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Permit ii :''''14"):',1"::'1 ` ���� ®� �I���® MASTER PERMIT v 0 COMMUNITY DEVELOPMENT Permit #: MST2010 -00009 T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/17/2010 Parcel: 2S 102 DCO3300 Jurisdiction: Tigard Site address: 13903 SW BRAYDON CT Subdivision: MCDONALD WOODS Lot: 6 Project: McDonald Woods Project Description: New SFR. BUILDING Floor Areas Required Setbacks Required Stories: 2 Bedrooms: 4 First: 1252 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 26 Bathrooms: 3 Second: 1613 sf Garage: 457 sf Front: 20 Smoke Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes Total: sf Value: $311,159.21 Rear: 15 PLUMBING Sinks. 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Catch Basins: 0 Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Other Fixtures: 0 Tubs /Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1 Natural Gas Heat Pump: N Hoods: 1 Other Units: 0 Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4 Furn > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 0 -200 amp: 0 WI Svc or Fdr: 0 Ea add'I 500 sf: 5 20 1 -400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp /volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: Owner: Contractor: Required Items and Reports (Conditions) GERTZ CONSTRUCTION CO INC GERTZ CONSTRUCTION CO INC 1 MST Ersn Cntrl 503 - 681 - 4444 19200 SW 46TH AVE 19200 SW 46TH AVE TUALATIN, OR 97062 TUALATIN, OR 97062 PHONE: 503 -692 -5433 PHONE: 503 - 692 -3390 FAX: 503- 692 -5433 Total Fees: $16,511.47 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. AT ION: • • - .on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 0010 through OA' • - 011 -8100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 6.6699 or 1.800 332.2344. 0 i Issue y: ' /' . � � L.. Permittee Signature: Bui Permit Application Residential RECEIVED FOR OFFICE USE ONLY • • City of Tigard JAN 3 2010 Received _ Permit No. . , to .1 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review'► Phone: 503.639.4171 Fax: 503.598.1960 Date /B : . (t` �� Other Permit�� 0 . '����` TIGARD Inspection Line: 503.639 CITY OF TIGARD Date Ready /By: t 65 See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISIO ► Notified/Method: 4,, PAIN1 0 Supplemental Information 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. Valuation: .221;941.00 ® I- and 2- family dwelling El Commercial /industrial "1� �1 , �\ ❑ Accessory building El Multi-family Number of bedrooms: 4 ❑ Master builder ❑ Other: Number of bathrooms: 2.5 JOB SITE INFORMATION AND LOCATION Total number of floors: 2 Job site address: 13903 SW Braydon Ct. New dwelling area: 2865 square feet City /State /ZIP: Tigard OR 97223 Garage /carport area: 457 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: 41 square feet ( 1013 Cross street/directions to job site: 92 off McDonald Deck area: square feet 1.z52 Other structure area: .F5oz square feet G6 REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: McDonald Woods Lot no.: 6 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 2S102DC 03300 Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. New Home Valuation: $ Existing building area: square feet New building area: square feet, ® PROPERTY OWNER ❑ TENANT Number of stories: Name: Gertz Construction Co INc Type of construction: Address: 19200 SW 46 Ave Occupancy groups: City /State /ZIP: Tualatin, OR 97062 Existing: Phone: (503)692 -3390 Fax: (503)692 -5433 New: ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Gertz Construction Co Inc All contractors and subcontractors are required to be Contact name: Ken Gertz licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 19200 SW 46 Ave jurisdiction in which work is being performed. If the City/State/ZIP: Tualatin, OR 97062 applicant is exempt from licensing, the following reasons apply: Phone: (503 -) 692 -3390 Fax: : (503) 692 -5433 a A -,..