Permit s /3gS ,A0 95
CITY OF TIGARD MASTER PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MST2009 -00149
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009
Parcel: 2S102CD05600
Jurisdiction: Tigard
Site address: 13882 SW 95TH AVE
Subdivision: FLETCHER WOODS Lot: 6
Project: Fletcher Woods
Project Description: New SFR.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 3 First: 1163 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 24 Bathrooms: 3 Second: 1544 sf Garage: 1059 sf Front 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: sf Value: $320,302.84 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: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum > =100K: 1
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'I 500 sf: 6 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 add'I 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:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
MCADAMS, JAMIE & SUSAN 1 MST Ersn Cntrl 503 - 681 -4444
24300 NW GREEN MOUNTAIN RD
BANKS, OR 97106
PHONE: 503 - 780 -5542 PHONE:
FAX:
Total Fees: $17,436.51
This permit is issued 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 in accordance with 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are s= forth in OAR
952- 001 -0010 thro •h OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.24•••99 or 1.800.332.2344.
Issued ByNi■ ���— - . / Permittee Signature:
11/13/2009 14:33 5033240580 MALMEDAL ENTERPRISES PAGE 01/01
. A.t Weef , ± l' rtrunt Application .
• Building Fixtures RE
City of Tigar nemrved
11- , i 97n3 •i! I L 15 200' paillta1: "�'nNo,�5'T-aBa9 10 0/ 11 /9 Phone: 503.639.4171 Fax: 5
pal e`Icoo
- Inspection Lino; 503.639.4175 MY OF11OA' •' °Wa
Caber Permit Nod r lntm�rlot www.tigAra -or.gw >t i ;� • Rexdy/eyd Aria o ��. .., lVIS l. • eenmcdmod:
ow commotion 0 Demolition `` �st i ro ut: t '
ecome
❑ AddidaNalteratipn/replm 0 Other: Drsni •lion . {� �1' Total l ,rx, �.- 1:�.,+ � x;. .c.. New 1- Munn, dwell togs (Includes 100 ft. for each utility connection)
�, ;, " , ;,� i �}"�il t��; fir Ity connection
Jiacir�.a..M(6� SFR (1) bath 24920
Al- and 2- filthily dwelling ❑ Commereialhntinstrial SFR (2) bath y
C:1 AcOes my building 950
Q Multfgorrlily SFR (3) bath
NM 399.00
Master builder ❑ Emil additional
Otlxr_ brnh/kitehen 43.00 NM
4 g ''; .4� it .rL'a'•'(t : y a .B 1 S , y � r, Fix sprinkle► L.,•• _ eq. R,) r P 2
Job site address:
���_y� C ei Catch basin or area drain 16.60
City/Stare/ZIP: i pfaiS >w MINN
• Drywall, leach Ih10, or trench drain i 16,60
Saito/bldg. /apt. no.: Project name: Poenng drain (no. Hiieer ft.: _.) ��•+.
Croce atteoddirbotiotts to Job site: Menultictumd home utilities MN 110.00 MINN
Manholes 16.60 MIMI
Rain drain connector _ 16.60 r
Sanitary sewer (no, 'inset It,: `�) Page 2
St01r► Sewer (no. linear ft.: NOG 2
Subdivision; Water sorviao
Lot no.:
(no. J1npp R,; J
Tax Tr ap /poled no.: Fixture or item
?�??. , , i -�. Abrerpsian roti
:t:, U�} 71 'a �D } rGS Ybtr.Cri c , ri � v to 16.60
X11 ' ^- r b r
ra Banes. prevents
Backwater valve 18.60
Clothes washer 16.60
''' : '` ,. !Nemesis,* !Nemesis,* MI 16.60 EMI
, A . V, ; f i
,m- +`.r • - mtain
16.60
Name:
,a ggsqqpt( Drinking fal
tkieta ldaump 16.60
Address: Expansion tank Me
City/Staic/VP: — -- F ` 16.60 IIIII
( )
Fax: Oarb drain /door smfdhub
Phony ax: 16.80
; - - ( ) Garbage dismal I
xiac x..!r f! • • ' fir.,.. 1-loscbib
ft +ii Frr \ Y w' A, 1 r i : ;i j lr�i •„ r �i: 314'i-44. . 16 4° r Icc Business
mire:
Contact name: " "" ' :, 16.60 NM
Address: Medical gas (value: $ _ ) 111111111221
—
Primer 16.60
City/State/41: Roof drain (commercial) 16,60 Ma
Phone:( ) Fax:;( )
E-mail:
�- -- 16.60
16•60 MN
'�1�:bm `eYk 16.60
Business name: wafer closet Mil
A 8 • 1, ' 4 a r L 16.60
Address: O -'• Water heater 16.60
•
City/Slate/ZIP: if Other ��
S '7 1' + 170
Poona: (,� • ) A — O 5."- �,�.������ . •
�iiiYZIKAW„ ' % Residential minimum pion foe: $72.50 _ -
-cat Lic.: Q �� 1 .Idr dgttial bticktlow minimum • it fee: $36.25 `jL ( •
4061_ //LJ:,I rug Lic. no.: • -A76 f7� „ .
