Permit CITY OF TIGARD MASTER PERMIT
IN .,
.., COMMUNITY DEVELOPMENT Permit #: MST2011 -00147
TICARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/21/2011
Parcel: 2S110CB08500
Jurisdiction: Tigard
Site address: 12499 SW ST ANDREWS LN
Subdivision: MOUNTAIN VIEW ESTATES Lot: 10
Project: Mountain View Estates, Lot 10
Project Description: New SF
BUILDING
Floor Areas Required Setbacks Required
Stories 2 Bedrooms, 4 First 1550 sf Basement 0 sf Left 5 Parking Spaces 0
Height 30 Bathrooms 4 Second 1799 sf Garage 750 sf Front. 20 Smoke
Dwelling Units 1 Third 0 sf Right. 5
Detectors Yes
Total' 3349 sf Value $380,40122 Rear 15
PLUMBING
Sinks 1 Water Closets 4 Washing Mach' 1 Laundry Trays 1 Rain Drain 1 Urinals 0
Lavatories 6 Dishwashers. 1 Floor Drains 0 Sewer Lines 100 SF Rain Storm Sewer. 100
Drains 0
Tubs /Showers 4 Garbage Disp. 1 Water Heaters 1 Water Lines 100 Catch Basins 0
Bckflw Prevntr 0
Footing Drain 0 Ice Maker 1 Hose Bib 2 Backwater Value 1
Other Fixtures 0
Drywell- Trench Drain 0
Other Fixture Units
MECHANICAL
Fuel Types Air Conditioning N Vent Fans' 6 Clothes Dryers' 1
Natural Gas Heat Pump N Hoods 1 Other Units 0
Furn<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 W/ Svc or Fdr 0
Ea add] 500 sf 7 201 -400 amp 0 201 -400 amp 0 W/O Svc /Fdr 0
Mfd Home /Feeder /Svc 0 401 -600 amp 0 401 -600 amp. 0
601 -1000 amp: 0 601 +amp -1000v 0
1000 +amp /volt 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo N HVAC N Security Alarm N Vaccuum System N Garage Opener N All
Other. N Other Description Ecompasing Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R -3 3349
Owner: Contractor:
JT ROTH CONSTRUCTION INC J T ROTH CONSTRUCTION Required Items and Reports (Conditions)
12600 SW 72ND AVE 12600 SW 72ND AVE #200 1 Ersn Cntrl 503 - 681 -4444
TIGARD, OR 97223 TIGARD, OR 97223
PHONE 503- 639 -2639 PHONE 503 - 639 -2639
FAX* 503- 624 -0239
Total Fees: $19,800 82
This permit is is -. .: -ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will
be done in - cordance with : .proved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days AT ENTION Oregon la - • ir- - ou to follow the rules adopted by the Oregon Utility Notification Center Those rules set forth in OAR
952 -001 6010 t rough OAR 952-601-00•O You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1.800 332 234
o f
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Issued s : _ � _ / ' _ / 4L Permittee Signature: 411P., •
- Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr. -ct.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
r i o ril Ir ..
Residential ti FOR OFFICE USE ONLY
•
City of Tigard Received Permit No Q /$/
Date/B . - mien S ?�
° 13125 SW Hall Blvd , Tigard, OR 9722 2 5 2011 Plan Review 1T. 7
' °? Phone: 503.718.2439 Fax 503.59 X 0 Date/ kilo ,Aj � Other Permit .�eaQ / i- - ot o t 7
TIGARD Inspection Line' 503 639 4175 k }' 9 OF TIG ' � Date Ready /By Juns ® See Page 2 for
E n
Internet: www.tigard-or.gov B�JIIj�1� i t } ' ir iSaO � 9 Notified /Method 5 Ot4( i� Supplemental Information
TYPE OF WORK o��JC F4� REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction El 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 El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2- family dwelling 111 Commercial /industrial Valuation: 0o �f Z�
El Accessory building El Multi-family Number of bedrooms: 4
ID builder ❑ Other: Number of bathrooms: 3.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 12499 SW St. Andrews Lane New dwelling area: 3349 square feet
City /State /ZIP: Tigard OR, Garage /carport area: 750 square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: rr5 square feet ('711
Cross street/directions to job site: Beef Bend to 122nd. Left on Autumnview, Deck area: 0 square feet ' s? . C,
Left onto St. Andrews Other structure area: are feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Mountain View Estates Lot no.: 10 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Taitap /parcel no.: equipment, materials, labor, overhead, and the profit for the
: •; DESCRIPTION OF WORK work indicated on this application.
