VAR2005-00101
CITY OF TIGARD
OREGON
February 6, 2006
Riverside Homes, Inc.
1925 NW Amberglen Pkwy, Ste. 200
Beaverton, OR 97006
Re: Permit No. VAR2005-00101
Dear Mr./Ms.:
The City of Tigard has canceled the above referenced permit(s) and enclose a refund for
the following:
Site Address: 15576 SW Raphael Ln.
Project Name: Bella Vista
Job No.: N/A
Refund: Check #43460 in the amount of $205.60.
Credit card "return" receipt in the amount of $N/A.
0
Notes: Per applicant's request to cancel variance as adjustment was not required after
repositioning dwelling on site plan; refund 80% of application fee.
If you have any questions please contact me at (503) 718-2430.
Sincerely,
4099,~-
Dianna Howse
Permit Specialist
Enc.
is\Building\Refunds\LtrRefund-CancelPermit.doc 05/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772
City of Tigard
Check Refund Request
Lk
City o Tigard
This form is used for refund requests of permit application fees paid by check transactions only.
Receipts, documentation and applicant's request for refund, if applicable, must be attached to
this form. Approved request due to Tidemark System Administrator by Friday at 5:00 PM
for processing each Monday. Accounts Payable will route refund checks to Tidemark System
Administrator for distribution and refund of case fees.
VENDOR NO.: DATE: January 26, 2006
PAYABLE TO: Riverside Homes, Inc. REQUESTED BY: Dianna Howse
1925 NW Amberglen Pkwy CAC
Ste. #200
Beaverton, OR 97006
TRANSACTION Receipt 2005-6435 Case VAR2005-00101
INFORMATION: Receipt Date: 12/20/05 Site Address: 15576 SW Raphael Ln.
Check 14939 Project Name: Bella Vista
EXPLANATION: Per applicant's request; adjustment not required after repositioning dwelling on site
plan. Refund 80% of application fees.
EXPENDITURES:
Fee Description From Receipt Revenue Account No. $ Amount
Example: BUILD Permit Fee Exam le: 245-0000-432000
LANDUS Development Adjustment 100-0000-438000 $179.20
LRPF LR Planning Surcharge 100-0000-438050 26.40
TOTAL REFUND: $205.60
APPROVALS:
If under $500 Professional Staff
If under $5,000 Division Manager
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: B :
i:\Building\Refunds\RefundCheckRequest.doc 10/27/05
Planning Division
Request for Permit Action or Refund
Ci o Tigard
TO: CITY OF TIGARD
Permit System Administrator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960
FROM: ❑ Owner V1 Applicant ❑ Contractor ❑ City Staff
(check one)
Name: 't_ _
(Business or Individual) V P S~ t I f~ ~1P J l-r~ C
Mailing Address: -U a-oc'
i 1.~5 ~1 in. ~R.rt b~ . (er, PKr„s
City/State/Zip: ~e c~v Iv L'R 970vW
Phone No.: (5vvl) (,-,15 c~ -1i S (o
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED
CANCEL PERMIT APPLICATION.
REFUND PERMIT FEES (attach receipt, if available).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit VAR:~()p<_ 00101
Site Address or Parcel 155'-7 (v SL-) -4"6a Lv,
Project Name: Subdivision Name: Be I I P- \J i y Lot
EXPLANATION: L
?p 1; c ct -E Chu 5 C
oJ:aS)men~ L,,Jois y,ol VIee effct r-1 .
Signature: &U.4 Q Date: --pU
Print Name: C~~.✓ y C~~ i n f J
Refund Policy
1. The Director may authorize the refund of.
a) any fee which was erroneously paid or collected.
b) not more than 80 percent of the application fee when an application is withdrawn or canceled before any review effort
has been expended.
2. Refunds will be returned to the original Payer in the same method in which payment was received.
FOR OFFICE USE ONLY
Rte to Sys Admin: Date B Rte to Bldg Admin: Date B
Refund Processed: Date B Invoice Processed: Date B
Permit Canceled: Date B Parcel Tag Added: Date B
Receipt # Date Method Amount $
I:\Building\Forms\RegPermitAction-Ping.doc Rev 10/17/05
ADJUSTMENT
TYPE I APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX.• (503) 684-7297
GENERAL INFORMATION
Property Address/Location(s): 5 S W A- r? (L41,
G 0- 2 Z FOR STAFF USE ONLY
-Ti Tax Ma & Tax Lot #(s): a.61 v 9 Df> ° y9goo
Site Size: Case No.: V Ala a o05 - 00 10
Applicant*: C . Other Case No.(s):
Address: 2- uV ~W -9 0 Receipt No.: 2005 - (04 35
City/State: VA 0' Zip: 00 (p
Primary Contact: b 01 N Application Accepted By: C
Phone: S -(p 1( -5- -(fif S(P Fax: 5-ZF;5_ La. L.- ZgLi
Z
Date: la -a o 05
Property Owr~e~IDeed Holder(s)*: (Attach list if more than one)
L~ Date Determined To Be Complete:
Address: Phone:
City/State: Zip: ~o?-aa- n5
Comp Plan/Zone Designation:
* When the owner and the applicant are different people, the applicant M&a Me& pert Res A- 7
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 in the space provided on the back of this Rev. 8/26/04 is\curpln\masters\revised\adjustment-1.doc
form or submit a written authorization with this application.
