Permit CITY OF TIGARD MASTER PERMIT
III
I= ' 1 COMMUNITY DEVELOPMENT Permit#: MST2010 -00030
TIGARD A R. O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010
I
Parcel: 1S125DC07800
Jurisdiction: Tigard
Site address: 7009 SW ASH CREEK CT
Subdivision: ASH CREEK ESTATES Lot: 11
Project: Ash Creek Estates
Project Description: New SFR.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First: 1116 sf Basement 0 sf Left: 3 Parking Spaces: 0
Height: 25 Bathrooms: 3 Second: 1280 sf Garage: 609 sf Front 20 Smoke
Dwelling Units: 1 Third: 0 sf Right 3 Detectors: Yes
Total: sf Value: $270,415.31 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: 3 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
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 addl 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 addl 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)
ASH CREEK PROPERTIES LLC WINDWOOD CONSTRUCTION INC 1 MST Ersn Cntrl 503 681 - 4444
12655 SW NORTH DAKOTA ST 12655 SW NORTH DAKOTA
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: PHONE: 503 -625 -6526
FAX: 590 -7606
Total Fees: $15,633.21
This permit is is ued_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 i ccordance wi . 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. ENTION: Oregon la - •uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 1 -0010 through OAR 9522 010 ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
lss ed By: . Permittee Signature:
Building Permit Application RECEIVED FOR OFFICE USE ONLY .' . ,
City of Tigard
Received
Illi DateB : Permit No.: �1 • 6.00436
13125 SW Hall Blvd., Tigard, OR 97223 ' ? Plan Review ��� �D R IL _
Phone: 503.639.4171 Fax: 503.598.1960 Date B : ('� Other Permi . • �
TIGARD Inspection Line: 503.639.4175 BUILDING CITY OF TIGARD Date Ready :y: ���� � ® See Attached Checklist for
Internet: www.tigard- or.gov BUILDING DIVING Notified/Method: / � n I _ JI 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.
® 1- and 2- family dwelling ❑ Commercial/industrial Valuation: S 2:7 X i 31
❑ Accessory building ❑ Multi - family Number of bedrooms: /
❑ Master builder ❑ Other: Number of bathrooms: 2 /�
JOB SITE INFORMATION AND LOCATION Total number of floors: _
Job site address: Ida- f 5 GIL New dwelling area: p_39c. square feet
City /State /ZIP: ! (� ) �JL "3 Garage /carport area: id q' square feet
Suite/bldg. /apt. no.: Project name:,, i ? , '3 4 4 Covered porch area: ICI, square feet 12430 Z
Cross street/directions to job ste: 4� ` Deck area: r square feet 1, i
Other structure area: ' square feet 2_.
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: :L( /e 43 l Lot no.: // / Permit fees* are based on the value of the work performed.
Tax map /parcel no.: !! ! / Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
NEW SINGLE - FAMILY RESIDENCE Valuation: 5
Existing building area: square feet
New building area: square feet
4
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name: WINDWOOD CONSTRUCTION INC Type of construction:
Address: 12655 SW NORTH DAKOTA STREET Occupancy groups:
City /State /ZIP: TIGARD OR 97223 Existing:
Phone: (503)780 -4375 Fax: (503)590 -7606 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: WINDWOOD CONSTRUCTION INC All contractors and subcontractors are required to be
Contact name: DALE RICHARDS licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12655 SW NORTH DAKOTA STREET jurisdiction in which work is being performed. If the
City /State /ZIP: TIGARD OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 780 -4375 Fax: : (503) 590-7606
E -mail:
CONTRACTOR
Business name: WINDWOOD CONSTRUCTION INC BUILDING PERMIT FEES*
Address: 12655 SW NORTH DAKOTA STREET (Please refer to fee schedule)
City /State /ZIP: TIGARD OR 97223 Structural plan review fee (or deposit):
Phone: (503) 780 -4375 Fax: (503) 590 -7606 FLS plan review fee (if applicable):
"� freT/ — Total fees due upon application:
CCB lic.: 50196
!! 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: DALE RICHARDS Date: a/ ),, 7`e + Fee methodology set by Tri- County Building Industry
Service Board. c`
1. V3uildinglPermits1BUP •PermitApp.doc 03/21/06 44046I3T(I I /02/COM/WEB) I7' , 51 x ,'I
0 6 %0010 07:16 5 @36489723 JERI.IOE ELECTRIC INC PAGE 02
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Electrical Permit Application o 1 ()12 ()I 11C 1 l l (1 \1 1 -rr*
t`r , Roce(vcd Permit No.: , . VI Zoe 0 ' 0 & e 30
;: _ _ City of Tigard R
III 1 3125 SW Hall Blvd„ Tigard. OR. 97223 Plan Review Other Permit:
,r Ii ' Phone: 503.639.4171 Fax: 503.598,1960 Datc/B
Date Ready/By: 1uis: M Sec Page 2 for
.TIC Att17
Inspection Line: o 9. ov Notified/Method; Supplemcotal Information
�: � lntcrnme www,tigardrd.or.(:ov
TYPE OF WORK _ PLAN REVIEW
❑ Ncw construction ❑ Addition /alteration/replacement
Please check rail thnt apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 ramps or more ❑ Building over three stories.