�- j �p E -mail: Ken @Gertzco.com Cam --Gee AO CONTRACTOR Business name: Gertz Construction Co Inc BUILDING PERMIT FEES* Address: 19200 Sw 46 Ave (Please refer to fee schedule City /State /ZIP: Tualatin, OR 97062 Structural plan review fee (or deposit): Phone: (503) 692 -3390 Fax: (503) 692 -5433 FLS plan review fee (if applicable): CCB lic.: 34350 Total fees due upon application: Amount received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Kenneth ertz Date: 11/24/09 * Fee methodology set by Tri- County Building Industry Service Board. 1: \Building \Permits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(11/02/COM /WEB) , Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received `, b Permit o. t Date/B N r III . "46 q ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' C, • Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready /By: Aids: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ® New construction ❑ Addition /alteration /replacement ❑ 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 ", "I- 2 ", "I -3 ", Job no.: Job site address: 13903 SW Braydon Ct. I00HP or more. occupancy. ❑ 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: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: 92 " off McDonald Description i Oty• 1 Fee. 1 Total 1 • New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less I 1 168.54 168.54 Subdivision: McDonald Woods Lot no.: IS I 4 _ Ea. add'I 500 sq. ft. or portion 5 33.92 +t, (c)1 Tax map /parcel no.: 2S102DC 03300 Limited energy, residential 1 67.84 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family New Home residential (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: Gertz Construction Co Inc 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 19200 SW 46 Ave Over 1,000 amps or volts 552.26 2 City/State /ZIP: Tualatin, OR 97062 -8770 Temporary services or feeders installation, alteration, and /or relocation Phone: (503)692 -3390 Fax: (503)692 -5433 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, l er panel Owner signature: Date: A. Fee for branch circuits with ® APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: Gertz Construction Co Inc B. Fee for branch circuits without service or feeder fee, Contact name: Ken Gertz 56.18 2 first branch circuit Address: 19200 SW 46 Ave Each add] branch circuit 7.42 _ 2 Miscellaneous (service or feeder not included) City /State /ZIP: Tualatin, OR 97062 Each manufactured or modular 67.84 2 Phone: (503) 692 -3390 Fax: : (503) 692 -5433 Rec onn nect only and /or feeder Reconnect 67.84 2 E -mail: Ken @Gertzco.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Brighten Electric Signal circuit(s) or limited - energy panel, alteration, or Address: P.O. Box 2330 extension. Describe: Page 2 2 City/State /ZIP: Redmond, OR 97756 Each additional inspection over allowable in any of the above Per Phone: (503) 522 -3115 Fax: (503) 693 -9445 inspection 66.25 per hour (I hr min) 66.25 CCB Lic.: 132222 Electrical Lic.: Suprv. Lic.: 34 -483C Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 405, �a Plan review (25% of permit fee): Print name: Tony Sheridan Date: 1/12/09 State surcharge (12% of permit fee): 4K----(2 Authorized signature: I —��_ TOTAL PERMIT FEE: 444, 1 0 This permit application expires if a permit is not obtained within 180 Print name: Ken Gertz Date: 1/12/09 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11/05 /COM/WEB • Mechanical Permit Application FOR OFFICE USE ONLY Received m6TZ0 • • !0 City of Tigard Date /By: Permit No.: U " q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit: T 1 G A R D Inspection Line: 503.639 Date Ready /By: Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 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: $ ® 1- and 2 -famil dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 2-family g ❑ Commercial /industrial ❑ Accessory building ID Multi For special information use checklist. y ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 13903 SW Braydon Ct. Air conditioning (requires site plan showing placement) 46.75 City /State /ZIP: Tigard OR 97062 Furnace 100,000 BTU (ducts/vents) 1 46.75 (0.7 Fumace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: 92 " off McDonald 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: McDonald Woods Lot no.: VC Flue /vent for any of above 23.32 Other: 1 23.32 Tax map /parcel no.: 2S102DC 03300 Other fuel appliances DESCRIPTION OF WORK Water heater 1 23.32 Gas fireplace 1 33.39j, New Home 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 ❑ TENANT Chimney /liner /tlue /vent 23.32 Other: 23.32 Name: Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 1 33.39 City /State /ZIP: Clothes dryer exhaust 1 33.39 `33.3`x' Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) ' 23.32 1 1c3•t ® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: Gertz Construction Co. Inc. Fuel t 1n P g Contact name: Ken Gertz $14.15 for first four; $4.03 for each additional Address: 19200 SW 46" Ave Fumace, etc. Gas heat pump City /State /ZIP: Tualatin, OR 97062 Wall /suspended/unit heater Phone: (503) 692 -3390 Fax: : (503) 692 -5433 Water heater Fireplace E -mail: Ken @Gertzco.com Range CONTRACTOR Barbecue Business name: Oregon Comfort Heating Clothes dryer (gas) Other: Address: P.O. Box 190 MECHANICAL PERMIT FEES* City /State /ZIP: Eaglle Creek, OR 97022 Subtotal Phone: (503) 655 -0221 Fax: (503) 650 -2993 Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB Iic.: 42519 State surcharge (12% of permit fee) 'r (2 TOTAL PERMIT FEE 33 , t Authorized Signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Ken Gertz Date: 1/12/09 ' Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \Permits\MEC- PermitApp.doc 10/01109 440.4617T(1I/02 /COM/WEB) Plumbin! Permit Application Building Fixtures FOR OFFICE USE ONLY City of Tigard Received Date/By: I t (L /�/y�� g an Permit No.:�1n L O IJVQJV 7 III ' 13125 SW Hall Blvd., Tigard, OR 97223 C Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Other Permit No.: Date/By: T 1 G A RD Inspection Line: 503.639.4175 Date Ready /By: Juris ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ® New construction ❑ Demolition For special information use checklist. Description Qty. J Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi- family SFR (3) bath 1 500.32 v, Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 13903 SW Braydon Ct. Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: Tigard, OR 97223 Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 92 " off McDonald Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: !) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: McDonald Woods I Lot no.: pup Fixture or item: Tax map /parcel no.: 2S102DC 03300 Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New Home Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER l ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain /floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Gertz Construction Co. Inc Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Ken Gertz Roof drain (commercial) 12.51 Address: 19200 Sw 46` Ave Sink/basin /lavatory 25.02 City /State /ZIP: Tualatin, OR 97062 Solar units (potable water) 62.54 Phone: (503) 692 -3390 Fax: : (503) 692 -5433 Tub /shower /shower pan 12.51 E -mail: Ken @Gertzco.com Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Threefoot Plumbing Inc. Water p t p to DWV 56.29 Address: P.O. Box 274 Other: 