more than 50% of the ducts are in conditioned space, the home does not qualify for PTCS Duct sealing. if 1
House Pressurization and Duct Blaster Tests
Do either of these special conditions apply? (check if "yes ") Testing Equipment Used:
it Record Only — no duct sealing work done ❑ Energy Conservatory ❑ RetroTec
❑ PTCS Certification ONLY — pretest leakage too low for BPA program ❑ AeroSeal ❑ Air Care ❑ Other:
Hose Pressurized (Blower Door) to: Duct Blaster Location: Pressure Tap Supply.Register Location:
Nil +50Pa ❑ Other Pa it Return Grille El Other: 2.4 'ki b sufp 1
Duct Leakage Test: TYPICAL DUCT BLASTER CFM READING with Duct Pressure at OPa and Blower Door @ +56P
DB Fan Pressure: Found using equipment; it is the fan pressure, not the house pressure. (Ex. Ring 1, 78 Pa, 364 CFM).
Definitions: (DB)= Duct Blaster (BD)= Blower Door (AH) =Air Handler (SW)= Single Wide (DW)= Double Wide (TW)= Triple Wide
. .New Construction Existing Home, New Ducts' :: Existing Home, Existing Ducts Manufactured Home
Pre=test R) --- _ - _ _'- Oen 1 2 3 Open 1 2 3
~�-�.'.�; = - , � - _ ,�. �. e� ` r= � = : ,,Y� , ���:'rfi! _ dt A ' pP(ic af ile�, .,. � +� ;
:;:> =:( one . •.s"' ? = r,: S'.a , c r ;: . ZIVZ H ❑ M ❑ L ❑ H ❑ M L
U. SD Fa n -Pr essure�. - _ - : Dot A 11 'Z n: . _ Not i _"li co file '4 - ;.= Pa Pa !
j ii
DB ' CFM_ ; ; -• : - E:- : -.,Nat Applicable � r ; F_NotApplicabie a CFM CFM •
' g ?P ' , ,:, , :::::.i'; ;; sL_i_ . = �- . -,- rr f:: ;;; 7__ _ : k ❑ 2 100 CFM, SW
�: _` —.�` : � . =- -1:�.� - _ l = - z_: ; '_� 2 l .f able : a r� ❑ 2 250 CFM ( >1667 sq ft)
e Requirements _ NotApp!icob e __ r- NotAppi 1_ ❑ z 150 CFM, Ow
,
•
' BPA 1 -Onl y ;� :, - , , . a
� : ,, _ � =- ! 3 s ❑ > 15% of home's sq ft
.-r _:- t_--. ;r� r =. _._ Z .. _ V. . 1 ❑ 2 225 CFM, TW
F; P St ,t 'Ring;;: El open ❑ 1 ❑ 2 [143 ❑ Open ❑ 1 ❑ 2 ❑ 3 ['Open ❑ 1 ❑ 2 ❑ 3 ❑ Open ❑ 1 0 2 0 3
�,,_- . ,,,, -
z; elect�one )_,; y;,� - ❑ H ❑ M ❑ L ❑ H ❑ M ❑ L ❑ H ❑ M ❑ L ❑ H ❑ M ❑ L
., : }- - ,134, s Pa Pa Pa Pa
A
`. F :a - ` DB CF ` = 42, CFM CFM CFM CFM
H s9'`'; ,,; � ; ;ki : _ ❑ 550 CFM;SW
._._._,...._....
O: '; ,.: _ __
a 4 Cerfrficgtlan,Req y= 5 6% o f sq ft w/ AH ❑ 5 10% of home's s ft
r .
checks llha ❑ < 10% of home's sq ft
q ❑ 5 80 CFM, DW
li = - ❑ 5 4% of sq ft no A ❑ ? 50% Reduction ❑ 5 120 CFM, TW
O` - ;;,..,: -`: < = ❑ z 50% Reduction
The duct sealing at this site meets program requirements including: plenum, main ducts, takeoffs and boots sealed; a good faith effort
was made to remove existing duct tape and cover with mastic; metal duct connections are secured with screws. ❑ Y ❑ N
Last updated: 30 November 2012 , . Page 1 of 2
Combustion Appliance Zone (CAZ) Test _
Are there any combustion appliances in the home? Combustion Appliance Type: ❑ Fireplace or wood stove
Y ❑ N ❑ Gas Furnace ❑ Gas water heater 0 Other:
Is there a UL- approved and functioning CO detector A carbon monoxide (CO) detector installed in the home is required in all cases
Installed in the home? where a sealed or non - sealed combustion appliance is located in a conditioned
❑Y N space or attached structure i.e. garage. RECOMMENDED CO detector specifications: =
UL 2034 /CSA 6.19 -01, digital display, peak CO memory and recall.
