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Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT V 0 1 0 114 a Request Permit Action .2/„7_5113 41 994 T I c; n It r) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: CITY OF TIGARD Building Division Services Supervisor 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) O 63E, �1 (P , 4-0 K 6 Mailing Address: j (e q 6 & ( /k)L . 5b5 City /State /Zip: i. gyp Oft 9763 5 Phone No.: 0 " ' 0 7 - 757 7 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): 15-- CANCEL /VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: i` i` i i C /fi,e.cC//-w 000 l / Site Address or Parcel #: / �J l 34? &AD H I-d fC t t)1 E C1,J VC. Project Name: AQL11 l.) f) 14 ti 6 fir 16o 3 / 7 Subdivision Name: Lot #: EXPLANATION: etc) /...i, [,ra AA /3 5 I/ 7> 46 8 H Sr ao t - Doer ei . / sa i z - -, /3 —oo oor Signature: ■ , / .O /� � ��` Date: / / /(o// 5 Print Name: E66/i- R_. CiciCC ( Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds. FOR OFFICE USE ONLY Rte to S s Admin: Date ( Pu ,'�INI J Rte to Bld • Admin: Date cPAEFAillill Refund Processed: Date I FAIIIIIE:j �I� Invoice Processed: Date a. , Mill B �?� Permit Canceled: Date , - o2,5 /3 By ,iii VA 'arcel Tag Added: Date By Receipt # Date Method Amount $ I:\ Building \Forms \RegPermirAction.doc Rev 05/25/2012 Er CITY OF TIGARD Building Division TIGARD 13125 SW Hall Blvd.,Tigard, OR 97223 503.718.2439 INVOICE TO: Stone Bridge Homes Customer ID: 173318 16869 SW 65 Ave., #505 Invoice No.: INV2013 -00003 Lake Oswego, OR 97035 Invoice Date: 2/25/2013 Date Due: 3/25/2013 Case No. Site Address Subdivision - Lot # or Project Name Amount Due MST2011 -00091 15188 SW Summerview Dr. Arlington Heights No. 3, Lot 57 $929.10 Note: This permit was submitted 6/1/11, plan review was completed, the permit was made ready to be issued and balance of plan review fees due were never paid and permit was never issued. New plans were submitted 1/10/13 and permit MST2013 -00004 has been issued. Invoice Total: $929.10 E Please see attached fee schedule for description of fees due. (Detach and return this portion with payment.) Case No.: MST2011 -00091 Customer ID: 173318 Site Address: 15188 SW Summerview Dr. Invoice No.: INV2013 -00003 Project: Arlington Heights No. 3, Lot 57 Invoice Date: 2/25/2013 Date Due: 3/25/2013 Invoice Total: $929.10 Amount Paid: $ Office Note: Route copy of receipt to Dianna Howse. Please mail payment to: City of Tigard, Building Division Attn: Dianna Howse 13125 SW Hall Blvd. Tigard, OR 97223 I: \Buildin Accountin \Invoice.doc 01 /14/2011 all CITY OF TIGARD FEE AND PAYMENT HISTORY _ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD MST2011 -00091 - 15188 SW SUMMERVIEW DR, TIGARD, OR 97224 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due Plan Review 2300000 -43106 $751.34 $751.34 $750.00 6/1/11 Check 182680 $1.34 Plan Review 2300000 -43106 $634.24 $634.24 $634.24 DC Provision Review, SF - Ping 1003100 -43112 $64.00 $64.00 $64.00 DC Provision Review, SF - LRP 1003100 -43117 $9.00 $9.00 $9.00 Erosion Plan Review CWS 1003100 -22003 $36.40 $36.40 $36.40 Erosion Plan Review COT 2300000 -43107 $36.40 $36.40 $36.40 12% State Surcharge - Electrical 1003100 -24001 $57.72 $57.72 $57.72 Additional Plan Review 2300000 -43106 $90.00 $90.00 $90.00 Totals for Fees $1,679.10 $1,679.10 $750.00 $929.10 Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount 182680 Check 33058 Stone Bridge Homes 06/01/2011 $750.00 NW, LLC. Total Payments: $750.00 Balance Due: $929.10 Building Application 0 1 0 , „ , , � z ' k i t gPe rmi Permit � � �� Residential .� FOR OFFICE USE City of Tigard \ :11 / 4,t--_- `��� ,.14\\ Received / �,, Permit No.: „'r ��OG� nn \\ t f' . II I • 13125 SW Hall Blvd., Tigard, OR 97223 ,�\V T , �� Phone: 503.639.4171 Fax: 503.598.1960 c .-c\ _ i i. 9 . , 4: , jam' Other Permit: , ,f . 