25.02 City /State /ZIP: West Linn OR 97068 Subtotal 560,3 :2_ Phone: (503) 557 -7585 Fax: (503) 650 -8212 Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: 103792 Plumbing Lic. no.: 3 -259pb State surcharge (12% of permit fee) C CA Authorized signature: TOTAL PERMIT FEE r j�, 4Ln Print name: Marshall hreefoot Date: 1/12/09 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits\PLMU- PermitApp.doc I0 /01/09 440- 46t6T(I0 /02 /COMM'EB) t. REC__.."1v ,k-'■ , )1: ;t immer,0 111 FD ,.. Elev 218 a a a�3 a� aou Go Elev 2 16 2010 • 82.48' :e CITY OF TiGARD � ' Thee Protection \ ' BUILDING DIVISION I _ * r — - - 2- • tCD !Pr M ,..LOT 15' radiu$ , ; ... q _._ e,490 ' s.F . ' s _ 1 /, � 6 Street - . trees, either .. I i i " 7: ' 2" caliper, I Elev 214 Prunus s. • 9.23 1 — Amanogawa' MAIN 1}LOOR ; i � 1 or existing -5.-0 11 <1 DBH 1 1 6 ' SIDEWALK m L lir ' / � EASEMENT cedars , _ , ; / should they / � _ ; - survive 6>Zi .-- .=E3, 7 . construction C o, I / /�\� (which iFF Elev 2 doubt since -- GF Ele1r21 I 1 I g , i iii. ` GARAGE ° ; I ; , most are 15' radius _ ' 0 co; e dead, but u a _031. m�- ...� - -71 / will ry) wew try). No e I , , I o : 00... protection -, ® of cedars T , I a ,-- _ �� / () necessary .4 _ 3 ' per 18.790 �� t. m G ravEr osi 6 r i ve v7' � , P , ,faF�Eron/ � o�0t�q36, // ' c/ e e _ � 5. \ „fe e ,f c tI: Ads, 9 -0 WARNING: Elev 21 j. �1 / / 1 OBTAIN LOCATES PRIOR TO ANY -- 1 Q � , ACII EXCAVATION t •i GJ Elev 211 I C3 PL O T = - A ND TREE PROTECTION :PLAIN- GE* TZ CONSTRUCTION HOME SQUARE FOOTAGE COM PANY IN MAIN FLOOR = 1252 SOFT. BUILDING O N UPPER FLOOR = 1613 SQ. FT. CUSTOM HOMES SINCE 1977 TOTAL = 2865 SQ. FT. „ (503) 692 -3390 GARAGE = 427 SQ FT. ' ,jadon Ct. Lot 6 NIttofigld Woods SCALE 1” = 20' r.. GERTZ CONSTRUCTION COMPANY INC. PLOT PLAN 2/16/10 ' . 4) 1: 1G9 CITY OF TIGA.RD - SITE PIA REVIEW BUILDING PERMIT NO.: -1 1 - 2•4/0-0004Y PLANNING DIVISION: Required Sett)acks: Er Not Approved Side: _ID Street Side: Front. Gyage. 4)() Rear: I Visual Clearance: 0' Approved Not Approved Maximum Building He4.tlit 3.0) fet CWS Service Provider red. Ell Yes 0 No I / Li cciveci i3N : ENGINEERIN■EPAI /MEM : Actual SIo : Approved 0 Not Approved Site Pkz: all pproved 0 c • Troved By: Date: 2.- Notes: 0 , 624 , trve j_ friA e l 41 CITY 0 TIGARD - SITE PLAN ' VIEW BUILDING PERMIT NO: Street Trees: .../ APProved 1:3 Not Approved Protected TT Appooved I , ot Approved Date: Notes: Oregon Residential Specialty Code R318.2 /91 66 r24 /U- 0000 MOISTURE CONTENT ACKNOWLEDGEMENT FORM I, ;8l2,0t-6 TvAe__ , am the general contractor or the owner - builder at the following address: Site Address: )3 703 JA-t) 844 yiiviu City: Permit #: t 2 /P . ©0o Subdivision/Lot #: lyj� soNA-w tetavo 5 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: D/c /lJ General Contractor or Owner - Builder I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08 Oregon Residential Specialty Code N1107.2 HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS Permit No.: D vhf 9 Jurisdiction: 7/71 1211"f3 Site Address: / U3 / 2340)40 G 77 Subdivision/Lot #: G 0A-) 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: Date: f.6 `0' Owner /General Contractor /Authorized Agent Print Name: & ' r2 ,,,‘ ' 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. 1: \Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08 STREET TREE CERTIFICATION I, i2 P\A-e__. Owner- /Agent for (PLEASE PRINT) (PERMIT HOLDER) • Do hereby' certify that the following location meets City of Tigard land use and ;development standards for street tree installation. ADDRESS: 13 ?03 $ ;4/ 8i2, ao0ti ) SUBDIVISION: ��/Jw�,a -c-� 0.01/412 S LOT: SIGNATURE: r At" DATE: /D / 0 (OWNER/ AGENT) RECEIVED BY: DATE: (CITY OF TIGARD) l: \Baulding \Forms \StreetTreeCertificate 0i /19/07