Permit City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
_. • "
•
: 1 Request Permit Action R ECEIVED
- r lc; A R I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tig4i &o202012
TO: CITY OF TIGARD BUI LDINGDIr itij
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223 (j n
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov \ I `1' J
FROM: 1 Owner ❑ Applicant ❑ Contractor ❑ City Staff /.Z /, y
(c heck one)
REFUND OR Name:
INVOICE TO: (Business or Individual) (... 8 r L (4. A/4 Li_ 6—
• M ai ling Address: am - -6' ".�3 f 4�36 6 -1 ",..I( S+
City/State /Zip: t 4, Et- °"'..4-9' / /
Phone No.: C4 3) 3 g7- 75-7 7 d f eg
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
iga CANCEL /VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
El INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: " i t,_ i t,_ 5r 2. o i 2 00 q( Q 6.11 12-aq. v q
Site Address or Parcel #: /..). 7fi8' f -,* •_ et.,,__ L..-.
Project Name:
Subdivision Name: / 4f 1 . vt, de.. , f. 4..-15 Lot #: if
EXPLANATION: 2 .,.., --4:c - 3 ,•t,c,., /l-... 47,. ce,+., 1 ° ' 4--
aEL Hrada -ooaAo
Signature: C/ . e_____ Date: 9/.2 •/�
Print Name: i ,,! 7o .,,..- _ f
Refund Policy
S03 – 7 53 81 C) f � 3// z 9 Ce 'A d-T� 9-r y 7o '9
.,1 € hC t-�. W rfriT
1. The Director or Building Official may authorize the refund of: / !r" � A,
a) any fee which was erroneously paid or collected. � �Sfi46�7 /T/ -ter-- ?a /O /_
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. gps ( 20/2 , ._
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. Ooo6 ? .
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 a Qn' : Rte to Bid: Admin: Date "AUBE B 4e,
Refund Processed: Date Aff,111.1 B OrrAZ Invoice Processed: Date ,j7._ irAll B _•,_C o,, ,
Permit Canceled: Date i 2 2 /- -By 4 t ' Parcel Tag Added: Date By
Receipt # Date Method Amount $
1:\ Building \ Forms \RegPemvtAction.doc Rev 05/25/2012
o CITY OF TIGARD
111111 •
Building Division
TIGARD 13125 SW Hall Blvd.,Tigard, OR 97223 503.718.2439
INVOICE
TO: Stone Bridge Homes NW LLC Customer ID: 173318
4230 Galewood St., Ste. 100 Invoice No.: INV2012 -00008
Lake Oswego, OR 97035 Invoice Date: 08/22/2012
Date Due: Upon Receipt
Case No. . . Site Address . Subdivision - Lot # or Project Name Amount Due '
MST2012 -00081 12758 SW Willow Point Ln. Arlington Heights No. 3, Lot 115 $1,181.50
Invoice Total: $1,181.50
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2012 -00081 Customer ID: 173318
Site Address: 12758 SW Willow Point Ln. Invoice No.: INV2012 -00008
Project: Arlington Heights No. 3, Lot 115 Invoice Date: 08/22/2012
Date Due: Upont Receipt
Invoice Total: $1,181.50
Amount Paid: $
Office Note: Forward copy of receipt to Dianna Howse when paid. .
Please mail payment to:
City of Tigard, Building Division
Attn: Dianna Howse
13125 SW Hall Blvd.
Tigard, OR 97223
I: \Building \Accounting \Invoice.doc 01/14/2011
CITY OF TIGARD FEE AND PAYMENT HISTORY
I n _ 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIIGARD
MST2012 -00081 - 12758 SW WILLOW POINT LN, TIGARD, OR 97224
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due
Plan Review 230 -0000 -43106 $751.34 $751.34 $750.00 4/18/12 Credit Card 186367 $1.34
Plan Review 230 -0000 -43106 $930.16 $930.16 $930.16
DC Provision Review, SF - Ping 100 -0000 -43112 $65.00 $65.00 $65.00
DC Provision Review, SF - LRP 100 -0000 -43117 $10.00 $10.00 $10.00
Info Process /Archiving - Lg $2.00 (over 230 -0000 -43135 $40.00 $40.00 $40.00
11x17)
Info Process /Archiving - Sm $0.50 (up to 230 -0000 -43135 $45.00 $45.00 $45.00
11x17)
Additional Plan Review 230 -0000 -43106 $90.00 $90.00 $90.00
Totals for Fees • $1,931.50 $1,931.50 $750.00 $1,181.50
Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount
186367 Credit Card Andrew Thomas - Stone 04/18/2012 $750.00
Bridge Homes NW LLC
Total Payments: $750.00
Balance Due: $1,181.50
B'uil'ding Permit Application ,, % \,1 ' V 0 1 0 e/22-Az- 46
Residential a � \� ' v
FOR OFFICE USE ONLY
Date /By
APR g 2012
City of Tigard Received b � /
Date /B : 0 Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Reie
I
h
I Phone: 503.639.4171 Fax: 503.59> 96� OF T Ac ,D l( Other Permit �Q/a. y
Inspection Line: 503.639.4175 BIJ t ILD, , 1�� Dl'U1SI0�� Date Rea y: Juris: ® See Page 2 for
l'IGi1Il
Internet: www.tigard- or.gov Noti d/Method: �� :,' Supplemental Information
m _ ' , .' . .