0 Demolition ❑ Other: where the available iltnit 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
0 I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildingS.
Other: ❑ Fire pump. ❑ Installation of 75 KVA or
Multi-family ❑ Master builder ❑ O ❑Emergency system. Inrger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition anew motor lend of ❑ "A ", "E". "1 -2 ", "I -3",
,,�� � /� _ / Je 100HP or more, occupancy,
Job no.: I Job sitc address: --70617 Qd ,S A J"/PT�J (JrN `ter ❑
Six or more roxldmtialunits. ❑Recrcotionnl vehicle parks.
9 7 ') ❑ Health -care facilities. ❑ Supply voltage for more than
City /State /ZIP: 9 ❑ Hsanrdot location. 600 volts nominal.
Suite/bldg./apt. no.: 1 Pro ect name: // D Service or feeder 600 nmps or more.
j �J e/404 FEE SCHEDULE
Cross street/directions tojeb sitc: 5/ ,� Desrripl:on I Qt I Frr. L Telel 1
J
New residential single- or multi family dwelling unit.
Includes attached garage.
1000 s q. R . or Icss 168.54 (1 4
Subdivision: _ Lot no.: L f
�`, , _ ��f/ G FEa. add'1 500 sq. ft. or portion �7 � 33.92 1G"(• jeC 1
Tax map /parcel no.: Limited energy, residential 1 67.84 1 2
DESCRIPTION OF WORK (with above aq. R.)
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation alteration, and/or relocation
200 amps or Icss _ 100.70 2
❑ PROPERTY OWNER 1 - ❑ TENANT 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name: G C ` ? (u t�itS� 601 amps to 1,000 amps 301.04 2
Address: /2. S Gt) �� /v `� OM 1,000 amp or volts 552.26 2
( �t Temporary services or feeders Installation. alteration, and /or H City/State/ZIP: /�'� (� C/ �'C Q? a 3
Phone: ( ) 7 Q - relocation
[� 7 ," 1 I Fax: ( ) �� /b X cr4 200 amps or less 59.36 I
a j /
201 amps to 400 amps 2 ,
Owner Installation: This installation is being made on property that 1 own which is not 2 0 1 amps to 599 amps 1 25.08 128.5 2
intended for sale, lease rent, or exchange, according to ORS 447, 449, 670. and 701. Branch circuits -• new, alteration, or extension, per pone)
Owner signature: _Date: A. Pee for branch circuits with
❑ CONTACT PERSON above service or feeder fee, 7.42 2
❑ APPLICANT each branch circuit , milii Business name: 3 / B. Fee for branch circuits
without service or feeder fee, 56.18 2
Contact name: first branch circuit
Each add'I branch circuit 7.42 _ 2
Address: Miscellaneous (service or feeder not Included) _
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) I Pax: : ( ) _Reconnect only - 67.84 2
Pump or irrigation circle 67.84 , 2
E -mail: 67.84 2
CONTRACTOR Sign or outline lighting
• � /' � Signal circuit(s) or limited -
Business name: ' D A / 1 . 1 � 1 I f I Le • energy panel, alteration, or Pagc 2 2
t J' fr ( extension. Describe: ag
Address: r u t ` iS 1
Each additional Inspection over allowable in an of the above
City /State/ZIP: �� �: a �� _ Per inspection 66.25
/►
Phony ) / 1 �, ��/ �I�► [nvcstigation per hour (t hr min) 6G.25 ,
Industrial plant per hour 78.18 1
CC(3 Lid:: Electrical Lie.; Suprv. tic.: �a� ELECTRICAL PERMIT FEES
1 ' f - � VD W
Subtotal: 40 , 9
Suprv. Blccttie a re, required: Plan review (25% of permit fee):
Print name: t r • AI / Date: ,.....t• .0 State surcharge (12% of permit fee): "Cr ' , 72
T OTAL PERMIT FEE; 4-64-.1 d
Authorized signature:
/ 1 T his permit application expires if o permit is not obtained within 180
Print name 1 Date /y�7 days piker it hug been accepted 13 complete.