Is a Combustion Air Zone (CAZ) test required by the electric utility? D Yes, complete the fields below ❑ No, skip to notes
Baseline Pressure with reference to outside (all exhaust devices Weather conditions on day of test: ❑ Calm ❑ Windy.
and air handler fan off): Pa _
•
With air handler fan ON record' gauge: readings:- • Interior doors.open .. • .Interior doors closed : •
Zone Description Reading (Pa) Net (Pa) Reading (Pa) Net (Pa)
Zone 1
Zone 2
I '.
Net Depressurization = Net (Pa) = All fans off Reading (Pa) (minus) Air Handler Fan on Reading (Pa)
Example: Baseline reading with all fans off = 1 Pa; Reading with air handler fan on = -2Pa. Net Depressurization = 1– ( -2) = 3 Net Depressurization
"Net" equals how much the pressure goes down when the air handler is turned ON (compared to the fan off baseline pressure)
Installation/Technician Notes: 4; G pi p et, Jib
•
II j.
Vowel?. bog: byeI��e: •-I. g.-0.4, A (2204, sb Cap,, -51. t �.
Required Signatures: To be filled out by the electrical utility account holder. This form must be signed by the person whose name appears
on the electric utility account. ENERGY INFORMATION RELEASE: The undersigned utility customer requests and authorizes the specified utility to
release billing and usage information for the account listed below to the PTCS program. With this authorization, the PTCS program can request =,
billing information for up to two years pre - installation and two years post - installation. The utility customer also hereby releases the utility
company from any and all liability arising from or connected with providing this information.
_ I
Electric Utility: Account #:
Account holder name: •
Accountholder signature: Date:
By signing below, technician certifies that this form and any accompanying documentation are complete and accurate, and that all
measures associated with this project were completed as of the signature date below. _
this proj Installation Tech Phone #:
- name: V Exl ke-Q1/ Company: �t, fettiviiCt 111E6%11 ( 'l I ) 5 - e f72
Technician Signature: i Date: O 3/1 Q �)
= l 3
PRIVACY ACT STATEMENT t
Basic authority for collecting th info ation is authorized by 16 U.S.C. §§ 832 et. seq., and 838 et. seq., pursuant to Bonneville Power
Administration's Conservation Program system of records established in 46 FR 31700.
This information is primarily intended to further, but is incidental to the performance of, BPA's overall Energy Efficiency Program, the objective of
which is to acquire energy resources through energy efficiency, to determine what cost - effective conservation and direct application renewable
resources measures should be installed or adopted under different circumstances, and to provide incentives for the installation of such measures.
Other routine issues of this information include: aggregation Into a public database on energy efficiency; furnished to authorized personnel for
installation /repair of equipment; aggregated into a database for program publicity; and in some instances information regarding buildings will be
made available to subsequent purchasers of the buildings. Your disclosure of the requested information is voluntary, however failure to provide
requested information means that it will not be possible for you to participate in this BPA Energy Efficiency program.
{
Last updated: 30 November 2012 • P
)
._......._. .zx: :_.y., _,-_.- ::.:_�.`__r^..i'. 7 tea' . __- - ...i -9 • iG'-:.:v., r ..,..'!l'•,`....
S aj �s " s -d
l
2 5 t
. - 4 E r,, ,, Fr n r r� I 5 ' . - r 3 y 4 a
Performance Tested '. - . a „ � �� ,•; .-, .. ,, :44''';-:,6,1• x
COmfort'ystemS . `_ � ``= i q •i Z ki a -
co
PTCS Duct Sealing Certification Form
All sections must be filled out by a PTCS- certified Technician at the time of installation, signed and dated. A copy of the
completed form must be promptly submitted to the utility and homeowner in accordance with utility policy. Please :
enter online at www.ptcsnw.com or fax to 877 -848 -4074. Questions? Call 800 -941 -3867 or email ResHVAC @bpa.gov.