PROPOSAL SUMMARY
The owners of record of the subject property request permission for an
Administrative Adjustment to the following provision(s) of the REQUIRED SUBMITTAL ELEMENTS
Community Development Code (please circle one only):
>Development Adjustment- Front Yard, Interior Setbacks and Lot Coverage
>Soecial Adjustments: ✓ Application Elements Submitted:
♦ Adjustments to a Subdivision Application Form
♦ Reduction of Minimum Residential Density
♦ Landscaping Adjustments - Existing/New Street Trees d Owner's Signature/Written Authorization
♦ Parking Adjustments - Reduction in Stacking Lane Length
♦ Parking Adjustments - Reduction in Minimum Parking for Transit Improvements/Existing Dev.~ Title Transfer Instrument or Deed
Setback Adjustments Setbacks to Reduce Tree Removal Site/Plot Plan (2 copies)
♦ Wireless Commurnca ion Facility Adjustments - Distance From Another Tower
♦ Washington Square Reg. Center Density Adjustments [:K Site/Plot Plan (reduced 81/2" x 11
Please st to the reason for the Adju t en r quest: r Applicant's Statement
(Addressing Criteria Under Section 18.370.020)
mA j 9)I Sfd:(~U(~VG hut/ K k I M I -AYL
r g 6V 11 V' m [ Filing Fee
Of V[ b~1 mm
S VV, 01 16-W 4 , S Jurisdiction: ❑ City ❑ Urb
5L C UC4 cc 6(1
(Gc
anC ( G GVo 1061d/(
JL4 au 1-04.
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.
(Detailed Submittal Requirement Information sheets can be obtained, upon request, for all types of Land Use Applications.)
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.
DATED this day of , 20
pplica t orized ent Signatu a Owner's Signature
Owner's Signature Owner's Signature
CITY OF TIGARD 12/20/2005
13125 SW Hall Blvd. 3:59:05PM
Tigard, Oregon 97223
(503) 639-4171
Receipt 27200500000000006435
Date: 12/20/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
VAR2005-00101 [LANDUS] Development Adjust 100-0000-438000 224.00
VAR2005-00101 [LRPF] LR Planning Surcharge 100-0000438050 33.00
Line Item Total: $257.00
Payments: •
Method Payer User ID AcctJCheck No. Approval No. How Received Amount Paid
Check RIVERSIDE HOMES, INC CAC 14939 In Person 257.00
Payment Total: $257.00
"~iQe. •
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER 009
rlt• ,m'„ ;•tu. °i%/~2., ,w rii/ji /'iq,
-,RIVERSIDE `HD,.MES:.INC r _
„ ~..,/,i, aq ' ~i ? 5./a ~7 i,... !<f :j,OLDR '1,1~, t 1 ,,i" •lt:
.
VIM', ~117/
,.1925 NW A1l'MBERGLEMPKW1''S
tan :d . ~dC i wr. ; / ,d., / . / 1 ' f - ; ' t,.l • `1 #V'\
a' i ii - '✓':i, •>ir
B A,YERTON, OR 97006 t 2a
N 7~, . !!/;S't3~.; ~ ri•:,r c. r . ~f' ~s~~f; J;, r. , fi %r~ is' ln~ `n\., 1 d '"g,1.•.
(503)'645=0986
AMOUNT
l ~j Ef'K NO.
K,`F:.::i~ke":'1~1A` .4.•,,,;'r"/ r. r/ ''YY~~•++ t r .i~ r':.»,:.
4 F` December 10, 2005 14939 257.00
- r .',a;H •`.'y. r//f- iy//';~," 'i / r~ ~..t~k ffr - ; ~~j/',
Pay Tw6)jun~irel ferti dd~ais anr>€ cegtst fvV,
5 - 42
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PAY :i:-CITY'OF TIGARD ' i ,
Td THE., PO BOX 230000
ORDER'OF ~ '.~:,~i/ //r~jr 4 ' r= „
TIGARD, OR 97281-1999 ~:t
cReceil _'e4
n
December 10, 2005
The City of Tigard
13125 SW Hall Blvd
Tigard OR 97223
To Whom It May Concern:
Riverside Homes, Inc. requests permission to adjust the side yard set backs of Bella Vista
Lot 24 in order to fit like product selected for this neighborhood. As it stands now the
side yard setback for this lot are as stated in the criteria under section 18.730.020 B that a
10 foot side yard be preserved. Riverside Homes, Inc. proposes to adjust Bella Vista Lot
24 side yard setbacks from 10 feet to 8 feet on both East and West sides of the lot. This
adjustment meets criteria stated under section 18.370.020 of the City of Tigard's
Development Code.
Your possible consideration in this matter is greatly appreciated
Sincerely
a o(P(-77~c.~, I~G
Allison May
Plans/Permit Coordinator
Riverside Homes, Inc.
1925 NW Amberglen Pkwy # 200
Beaverton, OR 97006
(503)645.0986 P
(503)690.2942 F
Riverside
www.RiversideHome.com Homes
FSETBACKS 007' E 0 ' 20~
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REAR 20'
SIDE 5'
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ELLA VISTA LOT 24 SCALE: 1" - 20' -
ENGINEERING & LAND SURVEYING DESIGNED: PREPARED FOR:
RJ
8835 SW Canyon Ln. DRAWN: RIVERSIDE HOMES
Suite 402 SW 1925 NW AMBER GLEN PKWY, SUITE 200
Portland, OR 97225
BEAVERTON, OR 97006
" CHECKED:
•~(503) 645-0986
H ,Inc o RJ (503) 690-2942
DATE:
4 3 5503) 291-9398 6/20/03
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