TRE2017-00039 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
11,1111 Request for Permit Action
T I i A R I-) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD kt. rt 1 ,,,,
Building Division 4 '
13125 SW Hall Blvd.,Tigard,OR 97223dA$'I---
/ � ��
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: [l Owner ❑ Applicant ❑ Contractor ® City Staff
Check(1)one
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State/Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
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 #: TRE2017-00039
Site Address or Parcel#: 7340 SW Hermoso Way
Project Name: Lyman
Subdivision Name: N/A Lot #: N/A
EXPLANATION: This case was created in error; no permit is required to remove this tree.
Date: 1/30/18
-1___S:-fije_:7:1_,
Signature: —�—
Print Name: I,ina Smith
Refund Policy
I. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date By Route to Records: Date /2 4r- By ../
Refund Processed: Date •J/,- Bydat Invoice Processed: Date By
Permit Canceled: DateL.2//J B Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_ 923144(doc
City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
111
I WARD
05/17/2017
August Peverly
15532 SW Pacific Hwy
PMB 304
Tigard, OR 97224
Re: Tree Removal Permit Record Number: TRE2017-00039
Dear August Peverly:
On 05/17/2017 you submitted an application for tree removal at 7340 SW HERMOSO
WAY. Your application specified that:
1 Apple
is/are proposed for removal. Based on the information supplied on your application,
this is a simple tree removal permit request.
City staff has reviewed your application and based on the relevant approval criteria in
the Urban Forestry Manual, your application has been:
Street Tree Replacement Required
Approved with conditions:
The applicant shall plant a replacement tree for each tree removed in accordance
with the Street Tree Planting Standards in Section 2, part 1 of the Urban Forestry
Manual. Existing trees may be considered as replacement trees if they meet all
applicable species, size, condition and location requirements in Section 2, part 1
and were not already required to be planted or preserved by the Tigard Municipal
Code.
This decision is final and valid for a period of up to one year after issuance unless
otherwise specified. Nothing prevents you from submitting another tree permit
application if the conditions and circumstances surrounding this removal have
changed.
If you have any questions, please contact us at arborist@tigard-or.gov or
503-718-2421. Please be sure to reference record number - TRE2017-00039.
Best regards,
Community Planning Division
City of Tigard
RECEIVED
INCity of Tigard MAY 17 2017
= COA1mL'NITY DEV1 L(:)PIt1L?NT 1) PART11fENT
1, CITY OF TIGARD
TIGARDTree Removal Permit Applcatio1 ING/ENGINEERING
PROPERTY INFORMATION
REMOVAL CRITERIA
Address/location: 7340 SW Hermoso Way, Tigard. OR, United States If you are applying for a simple review,
your application must address one or
APPLICANT INFORMATION more of the relevant removal criteria for
Name: Kyle Lyman the type of tree you propose to remove.
7340 SW Hermoso Way The removal criteria can be found in the
Address: Urban Forestry Manual as follows:
City/state: Tigard, OR 7ip: 97223 •Street Tree:Section 3
Phone: 503-753-8531 Email: klyman@rosendin.com • Median Tree:Section 5
•Sensitive Lands Tree:Section 6
Owner: li'Same as applicant •Development-required Tree:Section 7
•Urban Forestry Fund Tree:Section 8
CONTRACTOR/ARBORIST INFORMATION •Heritage Tree:Section 9
Name: Evergreen Tree Services •Documentation(e.g.arborist report,
photographs,site plan,tree risk
ISA/CCB#: / 199579 Expiration date: 10/10/2019 assessment form,etc.)of the
Address: 15532 SW Pacific Hwy, PMB#304 conditions described must be included.
Tree replacement is required,unless
City/state: Tigard, OR lip: 97224 otherwise stated in the approval.
Phone: 503-625-4595 Email: office@evergreentsl.com
Contact person: August Peverly Hitt.tt. r\i i t !Ni. o N.1.n
REQUIRED SUBMITTAL ELEMENTS
TREE REMOVAL INFORMATION—to be completed by applicant X Owner's Signatufe/Wm Authorization
Tree species: App1e Num.of trees: 1
K5ite/P1otPlari(show location&species
Tree location: backyard left side of cad2 copies)
)'l Documentation(see removal criteria)
Reason(s) for Removal vOVIling Fee(complex anly)
jibji 't'f*tt��N,�q �. :::'!-,7v.4-:i- -i�v. ��ty ni�,,7^�
: WPcm
yf plex
LI Tree is a hazard ❑ Removal required for approved
i2r Tree is in an advanced state land useor building permit Fee(complex _1 ��)L:C SSC/3?
of decline ❑ Tree is dead Case No.:
CvVtel
❑ Location conflicts with ❑ Roots are causing damage Rimed Case No.(s):
TSP project ❑ Thinning necessary to rotect �q/
€� P Tax Lot Ill: .lo1 30I�Cl f
❑ Species is on nuisance tree list other trees
tX Tree is infested with pests 111Location does not meet Application accepted:
or disease planting standards By: /...- Date:
❑ 'Free has sustained physical ❑ Recommended by fire marshal Application determined complete
damage By: .1._.\ Date: .
..\0.4,,..,,u,...„„...,,.....Appiaiin, Rev.12/11/23M1
Continued on reverse-for complex review see page 2
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
COMPLEX REVIEW PROCESS(check applicable with brief proposal summary)
❑ Blocking views or solar access ❑ Undesirable species ❑ Other(expLam below)
APPLICANTS
To consider an application complete,you will need to submit ALL of the REQUIRED SU_BMITtAT ELEMENTS
as described on the front of this application in the"Removal Criteria"box.When the owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner
or an agent of the owner.The owner(s)must sign this application or submit a written authorization with this application.
THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate any deed restrictions that may be attached to or imposed upon the subject property
• If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the
conditions and limitations of the approval.
• All of the above statements and the statements in the plot plan,attachments,and exhibits transmitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such
statements are false-
• The applicant has read the entire contents of the application,including the policies and criteria,and understancs the
requirements for approving or denying the application.
SIGNATURES of each owner of the subject property required.
pplicant's signature Print name _ / Date
O s signature Print name Date
•
•
---
Owner's signature • Print name Date
Authorized agent's signature Print name Date
TREE REMOVAL PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd • Tigard,Oregon 97223 • wwwtigard-ot.gov • 503-718-2421 • Page 2 of 2
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