Authorlted signature. ' 70 Setae surcharge (12% of p
permit fee) Li i►r
.I�r Imnle: t1/ //tom
T( O per it is act ?imam o b - !
r This permit application expires U's permit In not obtained within -
180 days after it has been steepled es complete,
t lasae LAtp•senelurTdos wanes
satiAsismnrovcownwan
'Fcc methodology set by Trificunty Building Industry Service Board.
' ; ,
a - Mechanical Permit Application RECEIV : FOR OFFICE USE ONLY
Ini
City of Tigard Pamit No.�ls�aao 9 -Qoi
ate/By:
13125 SW Hall Blvd., Tigard, OR 97223 Received
1 5 20 "Plan
Phone: 503.639.4171 Fax: 503.598.1960 J�,lan Review Other Permit:
MI Inspection Line: 503.639.4175 Date/By:
CITY OFTIG ' '47: Ready/By: runs: 6i See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVI
run
Method. Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
"New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
LID 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. ( Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12 Db o� - Air conditioning or heat pump v�t
i_� (requires site plan showing placement) 14.00 4.4w
City/State /ZIP C'1--1 Furnace 100,000 BTU ( ducts/vents) 14.00
i ? YG
Furnace 100,000+ BTU (ducts/vents) ( 17.90 ' ?
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
_ 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. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 10.00 (O.
ik l ) T G uevent fce g 1 10.00 IP.co
i Flue vent for water heater or as
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: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00 �.
City/State/ZIP: Clothes dryer exhaust 1 10.00 (0.6C
Single -duct exhaust (bathrooms, ��
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) ' 6.80 / CC1
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
J,
Address:
Furnace, etc. I )
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range I
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: tk3 Z I f .Q e. A. 6 , , / „k. t A' T�� /,vaher:
t
Address: /7 , At As/ i 4/1-- MECHANICAL PERMIT FEES*
City/State/ZIP: i `L3o.r✓O , Q 2 77 /.Zy Subtotal j t 1 . 2,0
Phone: (,I) C yf ` - / s6 � s� / I Fax: ( ) Minimum permit fee ($72.50)
BB Plan review (25% of permit fee)
6.L.CCB lic.: 143 E, Q s 7//i �i State surcharge (12% of permit fee) 1 , ?�
ffffff777777������ TOTAL PERMIT FEE t Z 6 6
Authorized signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete. i
Print name: Date: * Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits \MEC- PermitApp.doc 01/19/07 440- 4617T(11 /02/COM/WEB)
' ui'h hng Permit Application
• Res.dential RECEIV : FOR OIFI('E USE ()NIA
City of Tigard Received 7 /S M ari a" \
C /7 PermitNo.: (w 2 i ∎ -•
DateB �`� , It ,
• 13125 SW Hall Blvd., Tigard, OR 97223 1 5 O I'•Ian Revie- 2L I'
s . Phone: 503.639.4171 Fax: 503.598.1960 U Date : /t. r � Other Permit: _ ) .. „ doo c 4
Inspection Line: 503.639.4175 Bate Rea y: luris. ® See Page 2 for
TIGARD Internet: www.tigard- or.gov CITY OFTIGA N otified Method: 5 y �� � Supplemental Information
ILDING DIVI • '
TYPE OF WORK ' t ` *.a> 6 i't t 9' _( t�
Chew construction ❑ Demolition Permit fees e based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement er: e materials, labor, overhead, and the profit for the
�. �, ,r7 i, , � 130th. �, . . k . ? work indicated on this application.
e , rr ,,
r. 1- and 2- family dwelling ❑ Commercial /industrial Valuation: _I�� YI M
m al
Number of bedroom .