TYPE OF WORK REQU61 t 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 this application
® I- and 2- family dwelling El Commercial /industrial Valuation: g • > �j 1
El Accessory building ❑ Multi- family Number of bedrooms: `r � tr. �� I
❑ Master builder El Other: Number of bathrooms: 3
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: in Val VA/ W I (,t, W 1 701 147 LA44 E New dwelling area: 4 357 square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 710 square feet (`7
Suite/bldg. /apt. no.: Project name: Arlington Heights _ Covered porch area: 120 square feet( ,
Cross street/directions to job site: Deck arca: 2ft) 0 square feet l l
Other structure area: �`7 square feet 29'
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: Arlington Heights Lot no.: I 16 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 I ❑ TENANT Number of stories:
Name: Stone Bridge Homes Type of construction:
Address: 4230 Galewood St, Suite 100 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 /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I 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: ( ) I Fax: ( ) FLS plan review fee (if applicable):
Total fees due upon application:
CCB lie.: 173318 75 ..6•0 Amount received:
Authorized signature: - 1)1,....Q .
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:' R e t 1' I Date: 04.17. 12. I • Fee methodology set by Tri -County Building Industry
{ Service Board.
I:\Building\Permits \BUP -RES PermitApp.doc 10/01/09 440 - 4613T( I 1/02 /COM/WEB)
P l um b i ng Permit Applica io � `1? ��
� V 0 1 D
Building Fixtures ppg g g 2012
City of Tigard Received y �� G
Date
Illi 4'f i v e a Permit No.: l T /2� �/
13125 SW Ha ll Blvd., Tigard, OR OF (� n ,!�
0 ro; 01;21.:j1\; ' `!ti� Plan RevieReview 1 Phone: 503.639.4171 Far: 50? § t v Date /By: Other Permit No.: p'S f J 9
Inspection Line: 503.639.4175 J •
T I G A R I) Date Ready /By: kris: El See Page 2 for
Internet: www.tigard- or.gov Notitied/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32 ),�
❑ Accessory building ❑ Multi- family
Each additional bath /kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
' 2 I % SW W I , , W P k `' Catch basin or area drain 18.76
Job site address: A vKJ ^I ,
Drywell, leach line, or trench drain 18.76
City /State/ZIP: Tigard, OR 97223
Footing drain (no. linear fl.: _) 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 fl.: _) Page 2
Storm sewer (no. linear f.: _) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: Arlington Heights I Lot no.: (I S 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
co PROPERTY OWNER l ❑ 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 Hose bib 25.02
Phone: (503)387 -7577 Fax: (503)387 -7615 Ice maker 12.51
❑ 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 Qstonebridgehomesnw.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Jardine Plumbing Water P�P� b 1 1n' /DWV 56.29
Address: PO Box 186 Other: 25.02
City /State /ZIP: Estacada, OR 97023 Subtotal
Phone: ( 503)3514532 Fax: (503) 6302882 Minimum permit lee: $72.50
CCB Lie.: 108747 Plumbing Lic. no.: 93- 1185347 Plan review (25% of permit fee)
v � State surcharge (12% of permit fee)
Authorized signature: ij` TOTAL PERMIT FEE
Print name: Jay Jardine Date: 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.
I: Utuilding \PenniLs \I'I.AIU- I'ermitApp.doc 10'01/09 44U -06161(IU /02 /CONI /W1i1)
I• ll ll L- ; .1; , , .