Construction on new single family residence Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER El TENANT Number of stories:
Name: J.T. Roth Construction Inc. Type of construction:
Address: 12600 SW 72 "d. Occupancy groups:
City /State /ZIP: Tigard OR, 97223 Existing:
Phone: (503)639 -2639 Fax: (503)624 -0239 New:
® APPLICANT El CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: J.T. Roth Construction Inc.
Structural plan review fee (or deposit): .
Contact name: David Jensen
Address: 12600 SW 72 "d. FLS plan review fee (if applicable):
Total fees due upon application:
City /State /ZIP: Tigard OR, 97223 .
Phone: (503) 806 -0602 Fax: : (503) 624 -0239
Amount received: /757) • Cir:i
E -mail: davidj @jtrothinc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted Photo Voltaic Solar Panel System.
Business name: J.T. Roth Construction Inc. Sub • two (2) sets of roof plan with connection details -
Address: 12600 SW 72 ° ' and fire ent access, along with the 2010 Oregon
Solar Installatio cialty Code checklist. - ,
City/State /ZIP: Tigard OR, 97223 Permit Fee (includes plaiiseview $180.00
and administrative Fe
Phone: (503) 639 -2639 Fax: (503) 624 -0239 Stat�urcharg \
e (12 "/0 of permit fee): $21.60
CCB lic.: 31700 ../ Total fee due upon application: $201.60
Authorized signature: permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: David Jensen Date: 8/22/11 * Fee methodology set by 'Fri-County Building Industry
Service Board
I \Building\Permits\BUP -RE ' -rmitApp.doc 02/ 24/2011 440 4613T(I 1/02 /COM/WEB)
Electrical Permit Application f„:11,..Utili CI)
qUG 2 5 29 11 FOR OFFICE USE ONLY
Received ffi � �� /.` ` � / V
City of Tigard Date/By ' ' Permit No �{
214 n 13125 SW Hall Blvd , Tigard, OR 97221 Or- TIG ','liD
r n n_ j � 0 / �
° :' ' Phone: 503.718 2439 Fax. 503.598.19 Other Permit K OU
� lt"��i ON
tiS lbl`a Plan Review Dare /
TI GARD Inspection Line 503 639.4175 ��,,� .L= Date Ready /By Juns ® See Page 2 for
Internet www tigard gov Notified /Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
® New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ 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 denved system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 12499 SW St. Andrews Lane 1001/P or more occupancy
❑ Six or more 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. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Beef Bend to 122 " Left on Autumnview, Description I Qty. I Fee. I Total I *
New residential single or multi - family dwelling unit.
left onto St. Andrews Includes attached garage.