❑ Accessory building ❑ Multi - family �2f�� "PAZ ,8 •
❑ Master builder ID Other: Number of bathrooms:
JOB -SITE INFORMATION ° ND' LOCATION ' Total number of floors:
4 Job site address: 1 36'2 5 lA, 95 Ave New dwelling area: square feet
City /State /ZIP: -{.-1 c„ PA) Q 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: _ , ' - tAi it _ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
_ < -mss
WIN ! 't r I t
Subdivision: 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
xD �Ti1*' +E '•� work indicated on this application.
elk) • Valuation: $
X `
Y �► U ` Existing building area: square feet
New building area: square feet
in s" s € d s -, , , ,47.4 , 70' - '44-'": ° " Number of stories:
4 Name:. - SKlar. m Ada `"^•S Type of construction:
Address: ZC/ 3 00 IV W 6 rrc,^ r"o„.4}ti RCQ. Occupancy groups:
City /State /ZIP: `tea Kks a P. 1 7 /b,. Existing:
Phone: (503 )7a0-5Se.4 Z Fax: ( )
New:
❑ A'AT Pt * s
.. • +;., : ..4 as +.. u .. i -h� -4t `. �". M '( >� �w ^a, ��
S
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax::( )
E -mail:
Business name: ti � �. + . ' •. I : _ •Y•' r , i'- r '' 3 ,t
Address: L --a3 l 5 Ai W D_vci IIYt co r te - . a . , q r r�
' ^ V 6
Structural plan review fee (or deposit):
City /State /ZIP: � v-I,Y2 -, I a I
1.
Phone: (5 3) .5.7-Z - /3 ,-13 T Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: L (Q 5(Q 4-8 Total fees due upon application:
G' Xf i 2ib //4/0", c liff/AO ii 4C771/6 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: Date: * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Permits \BUP -RES PermitApp.doc 11/6/07 440- 4613T(11/02 /COM/WEB)
,
• Electrical Permit Application i tD L r. 'al I� ill NM 1 FOR OFFICE USE ONLY
' City Of Tigard " \ ' 1 'ii Y
Date/By: Permit No. 1 2/
13125 SW Nall Blvd., Tigard, OR 97223 P r Plan R eview
Phone: 503.639.4171 Fax: 503.598.1960 1 1 + Other Permit:
� DateB : _
Inspection Line: 503.639.4175 S 1 Le ( Date Ready/By: IBS: ® See Page 2 for
Internet: www.tigard - or.gov )) ' „ li Notified/Method: Supplemental Information
ti, t ' ) 1. t1 " ;'i ,l
TYPE OF WO':`
lQ New construction ❑ Addition/alteratio rep acement Please check all that apply (submit ? sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ 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
f e j 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
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ['Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
100HP or more. occupancy.
Job no.: Job site address: 1 b$c -A. .31 &) t1 L ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: \ l &.. 04._ ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: tfta Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty 1 Fee. I Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less ■ 145.15 IA6 - .1r 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 ' (,,4('; 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
A \ , L-:) Limited energy, multi - family 75.00 2
Il 1
Q . (1� `� r- residential (with above sq. ft.) _
/// ���►►► �C Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
g A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) - Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
^ Signal circuit(s) or limited -
Business name: c,l(Kx 9 l ce d c. I t/1 C , energy panel, alteration, or ,
Address: /P.a. 6 9� j � extension. Describe: Page 2 2
City/State/ZIP: / 14, $,6 py e 2 '7/..q....3 Each additional inspection over allowable in any of the above
/ Per inspection 62.50
Phone: 4543 ) 6 ��,,,, yt - 5� � Fax: ( ) ," Investigation per hour (l hr min) 62.50
1`, / CCB Lic.: I S8 ' t C t Electrical Lie.: a/ °f p C Suprv. Lic.: 7. g ( • Industrial plant per hour 73.75
4+t' '''i �, (( F ELECTRICAL PERMIT FEES
�' Suprv. Electrician signaturd,'f uttted:° _� Subtotal: 1,, ..
Print name: , l � - Date: 9/A /pal Plan review (25% of permit fee):
V State surcharge (12% of permit fee): , 4.7
Authorized signature: TOTAL PERMIT FEE: 7d 0 '.
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per, permit.
