Report STREET TREE
TIGARI)
CERTIFICATION
--SeisO , owner/agentfor
how e> -)
(PLEASt PRINT)
(PERMIT HOLDER)
do hereby certifi 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.: Ms-- ' o 17 00 3 S-3
SITE ADDRESS: /('1 7 7 S 5 _, p14
SUBDIVISION. ,5 ,'0 ,� ®� LOT#:
SIGNATURE:
DATE• —� p� — ) g
f (OWNER/AGENT)
RECEIVED & ))
VERIFIED BY c:e 1 , <,,bd DATE:
(CITY OF TIGARD)
Tree location verified per approved site plan.
1:ABuilding\Forms\StreetTreeCertificate 05/30/2012
Oregon Residential Specialty Code R408.1
MOISTURE BARRIER ACKNOWLEDGEMENT FORM
1, 11 ITS S%d 11 hop, /L✓1.^) , am the general contractor or the owner-builder
at the following address:
Site Address: /1 1 7 7
307_Py
City: ---
Permit#:
MSt — 00353
Subdivision/Lot #:
MI St on one_ii-d ocos Lof 9\
and/or
Map and Tax Lot #:
To conform with the 2014 Oregon Residential Specialty Code(ORSC), Section R408.1
Ventilation. I am notifying the building official that I have installed the Moisture Barrier as per
Requirement in ORSC Section 408.1 and have taken the following steps to meet this code
requirement:
r The round surface of the under-floor space is covered with 6-mil black polyethylene
sheeting with
Joints lapped 12" at seams and
xtending up the foundation walls 12".
lS
Signature: Date:
General C. tractor o Own-'Builder
I:\Building\Form\RES-MoisrureBamer.doc 09/13/2016
Oregon Residential Specialty Code N1107.2
HIGH-EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: t/1„s do 1 .7 — 00353 Jurisdiction:
Site Address: j/ •2 7
5 So z inn r/4-Ce--
Subdivision/Lot #: /
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)1
Signature: Date:
Owner/general C•I tractor/Authorized Agent
Print Name: SPA C4 S6 r\
1 ORSC Section NI 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.
1:\Building\Forms\RES-HighEfficiencyLighting.doc 07/01/08
MST A0/7 00 X5-3 I i 77 S1) 5'o2 A-NNE P1.
Form 640S 2017
Completion CertificSgn Inspection
New Homes Program—Single Family E ne rgyTrV Jt
of Oregon
To be completed by Verifier
CLEAResult is a Program Management Contractor for Energy Trust of Oregon,inc.
Payment information
Incentive Payee Company Name: 'Mission Homes NW,LLC IIs this payment redirected?: INo
Builder or Company: Mission Homes NW,LLC Redirect to Name:
Verifier Payee Company Name: Performance Insulation and Energy Redirect Payee Com
Affordable Housing No
Solar Ready Builder Incentive: 'Solar ReadyVerifier IncE1
Site Information
Development: Mission Meadows 'Lot 12 Axis ID: 1 IREM/Rate®ID:
Address: 11477 SW SUZANNE PL
Street Line 2 Multi-Family INo City: TIGARD State: OR Zip: 97223
Total conditioned area(sq.ft.): 3,222 House Volume: 1 30,642 Housing Type: Detached single family
Number of Stories: 12 Number of Bedrooms: 5 Foundation Type: Crawlspace
Electric Provider: Portland General Electric Gas Provider: NW Natural Gas
Solar installed Solar Installer Name/Company:
Blue shaded fields are required for EPS sheet
Verification Type Actual Model Equipment Details&Notes
Slab Perimeter Insulation R- 0.0 Slab Under Insulation R-
Insulation Framed Floor R- 30.0 Secondary Framed Floor R- 59.0
Above Grade Wall Insulation R- 23.0 Below Grade Wall Insulation R-
Flat Ceiling Insulation R- 49.0 Vaulted Ceiling Insulation R-
Windows Windows U- 0.3 SHGC:10.3 Total window area: 1458
Cooling Air Conditioning SEER: 0 Model#:
Primary Heating System Details AFUE: 95 Brand Ruud
Type: Gas Furnace HSPF: Model#: R95PA0851521MSA
Heating Fuel: Gas SEER:
Primary Heat
Source Comment: COP:
Location: Garage or ope Outdoor Unit(for heat pumps)
ECM: No Model#: 1
AHRI Certificate:6465001 #of Systems 11
Gallons: 1 Brand: AOSmith
Water Heater Type Heat Pump EF: 1 Model#: HPTU-80N 120
Water Heating Fuel Electric Location: 'Garage or ope AHRI Certificate:
Ducts and Duct Location 'Unconditioned %ducts inside: 10% 'Duct Leakage(CFM)@ 50Pa: 1163
Testing
Infiltration Air Changes per Hour(ACH)@ 50Pa: 2.78 1
Ventilation Ventilation Type HRV/ERV Model:
Supply Side-Air Cycler Airflow measured or why untestable? 'Roof Termination
Appliances
Refrigerator kWh/yr Model:
ENERGY STAR Diswasher kWh/yr Model:
Percent High Efficacy Interior Lighting(%) 100% Thermostat
Showerhead 1.5 GPH 1 Showerwand 1.5 GPH 1 Showerhead 1.6 GPH 1 IShowerhead 1.75 GPH 1
Notes:
New Water Heater Model:New Subdivision
iNkbTabl -- CO L(,•
"RIVER TERRACE EASTLis 5y\bl,L,#
oten-z_ 1 i 6t
LOT 76 c' • • ,
HUB AND TACK CERTIFICATION
NE & SE 1/4 SEC. 6, T 2 5, R 1 W, W.M.
CITY OF TIGARD, WASHINGTON COUNTY, OREGON
SURVEYED MARCH 2, 2018
PR PARED FOR:
POLYGON NORTHWEST COMPANY
703 BROADWAY ST., SUITE 510 S89.5543nE 50.00' ,
VANCOUVER, WA. 98660 i
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REGISTERED ..\ #
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ID 1 PROFESSIONAL N89.58#43##W 50.00
i.. LAND SURVEYOR
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< OREGON
1
... JULY 9, 2002
-0.
TRAVIS C.JANSEN
57751 SW SNOWDALE STREET
RENEWS: 6/30/2019
c I, TRAVIS C. JANSEN, A REGISTERED PROFESSIONAL LAND SCALE
IF2 SURVEYOR IN THE STATE OF OREGON, HEREBY CERTIFY THAT
I HAVE ACCURATELY SURVEYED AND STAKED THE OFFSETS . ri;Ti!T!1
9 TO THE FOUNDATION ENVELOPE FOR LOT 76 OF THE PLAT 1 INCH = 20 FEET
a-rt, OF "RIVER TERRACE EAST".
0..
2 DRAWN BY: T2 DATE: 3/13/18
...g PACIFIC COMMUNITY DESIGN
REVIEWED By. TCJ DATE, 3113/18
PLANNING - ENGINEERING - SURVEYING
PROJECT NO.: 395-041
(503) 941-9484 }