Me Permit Applicatii 1 g 2012 FOR OFFICE USE ONLY
City of Tigard Rrcrived Date /By: T r i Permit No.: �rat,t"- -aao8/
q 13125 SW Hall Blvd., Tigard, OR �a A t Plan Review v ����+
C Phone: 503.639.4171 Fax: 503,4 i++ VV r- ` --I/, l� f Date /By: Other Permit: 4� -‘Q/[P
I' I L. A It D Ins Line: 503 11 Dl l /I;�!l i!' Dale Ready/By: furls: 10 See Page 2 for
Internet: www.tigard or.gov Notified /Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
0 New construction ❑ Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Ot her: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® I - an d 2 - family dwelling r RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
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
Job site address: 1 2:7 rJ G W w po N' ' LN • Air conditioning
T/ I (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. /apl. no.: Project name: Arlington Heights licit pump 61.06
Cross street/directions to job site: Duct work 23.32
Hvdronic 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
(1 C Flue/vent for any of above 23.32
Subdivision: Arlington Heights Lot no.: 7
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater ( 23.32
Single Famil • Residential Gas fireplace
or 33.39
New, Sin
g S 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 ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32 _
Name: Stone Bridge Homes NW, LLC Environmental exhaust and ventilation _
Address: 16869 SW 65 Avenue #505 Range hood /other kitchen
equipment 1 33.39
City /State /ZIP: Lake Oswego, OR 97035 Clothes dryer exhaust 1 33.39
Single -duct exhaust (bathrooms,
Phone: (503)387 - 7577 Fax: (503)387 - 7616 toilet compartments, utility rooms) 6 23.32
❑ APPLICANT ❑ CONTACT PERSON Altic/crawlspace fans 23.32
Other: _
Business name: same as above -
Fuel piping
Contact name: Deirdre Britt $14.15 for first four; $4.03 for each additional
Address: Furnace, etc. I
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
I
Phone: ( ) Fax:: ( ) Water heater
Fireplace j
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
Phone: (503) 667 - 5595 I Fax: (503) 491 - 8252 Minimum permit fee )
Plan review (25% of permit msit fee fee)
CCB lie.: 1 10091 State surcharge (12% of pennit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: David Heldstab I Date: • Fee methodology set by Tri- County Building Industry Service Board
I:l ltuilding \I'ertnit. \>II:C- PermiuApp.doc 10101/09 440- 1617TI I I /NA:OAM /w1:131
•
Electrical Permit Applic IF �� 3 ; , ', -!' FoR oar• Ice: USE ONLY
City of Tigard �pp 18 2012 Da ei /�'Zr/fi; Permit No./ r�/ /1 Q /
11111 13125 SW Hall Blvd.. Tigard, OR _2 Plan Review i
B Phone: 503.639.4171 Fax: 503 19¢(1� ∎ ate/13v:
Other Permit: 'a /�l
Inspection Line: 503.639.4175 t t � t �i• v' Date Ready/By: Juris: 0 See Page 2 for
r1cAr.0
Internet: p c;;O
Inteel: www.tigard-or.gov �t �(I� 'J.:V�v Di �� l j ,�N Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans .v /items checked below):
® New construction ❑ Addition /alteration/replacement
❑ 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E" "I -2 ' " I -3"
Job no.: I Ito Job site address: IrlYb SW (N1 U,OW ?01tiIT 1.141, 1 U0HP 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.
Su ite /bldg. /apt. no.: Project name: Arlington Heights ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Description I Qty. I Fm. I Total I
New residential single - or multi - family dwelling unit.
Includes attached garage.
Subdivision: Arlington Heights Lot no.: i I Jr 1.000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion ,f; 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 1 7.7.`x' 2
Limited energy, multi - family 67.84 I 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Stone Bridge Homes
401 amps to 600 amps 200.34 2
601 amps to 1,0(10 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.
each branch circuit 7.42 2
Business name: SEE ABOVE B. Fee for branch circuits
Contact name: u•irhour service or feeder fee, 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
l'er inspection 66.25
Phone: (971) 404 -1714 Fax: (503) 625 -3052 Investigation per hour (I hr min) 66.25
CCB Lie.: 42422 ( 1 ��` 1 Electrical Lie.: 26 -289C Suprv. Lie.: 35925 Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Chuck Friesen Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if n permit is not obtained within MU Print name: Date: days after it has been accepted as complete.
e Number of inspections allowed per pemmit.