� /! • Number of inspections nllowed per permit.
- -- 440a6l ST(1 i to5/COMNieu
Meelvaiica1 Permit Application FOR OFFICE USE ONLY
City of Tigard Received _
`f g Date/By: Permit No.:hA 5`ZOIO " C-+
111 I ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 11 � `
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
T I 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- 2-family dwelling _ RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 0 Master builder
❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 4 G Q A c f
Air conditioning or heat pump
J ,O ➢ v'r_ lr.L c. � i� (requires site plan showing placement) 14.00
City /State /ZIP: P,t — —671'1,3 Furnace 100,000 BTU (ducts/vents)
,(_ �_ /
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: / .3,/air Gas heat pump 14.00
Cross street/directions to job ste: 5, ,LL Duct work 14.00
`�� "� Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: /93 4 c„,,, ce `�� 2 21 I Lot no.: // Flue/vent for any of above 10.00
/ Other: _ 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater , 1 11Z 32,
Gas fireplace . j
NEW SINGLE - FAMILY RESIDENCE Flue vent for water heater or gas 1
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
® PROPERTY OWNER ( ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: WINDWOOD CONSTRUCTION INC Environmental exhaust and ventilation
Address: 12655 SW NORTH DAKOTA STREET Range hood/other kitchen
equipment J
City /State /ZIP: TIGARD OR 97223 Clothes dryer exhaust 1?,3
503 780 -4375 Fax: 503 590 -7606
Single-duct compartments, exhaust (bathrooms, oats,
Phone: ) y (1 (. /
( ) ( ) toilet corn rt unlit rooms) 10t/
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: WINDWOOD CONSTRUCTION INC
Other: 10.00
Fuel piping
Contact name: DALE RICHARDS .r first four; or each additional
Address: 12655 SW NORTH DAKOTA STREET Fumace, etc. 14,1S
Gas heat pump
City /State /ZIP: TIGARD OR 97223 Wall /suspended /unit heater
Phone: (503) 780 -4375 Fax: : (503) 590 -7606 Water heater 1
E - mail: Fireplace 1
Range
CONTRACTOR Barbecue
•
Business name: PERFECT CLIMATE INC Clothes dryer (gas)
Other:
•
Address: PO BOX 3176 MECHANICAL PERMIT FEES*
City /State /ZIP: GRESHAM OR 97030 Subtotal 3e;0, 9c1
Minimum permit fee ($72.50)
Phone: (503) 491 -4848 Fax: (503) 491 -4849
Plan review (25% of permit fee)
CCB lic.: 118424 '1 1((11 State surcharge l2, fpermit fee) `%e I 2-- 1 TOTAL PERMIT FEE 6-3 I
Authorized signatur This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: RENEE JIMENEZ Date: i i /U • Fee methodology set by Tri- County Building Industry Service Board
I: Building 'Permits4btEC•PermitApp.doc 04 /06/06 440 -4617T (1 II /02/COM/WEB)
• g ■
PlumbinE Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received
Date/By: No.SL'� 1 O n/�va�
■ 13 125 SW Hall Blvd ,Tigard, OR 97223 Plan Review !!I� 1 tM Ate )
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juns: 0 See Pa e 2 for
Internet www.tigard- or.gov g
Notified/Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE
w construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 it for each utility connection)
CATEGORY OF CONSTRUCTION ' , SFR (1) bath 249.20
32'1and 2 -family dwelling ❑ Commercialfmdustrial SFR (2) bath 350.00
❑ Accessory building ❑Multi - family SFR (3) bath Y - 5-640.
❑ Master builder
0 �� Each additional bath/kitchen 45.00
Fire ( sq. ft.) g
F' sprinkler s . ft. Page 2
, JOB SITE INFORMATION AND LOCATION : Site utilities
Job site address: 70& el �w 6 Catch basin or area drain
16.60
City /State/ZIP: r, / an',/ U y '22 2-3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt no.: I Project name: A A 6i'"""r ( c-,...,/„..... Footing drain (no. linear R: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: S(. -./1 Manholes
16.60
Rain drain connector 16.60
Sanitary sewer (no. linear 8: ) Page 2
Storm sewer (no. linear R: ) Page 2
Subdivision: k ...C/6.-4/ ,4 . . . W ef I L no A O it Water service no. linear ft.: ) Page 2
Tax map/parcel no.:
Fixture or item
_• , . ..
_ on valve
_ �Pti 16.60
DESCRIPTION OF WORK Bac kflow preventer Page 2
n/ 64J S�/Z. Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
: '.. ❑ PROPERTY OWNER . ` °,r ❑ TENANT.
• Drinking fountain 16.60
/ y Ejectors/sump 16.60
Name:
�l A (� ,, y ` A'? r S ? 1)7 ( Expansion tank I 16.60
Address: /t2._6 ¶3 Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
• . ❑ APPLICANT 0 CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/State/ZIP: Roof drain (commercial) 16.60
Phone: Sink/basin/lavatory 16.60
( ) Fax::( )
Tub /shower /shower pan 16.60
E-mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Bus oi wt / j? /o n l D/I „,M Wa ter heater
- If/ 16.60
. ' 6 - !;or other:
Ut e e• i*S " Ci` '' -9-)-05-11 subtotal ,
Minimum permit fee: $72.50
Phone: ( ) 3a. - , ir 7 3 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Li 127,3g7 , . i&j (bi I Plumbing Lic. no.:: "..? p Plan review (25% of permit fee)
Authorized signature: ,�i /��� / " . I Cog surcharge f permit fee) 0
� / I / TOTAL PERMIT FEE
/ ! ,
Print name: >- -/t' //e X726r -i Date: g/� /U 7 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fec methodology set by Tri- County Building Industry Scrvicc Board.
" gib! 26 10 1 1 : 33a Flanagan (Laptop) 503-697-1976 p . 3
RECEIVED
La, J - ' ° o' T .1 FEB 2 6 2010
IA. dr CITY OF TIGARD
70aY 1,4 71. CT' BUILDING DIVISION
1/5 ..1.." - Pg ..71./ - z /3 ?3
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P2q T rie .() f It S D twx j 0
PC t- ( 5 M'Li j -M40 - ELy - 461 c,r
i 1M_ D A&— - 172E-k1 exi LOT 'I
- / AA A. L .A.c.e.-e-7 <-/-
1 S4 - �Cni4 fi toi 20 c3
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CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: VIZI Z(310.000 AC)
PLANNING DIVISION:
Required Setbcks: ErApproved ❑ Not Ani
Side: Street Side: 1 5 -
Front. Garage: 2() Rea.
Visual Clearance: Approved ❑ Not Approved
t� <� Maximum Building Height 31)._ feet
CWS Service Provider Letter Required: ❑ Yes ❑ No
B, ❑ 4f�/ Receio ved
ENGINEERING D Date: 3 /PARTMENT:
Actual lope•,% IA Approved ❑ Not Approved
Site PI n: - Approved ❑ of pproved
By: Date: 3
Notes: afetcuLEL
e �ehcl� A.A2 3
CITY O _ TIGARD - SITE PLAN ' VIEW
BUILDING PERMIT NO:
Street Trees:
Protected T t • roved
B • j ai , r - PPbved of Approved
o -
Notes: p s O pprovM
rho 14, .. - 1
•
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, ? /ca't/ /099.9/A , am the general contractor or the owner- builder
at the following address:
Site Address: - 7de s /y am ` �( / &y h
L /
Permit #: # 44 5,7, d`a -&da.gid
Subdivision/Lot #: s ' /0
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: - A,�
G eral 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.: Jurisdiction:
/27-5f 2 WO ord0
Site Address:
mo <S' #54 K�c(
SubdivisionlLot #: /
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: CAA/
• - eneral Contractor /Authorized Agent
Print Name: 1
ORSC Section N 1 107.2. High - efficiency interior lighting systems. A minimum of fifty (50) percent o the
permanently installed lighting fixtures shall be installed with compact or linear fluorescent, or a lighting source that
has a minimum efficacy of 40 lumens per input watt. Screw -in compact fluorescent lamps comply with this
requirement.
The building official shall be notified in writing at the final inspection that a minimum of fifty percent of the
permanently installed lighting fixtures are compact or linear fluorescent, or a minimum efficacy of 40 lumens per
input watt.
I:\Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08
,........
STREET TREE CERTIFICATION
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er i fo
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(PLEASE PRINT) (PERMIT HOLDER) 0,
7 Jti , oaf
Do hereby t hat the meets
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City of T �land u e a� d develop m ent standards
1441 for'streetitree installation {
u _ a F �� — q o-9 q!' ' -'
1154 e' 4,0,FM
mac-° re a M " �
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ADDRESS: - 7do r 9
SUBDIVISION: LOT:
SIGNATURE: DATE: //4///
(O [Y/NER /AGENT)
RECEIVED BY: DATE:
(CITY OF TIGARD)
L\ Building \ Forms \StreetTreeCertifcate 01/19/07