I:\Building\Permits\ELC- PermitApp.doc 05/ 23/06 440- 4615T(11 /05 /COM/WEB W '^'-)' Y t z_T- - 2‘71 -
t'2 9 --
MALMEDAL ENTERPRISES PAGE 01/01
11/13/2009 14:33 5033240580
. A.,lima><>'r,n~1~~~flil~x Appllc~ti(Iri •
Building Fixtara KECEWEJ~~~~
City of Tigard P.caipiwd t'cnnit No, S oZpp 9 D
• 111 SW 14911 Blvd, Tigard, OR 97.223 i1 1r 1 Z~Q Dxe1p,;
Phone* 503.639.4171 Fax: 503,599.1940 Plan eviCV Otho jwMitNo.:
lnspee0cm Linty; 503,09A175 CITY OF 7IGAR a Raidy/Byf Mk ® See Ps>`s 2 for
lrttcrrlat: Www.6tWr -or.l;ov
AlUaDING MI CceegJStttaod: Sepplrsetnr•I lnrbrtn,atioe
y f-~'r: ~;yl- v,' ~aL.r 'i`'"`,•';. ,i!• ~ ..y `ti'iJ` :7' +o~ '~+'aG7?,?ti;+:.:.
~]~yy~+1~~(~aC 7 :~i: "`f :iy.P. 7 P'. wr
.`.•,w:•.IhT." -.,:~yL: N .vfI tLL. ;YF, •..•T'n}. r
06
/J+1~. J~)~ `•.~Y aW1iconsrlva1;ion Atmolition Fors l rrn SOM tree charrli A
Descri lion Tatpl
Addition(altlTStip4t~fOpl000tnent Q Other New 1- 2.4imiiy dwellings (tnctudks 100 A. for eat}) utility connection)
i;:: try;.- ^ ' ~r • w' SFR (1) bath 249 zc
1 and'Yibtniiy tfwefling ❑ Commcraialfindttstrial ST-9 (2) bath 350,00
C} Ao=.4nry building Q Multi•ftunily $FR (3) bath 399.00
Each additional baMitchtm 45,00
Nestor builder Outer:
Fin sprinkler ( a:q. H.) Page 2
uc ito utilities
lob site address: Catch basin or area drain 16.60
city/statrAlp-- Drywall, loeoh 117te, or trench drain 16.60
suite/bldg./apt. na.; Project name: Woodnit drain (no, linear A.: Page 2
Mrt►itfactumd home utllitia~ t 10.00
Crops atrcot/dirootiorts to job Si1c; 1vlanholcq 16.60
Rain drain connector 16.60
Samitsry sewer (no, !inert Page 2
Storm scwcr(no, linear ft.: Pat 2
Subdivis'roni Lot no.: Watcr serviuo (no, linter A„ Page 2
Future or Item
tax map/parcel too.:
AWOrprion halve 16.60
.fir ~ 'a .i " "1~ - - r ~aClt~ltwr prWenfJCT Pagr: 2
133awatcr valve 16,60
Clothes washer 16.60
DialrwaRhu 16.60
Drinking fouritain 16.60
,:,;,,,:y~tt:,rf s d;~:,•,»..y::.eettntt/aump 16.60
Namc Expansion tank 16.611
Addrw: rixtMe/wwcr cap 16,60
City),statV21P; Floor dram1floor sink! O 16.60
Phone: ( ) Fax: ( ) 0wbap disposal 16.60
r s Hose bib 160
h I kc maker 16,60
Busincss name
InteroWor/grease trap 16.60
Contact name: Medical Qas (vaiue: $ ) PW 2
Address! Primer )6.60
City/State2lP: R06forain (oommmrafai) 16.60
Sin$ibasIrAt vmcry 16.64
Phone: ( ) 1'aa`' + ( ) Tublahoweti(sAower pzui 16,50
7~-m®fe Vrinai 16.60
16.60
Ot 01080 Bu Anon noyrte: Water heater 16.60
Address: P 0 Dthcr:
i~ Subtotal
CSrylState(LI}': i~1//t~ Minimum permit roe: $72.50
Phanc. 4 ) r Fax: (5,0 Residential backPow minimum it fee: 536.25
Plan review M% otpt►mh fa7
e,C03 Uc.: Q /l 9 Imbing Lic, no.: A76
Authorized eigraature. Stmt surcharge (12%ofpermit fee)
TOTAL. FERWrr pF,
Tint nKme: t w~ Date: This permit spplicettoti expIrcia iris pcrMIt it not *bMincd within
180 dRys after it has bttn Attepied as camploc,
'Fec methodology let by Tri-County Building fnduAry Service board.