Subdivision: Mountain View Estates Lot no.: 10 1,000 sq ft or less 1 168 54 `,%4- 4
Tax map /parcel no.: Ea add'I 500 sq ft or portion 7 33 92 V.;7,43,44 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq ft) 1 75 00 * 2
Limited energy, multi - family 75.00 2
Wiring of new single family residence residential (with above sq ft )
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
401 amps to 600 amps 200.34 2
Name: J.T. Roth Construction Inc. 601 amps to 1,000 amps 301 04 2
Address: 12600 SW 72 " Over 1,000 amps or volts 552 26 2
City/State/ZIP: Tigard OR, 97223 Temporary services or feeders installation, alteration, and /or
n g relocation
Phone: (503)639 - 2639 Fax: (503)624 - 0239 200 amps or less 59 36 1
201 amps to 400 amps 125 08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT 0 CONTACT PERSON above service or feeder fee 7 42 2
each branch circuit
Business name: J.T. Roth Const. Inc. B Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: David Jensen branch circuit
Each add'i branch circuit 7 42 2
Address: 12600 SW 72 "d. Miscellaneous (service or feeder not included)
City/State /ZIP: Tigard OR, 97223 Each manufactured or modular 67 84 2
dwelling, service and/or feeder
Phone: (503) 806 - 0602 Fax: : (503) 624 - 0239 Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E - mail: davidj @jtrothinc.com
Sign or outline lighting 67 84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: Grizzly Electric panel, alteration, or extension Page 2 2
Each additional inspection over allowable in any of the above
Address: 8002 NE Hwy. 99 PMB 248 Additional inspection (1 hr mm) 66 25/ hr
City /State /ZIP: Vancouver, WA 98665 Investigation (1 hr mm) 66 25/ hr
Industrial plant (1 hr min) 7818/hr
Phone: (971) 909 - 4080 Fax: (360) 644 - 8939 Inspections for which no fee is 90 00/ hr
specifically listed (V2 hr mm)
CCB Lic.: 189056 Electrical Lic.: C - 572 Suprv. Lic.: 2643 - S ELECTRICAL PERMIT FEES
Subtotal• ' O , 6tej
Suprv. Electrician signature, re u' ed:
Plan review (25% of permit fee) -
Print name: Ron Nelson Date: 8 -22 -11 State surcharge (12% of permit fee). ' 7 , 7
f TOTAL PERMIT FEE 5 F ,'7 G
Authorized signature:/
g This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Ron Nelson Date: 8 -22 -11
Number of inspections allowed per permit
I l BuildinglPermits \ELC- PermitApp.doc 07/01/10 440- 4615T(l i /05 /COM /WEB
1VYeclianical Permit Applicatt;e{ ��,� 1
FOR QFFICE USE O \1 l
11 a Received 1 �,
City of Tigard u 0 Da /By j 47S I / / Permit No -t , T�j/ /b7 2
i 1 ° ❑
❑❑❑❑❑❑ ❑❑❑ ❑
I❑ ❑H❑❑❑U ❑A❑❑❑,��G❑
Plan Review
91iDh 503.718.2439 Fax. 503 598.1960 ry� DateBy Other Permit 5 a _6)6 /a7
T LG AR D Inspection Line: 503.639 4175 c m 1 E i ���."i t �' y hr� Date Ready /By suns See Page 2 for
Internet: www tigard -or gov
��� "• t i O % Notified/Method' Supplemental Information
BUIDIIA
TYPE
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
Value: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family El Master builder ❑ Other: Description Qty I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 12499 SW St. Andrews Lane - * ''''''s '-'"° g I r i1 (requires site plan showing placement) 46 75
Furnace 100,000 BTU (ducts /vents) 1 46.75 4L
City /State /ZIP: Tigard OR
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: Beef Bend to 122 " Duct work 23.32
Left on Autumnview Hydronic hot water system 23.32
Residential boiler (radiator or
Left onto St. Andrews hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Mountain View Estates Lot no.: 10 Flue /vent for any of above 23 32
Other 23 32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater S 23.32 '2,-1,..
Plumbing of new single family residence Gas fireplace 33 39
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 CI TENANT Chimney/liner/flue/vent 23 32
Other 23 32
Name: J.T. Roth Construction Inc. Environmental exhaust and ventilation:
Address: 12600 SW 72 "d Range hood /other kitchen
equipment 1 33.39
City /State /ZIP: Tigard OR, 97223 Clothes dryer exhaust 1 33.39 ...
