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10095 SW CENTURY OAK DRIVE •t Y Y+ Ln V, N • i C) U' " � H Ln 5 U 77 r'^ -73 T 9 C) I �; c7 � ►t � � � � H� a H v 0 3 m z t -a I ! I • 1 10095 SW (:ENTURY OAK DRI4E .....wrr...urrrn..,.....nve..W .w»Y.rL.a�:wa.iww.A li.._ '�u...a• � y'r �� i /► 2A RIG MVO T.MIN20 MS S600T C W F- a LLJ W � � f H �1 G J Q ' F— U i �I O ►-� M a• t a r,, Q Ei r � F� ry >4 u I a. i W Iti y T J H r, E. Y CD � fryy H O `S t !x7 Ca. cr. cn 0 0 ti EMIBIT "B" �:500A CITY OF TIGARD CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION The City of Tigard hereby certifies that the occupancy of 7 the following described structure or premises with respect to which a restriction of occupancy wad, on mss! i 7 , 19 73, recorded in Book 1�, Page .z G� , Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRIPTION OF PROPERTY: �6��''` i OWNER: �_G BUILDING PERMIT NUMBER: BUILDING ADDRESS: /G'O/6— This SThis is to certify the said structure meets with the require- ments of the Building Code of the City of Tigard and the above referenced restriction is hereby released and terminated. IN WITNESS ~HEREOF, the undersigned authorized officer of the City of Tigard has caused this certificate and release of restriction to be ^xecuLed this �� - day of Title: STATE OF OROGON ) ;s. County of Washington ) On this \J�V day of _, 19U, person,.11y appeared before we the above named 1S "r , whose I signature appears hereon and who acknowledged to me that he executed the same in his offical capacity on behalf of tht City of Tigard. Notary Pub is of Oregon �cU My Commission`expire8: ] �1� - _ 3 II t)E,ex�J►^'.,...^�1 r,,.`/57,-ZV01.,jAM r NOUN T11OMSSEN,D F014-1 of R?Wds 6 Ebetlnm 11................... Bou F,tSE�VU a I Y r I 1 l/ STATE OF OREGON County of Washington ss and Ela Roger sandornssen Ex OfficDfrRetco�fde� Records Can- Yeythat th for said county, do hereby certify that the within Instrument of writing was received and recorded In book of record,- No. of sold Corm -------------- Witness my hand and seal affixed. ROGER THOMSSEN, Director of Records & Elections L7epu FEB 15 3 3s Pc"" yc�za ,. o'y s�'•�/� � ?/ •1 d+a tT' �' ,��a� �/3�'0 + Ag 02 � 1 OF 0 CITY OF TIGARD VC OREGON Owner:....Tual�ax.i.n...Qa.ve1.apmen.x...GQmRa.ny.......Permit No....... 3:7.22.6___ 4 r c Building Address.....10.09.5 ..S......W....Gen.tu.r.y....Qa.k..A><, .vs.............................. Ir. �4• ; Certificate is hereby given thi,..... 5tb....day of....Fv.bs.ua.r.y........... 19-7.4... f i that said building may be occupied and -I that it complies with all requirements of ; the Building Code for the City of Tigard, j ! as approved by the Tigard City Council. t .......... ............................_._................... ' `�hfi s Building Inspector ' /,_/�kTi,�an�' rt��+ ��, 1'Y b. � � `�� h 47d�' �,r/' +7r„ � '�r�1 � �A � �Yy*• I�� '^�+. �" ,`w` C.. @.o.•see UtWiM U. A. eew CITY OF TIGARD HEATING PERMIT DATE 7 PERMIT NO. RECEIPT 'NO. °�!'� FEE BY �(! � 1. Perms shall be 0 tained prior to cc,,ninencement of installation. 2. Permit shall be obtained for all arplz �.r.ces which are to become a fixture to the building 3. Relocation, replacement: a, `f:. r changes to t�,z.rners and dart war require permits. 4. All work t be concealed must be �.••:r....��� before cover up. n New Installation IL�J k�place ❑ elocation 1:1 Addition ElAlteration 1..! CONTR. 1!L ��'� r -- OWNER ADDRESS ���_.L ' WORK ADDRESS �` ✓ C-Q�• � 'r.?ice' 1�'�`�• f AFPLr'TCANT _&!e4 TEI.EFHCNE NO. FURNACE - MANUFACTURER _4c!�1��_ LC_f/'�>��'%'_ _ TELEPHONE NO. HEAT It put rating (Btu Per Hour ) 9D�['E' Vent Size � Flue Size FUEL OIL ❑ GAS ELECT ❑ OTHER TOTAL SQ. FT. Top Floor �-�-�_ Main Floor Z� evcq — Basement GENERAL ITEM NO. FEE AM'T ITEM NO, 7FEEAM' For Issuance of Permit 3�0 Boilers over_ '5_0 Hg �, New - Under 100,000 Btu 4 0 ~ Aix Handli�nq 10-0000 CFM 3.00 New - Over 100,0 0 Btu S5 A Air Hand 1 i na Over 1.0,E 000 CFM 5.0 Floor Furnace: _ r 4�0 Evaporative Cooler 3.0 01 1 Wall - Floor - Suspended 4, 0 Vent Fan r_ 2.0 01 1 Install Vents __ 2�0 Vent System 3.0 Repair -_Heat & CooJ.in— 4, 0( Hood 3.0 Boilers Under 3 Hp CO ! Domestic -nci.nerator 5.00 Boilers 3 *o 15 Hp _• 7, 5 ��~ Comm Inci_nezator _ _ 0.0 Boilers 15 to 30 _Hp _ 0�0 Other Not Listed 3.0 Boilers 30 to 50 ti 5�0 -- INSPEC'TOR' S COMMENTS APPROVED BY __ DATE _ ISSUED BY _� DATE t•Le C Cl Signature 6f Applica �% City of Tigard INSPECTION REQUEST for INSPECTION TIME: P127 PERMIT` NO. :Zl � DATE: �?f DATE ISSUED : I Z OWNERS NAME . ADDRESS' AME :ADDRESS: icl0ys 5 (n1 CONTRACTOR '. - TEST ONTRACTOR : _TEST : Air u, ;Nater❑ , Visual C] , Laboratory ❑ RESULT: Apnroved f81 Disapproved ❑ Pending SKETCH.* I SPECT0R DATE [OTE: Attach supplemental teat data beret(] i ALL. SPACES MU'3T BE EN'.D ORSED PRIOR TO APPROVAL Oi" T 3E PLANIS PURI-IC VJO"':,S COPT. RY --- D T. ri.^T. _:'f.J.__-.___--._-_ G 7AL , iL,:NiUCl _. . N V.. NATL*nAL GAS T. R F. D. { �5 i 1 r . "i'�iOt�li�.r,�., . � _,�;w;;4 ..:•,«.��.�1'�:. ..�atw�,.,�dri�'ilw- PLUMBING PERMIT APPLICIkTION Jurisdiction of No. Type of Fixture Fee Permit No. 2d/ a 2 Permit fee -LLL y, Water Closets Toilets ��� Permit IssueU 1,p ,¢ r:' Bath Tubs " Approved by avat, Wash Ba"ire io Building Perm Showerd Receipt No. ±sr�_L� Sinks, Dl„h�lr� Sinks i c en Sinks ordinary inar Locati of �ild ig in s �dr _� Automatic D i. w a s h e r __-_ - -----.--., Laundr,1 Traces_! Name 6 Add ess (1wrINr ,,,, Drains. Floorp _ - a.ns Area --- rains. Refr iWera or -- - R6�.n Drains ©! Automatic as Fier ^� � o Name A dress of Plumber _ oun .a ns. ren — Fountains Soda - "7,70 _ Hot Water an --- atFr Service iz� o - Ur l.Zals _ , �w Alter Repair or ,a h- assns - ar%i a Lawn. rink er 3--sem- — �� ;w.mm�n Poe b ler rin ger aystem —.� s� This permit becomes null and void if work or construction authorized is not commenced withir, 60 days, or if construction or work is suspended or abandoned for a period of L"O days at any time after work is commenced, All plumbing firms must be licensed by the City of Tigard and post a 01,000 bone I hereby certify that I have read and examined this application and know the sap to be true and correct. All. provisions of laws and ordinances g ,verni.ng this ty of work will be complied with whether specified herein cr not, the granting of s permit does not presume to give authority to violate or cancel the provisions ,c of any other state or local law regulating construction or the performance of �n construction. J Si tune of/ Applicant i City of Tigard INSPECTION REQUEST for SPECTION TIME : __ PERMIT NO. : I DATE .- DATE ISSUED :�� iNERS NAME '. ADDRESS: - - -- )N T R A C T O R : /1.DZ I EST : Air U, Woter❑ , Visual , Laboratory ❑ I SULT . ApnrovedA, Disapproved 0 Pending ❑ I (ETCH: I i I I i I _ I INSPECTOR DATE TE : Attach supplemental toot data berets I 1 �1 City of Tigard INSPECTION REOUEST for INSPECTION TIME :---- PERMIT NO. : _ DATE : // $1� DATE ISSUED / -L— OWNERS NAME : -� ---- -��-- ADDRESS : CONTRACTOR :__ _-- TEST. A r L7 , Water O , Visual W., Lah ,rotary [t RESULT: Approved,W; Disapproved _1 , Pending SKETCH: INSPECTOR DATE supplemental tett data herstil 1� City of i igard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. : __�_� DATE: DATE ISSUED : OWNERS NAME r ADDRESS- CONTRACTOR DDRESS:CONTRACTOR - 7EST : Air Li , Water 0 , Visual [] , l_abcratory 0 RESULT : Apnroved Disapproved ❑ , Pending [] SKETCH: INSPECTOR DATE i COTE Attach supplemental test data heret] r, t i City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. :-- DAT E: O. :_DATE: �� /l3i''J�' HATE ISSUED :---! Z OWNERS NAME : �- --- - — ADDRESS:CONTRACTOR : �- � =----- TEST : Air U, Water[] , Visual , Laboratory ❑ RESULT: Apnroved/)&C, Disapproved 0 , Pending p SKETCH: INSPECTOR DATE COTE Attacn supplemental test data here}] City of Tigard INSPECTION REQUEST for INSPECTION TIME : -'bc-.— PERMIT NO. : DATE: 1111/-77 DATE ISSUED:._'L 0 W N E R S NAME : ` „) Q . I D D R E S S : _ CONTRACTOR ' I TEST . A r ' , Woter�_ Visu4 , La'* ,ratory El RESULT. ApprovedA�, Disapproved Pending !] I SKETCH: I --7L el I � ; -77 f I INSPECTOR DATE 5r_ 1E Attach supplemental test data hereto] 1 c JLMI AN City of Tigard INSPECTION BEQUEST for SPECTION TIME: ���`c+cT PERMIT NO. : DATE : /11017--f DATE ISSUED : Z /NERS NAME : ADDRESS-. -- )N T R A C T O R . ST . Air u, Water 0 , Visual ❑ , Laboratory p =SULT: Apnrovedg , Disapproved ❑ , Pending p (ETCH: �IsPECTOR DATE TE . Attach supplemental test data hereto? i I City of Tigar -i i INSPECTION REOUEST for INSPECTION TIME :9-'O0 PERMIT NO. : ._ I DATE : DATE ISSUED---L /- OWNERS NAME : .��P� i ADDRESS : Z CONTRACTOR :- �t - - -- --- - ----- ITEST', A r J, Water L7 , wisl;c1X, La', .rotary h RESULT. Approved , Disapproved _l Pending Ll I SKETCH: I I i I I I INSPECTOR DATE COTE : Attach supplemental test data hereto J 7 M City of Tigard INSPECTION REQUEST for NSPECTION 4F PERMIT NO. - DATE . O. -DATE . 12' 102--f DATE ISSUED' OWNERS 'NAME ' T D, 40 DRESS ' - !26 I RESuLl- Hppr'AcIJ I SKETCH: I I I /INSPECTOR DATE IL )TEAttach u— -Pref] 1 CITY OF TIGARD 11410 S. W. Mein Slesel TIGARD, ORROON Tr APPLICATION FOR BUILDING PERMIT New Construction GO Demolish ❑ Addition ❑ Remodel ❑ Move❑ 7,ONING 0—n _ DATE ISSUED_ /fJ S ?3 BUILDING PERMIT GATE RECEIVEDBUILDING FEE $ 7.A OG No. + ri G ____ BY PLAN CHECK $ 10•00 7,3.