Site Information (Please print clearly)
PTCS Tech ���VVV ` _ Install Customer's
Tech # to } i Name , i Q `:mot' k01/ Date Electric Utility
Customer . i� ry 1t tM Site Installation n y •
Name POIGi � 1G F- Vei21R.e,tO2S Site Address* ii- 1 •} 5O SW a O 1 ' Ave,- L3 3
Site Site 7 Site Zip y Customer
City ' `� � a>� Q I State` ®1-- Code' 1 T 22 I Phone # ( 503 ) 6 6 If - 023
* if mailing address is different, record here ( #, City, St, Zip):
Home Type (provide information for just one type, either a Site Built or Manufactured Home):
Site Built Home: ❑ Existing (A New Construction Manufactured Home: ❑ V ❑ N
Site Built Home Foundation Type: # of Sections for a Manufactured Home: ❑ 1 ❑ 2 ❑ 3
❑ Crawl Space ❑ Full Basement ❑ Half Basement ❑ Slab Super Good Cents? ❑ Y ❑ N •
Year Built: 2 13 Heating System: ❑ Elec. Furnace ❑ Heat Pump gGas Furnace Heated Area z
Energy Star? ❑ Y I'N ❑ Other: . Gas Company (if applicable): (Sq ft) Required 2 3 ] 7
Are at least 50% of the ducts in unconditioned space? ❑ Y "❑ N # of supply registers it of returns
If more than 50% of the ducts are in conditioned space, the home does not qualify for PTCS Duct sealing. 1
House Pressurization and Duct Blaster Tests
Do either of these special conditions apply? (check if "yes ") Testing Equipment Used:
ET Record Only - no duct sealing work done ❑ Energy Conservatory ❑ RetroTec
❑ PTCS Certification ONLY - pretest leakage too low for BPA program ❑ AeroSeal ❑ Air Care ❑ Other:
Hose Pressurized (Blower Door) to: Duct Blaster Location: Pressure Tap Supply Register Location:
Nil +50Pa ❑ Other Pa rt Return Grille ❑ Other: 2na v h k Supp l'
•
Duct Leakage Test: TYPICAL DUCT BLASTER CFM READING with Duct Pressure at OPa and Blower Door @ OPa
DB Fan Pressure: Found using equipment; it is the fan pressure, not the house pressure. (Ex. Ring 1, 78 Pa, 364 CFM). •
Definitions: (DB)= Duct Blaster (BD)= Blower Door (AH) =Air Handler (SW)= Single Wide (DW)= Double Wide (TW)= Triple Wide
New Construction Existing Home, New Ducts Existing Home, Existing Ducts Manufactured Home
_ : °• ;Pre- testRin :. ,__ - ,...p
_.. .. . ,. - ,.,.. . . Open 1 2 3 Open 1 2 3
- , .No .,q f; lica a le ' �= � - � �r' ' %N lfcal ;_�; ,
}.:- ❑ ❑
.r^. ? r • :: = u - •:�:: ^?, i: -: �i'• c.:rr.,,: ; 5 pP c.• _ .... ;: -- - ❑ H ❑ M ® c
Pas =(. �). , .- : =r _ . _
..r-; - H M L
, , _ - :,. - - g .� �.,,:: _ Pa
w . ='D $ <;- " i;: A ';; ; �,:,;,: , Q :. Bp, :._- - ,. : " r ,': .
'' DBef1Vf '' , NotApp NotApplrcabl ,. x CFM CFM •
4 _4su; 7•Ai. », W _aGi,..f�.,:r — z.-- .,c; 4 -Ys,= c` di - : .,7.c?_._ =_ - .,:: -:_:_
= : i _ ,;Y ; ❑z 100CFM, ,.1 Pietest -_; =>!a- ;' - _ ❑ >- 250 CFM ( > 1667 sq ft )
= u ire ..� r _ pl'cabie.: i , ix; ` .=: No licable:s� = =
- __ �� ; � Rla .App -- _ f App . _ _
..�..::. r.::- ' ::; ...._ . - > 15% of home's s ft ❑ 2 150 CFM, DW
- ❑ q
. . ...Y.}, - -__, r _-, ; ,. r _. �= =�i!=" :::::7 - - >2J_SCFM,TW
<<...� z__. _ �:_:�_:, _. � : �- Wit, - - ,......._____..,,...._. ...... -
_..:..: :. r te, ; , , ., ,,
��y(seleu�or►rj
POSt;tesi R, ❑ open ❑1 ❑2[t!� ❑ Open ❑1 0 20 3 ['Open 01 02 0 ❑Open 01 0 03
. *.. ❑H ❑M ❑1 OH ❑M ❑L
T ❑ H ❑ M DL ❑ H DM Di
H . DB'Fan"P ens .' ) 34, 5 Pa Pa Pa Pa
I ill,' 'I `.;L }z CFM CFM CFM CFM
C = >; r- �:r„ :. -' El 50 CFM 5W
tfon �-
C I, '',gertr Ca -4 4;i:1 <- 6% of sq ft w/ Ali ❑ s 10% of home's sq ft ❑ s 80 CFM, DW
w °�(cfieckol 7hatr` ❑ s 10% of home's sq ft
=f 4- 71 ' h; ❑ 5 4% of sq ft no AN ❑ ? 50% Reduction ❑ <_ 120 CFM, TW
Y :i -,-' =. ` - - ❑ 2 50% Reduction
The duct sealing at this site meets program requirements including: plenum, main ducts, takeoffs and boots sealed; a good faith effort
was made to remove existing duct tape and cover with mastic; metal duct connections are secured with screws. ❑ Y ❑ N
Last updated: 30 November 2012 Page 1 of 2
•
}
Combustion Appliance Zone (CAZ) Test