(:1Dudd1„s~prnnita4PLMP•POfmllnpp,Qsp IL7T/Qt ~awe16'r(cnW~G;rynywaa)
' City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
Wednesday, December 16, 2009 i
T I GARD
Westek Manufacturing -
24300 NW Green Mountain Rd.
Banks, OR 97106
RE Transportation Development Tax (TDT) Refund.
Our Permit No. MST2009 -00149 for 13882 SW 95th Ave.
At the time the above building permit was issued you paid a Transportation Development
Tax (Tin) fee of $4,599.00.
Effective December 1, 2009, Washington County approved a Temporary Discount on TDT
charges and has made that discount retroactive to July 1, 2009.
The enclosed check represents a refund to you of the difference between your original TDT
payment for your project and the new Temporary Discount charge. The amount of the
credit refund is $920.00.
Please call e at 503 - 718 -2426 if you have any questions.
bert Shields
Permits /Projects Coordinator -
503- 718 -2426
Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard - or.gov • TTY Relay: 503.684.2772
City of Tigard
TIGARD Accela efund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be
attached to this form. Refund requests are due to Accela System Administrator by Friday at
5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela
System Administrator for distribution. Please allow 1 -2 weeks for processing.
PAYABLE TO: Westek Manufacturing DATE: 12/10/09
24300 NW Green Mountain Rd.
Banks, OR 97106 REQUESTED BY: Dianna Howse
AMS
TRANSACTION INFORMATION:
Receipt #: 174894 Case #: MST2009 -00149
Date: 08/18/09 Address /Parcel: 13882 SW 95th Ave.
Pay Method: Check Project Name: Fletcher Woods
EXPLANATION: Refund amount discounted for TDT per Washington County.
REF. N,I INFORMATIO.N: .
..... :. .. {, j w i � .. ..,.may'... .� �. �•., .,:... ...
�?ee= .Yeseh tion:From:Rece tj _ = Revenu"e'AccountNo: ,. Refund.; -.>
Exai i 'lei thLb. ;Perm t a
..... .p .. =[B, . ..�. .._ . .'.F e� .......' .. .. _ ' �Exairiple= .245 =Ob00- 43200:0
TDT - Transportation Development Tax 4050000 -43320 $920.00
TOTAL REFUND: $920.00
APPROVALS:
If under $5000 Professional Staff
If under $7,500 Division Manager
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
0OR-ACCELA; SYSTEM .AD11%IINIS'TRATION::U.SE:ONLY ';:: `........ „
Refund Request Reviewed: Date: ; By:
Case Refund Processed: Date: ' ' 4 - ter:
C 4a-- /o ai9 ?
I: \Building \Refunds \RefundRequest.doc 04/13/09
•
CITY OF TIGARD RECEIPT
p
E a . _ 13125 SW Hall Blvd., Tigard OR 97223
• 503.639.4171
TIGARD
Receipt Number: 176343 - 12/18/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2009 -00149 $ - 920.00
Total: $- 920.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 102199 DHOWSE 12/18/2009 $- 920.00
Payor: Westek Manufacturing
Total Payments: $ - 920.00
Balance Due: $920.00
•
Page 1 of 1
•
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
t 3
503.639 4171
,..,,,..., .4: TIGA'RD_ •
Receipt Number: 174894 - 08/18/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MST2009 -00149 Building Permit 2300000 -43104 $1,740.41
---;.• MST2009 -00149 TDT - Transportation Development Tax 4050000 -43320 $4,599.00, ••
MST2009 -00149 Plan Review 2300000 -43106 $ -16.26
MST2009 -00149 CDC Plan Review, RES 1003100 -43112 $46.00
MST2009 -00149 CDC Plan Review, RES - LRP 1003100 -43117 $6.00
MST2009 -00149 12% State Surcharge - Building 1003100 -24001 $208.85
MST2009 -00149 Metro Const. Excise Tax - Residential 2300000 -24011 $384.36
Use
MST2009 -00149 Tig -Tual School CET - Residential 2300000 -24102 $2,707.00