Phone: (503)639-2639 Fax: (503)624 -0239 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) (j 23.32 I 3
❑ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Business name: J.T. Roth Construction Inc. Other. 23.32
Fuel piping:
Contact name: David Jensen $14.15 for first four; $4.03 for each additional
Address: 12600 SW 72 "d. Furnace, etc. I 14,1-1:
Gas heat pump
City /State /ZIP: Tigard OR, 97223
Wall /suspended/unit heater
Phone: (503) 806 -0602 Fax: : (503) 624 -0239 Water heater
ll
Fireplace
E -mail: davidj @jtrothinc.com Range
CONTRACTOR Barbecue
Business name: B &M Heating Clothes dryer (gas)
Other
Address: PO Box 1111
MECHANICAL PERMIT FEES*
City /State /ZIP: Boring OR, 97009 Subtotal 324.3
Phone: (503) 515 -5763 Fax: (503) 637 -5244 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: 124757 State surcharge (12% of permit fee) , T2,
TOTAL PERMIT FEE 4 3, 2:3
Authorized signature: I/N-AjL)
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Bruce White Date: 08/22/11 * F ee methodology set by Tn- County Building Industry Service Board
P\Building\Permits\MEC- PermnApp doc 09/09/10 440 -4617T (I I /02/COM/WEB)
aCEMU
Plumbing Permit Application I ` o _
Site Utilities AUG 2 5 1 FOR OFFICE USE, ONLY
City of Tigard T`i+ -•: "ed
13125 SW Hall Blvd., Tigard, OR 97223 C1 � n� ` 99 t ` �� a Permit No "� H.5 r
q �' Q{ "PJan v
Phone 503.718 2439 Fax: 503.598.1960 p O` ��1v Other Permit No n, 7
f�U.l� DateJBY= iew
j/ f/-t /.2
T' G A R D Inspection Line: 503 639.4175 Date Ready/By Juns El 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 I Qty. I Ea. I 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 SFR (3) bath 1 500.32 7/9,
❑ ry g ❑ Multi - family
Each additional bath/kitchen 1 25 02 °Z 0
❑ Master builder ❑ Other:
Fire sprinkler (3349 sq ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12499 SW St. Andrews Lane Catch basin or area drain 18.76
City /State /ZiP: Tigard, OR Drywell, leach line, or trench drain 18 76
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: Beef Bend to 122 " Left on Autumnview, Manholes 18.76
Left on St. Andrews Lane 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: Mountain View Estates I Lot no.: 10 Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12
Clothes washer 25.02
Plumbing of new single family residence
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: J.T. Roth Construction Inc.
Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 12600 SW 72 "
Garbage disposal 25 02
City/State /ZIP: Tigard OR, 97223 Hose bib 25 02
Phone: (503)639 -2639 Fax: (503)624 -0239 ice maker 12.51
❑ APPLICANT ® CONTACT PERSON Interceptor /grease trap 25 02
Business name: J.T. Roth Const. Inc. Medical gas (value $ ) Page 2
Primer 12.51
Contact name: David Jensen
Roof drain (commercial) 12 51
Address: 12600 SW 72"a
Sink/basin/lavatory 25.02
City /State /ZiP: Tigard OR, 97223 Solar units (potable water) 62 54
Phone: (503) 806 -0602 Fax: : (503) 624 -0239 Tub /shower /shower pan 12 51
E -mail: davidj @jtrothinc.com Urinal 25.02
CONTRACTOR Water closet 25 02
Water heater 37.52
Business name: Malmedal Enterprises inc. Water pipmg/DWV 56.29
Address: PO Box 207 Other: 25 02
City /State /ZiP: Banks, OR 97106 Subtotal 6
Phone: (503) 324 -0759 Fax: (503) 324 -0580 Minimum permit fee $72.50
Plan review (25% of permit fee)
CCB Lic.: 102535 Plumbing Lic. no.: 34 -276PB
State surcharge (12% of permit fee) 63,04-
Authorized signature: Wiz — � TOTAL PERMIT FEE' �'
ti
Print name: Kris Malmedal i
Date: 8 -22 -11 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by Tri -County Building Industry Service Board.
