10220 SW CENTURY OAK DRIVE-1 0
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10220 SW CENTURY OAK DRIVE
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City of Tigard '
iNSPEC
Tio N REO U E ST
for
A&I
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INSPECTION TIME . �'�oPERMIT NO.: ______
DATE: DATE ISSUED: '
OWNERS NAME . G' /D-2.14
I ADDRESS : G&. S --
CONTRACTOR '.—., 19 ��-���� - ------
TEST . Air ❑, Water 0 , Visual Laboratory ❑
I RESULT: Approved/0 , Disnpproved ? Pending U
I SKETCH.
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INSPECTOR DATE
[OTE Attach suppIsMont t; ta*4 dOf0 herstl
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City of Tigard
INSPECTON REOUEST'
or
INSPECTION
INSPECTION TIME : PERMIT NO. :
DATE: _ Z WTJ Z5' DATE ISSUED-.—A
OWNERS NAME - --LL ,
ADDRESS :
CONTRACTOR :
TEST. Air O, Water, Vieil,sl�{-, Laboratory L]
RESULT: Approved , Disapproved D Pending I]
SKETCH:
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G� I
��I DE6P
INSPECTOR DATE
[OTE : Attach Supplemental test data heret01
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CITY 0F
BUILDING PERMIT APPLICATION TIGARD DATE— 9�1Q 19 �5 N° 0378
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER"HONE__
OWNER Tuala1tio '`Bivalupmunt. ' ADDRESS L02120 '9.��. Century 9ak �i
E} hODER PHONE
ENGINEER
BUILDER —ARCHITECT — DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION QREPAIR _❑RENEWAL ❑FIRE DAMAGE 7_❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOVT ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE (__1STORAGE LJSLAB ❑FENCE
❑BOND DMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COU u,l_APPROVED LJSIGNS
OCCUPANCY___LAND USE ZONE_ BLDG.TYPE _FIRE LONE__. PLAN CHECK BY _HEAT _
tronstrui.A. L192 sq. f`t. MsrkXj frame tii el l.i.jiy accurdinji t:w appiovea Planer
bedroom
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES i AREA 1192 VALLI:119 2 u
BUILDING DEPARTMENT SET BACKS FRONT �Q REAR 27 LEFT SIDE RIGHT SIDE
PermitTHIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pl3n Check 1Q�Q(� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIF ICA TIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
IOn State LICENSE. SEPARATF PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total
BV r m
—v --__
--- _ --- --- APPLICANT r)R AGENT �-
Approved Rebell,! No
ADDRESS —�SF{pNE A
DATE INSP TYPE INSPECTION REMARKS PLUMBING DATE
Contractor2ae,�®i'I na
Permit No. C�(�Y S' f
Rough-in
ezr 7 7A /O Fixture _
Final
HEATING
S .� r �,•tsi.r/ Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER I)C,
Final _
DRIVEWAY o�
Final
Storm Drainage
(Rain Drain) Final
Sidewalk LvC $ ao-7s
Curb&Street Final
_
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFIr:ATE OCCUPANCY Final _
C CERTIFICATE OCCUPANCY —
Landscaping
Zoning Final
•i
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City of `Fi,gard
INSPECTION REQUEST �
for
y
INSPECTION TIME' s Y PERMIT NO. :--.
DATE: -,q 11,31 DATE ISSUED :—
OWNERS
SSUED ._.OWNERS NAME : T'�C
ADDRESS:CONTRACTOR :
- -_---. --- -----
TE ST : Air p, Woter[] ,. Visual l� Laboratory p
RESULT: Approved,M Disapproved p , Pending [❑
SKETCH. S-13 - 7V
t c� P/Jel
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INSPECTOR DATE
[NOTE: Attach supPl*mental test data beret?]
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Thoa BOO .I�
IPJZZD SW. I.F-n+-u y Do,,k give
EXHIBIT "A"
10909
CITY Ov TIGARD
Residential Structure Occupancy Restriction
KNOW ALL 14LN BY TH:;E PREOENTS, That occupancy of residential
structure (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Deer Records
of Washington County, Oregon, is prohib'*ed by the ordinance of the
City of Tigard, Oregon:
DESCRII'TION OF PROPERTY: Summerfield - Lot
As recorded in Book 37- , Page 5-0 Plat records of Washingt a
Coui,t;, Oregon.
ADDRESS OF PROPERTX:
NADfE OF OWNER'
- L-Na.
ADDRESS OF OWNEci: f5no 5.CJ, A,
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed thioTLti
1•L— da
' OWNERS
1
"unl-tin
Nnwe q
APPROVED:
By:
Building Official
City of Tigard
STATE OF OREGON ) 6e
County of Washington ) 19 .
ersonal appeared before me the above name _
and acknowledged the foregoing inst me L tc be
r voluntary act and deol.
ON ho' ry 2'ubl.ic fo 0 e on
R
34
0909
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CITY QF' TIGARD
12410 S. W. Main Street
TIGARD, OREGON 97227
APPLICATION FOR BUILDING PERMIT
New Construction ® DemolishEl Addition ❑ Remodel ❑ A1oveL__J
ZONING_ DATE ISSUED_ -��=7 BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ J-0 No.
BY PLAN CHECK. $ /v.uJ r/sS'1t 7U�O�
OTHERAtOrIbL $ 4J,pJ VALUATION
TOTAL l J""'f RECEIPT No.
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
IAT A 5� _ MAP 8_-- CENSUS TRACT 1 JOB i—
5'Q53
.Architect or Engineer,=-,..1,,
Address Ls C 7C')-:? C 9 -AN LnL--- 1- /st- r'T_;alczcC� Phone
Owner M Mrd ---
Address 0-�,9 b �, L,,? —
Builder
Address Phone,_
BUILDING USE Single Res. U Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP No. of Stories \ Total Height Area of Lot—
Type of Construction I II III IV Floor Area ,i _ 1 -yam 2
Set Backs: Front 1 Back-,&o— L.Side y,G, R.Side�_ �
Private Sewer Pipe °ize Sewer lir 1 Septic Tank ❑
Water Service Pi a Size__3 Storm Sewer �C Ditch ❑ Drywell❑
P -Y
Street and Curb Requirements -,, s
Driveway Width_.—Lai_- No. of Parking Spaces____Z
SEPARATE PERMITS REQUIRED FOR CEWER AND PLUMRiNG
SPECIAL INFORMATION
ADDRESS ASSIGNED /0)-"
FIELD CHECK BY.—
PERMIT APPROVED BYaI�_ i 4�-
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 build ung will
not be occupied until a Certificate of Occupancy has been issued by the ity of
7`igard Building Inspector. ��..���
Signature f ApplAcant