MST2009 -00149 Park - Single Family Unit 4250000 -43300 $5,370.00
MST2009 -00149 Erosion Control 1003100 -22002 $112.00
MST2009 -00149 Erosion Plan Review CWS 1003100 -22003 $36.40
MST2009 -00149 Erosion Plan Review COT 2300000 -43102 $36.40
MST2009 -00149 Permit Fee - Elect (per dwelling unit) 2200000 -43103 $345.55
MST2009 -00149 Limited Energy 2200000 -43103 $75.00
MST2009 -00149 12% State Surcharge - Electrical 1003100 -24001 $50.47
MST2009 -00149 SFR - Baths 2300000 -43101 $399.00
MST2009 -00149 12% State Surcharge - Plumbing 1003100 -24001 $47.88
MST2009 -00149 Air Conditioning or Heat Pump 2300000 -43102 $14.00
MST2009 Furnaces >= 100K BTU 2300000 -43102 $17.90
MST2009 -00149 Water Heater 2300000 -43102 $10.00
MST2009 -00149 Gas Fireplace 2300000 -43102 $10.00
MST2009 -00149 Range Hood /Other Kitchen 2300000 -43102 $10.00
MST2009 -00149 Clothes Dryer Exhaust 2300000 -43102 $10.00
MST2009 -00149 Single Duct Exhaust (Bathrooms, Toilet, 2300000 -43102 $34.00
Utility Rooms)
MST2009 -00149 Fuel Piping 2300000 -43102 $5.40
MST2009 -00149 12% State Surcharge - Mechanical 1003100 -24001 $13.36
MST2009 -00149 Plan Review 2300000 -43106 $397.53
Total: $16,670.25
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 484 LSELLERS 08/18/2009 $16,670.25
Payor: Westek Manufacturing
Total Payments: $16,670.25
Balance Due: $0.00
•
Page 1 of 1
7034
NEW
ea ' EXISNG
PNWS -AWWA BACKFLOWASSEMBLYTESTREPORT 0REMO ED
PROPERTY ^^ ❑ REPLACEMENT
OWNER: :TA YY1 ■ •E ill r ! roS PH ONE: 7R'C�`5 C 7
MAILING nn •
ADDRESS: 1 �j S S Z S tA/ (T j ' h A t/ P
CITY - 1 - 1 A rcl STATE (5k- -ZIP 9 7223
ASSEMBLY S Ari.9—
ADDRESS:
STREET
❑R.P.B.A. t!9 D.C.V.A. ❑ R.P.D.A. ❑D.C.D.A. ❑P.V.B.A. ❑S.V.B.A. ❑A.V.B. ❑AIR GAP
SIZE: 1 1''.11°1 MAKE: W t I K�-1'l S MODEL: 3 �
WATER SERIAL -
PURVEYOR: (.-4 t I (Y, —� I t o E , fcC NUMBER: A o7-2 31
ASSEMBLY i �
LOCATION: Vs SI c o C V e LJ Ay
REDUCED PRESSURE ASSEMBLY P. V.B.A. / S.V.B.A. INITIAL TE '(
MI CHECK If DOUBLE ; CH CK;(- AIR CHECK PASSED []'
PRESS DROP (A)I CHECK 1 INLET FAILED ❑
INITIAL RELIEF VALVE g TIGHT 2. t] O PENED AT: PRESS DROP
TEST OPENED AT ( ) DATE:
MIN 2 PSID LEAKED ❑ PSID
RESULTS BUFFER PSID PSID 2/ w
A - B = I CHECK 2
MIN 3 PSI
RELIEF VALVE 'TIGHT I, V DID NOT FAILED SYSTEM
PASS ❑ FAIL ❑ 'LEAKED ❑D OPEN ❑ ❑ PSI
COMMENTS
REPAIRS
AND /OR
PARTS
REDUCED PRESSURE ASSEMBLY ..P.V.B.A. /S.V.B -A. AFTER REPAIRS
MI CHECK D:C.V.A.
PRESS DROP (A) (\- DATE:
TEST • RELIEF - I CH #1 OPENED AT PRESS DROP
AFTER OPENED (B) TIGHT ❑ PSID
REPAIRS BU _ - '@1P� IC #2
• A - B = .,@,,,a I TIGHT ❑ PSID PSID PSID PASSED ❑
{ IN COMPLETING AND SUBMITTING THIS TEST REPORT,•THE TESTER. CERTIFIES THAT THE
y ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE
j RULES AND REGULATIONS OF THE WATER SYSTEM, AND STATE REGULATIONS. •
GAUGE CALIBRAT D - IT /01 DETECTOR METER READING -
`--rY L ' c .' . _ - 4526,
TESTER SIGNATURE - - CERT
1E-V-1 1 k 6 P.--
1 / 02o Y Z0
TESTERS NAME PRINTED - I s 333 Al L ) t-- '' 1,) 7 `� -� \ 324G-ATE y . ,
• TESTERS ADDRESS - ( _.. PHONE M
LI,R1 n oyv L l.1 In - c 4
COMPANY NAME• -
- SERVICE RESTORED -
REPORT RECEIVED BY (REPRESENTATIVE OF OWNER)
s
. WHITE • Water System Copy PINK - Customer Copy YELLOW - Tester Copy
CITY OF TIGARD CERTIFICATE OF OCCUPANCY
_ a Permit #: MST2009-00149
-' COMMUNITY DEVELOPMENT Permit Issued: 08/18/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Parcel: 2S102CD05600
Jurisdiction: Tigard
Site address: 13882 SW 95TH AVE
Subdivision: FLETCHER WOODS Lot: 6
Project Description: New SFR.
