Permit II CITY OF TIGARD MASTER PERMIT
I3 COMMUNITY DEVELOPMENT Permit #: MST2010 -00152
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/21/2010
Parcel: 2S109DA18100
Jurisdiction: TIGARD
Site address: 15209 SW SUMMERVIEW DR
Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 110
Project: Arlington Heights No. 3, Lot 110
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 4 First 1650 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 25 Bathrooms: 4 Second: 1790 sf Garage: 568 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: sf Value: $362,990.92 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 4 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Catch Basins: 0
Lavatories: 6 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 Tvpes Air Conditioning: N Vent Fans: 6 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Fum <100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Fum > =100K: 0
ELECTRICAL
Residential Unit Service Feeder Tema 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 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: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
Owner: Contractor: Required Items and Reports (Conditions)
STONE BRIDGE HOMES STONE BRIDGE HOMES NW LLC 1 MST Ersn Cntrl 503 - 681 - 4444
16869 SW 65TH AVENUE #505 16869 SW 65TH AVE # 505
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035
PHONE: 503- 387 -7577 PHONE: 503- 387 -7577
FAX: 503 - 387 -7615 .
Total Fees: $18,243.80 -
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 it work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Tho rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1. 0.332.2344.
Issued By: LSl Permittee Signature: G/
Bu Permit Application
Residential RECEIVES FOR 01.1 USE C)N1.1
11,1 City of Tigard Received Permit No.: M
° 13125 SW Hall Blvd., Tigard, OR 97223 SEP 0 2 2010 Plan Review
II Phone: 503.639.4171 Fax: 503.598.1960 Date/B : 1 `l, kD Other Permit: AP .t• 1 — 111 :~
T I G n ti D Inspection Line: 503.639 F TIGARD Date Ready/By: , / � f funs: See Page 2 for
Internet: www.tigard -or.gov B �j D NG DIVISION fled hod: Supplemental Information
TYPE OF WO REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction ❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on indicated application. Q r
® I- and 2- family dwelling ❑ Commercial/industrial Valuation: ,54,47-7s-e. $ 3 '7o p 1�'
❑ Accessory building ❑ Multi- family Number of bedrooms: 4
❑ Master builder ❑ Other: Number of bathrooms: 5
4
JOB SITE INFORMATION AND LOCATION Total number of floors: 2,
Job site address: 5Z0q SW .fVl'N1NlrlGlVIC.U) 'Nye New dwelling area: 3 4 0 square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 5(J4 square feet
Suite/bldg. /apt. no.: Project name: Arlington Heights Covered porch area: 2Asquare feet (0
Cross street/directions to job site: Deck area: f7j square feet 1 '
Other structure area: 34 square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Arlington Heights I Lot no.: 110 Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New, Single Family Residential Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 16869 SW 65th Avenue #505 Occupancy groups:
City/State /ZIP: Lake Oswego, OR 97035 Existing:
Phone: (503)387 -7577 Fax: (503)387 -7616 New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: SEE ABOVE All contractors and subcontractors are required to be
Contact name: Gayland Forsberg 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
applicant is exempt from licensing, the following reasons
City/State /ZIP: apply:
y:
Phone: ( ) Fax:: ( )
E -mail: gayland @stonebridgehomesnw.com
CONTRACTOR
Business name: SEE ABOVE BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State /ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
CCB lic.: 173318 Total fees due upon application:
y � Amount received:
Authorized signature: / Y 1 This permit application expires if a permit is not obtained
�/� within 180 days after it has been accepted as complete.
Kv 4
Print name: c.A 1 y/ l t er rt A Date: * Fee methodology set by Tri -County Building Industry
Service Board.
1: \Building\Permits\BUP -RES PermitApp.doc 1 0/01/09 440- 4613T(11/02 /COM/WEB)
- 1
b
Electrical Permit Application 1. 01.- Fici.: 1itii: ONl.)
City of Tigard Date/Be: Permit No.:
I I I 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' C , Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
T 1 G n R D Inspection Line: 503.639.4175 Date Ready/By: )uris: ® See Page 2 for
Internet: www.tigard - or.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 fader 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
® 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 - . A
❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "13 ",
J ob site address: Z� 100HP or more. occupancy.
Job no.:
14 $ S w . Sv/nIs.ire 'hnv� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SCHEDULE '
Cross street/directions to job site: Description 1 Qty. I Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: 11 b 1,000 sq. ft. or less t 168.54 (IA, — 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 7 33.92 '231.44-1
Limited energy, residential
' .DESCRIPTION OF WORK ; (with above sq. ft.) ( - Ka) 75.00 2
Limited energy, multi - family 67.84 2
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
Name: Stone Bridge Homes 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 16869 SW 65th Avenue #505 Over 1,000 amps or volts 552.26 2
City/State/ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)387 -7577 Fax: (503)387 -7615 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
, ® APPLICANT - I . ❑ CONTACT. PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: SEE ABOVE B. Fee for branch circuits -
Contact name: Gayland Forsberg
without t branch service or feeder fee, 56.18 2
Y � first branch circuit
Address: Each add'l branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: gayland @stonebridgehomesnw.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
• Business Signal circuit(s) or limited -
usiness name: City Electric
energy panel, alteration, or
Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 2
City/State /ZIP: Sherwood, OR 97140 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (971) 404 - 1714 Fax: (503) 625 -3052 Investigation per hour (1 hr min) 66.25
CCB Lic.: 42422 Electrical Lic.: 26 - 289C Suprv. Lic.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 144{Q,
Plan review (25% of permit fee):
Print name: Chuck Friesen Date: State surcharge (12% of permit fee): 5 7." j
Authorized signature: e.,,,, �� TOTAL PERMIT FEE: 63 d 7 Q
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
D Building \Pemtits\ELC- PennitApp.doc 10/01/09 440- 4615T(I1 /05 /COM/WEB
. .
Mechanical Permit Application 1:01( (lrrlci.: (isE ON1.v
Received
City of Tigard Date/By: Permit No.:
1,11 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
II Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: iwis: ® See Page 2 for
Internet: www.tigard or.gov Notified/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: $
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. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
r � a T Air conditioning
Job site address:
52.{/ 1 S w ,SL,fl,41,04 , , 0 in (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) i 46.75 4-10:77,:,
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: Arlington Heights Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Arlington Heights Lot no.: ( ( 0
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 23.32 . 'fi
Gas fireplace ( 33.39 '. 1.gci
New, Single Family Residential 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
C4 PROPERTY OWNER I ❑ TENANT Ot y/liner /flue /vent 23.32
Other: 23.32
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 16869 SW 65 Avenue # 505 equipment I 33.39 . 33`1
City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust ( 33.39 -. 3.. 7
Single -duct exhaust (bathrooms,
Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility rooms) 6 23.32 1
0 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: same as above
Fuel piping
Contact name: 514.15 for first four; 54.03 for each additional
Address: Furnace, etc. ( 10c. (
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) pax :: ( ) Water heater
Fireplace t
E-mail: Range (
CONTRACTOR Barbecue
Business name: Comfort Zone
Clothes dryer (gas)
Other:
Address: 1032 NW Corporate Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Troutdale, OR 97060 Subtotal 324,3
Phone: (503) 667 -5595 I Fax: (503) 491 -8252 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 110091 State surcharge (12% of permit fee) ' , 9'
TOTAL PERMIT FEE 3, 23
This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
Print name: David Heldstab Date: • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Pemtits\MEC- PermitApp.doc 10/01 /09 440 - 4617`(11 /02 /COM/WEB)
Plumbina Permit Application
Building Fixtures rl)R tr1F1Cl: rSE ()Nix
Re ceive
City of Tigard Received :
,, Pemnit No.:
14-".,.
13125. SW Hall Blvd.. Tigard, OR 97223 Plan Review
Phone:. 503.639,4 171 wax: SO:598.1969 Dotri7iy. Other Permit No.:
Inspection Line: 503.639.4175 fy Ready/By: �B lufn: fa se. Page 2 Lie
TIC;ARD y y:
Internet: wwve.ligard- or.guv Notified/Method Supptemental.laiormation
TYPE OF WORK FEE * - SCHEDULE
® New construction ❑ Demolition For Special iR /arrnathw tine ebeeklist.
Description I Qiv. I En. I Total
❑ Addition/alteration /replacement ❑ Other. New 1. 24amily dwellings (includes 100 h. for each utility .connection)
CATEGORY OF CONSTRUCTION SFR 11) bath 312.70
® 1 -and ?- family dwelling
❑ Commercial/industrial SFR (2) bath 437.78
. ^ SFR (3) bath ' 500.32 50 z.-
❑ Accessory building ❑ Multi-family
Each additional bath/kitchen ' 25.02 2.5,07.-
❑ Master builder ❑ Other: Fire sprinkler 1 so. ft.1 _ Page 2
JOB SITE II FORMAT1ON AND ,LOCATION Site utilities:
lob site address: 1 � i OW Summit (6 Ct-3 Di) k ( Catch basin or line, dram I I t 8.76
C)t}•urEl; leach linea , to trench drain 1 5.76
CityIState/LCP: Tigard, OR 97223 2 Footing drain l nn. linear ft.: i) Page ..
Suite/bldg. /apt. no.: I Project name: Arlington Heights Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 15.76
Rain drain conncrlur 18.76
Sanitary sewer (no. linear 6.: 1 Page 2
Storm sewer (no. linear It.: _,_) Page 2
Water service (no. linear ft.: _ f I Page 2
Subdivision: Arlington Heights I Lot no.: in) Fixture or hem:
Taxmaplparcel no.: Backflow preventer 31.27
DESCRIPTION :OF WORK tlackwraer valve 12.51
Clothes washer 25.02
.New, Single Family Recidrntial Dishwasher 25A2
Drinking tbuntain 23:02
•
Ejector /sump 25.02
® PROPERTY OWNER I ❑ TENANT Ecpamsion tank 1151
Name: Slone Bridge Homes Fixture/sewer cap 25.02
Fluor drain /floor sink:hub 25.02
Address: 16869 SW 65 Avenue #505
Garbage disposal 25.02
City/State/ZIP: Lake Oswego, OR 97035 Bose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑. APPLICANT ❑ CONTACT PERSON: Interceptor/grease trap 25.02
Busut s name: SEE ABOVE Medical gas (value: S ) Page 2
Primer 12.51
Contact name: Gayland Forsberg
Roof drain (commercial) 12.51
Address: Sinkibasinilavatnn 25.02
CityIStatefZIP: Solar units (potable water) 62.54
Phone: ( ) I Fax:: ( ) Tuli?shotverishower pan 12.51
E -mail: gaylandla)stonebridgehomesaw.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Legacy Plumbing ,.
Water 5029
Address: 8985 Harelvern Way Other: 25.02
CityfStatea2JP: Portland, OR 97223 Subtotal tj 2.5, -
Phone: (503)816-8887 Fax: (503) 297 -4587 Minimum permit fee: S72.50
CCB Lit:.: 159281 Plumbing Lie. no.: 26 -517P8 Plan trvicw (25 ti, of permit fee)
State surcharge (12% of permit fee) (03 ,04--
Authorized signature: 74,05/ --r.--- TOTAL PERMIT FEE j
Print name:. Matt Nelson I Date: I This prnait application expires. Ifa permit is not obtained %tibia 180 days
after it has been accepted as complete.
•fee n cthndulogy set by Tri•County Building Industry Servikc Board.
IIMUihli:+g CItiliis OILIt.ItrntitApp.4t*C 14 i t109 4411 tart10 11201:0kra tiI
Oregon Residential Specialty Code N1107.2
HIGH - EFFICIENCY INTERIOR LIGHTING SYSTEMS
Permit No.: m5 2.vw ° pU/ jurisdiction: ` 7 r
V
Site Address: S 20 S %) SLA- �"\A c G.) .,
Subdivision/Lot #: A,..,, 1/1.r) Gi 1f f q1,1
I. J
and /or
Map and Tax Lot #: I 1 6
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: V 'y,. Date: ) " - 1 \J
Owner /General ContractorMait�horized Agent
Print Name: ' 1)4^ V4 c 5Q
t 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:\ B uilding\ Forms \RES- HighEfficiencyLighting.doc 07/01/08
Oregon Residential Specialty Code 8318.
MOISTURE CONTENT ACKNOWLEDGEMENT FORM
4 6) . 0,1 - , am the general contractor or the owner- builder
at the following address:
Site Address: j
City:
wg_-p
Permit #: r 6 to — 00/
Subdivision/Lot #: 0
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: — , 0
General Contractor or Owner - Builder
I:\ Building\ Form \RES- MoistureSensitiveWood.doc 09/25/08
STREET TREE CERTIFICA TION
_o / agent for SA-D.Acg(e,d (►Jk),,
(PLEASE PRINT) (PERMIT HOLDER)
do hereby ce5 that t follovzng,location meets
City of Tigardland use and development standards
for street tree - installation an consistent
z with the approved - .site plan.
SITE ADDRESS: l ro o e J
SUBDIVISION: 41 ,s / , y !by( 11-e (• h 5 LOT #:
SIGNATURE: /./L -- -`--� - DATE: //
(OWNER /AGENT)
RE CEIVED &
VERIFIED BY: DATE:
(CITY OF TIGARD)
J Tree location verified per approved site plan.
I: \Buildin Forms StreetPreeCertifiicate 07/01/2010
STONE BRIDGE koss204 RECEIVE OBE: 1481
HOMES 1■TW LLC LOT: 110
S L I 0 L U DATE: 9/7/10
1. de et Iii SW d6th AVE . . Ai 606 � .... ,_ _. ..,.,,
L ♦_ N 0 8•_ G O. O B= 6 0 N 0 7 0 0 6
(503)387 -7577 ‘ CITY OF TIGARD PROPERTY: ARLINGTON
• BUILDING DIVISION HEIGHTS
CITY: TIGARD
'will I D SCALE: 1"=20'
PLAN No.: 199
STANDARD ELEVATION
s
0
29' -5'
EL 433' a
3 k-
Iii 432 11 430 430.1 TW 20' - I/4'
r , — 426.1 BW
m��� 100.88' RETAIN 0 430 TW i mt.: /���� r � 4 'i�� �L 426.1 BW 4T1 IM k
- _ 2x10' 1 426
29 '2' ..•..+...:• • 426
a ,
is,
i t kik, ' o F.F -426 r..': AY:
In
.4 e . ; ~ •:•4::::'•; •Q 424
�' = 3A40 Ski FT. 26:;'f � '.. -•.f
` 4
141. 18'10' 3' X6'6' � .
4' 3 V1 OATH
Q
il FF.E -4210' f=
3' t u % �
li . �� 51' A ry J : SEWER a
...c __ :: 3 STO
Ow EL. p
-T _ ' I - 7 4 \ 1---...1‘ �r �∎ - - w ar a - J WATER
430 W r �' EL.•42
E 4 2 % 426 42 • 10 0.0'1 IQETAINN* -
4252 TW W ALL, 4252 TW -
WW 4222 BUJ 4222 BW
al
N
LOT COVERAGE LEGEND
LOT AREA: 5,118 SQ. FT.
BUILDING AREA: 2,468 SQ. FT. — STREET TREES:
PERCENTAGE: 43.2% illir RAYWOOD ASH
- FRAXINUS OXYCARPA-
NOTES:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING LUALL I -IEIGI -ITS AND LOCATIONS ARE ESTIMATES.
THEY MAY VARY AND BE SUBJECT TO CHANGE. LOT 0 110
DRIVEWAY
REET
STREETLIGHTS, AND OTHER SITE CONDITIONS. OUTILITY BOXES,
ST 5,118 sq. ft.
ey0A111111
CV OF TIGARD - SITE PLA4 REVIEW
BUILDING PERMIT NO.: M 610 • 001C1....
PLANNING DIVISION:
Required Setbacks: Ed Approved 0 Not Approved
Side: - _ Street Side: _L.
Front. _LC-. Garage -2- Rear:
Visual Ck-v fl Not Approved
Maximum - 3$
CWS Sery ic.- ' • jiit No
By: Date: 979A
ENGINEERING DEPARTMENT:
Actual Z:1 Approved 0 No Ap oved
Site P n: El-Approved 041 t proved
By: Date: /
Notes:
B I • NG PERMIT NO:
Street Trees: ft4roved 0 Not AflPfoled
- : Approved Not AcProved
1 Dato: 0
• .
Notes:
CITY OF TIGARD \4T i 0 - o a 15
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171v ;dq �iEl���l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: tO � J TIME: PAGE:
SITE ADDRESS: I 5 z.6. 9 5v- -,,.,..v.•v L 4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
• Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
256 k_sS
� — i
Corrections /Comments/ Instructions:
Q7 J?
Fe
JD
1 ,4
❑ PASS !PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .C`1f Date: V J Phone #: (503) 718- 2-7 L-