MMD2018-00007 City of Tigard . COMMUNITY DEVELOPMENT DEPARTMENT
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Re uest for Permit Action
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division V 0 t ,.
13125 SW Hall Blvd.,Tigard, OR 97223 , /r� i'
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermit gard-or.gov
FROM: Owner n Applicant Contractor ‘,81 City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) TT'S P T21%.7 * kucvi*
Mailing
Address:
City/State/Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
.1 CANCEL/VOID PERMIT APPLICATION.
J REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).--AN > (c
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: V 0 D 2-01`i' - 00001
Site Address or Parcel #: v l oOD SVS' 1Iu (' (4y
Subdivision Name: Lot #:
EXPLANATION: iNI DAti CA SG —'1/ •e u617+eCl et cup �-'D�''2o 1 "' 1
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Signature: PIN'tkill Date: 1 2,(e ti
Print Name: O u• ALV
Refund Policy
1. 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• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort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 ���t, fd- By 27 f
Refund Processed: Date,:,Z/-2l14' By Invoice Processed: Date By
Permit Canceled: Date •2/.2fo/I� By arcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_692314.doc
Ippl RECErrDCity o f TigardCOMMUNITY DEVELOPMENT DEPARTMENTV 0 I E)
/-Zv /off . FEB 22 2018
RP . CITY OF -1 , f
Minor Modification Type I App ' ING
PROPOSAL SUMMARY (Brief description)
REQUIRED SUBMITTAL
Tigard-Tualatin School District proposes new construction of six(6)tennis ELEMENTS
courts grouped linearly,between SW 85th Avenue and the Tigard High School
gOwner's Signature/Written
Swim Center. Currently,there are six(6)grass soccer fields in the location Authorization
where the tennis courts are proposed,and the tennis courts would remove the X Title Transfer Instrument or Deed
two(2)south west fields. Site Plan(2 large plans drawn to scale
and one reduced to 8.5"x11'/2")
Statement/Narrative
Property address/location(s): 9000 SW Durham Road,Tigard, OR 97224
,?(Applicant's
(2 copies)Address criteria in:
MC 18.-5U.(i-l(i.1i
Tax map and tax lot #(s): Tax Map 2S114AA,Tax Lot 100 ❑ Filing Fee
FOR STAFF USE ONLY
Site size: 43.5 acres(total site), 1.80 acres impacted Case No.: /VDO/ 7 "e)Xt07-.
___E
Applicant*: Tigard-Tualatin School District , , . i / i i`,,i 1 Related CaseNo.(s):
Address: 6960 SW Sandburg St. Application Fee: cO3
City/state: Tigard,Oregon Zip: 97223 Application accepted:
Phone: 503-431-4000 Email: dpearsoon@DayCPM.com By: kS Date: //e)
Application determined complete:
PROPERTY OWNER/DEED HOLDER(S)* ❑Same as Applicant
By: Date:
Name: Tigard-Tualatin School District I\CommunityDevelopment\LandUseApplications\02_Formsand
Templaies\Land Use Applications Rev 12/14/2017
Address: 6960 SW Sandburg Street
City/state: Tigard,OR Zip: 97223 * When the owner and the applicant are
different people,the applicant must be the
Contact name: David Moore purchaser of record or a lessee inpossession
Phone number: 503-431-4000 with written authorization from the owner
or an agent of the owner.The owner(s)
must sign this application in the space
provided on the back of this form or
submit a written authorization with this
application.
APPLICANT'S STATEMENT
The applicant's statement must include a summary of the proposed changes. Criteria in either 18.780.040(B) or 18.740.020(B)
(2) must be addressed with a detailed response to each criterion. Failure to provide the information needed to process the
application would be reason to consider an application incomplete and delay review of the proposal.
In addition, the Director must find that the proposed change is in compliance with all applicable requirements of Title 18 of
the Tigard Development Code.To complete this review,the Applicant's proposal must include a discussion indicating how the
site expansion/change will continue to comply with the maximum setback,building height,parking,and landscaping standards.
Other requirements of this title such as clear vision,solid waste storage,non-conforming situations,signs,and tree removal
may also be applicable depending on the type and location of the proposed modifications.
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
APPLICANTS
To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS
as described on the front of this application in the"Required Submittal Elements"box.
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 understands the
requirements for approving or denying the application.
SIGNATURES of each owner of the subject property required.
A-
�. A Debbie Pearson
•0 . :nt's sig . re Print name Date
A David Moore4-1I S
Owner's signature Print name Date
Owner's signature Print name Date
ADDITIONAL OWNER/DEED HOLDER INFORMATION
Name: Name:
Address: Address:
City/state: Zip: City/state: Zip:
Signature: Signature:
MINOR MODIFICATION APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 2