Class of Work: NEW
Type of Use: SF
Type of Constr: VB
Occupancy Group: R -3
Occupancy Load:
Project Name: Fletcher Woods
Owner: MCADAMS, JAMIE & SUSAN
24300 NW GREEN MOUNTAIN RD
BANKS, OR 97106
Phone: 503- 780 -5542
Contractor: MLM CONTRACTORS INC.
12395 NW DEVONMOOR AVE.
BANKS, OR 97106
Phone: 503 - 572 -1343
Fax:
This Certificate issued 1/7/2010 grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the
group, occupancy, and use under which the referenced permit was issued.
® 0ri L Vet Nib ,,_ )
g Inspector Building Official
POST IN CONSPICUOUS PLACE
Oregon Residential Specialty Code N1107.2
HIGH- EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: dL I _ Qc. 1 9 Jurisdiction: c . I; r-vn
cll
Site Address: �Z � A 0 e 1 I C v
/
Subdivision/Lot #:
rie_I �1 r) _C0 S LO- 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: X/7111;Pi) Date: / 2 - 3 - 9
Owner /Ge ral Contractor /Authorized Agent
Print Name: P C -mil \il,
' 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.
1:\Building\ Forms \RES- HighEfficiencyLighting.doc 07/01/08
J.
Oregon Residential Specialty Code R318.2
MOISTURE CONTENT ACKNOWLE I GEMENT FORM
1, NA. . k, P v�v \ WV• , am the general contractor or the owner - builder
at the following address:
Site Address: Z 5 l /
City: ,--\
G-V
Permit #: aoo9_ l 9
Subdivision/Lot #:
cie+C\A. e W OOCO5 L-0 f
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 weig of dry framing members.
Signature: / /� Date: /Z - 31 - 0
General Contractor or Owner - Builder
l:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
STREET TREE CERTIFICATION
I, ivL1`el\c l [)t),./1/..c).._ , Owner /Agent for
(PLEASE PRINT) (PERMIT HOLDER)
Do hereby certify that the following location meets
City of Tigard land use and development standards
for street tree installation.
ADDRESS: / 3 SW 9c Aver eve o
SUBDIVISION: e do ci.5 LOT: (�
� , _
SIGNATURE: ij.,.i; AP' DATE: 1 Z -3 / d �
(OWI\TER /AGEI \iT)
RECEIVED BY: DATE:
(CITY OF TIGARD)
•
I: \Building \Forms \StreetTreeCertificate 01/19/07
t fir;
•
PERMIT NO. m f ' 1'®0) 9
CleanWater Services
y C O,ir cornmi,.enl is cI; °ar. � � - LOT
EROSI O C SSNTROL INSPECTION REPORT
DATE 1 ZO(0 INSPECTOR ,11.-iiek, SUBDIVISION 1 [ Q� OJr')(1 ,g
I
OWNER/PERMITEE QQ
SITE ADDRESS t?) ) L 6 OJI
tl s 117k F ;r 1 k �' i aka 7 , '
wy, L
•
THIS SITE MEETS THE POST- CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORT IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST – CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING `.:
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPI.''ETE
• OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION`CONTROLWiNSPECTION REPORT MUST BE
FORWARDED TO THE NEW O WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITYEOR;MAINTENANCE, REPAIR AND REMOVAL.
•
OTHER •
THANK YOU FOR YOUR COOPERATION!
INSPECTOR c PHONE ( 3 9
_
� v
t
Building Permit Application Checklist
One- and Two - Family Dwelling 1.014 tn. FRT. t si: 0\l.A
Cl of Tigard Re ceived
g D Permit No.:
13 125 SW Hall Blvd., Tigard, OR 97 223 Associated permits:
3 Phone: 503.639.4171 Fax: 503.598.1960
T I G A R D 24- Hour Inspection Line: 503.639.4175
ICI Electrical ❑ Plumbing ID Mechanical
Internet: www.tigard - or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW ' es No NI.