Are there any combustion appliances in the home? Combustion Appliance Type: ❑ Fireplace or wood stove
❑ Y ❑ N ❑ Gas Furnace ❑ Gas water heater ❑ Other:
Is there a UL - approved and functioning CO detector A carbon monoxide (CO) detector installed in the home is required in all cases
installed in the home? where a sealed or non - sealed combustion appliance is located in a conditioned
❑Y ❑ N space or attached structure i.e. garage. RECOMMENDED CO detector specifications:
UL 2034 /CSA 6.19 -01, digital display, peak CO memory and recall.
Is a Combustion Air Zone (CAZ) test required by the electric utility? ❑ Yes, complete the fields below ❑ No, skip to notes
Baseline Pressure with reference to outside (all exhaust devices Weather conditions on day of test: ❑ Calm ❑ Windy.
and air handler fan off): Pa
With air handler fan ON record gauge readings: Interior doors open 'Interior doors dosed . {
Zone Description Reading (Pa) Net (Pa) Reading (Pa) Net (Pa)
Zone 1
Zone 2
Net Depressurization = Net (Pa) = All fans off Reading (Pa) (minus) Air Handler Fan on Reading (Pa)
Example: Baseline reading with all fans off = 1 Pa; Reading with air handler fan on = -2Pa. Net Depressurization = 1— ( -2) = 3 Net Depressurization
"Net" equals how much the pressure goes down when the air handler is turned ON (compared to the fan off baseline pressure)
Installation/Technician Notes: perseu . lit 0 t4„
Blows boo l .: be,se Let _ 1.3 LI A 128Qclw $0 Caw, , 31. i
Required Signatures: To be filled out by the electrical utility account holder. This form must be signed by the person whose name appears
on the electric utility account. ENERGY INFORMATION RELEASE: The undersigned utility customer requests and authorizes the specified utility to
release billing and usage information for the account listed below to the PTCS program. With this authorization, the PTCS program can request
billing information for up to two years pre - installation and two years post - installation. The utility customer also hereby releases the utility
company from any and all liability arising from or connected with providing this information.
Electric Utility: Account #:
Account holder name:
Accountholder signature: Date:
By signing below, technician certifies that this form and any accompanying documentation are complete and accurate, and that all
measures associated with this project were completed as of the signature date below. _
Technician Installation { p { Tech Phone #:
name: LV�1{ t f)Qi «y / Company: .�,1,, r129 f1�} ( II ) 5-33 - 1112 6,
Technician Signatuure: Date: 0 3l1 ( f w)3
PRIVACY ACT STATEMENT r !
Basic authority for collecting th inforgation is authorized by 16 U.S.C. §§ 832 et. seq., and 838 et. seq., pursuant to Bonneville Power
Administration's Conservation Program system of records established in 46 FR 31700.
Thls information is primarily intended to further, but is incidental to the performance of, BPA's overall Energy Efficiency Program, the objective of
which is to acquire energy resources through energy efficiency, to determine what cost- effective conservation and direct application renewable
resources measures should be installed or adopted under different circumstances, and to provide incentives for the installation of such measures.
Other routine issues of this information include: aggregation into a public database on energy efficiency; furnished to authorized personnel for
installation /repair of equipment; aggregated into a database for program publicity; and in some instances information regarding buildings will be
made available to subsequent purchasers of the buildings. Your disclosure of the requested information is voluntary, however failure to provide
requested information means that it will not be possible for you to participate in this BPA Energy Efficiency program.
Last updated: 30 November 2012 Peg