Permit - .t � UILDING PERMIT APPLICATION TIGARD DATE , 19 3039
r' THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 441 - t' 701
'. OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _ 'n - 2d6 7
LOT NO. t:5Uu 2,11 -311a
�IwINER Uebber't Smith JOB ADDRESS I 95 S.W. lk2ltk Ave.
ARCHITECT
L ENGINEER
�. eX i n - r ait Coast. Co. P Sem 1 '- s DESIGNER
ADDRESS eluiCbak
TRUCTU ieNEW ❑ .REMODEL El ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
!..t] RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
CCU_ PANCY LAND USE ZONE R+:' BLDG. TYPE 5- FIRE ZONE PLAN CHECK BY HEAT • {i
k°�',. t ax :4, (..:Angle Family Dwelling and aco..i 2 bedrooms and lk ,i tn Se 31d'a'
• -tnect to sewer, and pump and fill . fit septic tack per code. 2 Bedrooms
.See Correction Sheet ittacitec. %;,tp e taec.Le,t a / ,l Bath
tio
EWER PERMIT // ° $. .J • ` ` , ( u - a.€ / x? � 4r e_ F� v ` J ' 1 f /
N.
• OCC. LOAD FLOO LOA a O HEIGHT NO. STORIES - AREA . NO. BEDROOMS - ,
,_
VALUE 48
BUILDING DEPARTMENT SET BACKS FRONT 7t. REAR , t, LEFT SIDE LvU RIGHT SIDE
• permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
L WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub -total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
State 1 7,24 In 1
SDC - - 4Uu.u� :.._.. .
Total 278.74 j k :,_ . > - ..fix. 44 ` rl,,r +r'
PDC# ,,100.00 W I ( APPUCANTORAGENT
By 1L+ /
Receipt No. ///,�/ : e,..,, , at ,, .. i.rit dL , y l /... +r,S/.•_. 4( 0/...
Approved _ 4 . ADDS PHONE
DATE INSP. 4 TYPE REMARKS PLUMBING DATE
AV ' 4t a .0 ! s ! /n 1 � /9 �r� Contractor
t(/Qzal� t-fif- Permit No. 2'? 7 3 S
A-7- Sro iscA p/s7 - 4- n•A vw Rou 4n
3-t3 $L Fixture O�
1-43 - 44 *cI etbv-s 4. e IC Final
- IS-4.0 lcit. /*S al&As A. • HEATING
S -11 -A iSNC, �iAr�if D Contractor
6--;„ „JD?I�i 7 teirr Permit No. /514. 14-Aa. 3./D. S o
fr-C 5c4 l • Gas or Oil Hewn /bMP•
- r ✓ _ I n Final
"'V 4./lvf p� ` i�Al∎itt eeer;e 4-4. SEWER
-- -t Y wt.G( UJ — Final /.2 -3/-79 6Ifz/4
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG_ DEPT. FIN /.L. I TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE Final
FICATE OCCUPANCY
Landscaping
Zoning Fins/
BUILDING PERMIT APPLICATION, oi.TE I T:Dee.... .21. _...... 19_7er
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE_ 44/1- 5 70 I
OR AS SHO." 0 APPROVED IN THE ACCOMPANYING PLANSaD SPECIFICATION OWNER PHONE
: - ( 11.1 LOT NO egkeel0 t S EMI
s
VNER JOB A °CRESS tavern/ I 2.1 Ave •
:,....,
. ..,.... _.."• ARCHt TEcT
= . .._ •
,. ,.• .
ILDER f OW ESS it 901111.X laitti 0 Dii SIGNER
-- —
RUCTUR E ': '..D.NEIN __ RFMr/DE L_ ADDITION D REPAIR - DRENEVA' OF IRE DAMAGE DEMOLITION
..._ - .
'i..S+DNCE n COMM DEDUCA : 4 ' ' . : - _. ni.,OV•1 (ThAF:_tOIOUS [1PATIO OCAR POHT FT.:. ''+E t S 1 G F n S L. A B 1
CUPANCY R AND USE ZONE 111. .FI PE 1 $7_14 = _JIRE ZONE___"___ PLAN BY e- HEAT
- - -
- ----- - .-- eillOs Nal restaliteele.•4 A 4 4 2 RAMINIA - t
041111 : MOS", 4 I .,. dt, _?fit. It 4 d•tk poi.o.41,..z.434_iftcos.s_
9 iebiatif•1/4, Tim+ A•4 • _ ..._
.cJI:to...713__KRIIIT ...i_ . ._ ...
i lobo
..c,. LQAD _ El..'..)0PI Lr.,...='. E. 400 HEIGHT AO NO SIORIU _. g . . AREA (VG/ V B'i DPI Q0M Vf.I.U.E_ 49, I VO
riiiii_ c),•-,-)11:1--PABT -, KS S F T REAR 7 VEN- LEI''' so i 100 mioH SIDE /7
,,
2(Mtt
-
s PERMIT IS ISSUED SUBJECT TO THE REGULATIONS LON T AINtO IN THE BUILDING CODE, Z)•,'.NG
•1 Check i s r , I ULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED I HAT THE
- — -- - I - -- •: WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WI1H
ub Iota: . li 4 ,. APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- - - --- -- -- --. - 1 - sTRiCTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
4
k:IJ ie Tax i ' ' - .ZNSE SEPARATE Pi .-MI TS REQUIRED FOR SEWER, PLU' AND HEATING.
DC#
By
11 ....,..., __I
_.__ gel.ras-1,*vN
.apeL., o oi uaiN
App: o T * - ---• - -
wt Receipt No
--- -- - — -
SDC - $ 4 °
-
PDC - $ 1- - / O
,
SFWER CONNIE' CTION $ 111 g0
SEWER INSPF.CT ION
SEWER SURCHARGE $ / PO L 1 44, . •
? 73
Comments:
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
T f �
-- ..r " _ ► •rte - �.. AA 41P ti
rate: PC ' Permit No.
Inspecto
CALL FOR REINSPECTION
3/30/79 A
SEWER EASEMENT 7Q►O t ZZ !o9 Qec..rJa
2:s4 =7v -79
Century 21 Homes, Inc., an Oregon Corporation, does hereby grant unto Patricia E. Smith,
her successors and assigns, the right to lay down, construct and perpetually maintain a
sewer or sewers through, under and along:
A strip of land in the S. w:154 of Section 34, T -1S, R -1W, W. M. Washington County
Oregon, 15 ft. in width being 7.5 fit„ on each side when measured at right angles
to the following described centeei Beginning at a point on the southwesterly
line of that tract of land described in Book 240, Page 335, Deed Records, Washing-
ton County, Oregon being S -41 ° 28'58 " -E 7.65 ft. from the most westerly Southwest
corner thereof; thence: S -61 ° 24'30 " -W 72.29 ft. to an existing sanitary sewer
manhole.
No structure shall be erected upon said easement without the w* tten" consent of the
Grantee.
The consideration for this grant is One Dollar ($1.00).
IN WITNESS WHEREOF, the grantor abme nameg has hereunto set his hand and seal
this 3 day of A.D., 1979.
Century 21 H• s,, %Inc.
By
Davi. .foring.0 a 'resid
B/ /
'au . 'n'erson, ecretary
STATE OF OREGON )
) ss
County of Washington ) ^
On this $ V day of !��(4 ` �- , 1979, before me, personally appeared
David L. Oringdulth, known to me as the President, and Paul A. Anderson, known to me
to be the Secretary, of the corporation described in and that executed the within
instrument, and also known to me to be the person who executed it on behalf of the
corporation therein named, and they acknowledged to me that such corporation executed
the within instrument pursuant to its by -laws or a resolution of its board of directors.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal,
this the day and year first in this ,my certificate, written. //;;;)
4;4 / Public fiZegon
My Commission expi res4• 2 �9YZ
144.0i T. SP
12 iqr SO 121 £} Ave.
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