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
basin protection, etc.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and
surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑
and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ 0 ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ . ❑ ❑
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. ❑ ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ .
architect licensed in Ore.on and shall be shown to be ap •licable to the . ro'ect under review.
.IURISDICTIONAL SPECIFICS
23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
1: \ Building \Permits\BUP- RES- PermitApp.doc 03/21/06 440- 4613T(11 /02/COM/WEB)
1 4
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits\MEC - PermitApp.doc 01/19/07 2
i 6
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\ / / PROPOSED
•\ TREE ro REMOVE
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06/30/2009 SRR
SCALE 1 " 2 0 ' - 0 "
N E ALAN MASCORD DESIGN ASSOCIATES, INC. IS N0T CITY
LIASLE FOR THE ACCURACY OF THE TOPOGRAPHY 2 1 6 A
WADER TION. IT IS Tiff SOLE RES DITION . IN OF THE F
.....
■ ETCHER OF WTIGARD OODS
WADER TO LACE ALL SITE CONDITIONS. INCLUDING
ANY FILL PLACED ON THE SITE AND NOTIFY THE LOT 6
OWNERS OF ANY POTENTIAL FIELD MODIFICATIONS.
COLLECTION
ALAN MASCORD DESIGN ASSOCIATES, INC.
°°'""''°'° °°" ° ""�, °" ,'�, (7,046 So. FT) FOR : JAMIC 8 SUSAN MCADAMS
•
•
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PLASTIC MESH TREE PROTECTION FENCE
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lo03.D.n T*. WwM Won IY - 400 NIlTES: PART Of THE CITY Of DOOM° PIM REVIEW PROCESS.
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FOR SRNI DI' PoN SITE DEVELOPMENT.
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EASUNES UNIT THE AMWNI Of END. DISTURBANCE WOO/Wm THE •
NESS AND UNIT THE REMOVE OF THE TREE'S ROOT SYSTEMS. 04E 0 TO �, E
N E NNA IO Of EVERY PROJECT, R 5 WARY ALL OF THE ABOVE Y M
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RELATOR TO WIMT WORN MEOS TO EM COMPLETED IN O. TEE'S 00040. ll
ON 441E SUPERVISION BY A COPPED AMORIST WILL BE DETERMINE° AND 'N S D
SUPPLIED AS NECESSARY. A - � It" t' .. . -
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• O1 TREES
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ARBOR., OR CITY FORESTER I Y L
0MIUI , •21aII T V._ I O1PICA1>
uC SPECIAL CONSPERATIONSO 0 0
SCALE 1
REFERENCE INFORMATION AND .0004. w ROTJNDS'I'DNE DEVELOPMENT INC. FLETCHER WOODS (nN� _
0050 EN BFAVODON IMASDALE Wel
AS BUILT ��� ° "° BRA503 -70 OR 910aS SW McDONALD STREET
._ ( 0I RM R 50.7- TOS- TfTT 5. TREE
PR A Al 00 .4.5 LS H ARRIS - MoMON ROLE ASSOCIATES. INC. "
NAM 0 13 . : 0. WA AM tat wurDMENSION, °°151 R - aDRYEYORR TREE PRESERVATION PLAN 5
• ISO OR INML "' SW McDONALD ST AND SW 95TH AVE Of 14
M RERR TO TRICKED FOR uTRr 11£1,61014 own JM °4 ./10/06 MORO 15.7 ••341-3433
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•
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.:0A cT .2C'r)cr • 00 14 q
PLANNING DIVISION:
Required Setbaks: Approved ❑ Not Approved
Side: Street Side: �
Front. _____
G rage: Rear: /{
Visual Clearance: [Approved ❑ Not Approved
PA 4 Maximum Building Height feet
CWS Service Provider Letter Required: ❑ Yes
❑ Received
IJ : � Date: `7/'4/ DI IN � DEPARTMENT:
ENGINEE
Actual Slope:% A Approved ❑ Not Approved
Site Plan: Approved ❑ Not A roved
BY: 4L �� % f r v� t t �/% Date:
Notes: _.
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO: Jf A. u\ 7 $ C • OCR` L-(1
Street Tr � A pproved ❑ Not Approved
Protected T L' Approved ❑ �t Approved
B Date: 4/it 9,
Notes: