10180 SW CENTURY OAK DRIVE i
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10180 SO CENZJPY OAK DRIVE a
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CITY OF TIGARD
P. O. Box 23557
12420 S. W. Main
TignA. Oregon 97223
"-ptember :1, '"74
Roger Themssen
Department of Hecords h Elections
Washington County Courthouse
Hillsboro, Oregon 97123
Dear fir. Thoms-en:
Please record tFe following residential release of
occupancy restriction in the Washington County Deed
Records.
10.180 S.W. Century Oak Drive - Release
Our check to cover recording costs is enclosed.
Sincerely,
Doris Hartig
City Recorder
by Faye Sundt
f--
enclosures
�• pO
By
loner N io EXHIBIT "B" ++ 9
Pionecu National
Title Iusuragse Cuwpany
CITY OF TIGARD
CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION
Tlv: City of Tigard hereby certifi4s that the occupancy of
the fcllowing described structure or premises with respect to which
a restriction of occupAncy was, on May 1$ , 19 7Q,
rscorded in Book -c75 , Papp 1QA , Deed Record -f Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY:
Summerfield - lot 61, As recorded in Book 32, Page 50
Plat records of Wsshingtan County, Oregon
OWNER: Erskin Be Wood M,
BUILDING PERMIT NUMBER: 7A_77
BRILDING ADDRESS: 10180 S.W. Century Oak Drive
This is to certify the said structure meets with the require-
ments of the Building Cale of the City of Tigard and the above
referenced restriction in hereby releaeed and terminated.
:N WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigard has mused this certificate and release of restriction
to be executed this � day of ly%
Title:_ Councilmen
STATE OF UREWN )
County of Washington )ss
On this 1 day of Z' , 19;L4, personally
appeared before we the above mined Rj ijZE whose
signature appears hereon and wFx, acknowledged to me that he executed
the same in his offical capacity on behalf of the City of Tigard.
o ry bl c o gen
i oexpires:
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City of Tigard
INSPECTION REQUEST
for I
IrV$PECTION TIME: PERMIT NU. :
DATE: 1& 751 DATE ISSUED :---Z-/---
OWNERS
SSUED :._L_L.__OWNERS NAME :
ADDRESS: �'� �-t1�iy1/f1t�' Deep _
CONTRACTOR : _--
TEST : Air Cl, Water❑ Visua1X, Laboratory p
RESULT: Approved Disapproved ❑ Pending p
SKETCH;
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INSPECTOR DATE I
[NOT E : Attach supplemental fes? daf^ bereft]
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„ify of Tigard
INSPECTION
REQUEST
for I
SPF;TION TIME: w PERMIT NO. : ' IN;
DATE: 6 DATE ISSUED:- I Z
N ERS NAME : ,Zn c', OW
ADDRESS: ---
INTRACTOR . — _-�— I CO
:ST . Air ❑, Woter14, Visual p , Laboratory n I TE
:RUI.T. Approved U Disapproved U Pending p RE
ETCH: (0'��-7�f -' �, K
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INSPECTOR DATE
E: Attach supplemental telt dote beret] I OTE
1
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. �y-/,(9 ✓,
Permit fee
Water Closets T ilets4_ Permit Issue•
Bath Tubs Approved by
Lavatorn Wash Basin - Building Permt
i
Shower — _ Receipt No.
- Tin7_s Dishwashing-_____
c 5ink& Kitchen
Sinks, Ordinar Location ofBuild'ng/D/ �i(7 S LA-) —_
- Sinks. Bar-------- -��er^��c
Sinks
Slop__. _—
/ _Automatic Dishwa_sher `it
+ D i ssDo ss a al1 —
_
L_auririr Tra s ��' Naige & Act ress o_. `-�-
-Drains. Floor
Drains, Area
_ -Drain s_Rcfri orator
Rain Drains
Hutcmatic Washer Name & Address o .cam 1 mbe
_n
/ Fou •rains, rhin -- _
Fountains, Soda
-Nat Water Tank - -T &:go ZZ
Water Service SizE�j_ � —
urinals — B Old or ,Je Alter, Re air or
a ch--Basins-_Yarm— — ns _
Lawn Sprinkler System- —_—_-
-- Swimming Pool -- _--- O her —
Sprinkler System ----------_-- _-- --____ _.—This permit becomes null and void if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 Gond.
I hereby certify that I have read and examined this application and know the same
to be true and correct. All provisions of laws and ordinances governing this tyI
of work will be complied with whether specifiad herein or not, the granting of a
perm;.t does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
3 n
3 <1 Signature of Applicant
City of Tigard
INSPECTION REQUEST
for
1N$PECTION TIME: 41-,r_7mt, PERMIT
DATE: DATE ISSUED :___1_l__
OWNERS NAME : —Tn.� _
ADDRESS: �- G�- .�. ,•,a ��_-__
CONTRACTOR : _
TEST ' Air 13, Water[] , Visual ❑ , Laboratory p
RESULT: Approved , Disapproved ❑ , Pending U
SKETCH: �,'/5 - ` -/3- 7y
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NSPECTOR DATE I
_NOTE Attach suppleme-tol test data hereto
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City of Tjgard
INSPECTION REQUEST
for
INSPECTION TIME __2. jgy PERMIT NCI.