1 r 1 - �_ A �` t) Inspection Line: 503.639.4175 �\ �( ®;�`% OV \u i . to Read 3 Juris: ® See Page 2 for Internet: www.tigard - or.gov ` \ -0 Notified/Method: 7TCv supplemental Information TYPE OF WORK REQUIRED DATA: 1 - AND 2- FAMILY DWELLING ® New construction ❑ Demolition Permit fees* are based on the value of the work performed. c% Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit fc,the r CATEGORY OF CONSTRUCTION work indicated on this application _ ® 1- and 2- family dwelling El Commercial/industrial Valuation: $ 402- N 4 ❑ Accessory building El Multi-family Number of bedrooms: El Master builder 1:1 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 3 Job site address: I S 1 vb SW 5V M M eiz 1 on/ D12. New dwelling area: -- 6 11)2 square feet City /State/ZIP: Tigard, OR 97223 Garage/carport area: 1-4 0 square feet ( Z Suite/bldgiapt. no.: Project name: Arlington Heights Covered porch area: 1 I 2. square feet ( ?A Cross street/directions to job site: Deck area: I t .. square feet (0 rz square feet jL REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Arlington Heights I Lot no.: b 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 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: Deirdre Britt 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 / StatelZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: dbritt@stonebridgehomesnw.com CONTRACTOR Business name: SEE ABOVE BUILDING PERMIT FEES* Address: (Please refer to fee schedule) City / State/ZIP: Structural plan review fee (or deposit): Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): CCB lic.: 173318 Total fees due upon application: • 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: FRJR , 4 38177 Date: 1)S. t 6 ,' I * Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits \BUP -RES PermitApp.doc 10/01/09 440- 4613T(11 /02/COM/WEB) Electrical Permit Applicati FOR OFFICE USE ONLY City of Tigard + Received • 111 `J g 1 �Q�` Date /B AR1 M 131 SW W Hall Blvd., Tigard, OR 972 3 Y P lan Review /3 Phone: 503.639.4171 Fax: 503.598.1960 0 KS DatelBv: Other Permit: T I C A R 1) Inspection Line: 503.639 G ' ` en ' ' 1 ? ate Ready /By: turfs: El See Page 2 for Internet: www.tigard of a y� C j� \ Notified/Method: Supplemental Information TYPE OF WORK V ` PLAN REVIEW ® New construction ❑ Addition /alteration / Please check all that apply (submit 2 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 ® I - 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 ", "I -2 ", ' I -3". Job no.: 14' . Job site address: I 578 iW SUMMI:1ZV ION BIZ. 1001-11' or more. occupancy. 0 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.: I Project name: Arlington Heights ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qrv. I Fee. I Total I New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Arlington Heights Lot no.: rjl 1,000 sq. fl. or less II I 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. 0. or portion 7 33.92 ,_37 1 Limited energy, residential I 751 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi- family residential (with above sq. ft.) 67. 2 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 Owner si nature: Date: Branch circuits — new, alteration, or extension, per panel g A. Fee for branch circuits with ® APPLICANT I ❑ CONTACT PERSON above service or feeder fcc, each branch circuit 7.42 2 Business name: SEE ABOVE B. Fee for branch circuits Contact name: wi Bout service or feeder lec, 56.18 2 Deirdre Britt first branch circuit Address: Each add'I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E - mail: dbritt @stonebridgehomesnw.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: City Electric Signal circuit(s) or limited - 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 (I hr min) 66.25 CCB Lic.: 42422 Electrical Lic.: 26 - 289C Suprv. Lie.: 35925 Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 456, TB Plan review (25% of permit fee): Print name: Chuck Friesen Date: 05 ) u l' State surcharge (12% of permit tee): 1-7 7 , 7z. Authorized signature: e > ........ ) TOTAL PERMIT FEE: � � , 7 0 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. I :\ Building \Pemitc \BI.C- PcmitApp.dov 10/01 /09 440- 46I I I /05 /COM /\1'ItB Mechanical Permit Application FOR,nr P lc r USE ONLY City of Tigar Received �a Date /By: Permit No.: 0( -_ : 1 C ° 13125 SW Hall Blvd., Tigard, OR 9 _ 1 Plan Review ( Phone: 503.639.4171 Fax: X03.59 A. �Q 1 Date /By: Other Permit: T 1 G A R D Inspection Line: 503.639.4175 \ � � Date Ready /By: Juris: 0 See Page 2 for Internet: www.tigard- or.gov J fs 9% i fs Supplemental Information V \ ° , - \ \I \ S\C .1 TYPE OF WOti COMMERCIAL FEE* SCHEDULE - USE CHECKLIST Mechanical permit fees* are based on the value of the work ® New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: S RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ® I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling �.p Air conditioning Job site address t 5 Q c 7 S/V �VMM V I��/ DK-• (requires site plan showing placement) 46.75 City/State /ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) ( 46.75 , Furnace 100,000+ BTU (ducts/vents) 54.91 Suite /bldg. /apt. no.: 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.: rj, Other: 23.32 Tax map /parcel no.: Other fuel appliances 1 DESCRIPTION OF WORK Water heater 1 23.32 23 Gas fireplace 1 33.39 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 ® PROPERTY OWNER I Chimney /liner /flue /vent 23.32 ❑ TENANT Other: 23.32 Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation Address: 16869 SW 65 Avenue #505 Range hood /other kitchen equipment 33.39 ''3 City/State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust F 33.39 "5 Single - duct exhaust (bathrooms, y � Phone: (503)387 -7577 Fax: (503)387 -7616 toilet compartments, utility rooms) 5 23.32 I / i ,(OV ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: same as above Fuel piping Contact name: Deirdre Britt $14.15 for first four; 54.03 for each additional Address: Furnace, etc. 1 Kr 1 Gas heat pump City /Slate /ZIP: Wall /suspended/unit heater Phone: ( ) ( ) Water heater ( Fax: Fireplace E -mail: dbritt @stonebridgehomesnw.com 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 /, t / Phone: (503) 667 -5595 Fax: (503) 491 -8252 Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: 110091 State surcharge (12% of permit fee) V(.-- ( Z TOTAL PERMIT FEE 7, ( Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: David Heldstab Date: C6-11.0.11 * Fee methodology set by Tri- County Building Industry Service Board I:\t 3uilding \Peraitsit,n.:C- PermitApp.doc 10 /UI /09 440 - 4617 1,02/COM /\1'1:13) - a r. ' Plumbing Permit Application Building Fixtures FOR orrlCF. USE ONLY City of Tigard �n� Received Permit No.: 0 13125 SW Hall Blvd., Tigard, 4 ,� �{ Date/By: MS�^� J! _000,17 "1114 C Plan Review ; Ph one: 503.639.4171 Fax: 5 r::. t� V" Date/By: Other Permit No.: Inspection Line: 503.639.4175 � w\\ 1 Date Ready/By: luris: 0 Sec Page 2 for TIGARD Intemet: www.tigard- or.gov ,�\'` 09C3 Notified/Method: Supplemental Information TYPE OF WORK \ „i Or 1 ,� FEE* SCHEDULE ® New construction • \ 0 \ V For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition /alteration /replacement (•'ether: New I - 2 - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ® I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 ❑ Accessory building ❑ Multi - family SFR (3) bath 500.32 16X, Each additional bath /kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: S SW SJMME Vtav •DR• Catch basin or area drain 18.76 Job site address: City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: _) Page 2 Suite/bldg. /apt. no.: I Project name: Arlington Heights Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: _) Page 2 Water service (no. linear ft.: _) Page 2 Subdivision: Arlington Heights I Lot no.: S1 Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 New, Single Family Residential Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Stone Bridge Homes Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 16869 SW 65 Avenue #505 Garbage disposal 25.02 City/State /ZIP: Lake Oswego, OR 97035 Flose bib 25.02 Phone: (503)387 - 7577 Fax: (503)387 - 7615 Ice maker 1 2.5 1 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: SEE ABOVE Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Deirdre Britt Roof drain (commercial) 12.51 Address: Sink/basin /lavatory 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E - mail: dbritt @stonebridgehomesnw.com Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Legacy Plumbing Water P b/ 1 m' DWV 56.29 Address: 8985 Hazelvern Way Other: 2 5.02 City/State /ZIP: Portland, OR 97223 Subtotal 45 52.-- Phone: (503) 816 - 8887 Fax: (503) 297 - 4587 Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lie.: 159281 Plumbing Lic. no.: 26 - 517PB �.,� State surcharge (12% of permit fee) 00 „ ..il / Authorized signature: ' , ".--.