� OTHER $ 4.00 recording fsVALUATION $ 19.448 - --- vm percent RECEIPT No. _ TOTAL $ H8.84 TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT M _ 4— MAP N S1 2c1 inn CENSUS TRACT ,TOB N� Architect or Engineer_____Tuslatin nava op ant r-o- Addzess� 1530[1 S.W111iLtL_Ava- Phone _ Address Bi . (Apr same _ Address Phone — BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ ndustriall OCCUPANCY GROUP— No. of Stories I _ Total Height___ Area of Lot Type of Construction Xp(X)MXXAf00XX)=XAl Floor Area B_ 1 1208 2 set Backs: Front. 25 Bark-f,' 1..Side _ 5' R.Side_7162 Private Sewer Pipe blze_4" _— Sewer_uea_fili>ffAuYptic Tank ❑ Water Service Pipe Size 3 4" Storm Sewer D Ditch ❑ 1)rywe11 Street and Curb Requirements _ Ae Required by 511AN Subdivision_OOr ,,_- Driveway Width-,---- _ 18' - No. of Parking Spaces_ 2 SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED--`_____10095 S.Y. Crntlrv_jVl(_��._____ _ FIELD CHECK BY JB — _ DATF_ g-jHzZ3_^__ PERMIT APPROVED BY it is understood that all work will conform with applicable codes and ordinanct of the State of Oregon and the City of Tigard, Oregon, and that the building wi not be occupied until a Certificate of Occupancy has been issued by the City 01 Tigard Building Inspector. Signature gf- plicant 4536 EXHIBIT "A" CITY OF TIGARD Residential Structure nccupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (a) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Deed Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as a final inspection determines that the construction is eatiefectorily completed) DESCRIPTION OF PROPERTY`: v..L-c b X- a a o T's, 3 > , res o��. s V-- , \e.� P-.•t. C c c1-.., Ca W c..'s�• 1 C r V G�... ADDRESS OF PR&ERTY: r c'lv t NAME Or OWNER: <_l,•_ ��.� �c•a����_�- w ,�\. Qr. ADDRESS OF OWNER: IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this -%_" `---2' day of c--, , 19_,y OWNER:/!/ >i�t/ ��lvslePHl�v� Com. Z'�v�� APPROVED: Title— By' -- ui ng c e City of Tigard STATE OF OREGON County of Washington Be. October 3 19 73 Personally appeared before me the above named Roy Brown and acknouledged the foregoing instrument to be his voluntary act and deed. Notary Public for Oregon My Commission Expires: l 16 75 rood far nod.14 ...... R?CCA TMMPALJ+ Ph,.Mm dl a Elwrlinm 949 �c.r Pil�e rl.. �o 0 nw a ` $- � 0 cg C f EXHIBIT "A" CITY OF TIGARD Rsaidential Structure Occupany Restriction KNOW ALL IGEN BY THESE PRESENTS, that occupancy of resicentiai structure (e) on Lhs following described lands prior to the recording of an occupancy permit releasing the restriction in the Deed Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as a final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: ADDRE55 OFR0PERTY: NAME OF OWNER: %4y_ --4 N' ADDRESS OF OWNER: C-- IN WITNFSS WHEREOF, the undersigned has caused this restriction to be executed this dry of 19,, nIJNER: T ttL�T1/V w�igl/II<M �O as APPRnVFD: --tette Hy: Building is e City of Tigard STATE OF DRCGON County of Washington October 3 lg 73 Personally appeared before me the abo✓e named Roy Brow and acknowledged the foregoing instrument to he his voluntary act and deed. Notary Public for Aragon My Commiasion Expiias: 1/16/75