I \Building'J'ermits\PLMU- PermitApp doc 10 /01/09 440- 4616T(10/02ICOM /WEB)
Building Division
Development Code Provision Review
TIGARD Residential Projects
Building Permit No: 'I' plc / / CO / 4/7
CWS Service Provider Letter Received: Yes ❑ No ❑ N/A
Routed Plans:
Original Plan Submittal Date: q 01511/
1st Revision Submittal Date: ❑ Site Plan Only
2nd Revision Submittal Date: ❑ Site Plan Only
To the Applicant:
Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the
Building Division. Only checked (✓) items are approved. Items not approved and those listed in the notes must be
revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section.
Staff: please check items along left only if approved.
Planning Review (contact ( e$ 1 'J Pee- . r at 503 - 718 - 21fSL or /'t s H � G
@tigard- or.gov)
Lani Use Case No. S7 a00 2,/ Name A W11 r� Yr ��`e'
Zoning e
CYSetbacks:
Front 15 Rear (S Side S Street Side / 0 Garage 2.
ILI^Maximum Building Height .3' Actual Building Height 30
I '"Visual Clearance
asements
ensitive Lands Type: 5 1 46 /2-ter)
Notes:
Original Plan: Approved hd Not Approved ❑ Date: W1-61 if
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: I S
Notes:
Original Plan: Approved K Not Approved ❑ Date: g 2
Revision 1: Approved ❑ Not Approved ❑ Date:
Revision 2: Approved ❑ Not Approved ❑ Date:
(Review Continues on Page 2)
Page 1 of 2
ty Ciborist Review (contact Todd Prager at 503 - 718 -2700 or todd @tigard - or.gov)
,� / Trees
LN' Protected Trees //
Notes: Moc . /(�A /r- c yee C) ,J s .f 'ffee 1.f �r-r rel C3c�K
Original Plan: Approved Not Approved ❑ Date: Ti�
Revision 1: Approved ❑D 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 Applicant
Okay to Issue Permit: Yes K1 No ❑
Date Routed to Building: z / lig
/
Page 2 of 2
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Oregon Residential Specialty Code 8318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, 7S I G , k , am the general contractor or the owner- builder
at the following address:
Site Address:
.-1'iq s k . A,-,, e .&
City:
Permit #:
4tnt - oci w�
Subdivision/Lot #: `I i t�
M osAkA-0..; +� �tL2v� to lo
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: 1
g � , Date: C/a 31 /
Genera' Contractor or Owner - Builder
I: 1BuildingTorm aES- MoistureSensitiveWood.doc 09/25/08
M5 iaa /l ern / '1
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
DI W
Site Address:
I a
Subdivision/Lot #:
• Mou -Art - , r) \I\ ,,-, , ,k 10
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: C/ 4-5/ a
Owner/ eneral Contractor Authorized Agent
Print Name:
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.
l:\ Building\ Forms\RES - HighEfficiencyLighting.doc 07/01/08
/�sT�oi /- ov�y7
STREET TREE
TIGARD TI I ATI
CER F C ON
CZ A, , owner/ agent for sv , ,
(PLEASE PRINT) (PERMIT HOLDER)
do hereby certift 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.: 46,11 - 0o1(4
SI"1 E ADDRESS: a y g q s F ,,,,e s t.
SUBDIVISION: . ■.f LOT #: f p
SIGNATURE: DATE: /a3/ �a
(OWNE ' • GENT)
RECEIVED & ANIP
VERIFIED BY DA 1 E: 6"
(CITY OF TIGARD)
❑ Tree location verified per approved site plan.
I:\ Building \Forms \StreetTreeCertificate 04 /01/2011 •