Certificate of Occupancy CITY OF TIGARD CERTIFICATE OF OCCUPANCY
a Permit #: MST2012 -00263
COMMUNITY DEVELOPMENT Permit Issued: 11/20/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S109AB17200
Jurisdiction: TIGARD
Site address: 13198 SW WILMINGTON LN
Subdivision: HIGHLAND HILLS ESTATES Lot: 1
Project Description: New SF
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R -3
Occupancy Load:
Fire Sprinkler Required:
Project Name: Highland Hills, Lot 1
Owner: MISSION HOMES NW
PO BOX 1689
LAKE OSWEGO, OR 97035
Phone: 503 - 381 -3753
Contractor: MISSION HOMES NORTHWEST LLC
PO BOX 1689
LAKE OSWEGO, OR 97035
Phone: 503 - 381 -3753
Fax: 503 - 214 -8524
This Certificate issued 6/6/2013 grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the 2011 State of Oregon Specialty
Codes for the group, occupancy, and use under which the referenced permit was issued.
Mark VanDomelen
Building Official
City of Tigard
POST IN CONSPICUOUS PLACE
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I, Atsi I'0.11 , am the general contractor or the owner- builder
at the following address:
Site Address: [ Y S . . t.J l 1"; 4cv, h.
City: 4-1,7w
Permit #: 101),_- /-4
Subdivision/Lot #:.,
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: G—)--13
Gener I 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.: 1 00. _ k6 Jurisdiction:
Site Address: ci sr S L.) .1h 1h i
1'
Subdivision/Lot #: 11 , 4i I Q
F{y
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: Air' a Date: (9 2. — 1,3
Owner /General Contractor /Authorized Agent
Print Name: N5 W1,(
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.
I:\BuildingWonns RES- HighEfficiencyLighting.doc 07/01/08
•
STREET TREE
..° TIGARD CERTIFICATION
I, Ana (� , owner /a for M s s '
( P LEASE ) (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.: ?.° t)% — 00 d.G 3
SITE ADDRESS: 3 q F I h
SUBDIVISION: i toi; �;�� s LOT #:
SIGNATURE: /' DA"IE: ( -), -(1
RECEIVED & / . '.' R/AGENT)
VERIFIED BY G% DA 1 E:
CITY OF TIGARD)
❑ Tree location verified p ' approved site plan.
I: \Building \Forms \StreetTreeCertificate 05/30/2012
PTCS �-
a Performance Tested ''- ' -.., ` .._ _
Comfort Systems _ ° : ate..__ s., _ ....... ........ _......
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.Dtcsnw.corf or fax to 877 - 848 -4074. Questions? Call 800 -941 -3867 or email ResHVAC @bpa.gov.
Site Information (P1 print deady) . .
PTCS 1 d e , , Tech U install ' Customer's
Tech # O Name lovM VD r-'1 Date to Electric Utility r1, E
Customer installed t `I t
Name M-\ SS) O� k �• -S Site Address* 1 �i $ Sw W
Site . Site Site Zip Customer oxr
city 71 state• Code* R l 0 Phone # (S.. 3 ) 3 g ( - 3 S3
e lf mailing address is different record here (#, City, St, Zip):
Home Type (provide I motion for lust one type, either a Site Built or Manufacturd•Nome):
• Site Built Home: ❑ Existing New Construction Manufactured Home: ❑ Y L
Sitelulit Home Foundation Type: # of Sections for a Manufactured fame: Di ❑ 2 ❑ 3
Crawl Space ❑ Full Basement ❑ Half Basement ❑ Slab . Super Good Cents? ❑ Y
Year Built: 49-0 a Heating System: ❑ Elec. Furnace ❑ Heat Pump as Furnace Heated Area aa,c{ r
Energy Star? ❑ Y air ❑ Other: Gas Compan (if applicable):. (sq ft) &s#laed
Are at least 50% of the ducts In unconditioned space? El N # of supply registers # of returns
11 Mere than so% of t e ducts are in conditioned space, the home does not qualify for PISS Duct sealing.: I ,3 0 2
House Pressurization and Duct Blaster Tests .
