Report (21) 1111 s STREET TREE
TI GARD-
ER TIFIcA
rlON
-Ty Lis G- , owner/agent for 61 JJ; 113 r,c, LLQ
(PLEASE )
(PERMIT HOLDER)
do hereby cert 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.: I'l�Si (Dooso
SIlh ADDRESS: I o a i 3 s3, �� v�
SUBDIVISION. cA_V, w s LOT#:
SIGNATURE:
--� DATE: 1 a
(Oil NER (NT Ni
RECEIVED &
VERIFIF,D BY:
DA 1E: a�aaf/e.
(CITY OF TIGA'
UTree location verified per approved site plan.
•
1:\Building\Forms\StreetTreeCertifieate 05/30/2012
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
I' L_, S el); + , am the general contractor or the owner-builder
at the following address:
Site Address:
i O X 13 S� ✓�
City:
-77
Permit#:
"1S1 01-1 -0(0 0 f.50
Subdivision/Lot#: r
C 0. \0c)4.45
and/or
Map and Tax Lot#:
IS 1�� �1A — I�-1-8ba
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:
General Contractor or Owner-:"der Date: 0�/5'�
1:\BuildingWorm\RES-MoistureSensitiveWood.doc 09/25/08
•
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: Jurisdiction:
0 s cyt vd
Site Address:
\oI<Dst6
Subdivision/Lot#:
00_1 u300dS / _. 1 a
and/or
Map and Tax Lot#:
By my signature below, I certify that a minimum of fifty(50)
of the permanently
installed lighting fixtures in the above mentioned buildinhave beentinstalled with compact or
linear fluorescent, or a lighting source that hast a minimum efficacy of 40 lumens per input watt.
(Oregon Residential Specialty Code N1107.2)
Signature:
Owner/Generaltor/Authelriz Agent Date: ( a / /7
Print Name: Li S -
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:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08
tip 5.1WCheCk, LIC
hallow R Irrigation
_____
BACKFLOW EXISTING n REMOVED
PREVENTER REPORT X NEW REPLACED
REPAIRED OLD SiN:
PROPERTY NAME New Construction - 10213 PHONE
CONTACT.NAME
PHONE
MAILING ADDRESS 10213 SW 69th Ave
crrY Tigard STATE OR ZIP 97223
PREVENTER ADDRESS 10213 SW 69th Ave Tigard, OR 97223
WATER SUPPLIER Tualatin Valley SERIAL# HE42550
LOCATION By meter
MAKE Febco MODEL' 850 SIZE 1"
TYPE n ... fl RPDA 0 RPDA-II n DC n DCDA D DCDA-II [1 PVB ri svn ii AVB n AG
HAZARD PROTECTED fl PREMISES ISOLATION ad IRRIGATION n NIUE SYSTEM 11 BOILER rl OTHER.
APPROVED: EXI ASSEMBLY El INSTALLATION Du ORIPNTATION n AIRGAP PIPE SIZE in 7,17aoceAA'. in
REDUCED PRESSURE ASSEMBLY PVIIAMVBA INITIAL TEST
DOUBLE CHECKAIR INLET CHECK VALVE PASSED Dt
CHECK I/I CHECK ill TYPE II flOPEPIED AT: MSS MOP:
PRESS
TIGHT n
FAILED 1--
mop,
mrrnm, ISM snap 2.6
TEST RELIEF VALVE •LEAKED fl ........ ........ ....,inin) DATE 10-06-17
RESULTS orreme AT:
°LIMED
NIH 2 PS1D (BECK Kt FULLY El FAILED SYSTEM PSI 70
RELIEF VALVE: TIGHT Vj DID NOT Li DETECTOR METER
,A.....
El FARED 1 1 2.8 OPEN 1 1 READING:
LEAKED n PADI I MY
NOTES
REPAIRS
PARTS
REDUCED PRESSURE ASSEMBLY
PVIIA/SYRA TEST
CHECK#1 DOUBLE CHECK AFTER REPAIRS
PRESS
DROP: CingeK a TYPE ITn AIR INLET CHECK VALVE
REPAIR MN 5 PSID TIGHT CtPINED AT: mess mop:
RESULTS RELIEF vAiNg
DATE
mom ar: am=pg WWI MD NMI run ham I MD
MAW VALAIS r2I ) TIGHT fl
y ri PASSED
0
PASSED n FARM n NE1211610
GAUGE Sib( 02142940 MAKEIMODEL MidWest 845-5 CALIBRATIEON DATE 04-25-17
In completing and submitting this test report,the tester certifies that the assembly was tested and maintained in accordance with all applicable
rules,laws,codes and regulations of the stale and water system using approved totting equipment and approved testing procedures.
INITIAL TEST TEST AFTER REPAIRS
s16.73.
6028
TESTER RE
TESTER SIGNATURE TESTER aiRT#
Robert Jones
4 503444114R
.
TESTER NAME(PRINTED). TESTER NAME(PRINTED) PHONE#
PO Box 4093 Hillsboro, OR 97123 ,rob@fiOwCheCklic.Corn
TESTER ADDRESS TESTER ADDRESS
EMAIL
Flowcheck
DTI WATER RESTORED?
COMPANY NAME COMPANY NAME
t----i FOUND OFF,LEFT OFF
. REPORT RECEIVED BY(RIVRESENTATTVE OF OWNER) REPORT RECEIVED BY(RRPRESENTATIVE OP OWNER)
AS-1 2017-Gb0g:3,
OEESC 2014 AIR LEAKAGE TEST RESULTS
BUILDER/OWNER: '314,1% i �o,J sr 17.4)cr+twv LL
PICs
ADDRESS: t 02.43 cam,,., 6'1 4.4.C.-rt GA.¢-v * Tested
S
S mit
DATE: 2,11'31 IS
s
BLOWER DOOR: J�.cp�""s"� q��
CFM: 1gs-z� @CFM50 ACH50: .2� '� ' 9'�
WESTSIDE
DUCT LEAKAGE: * INSIDE
CFM: @CFM50 % OF SF: pG ENERGY PROGRAM �Q
�v — v Westside Drywall & Insulation, Inc.
Trade Ally of ��� 205 SE Spokane Street, Suite 300
CC Portland, OR 97202
bRti,WAL t..AT�Os Gni Teta t 503.238.7486
L & INSU ofOreo
9 �►