DATE: DATE ISSUED :--J
OWNERS NAME :
ADDRESS:
CONTRACTOR :
TEST . Air 11, Water visualf
0, Laborator,, O
RESULT. Approved Disapproved 0 r�endinq U I
SKETCH:
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SPECTOR DATE I
MO?F Attach *UppiemVntii telt duta beret a]
EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MEN BY THESE PRESENTS, That occupancy of residential
structure (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Deet. Records
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon[
DESCRIPTION OF PROPERTY[ ummerfield - Lot red—
is recorded in 3ook , Page 'oQ�_, Plat records of Washington
County, Oragon.
ADDRESS OF PROPERTYi
NAME OF OWNER[
ADDRESS OF OWNER[ /Jai �] 1��,.-,r r 17�G '
1N WITNESS WHEREOF, the undersigned has caused this restriction
h
co be executed this '7 L day of P/r,�,
OWNER[
Tualatin De ment (;.Wal. InC.
Name
APPROVEDt Byi
�. Title
lhd
lding Official
City of Tigard
STATE OF OREGON
County of Washington ) _4 11 _, 19,,,�
sonally appeared before re the above named T�
_ and acknowledged the foregoing instrument be
.� voluntary act and deed
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Nothry Public f r Oregon r
ru.etar.ae,e.o :...!,f__. ,a7�a►�L AM M1� MN Comm!asion Expirest
aoottt"o[sestro.th—n,n[p—,1, s ,.., ___ �,2- - y!'
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EXHIBIT "A"
CITY OF TICARD
Residential Structure Occupancy Restriction
KNOW ALL MLN BY THESE PRESENTS, That uccupancy o: residential
structure (s) on the following descrioed lands prior to the recording
of an occupancy perms; releasing the restriction in the Deec Records
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTYt Summerfield - Lot f _
As recorded in gook jam, Page "1 , Plat records of Wnshinp.ton
County, Orogon.
ADDR'x,S OF PROPERM In I SC> �`! ,�I�r„r�- ,yr�,1� CIr;v e.
NAME OF OWNER i - _- � .=—
ADDRESS OF OWNER t /527 S~ :��,.,c�n
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed this '7 f. day of /� �,,,, _ 192"
OWNERS
, 7
Name
APPROVED,, Bys
�. Title
Byt
Building Official
City of Tigard
STATE OF OREGON ) Be.
County of Washington LOA
•>Persona y appeared before me the above named
and acknowledged the foregoing instrumen be
volun'sry act and deed
No ry Public fo 04egon
My Comm!ssion Expirest
CITY OF TIGARD
12420 S. W. Mein Sfrasf
TIGARD, OREGON 47227
APPLICATION FOR BUILDING PERMIT
New Construction R1 Demolish ❑ Addition ❑ Remodel ❑ Move ❑
20NING,L-7 DATE ISSUED 5--7-741 BUILDING PERMIT
DATE RECEIVED BUILDING FEE ��� _ No.
BY PLAN CHECK $ 4� y � C/-7,;7 L
OTHER f Le' $ y --_ VALUATION $ Q j )�-__
TOTAL y'rr 19/ RECEIPT No,
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT $__rte I MAP A_ _ CENSUS ,TRACT TOB . 2el- _
Architect or Engineer:'-; ,A_,, u11% L-12 .kj f, 10 11h1(Oa� �('
AddresayS 3no el,W- if'��� laves �.n.-iI —Phone-6-39 jr/0/
Owner��q k:r, e►_ IA/nc�
Address /s p� <-��- / / 'y Phone j7
Builder-f7
Address_ _ _ _Phone__ _
BUILDING USE Single Res. a Multi Res. ❑ Comm. n Tndustrial❑
OCCUPANCY GROUP. No. of Stories I — Total Heigh t — Area of Lot—
Type of Construction I II III IV (�oor Area B- 2_
Set Backs: Frontj_Q_ Back_gn' L.Side R.'31de—
Private Sewer Pipe Size y � SewerCASeptic Tank ❑
water Service Pipe Size7& _ Storm Sewer x Ditch -1Drywell❑
;street and Curb Requirements_��
Driveway Width/,0 No. of Parking Spaces `Z_
SEPARATE PER141TS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED_.,/Cj f-Q
FIELD CHECK BY _---DATE__JF Y_
PERMIT APPROVED BY_�i�2" - ` --
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of Occupancy has been issued Ly the City of
Tigard Building Inspector. _
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