Do either of these special conditions apply? (check If °yes°) Testing.Equipment Used:
❑ Re�c Only - no duct sealing work done Blitergy Conservatory ❑ RetroTec
IP'r Certification ONLY - pretest leakage too low for BPA program ❑ AeroSeal ❑ Air Care ❑ Other:
Hou - urized (Blower Door) to: Duct ter Location: Pressure Tap Sup. ly Resister Location:
+50Pa ❑ Other Pa Bltetum Grille ❑ Other: U + ,o. ` r ti •.... C'► J
Duct Leakage Test: TYPICAL DUCT BLASTER CFM READING with Duct Pressure at OPa and Blower Door @ +50Pa.
DB Fan Pressure: Found using equipment; It is the fan pressure, not the house pressure. (Ex. Ring 1, 78 Pa,.364 CFM).
Definitions: (D8)= Duct Blaster (BD)=Blower Door . (AH) =Air Handler (SW)= Single. Wide (DW)=Double Wide (TW)=Triple Wide
Nett! C onstruction Existing Home N ew. Ducts : - Existin Home, EM sting .Ducts . J - J s f' .,
s' k , r : -..::,' s'
�:�� ;;��;�����> ... • ��'��:� ;:;�= _'��., �w . >., x °- �:.;''� „ ,�' ❑ i p 2 p 3 • ❑ ope
❑open n p 1 ❑ 2 ❑ 3
r L. a• i, f e '1t , `' ] i, T,A O D ❑ H ❑ M D L
t 4. � f ^�. !J �1����111. � �f t/.�� ��I�1.J 14 Y �
-Th.,j. E! 4'- }.•_;A'i'f:•`yl'' c'x,..i� •qtr �E�= :.= :��:4'.'�:"r. :'
,/ / �, ..•.. . . 1 l , k A :Y7 --s..( .Iy( x5- RrJ i __ .. _ ,t i Pa Pa
F . L. }.. F �. .� � �:..,. ��: ,. . } •��.. - . `{:" .. �'^_.
• v
a R's`S' °..-� �t . M4T F :.ry � y ��_. Y ..� $.�,�: � �..r - _.- i ...
=4c:: -1 T �• p 1 [ ��_ s�s.s a:-3F` ,'`•- : f ,.n CFM CFM
(
1 3 a. � '`F r f `. •s a .: ke " ; , '. �,i �
7 : : ,1. . - :n it �• '' ? ss..,,„ ��- :: , ' i,' '• i ,,,,, , 4 0 ❑ t. 1000FM, SW
2 250 CFM ( >1667 sq ft)
�lf�rryy r. �yy,yy n,- '= s ;� 7 �r � `!_ :,`�r -: Q2 i50CFM,DW
J' 1 ``� " w ,. ❑
A J 15 % of homess
..;4::!-, , -, _ , d N y ,t!1: t j '� % 1 ..d : -, ? ', . i L _. -. Fx.' :1. � , ' �*y, rl' F �o- � `•K. �."k ` r. �.: �; ❑ 2 225 CFM, TW
• ;! �� .... �' � • _":`. �.:. � .., ���zl' qb r �` s._. �: �yye� :?;" ' .!�sa� � �� � �a:.,
uKl c Y ; ��r ..b W ii D Open ❑ 1 C 2 ['Open ID 0 210 3 ❑ Open ❑ 1 0 2 0 3 ❑ Open 010203
.,ri+.Sc: l; s_ ( '2•F .ii; DH ❑M W DH OM DL OH OM DL ❑H OM 0i.