I: \I Building \Pcmmimsl:l.C- PcrmitApp.doc 10/01/09 440 - 461ST( I I/05 /COMM /NIB
� & A # L //5
/a 8 gio Gv, / /vev e- d- 1.
1111 o ° Building Division
Development Code Provision Review V 0 / E
T I G A R D Residential Projects 2L Py :z ,
Building Permit No: 5 9c /a -c ' /
CWS Service Provider Letter Received: Yes ❑ No ❑ N /A;r1.
Routed Plans:
Original Plan Submittal Date: /7
1st Revision Submittal Date: 1 ❑ Site Plan Only
2 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 (✓) 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 alon left only if approved.
Planning Review (contact Irt5 I--a.) re-a-4,4.,) at 503 -718- 2 Y S Z Y or f(S ' e.) @tigard- or.gov)
Land Use Case No.5 U 200(e--AM0 Name A a J nwj-on �Itks A6. 3
ET Zoning //CC
L' Setbacks: •
Front I S Rear IS Side 5 Street Side is Gara f 2e7 ErMaximum Building Height 35 Actual Building Height 2-q Y Z--
❑ Visual Clearance
❑ Easements
CY Sensitive Lands Type: SAlle-S r 4.44-1 S 3 ' yn. amog, ?err
Notes:
Original Plan: Approved DV
Not Approved ❑ Date: e eli v
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)
g Actual Slope: - S {" %
Notes:
Original Plan: Approved ,17 Not Approved ❑ Date: 4 / M / 12-, Revision 1: Approved #0 Not Approved ❑ Date: 4 2 4 2
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)
H ,greet Trees
09 Protected Trees
Notes: .1vna ( j-
Original Plan: Approved ❑ L4' Not Approved Date: " Om�`
Revision 1: Approved [ Not Approved ❑ Date: NS —an /1
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 Applic nt
Revision 2: Date Sent to Ap cant
J /9
Okay to Issue Permit: Ye ; No ` r4 . + - ,
Date Routed to Building:
it
•
Page 2 of 2
•
v 0 ! 0 0 2 ,
k STONE BRIDGE OBE: 1486
HOMES NW LOT: 115
4230 GALEWOOD ST. SUITE too DATE: 4/7/12
RECEIVED PROPERTY:ARLINGTON HEIGHTS
LAKE OSWEGO, OR 97035
(503)387 ' . 0 1 012 COUNTY: WASHINGTON— COUNTY
SCALE: 1
CITY OF TIGARD PLAN No.: 238
i I.1ILDING DIVISION PRAIRIE ELEVATION
12158 SW WILLOW POINT LANE
314 312 310 3 (k1 3 LLII f . i .
68 ' ' 4 ' '
AMMO
- ..; y _, `.:.`., ' " .SID - ALK 0 1
E ■315' 8' i-
B - _- '�:.KDRIVEWAY,I — — 1 - PuE S .
] 1 I
_ . - " I , .'
5 ,_ 0 . - - -=7..7.-: "
3 4 I ' ,l� t r _ :314 36 I I
314 PORCH ,9
1 i. -- 362
ge F T- -i—
�' 362
� FE 914 B 18 ' ..,
m
02
364 25 3 .9 18'
v R 358
e -. 4,351 541. PT.
Q� Z8'
3 BATH F. ill
PPE 9143'
12'6' A I
I � J51
33'b' 14'xlo
3 - 2 DE 9 356
I
I 14'
1
/� T - - 15' WE
r. / I
362.. '
354
-L 1 J
EL■ 1' 360 �3' 3 56 V 1 L ■954'
358 v LEGEND
LOT COVERAIGE
LEGEND
LOT AREA 5,590 SQ. FT. — STREET TREES
PARKWAY MAPLE
BUILDING AREA 2,514 SQ. FT.
PERCENTAGE: 450%
-ir e
' = - ; RETAINING WALL
NOTE8:
ALL GRADE AND PROPERTY LINES ARE ESTIMATES OF CURRENT LOCATIONS.
ALL DIMENSIONS AND SQUARE FOOTAGE ARE APPROXIMATE FIGURES.
ALL RETAINING WALL I-IEIGHTS AND LOCATIONS ARE ESTIMATES
THEY MAY VARY AND BE SUB ECT TO CI-4ANG•A L07 0 115
DRIVEWAY MAY DIFFER DUE TO LOCATION OF UTILITY BOXES, 5 »90 8Q FT.
STREETLIGHTS, AND OTHER SITE CONDITIONS.