---- TOTAL PERMIT FEE t Print name: Matt Nelson Date: O5 i kP ,1 I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1 I:\ nuilding \I'ermits\t't.MU.1'enni 10/01/05 440 46161(10 /02 (COx1 /WEIi) Michael K. Brown S.E 5346 E. Branchwood Dr., Boise; ID 83716 208- 850 -7542 Mikebrown.se @gmail.com LATERAL STRUCTURAL DESIGN CALCULATIONS FOR LOT 57, ARLINGTON HEIGHTS TIGARD, OR ENGR. JOB # DM11 -056 .0 i o f 1 ( It • EXPiRAT1O)I rATL: 4 L 2 Prepared for: StoneBridge Homes, NW, LLC Plan #: 240 OTE: 1437 Date: 05 -09 -2011 The following calculations are for basement retaining walls, Garage Floor Framing, and lateral wind and seismic engineering only. Gravity loading and the design of foundations other than the basement retaining walls are outside the scope of this design. The design is based on information provided by the client who is solely responsible for its accuracy. The engineering represents the finished product. Discrepancies from information provided by the client invalidate this design. Michael K. Brown, S.E. shall have no liability (expressed, or implied), with respect to the means and methods of construction workmanship or materials. Michael K. Brown, S.E. shall have no obligation of liability, whether arising in contract (including warranty), Tort (including active, passive, or imputed negligence) or otherwise, for loss or use, revenue or profit, or for any other incidental or consequential damage 6 \A) p dt-L-(.. -L 11,11 " Building Division Development Code Provision Revlevi T[GARD Residential Projects Building Permit No: f l37 e :) I / — 00 () c 1 CWS Service Provider Letter Received: Yes ❑ No ❑ N/A ❑ Routed Plans: Original Plan Submittal Date: / // 877 1st Revision Submittal Date: ❑ Site Plan Only 2 °d Revision Submittal Date: ❑ Site Plan Only To the Applicant: Each review type must be approved. If the plan is not approved, please revise and resubmit three (3) copies to the Building Division. Only checked (1) items are approved. Items not approved and those listed in the notes must be revised prior to re- submittal. For questions please contact the appropriate staff person(s) listed above each section. Staff: please check items along left onl if approved. /' Review (contact �J T 14. 4.0 .r'ww• -n at 503 -718- Z Y Z or F. i '� $ � Planning C. ti and -or. ov g ( � @ g g ) Land Use Case No.. 2004 - 00‘301 Name ice- 1( d-o•1 i'j"" J s Iv o.3 D- Zonin g- 7 J C' Setbacks: Front !S Rear 1 Side S Street Side 1 O Garage Ye— / lie Maximum Building Height 3 5 Actual Building Height 3 ! e— U"Visual Clearance CVEasements • I "Sensitive Lands Type: S .S/c # tl A d � r �Aa � 5 5 4 �1 Notes: VV fro,0/c , Original Plan: Approved E( Not Approved ❑ Date: 7 AS hi Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Engineering Review (contact Mike White at 503 - 718 -2464 or MikeW @tigard- or.gov) 4i Actual Slope: sF.� �( / Notes: . ! r Original Plan: Approved Not Approved ❑ Da te: 7 l' ' ' "l � ft Revision 1: Approved ❑ Not Approved ❑ Date: {' Revision 2: Approved ❑ Not Approved ❑ Date: (Review Continues on Page 2) Page 1 of 2 City Arborist Review (contact Todd Prager at 503 - 718 -2700 or todd @ tigard - or.gov) JO S treet Trees ❑ Protected Trees ND►Ire S f(OwA1 Notes: Original Plan: Approved • Not Approved ❑ Date: 7• 18- '1 i Revision 1: Approved ❑ Not Approved ❑ Date: Revision 2: Approved ❑ Not Approved ❑ Date: Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) ❑ Conditions of Approval Prior to Issuance of Building Permit Notes : Original Plan: Date Sent to Applicant: Revision 1: Date Sent to Applicant Revision 2: Date Sent to Applica Okay to Issue Permit: Yes `No ❑ Date Routed to Building: 9- , _ / / I Page 2 of 2 REC .. IVE D STONE BRIDGE JUN 120„ OBE: 1428 HOMES rTW T.T"c LOT: 57 10009 O >9 w s a 00 O AVE.. # Y 7 x 0 S CITY OF TIGARD DATE: 5/4/11 (508)387 -7577 BUILDING DIVISION PROPERTY: HTS HEIG CITY: TIGARD EL •4106 SCALE: 1 " =20' 40 PLAN No.: 198A OPT. 2 ELEVATION a . I, 0 ,.\ --'-\. CY 490 ♦� ` � \p0 1.3 1 11%. ‘`. ,4'' ti 1 /' Nr % .`• ..;::.1:.; - 11 1 4 : X90 i �, '�" V ` .. : ' CON C t'. ♦ ,'ti csba ' .�. •..DRIVEWA �� ., 1 , � • b/'' ♦ AO F . 1 A.,,,, Al• 1 / / 4 1 � -- U i iit .. ,, 0.0 Pi in ,o'' - - 4 - 7 e. „,s i L .., -.. €00 tur ':EL 426' eev i" SW MOUNT VISTA LOT COVERAGE STREET TREES LOT AREA: 4,111 SQ. FT. BUILDING AREA: 1,810 SQ. FT. PERCENTAGE: 39 0 — PYRIJS CALLERYANA ORNAMENTAL PEAR NOTES: . ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS. ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES. THEY R MAY VARY AND BE SUB ECTT TO CA ARE ESTIMATES. CHANGE. LOT 1 51 DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, . 4,Tii 64 ft. - STREETLIGI -ITS, AND OTHER SITE CONDITIONS.