j . 1Y}` j. A-" Pa 1 Pa Pa
r.:Z117 '+ °� CFM CFM . CFM
c - -. R:.::` 'r ^: ❑ 5 50 CFM, SW
t .. :' - - ` L .us' ,, i a; ' ❑ 5 6% of sq ft w/ AH ❑ S1096 of home's sq ft ❑ 5 80 CFM, DW
ilt .: ° , `'i(' ❑ S10% of home's s q ft
1 �' " f 4 W
G ❑ 5 4% o sq ft no AH ❑ 2 50% Reduction 0 5120 CFM, T
❑ 2 50% Reduction
The duct sealing at this site meets program requirements including: plenum, maln.ducts, takeoffs and boots . sealed; a go h effort
was made to remove existing duct tape and cover with mastic metal duct connections are secured with screws. ❑ N
Last updated: 30 November 2012 Page 1 of 2
•
Combustion Appliance Zone (CAZ) Test • •
Are ny combustion appliances In the home? Combustion Appliance Type: ' (replace or wood stove G 0.S
• ❑ 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
instal n the home? . ' . where a sealed or non - sealed combustion appliance is located in a conditioned
space or attached structure Le, garage. RECOMMENDED CO detector specifications:
N . UL 2034 /CSA 6.19.01; digital display, peak CO memory and recall.
. Is a C Air Zone (CAZ) test required by the electric utility? ❑ yes, complete the fields below o, 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 handier ON; ,record gauge _readings .. ' Interior. doors open, :. .. Interior doors _Closed, " '
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/Te Notes:
•
•
•
Required Signatures: To be filled out by the electrical utility account holder. This for 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 an and all liability arising from or connected with providin this information.
Electric Utility: G Account ff:
•
Account holder name: `' SS tf' 6� 5 fk.Q_ S
•
Account holder signature: • • 'Date: •
By signing below, technician 'certifies that this form and any acco documentation are complete and accurate,•and that all
. measures associated with this project were completed as of the signature date below. .
Technida Installation ,,nn Tech Phone #:
name: � , (pr co ny: f-Td.
tt (St93 ) 393 - ,53 /s
T Signature: l Date: El l ' 13 •
• PRIVACY ACT STATEME
Basic authority for collecting this information 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 Effidency Program, the objective of
which Is to acquire energy resources through energy efficiency, to determine what colt- 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 Page 2 o
•
FOR OFFICE USE ONLY - SITE ADDRESS: /3 /j ) /0 ,k
This form is recognized by most building departments in the Tri -County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
a . ° Transmittal Letter
T I G A k I.) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: UP-4_.14Ia -- DATE CEIVED:
DEPT: BUILDING I?PVISION y 1 CEIVED
. E.RE -T JAN 22 2013
FROM: ,/m3 L k.c /f 0 CITY OFTIGARD
COMPANY: /14/x0". b6 CV/ //iiJ BUILDING DIVISI
PHONE: co, - 38y - 3 753 By:
(�LLct 6`'`) �t1A.'"A �e a3 Nl�� (a— ODDS
(Site Addres ( Permit Number)
.
i I
'roject n. �,, or su' ivtston name an' ' it num9er IF
ATTACHED ARE T ' FOLLOWING ITEM :
Copies: Descripti I : Copies: Description:
Additio al set(s) 0 tans. Revisions:
Cross ection(s) and etails. Wall bracing and/or lateral analysis.
Flo e /roof framing. Basement and retaining walls.
B- em calculations. Engineer's calculations.
• her (explain):
REMARKS: \ 4- L11....1-
�___--40R OFFICE USE ONLY
Routed to Permit Technician: Date: 1/49-4 5 Initials:- -
Fees Due: Yes El No Fee Description: Amount Due:
= e ? 3 � 2 j $ /&? .6e'
$ • 35
$ - /g? . ,
Special
Instructions:
Reprint Permit (per PE): ❑ Yes O ❑ Done
Applicant Notified: Date: //,44f (?j AL_ t s2 (t___ Initials
1:\ Building\ Forms \TransmittalLettcr- Revisions.doc 05/25/2012