10295 SW CENTURY OAK DRIVE-1 w wAW-1ww w w w
r.:
J I y y
4 83
Ld
(�
Cq i 7
txj
�1
r
r
10295 SW CENTURY CAK DRIVE
3AIHO MVO AM,T,NSJ MS S6ZOT
0
a
M w cC
6A -
�yy
H �0
E
� y 1
o � a1v � 6
fa Ch n r u7 W F*, G•�
cn '7
v
77
C"7 1
to
E-4 Fl
44
ON
�r
ON
I!
I
ON of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: �r PERMIT NO. :---
DATE:
O. : __DATE: -31-1 Z7V DATE ISSUED :--
OWNERS
SSUED :--OWNERS NAME :
ADDKE S S:
CONTrACTOR : _ T Dc�_ _
TEST : kir p, WaierQ , Visual p , Laboratory U
RESULT: Approved , Disapproved O Pending p !�
SKETCH:
I
I
I
l
fNSPECTOR DATE
1r 01E: Attach supplemental ►opt dnto berets]
■ 'ww.'awasas•>•neeeswsss�� sssssn��w�■��
1 y EXHIBU „B"
14x:4'7
CIT; OF TIGARD
C:H'1'IFICATE 01' GC"UPAJICY AN) REUME 01' RESTRICTION
,The City of TiEA,rd horeby certifies that the occvpaney of
the following des:ribed structures or premines with respect to which
a restriction of occupancy was, o❑ ,�? Z_2.7. 7 4' _, 19_,
recorded in Book =,_, Page _sir, , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESC'.Ri1'PION OF PROPERTY!
OWNER:
BUILD_NG PERIGT NUMBER:
I
BUILDLNG ADDRESS: /029S' S -0 et,[7N,ey 641<- ,k .
This is to certify the said structure Teets with the require-
ments of the Building Code of the City of Tigard and the above
referenced restriction is hereby released and terminAted.
IN WITPV'3S WIIF!MF, the undersigned authorized officer of the'
City of Tiga7d Las caused this certificate and release of restriction
to be executed this 77 day of -gob , 19 .
Title:__li
STATE OF OREGON
County of Washington )ss.
On this 27 day of Feb r 1974, personally
appeared before me the above named Dorts Hartig _, whose
signa:.ure appears hereon and who acknowledged to me thst he executed
the same in his offical capacity on behalf of the City of Tigard.
CAa
Notary Pu lie of Oregon 0
May Commission expires:
►.wed....3...":I-
192Y
Hoop 964 F%L703
�i
cn
� y
_ ii■®iii ■
City of 'Tigorld
I
INSPECTION REQUEST
I , for
INSPECTWN TIME : PERM �---_-
I T N 0. . .
DATE: %" DATE ISSUED:_
I OWNERS NAME : /U
ADDRESS : ' � � f sW
- CONTRACTOR :__
j TEST A r ;], Water Ll , "is"GI ;] , La'• ,ratorl p
I RESULT: Approved , Disapproved _l , Pending
;KETCH:
's2l� f
I �
'INSPECTOR DATE
INOTE : Attach su
L PPlemen}al rr,st data hr.rcf]
1
i
City of Tigard
INSPECTION N RE® U E ST
I for
INSPECTION TIME : PERMIT NO. : —
DATE: DATE ISSUED.'
OWNERS NAME . Q0'.--
ADDRESS :
'ADDRESS :
I
CONTRACTOR :--
TEST .
ONTRACTOR :TEST. Air J, Water [] , VisuallK, La'• ,raiory L-1
RESULT. Approved , Disapproved _1 Pending 0
I SKETCH
I
I
I
I
I INSPECTOR DATE
OTE : Attach supplemental test do a nerst-10
uo.+.,. ,,., A�Willl�ll�.;,wyi�jw . .,..wM. .W„wi�ayuii. ad. �10�1► e1.
PLUMBING PERMIT APPLICATION
Jurisdict: in of
No. ' Type of Fixture Fee Permit No.
ea Permit fee
Waier Closets (Toilpt.s_ Jam-'' Permit Issued 1 �3
Bath TubsApproved by
ava for Wash Basin _ _ Building PerF,_ _
it 0
Shower _ Receipt No. Q_p
in s D; shwa,,T n
„inks itchen _ vv
_Sins ,_ Ordinary - _ Loca;hion of Buil g
Sin s Bar
Sinks, Slob _
M
Automatic nis iwas er
i
L-aundry Trays _ Nam & Address of Owri'=�
Drains Floor
Drains Area
Drains, e ri erator T -
Rain Drains
utom��i is Was'ner ')00 Nd. of umber �
Fount irises r- n in - _
Fountains Soda _
Hot Water Tank
f Water Service Size o -
Urinals Bui Old ' r Jew Alte -.., epair or
Catch-Dash- Yard
Lawn Sp rink er stem 77 5_� lL_.Z 2_,c
swimming Poc —_ 7JUTer
Sprinkler System
This permit becomes null and void if work or constniction auth_,rized is not
^ommenced within 60 days, or if construction or work is suspended or abandoned
for a period of is O days at any tim.? after work is c -.mmenced,
r All plumbing firms must be licensed by the City of Tigard and post a $1,000 bonc
I hereby certify that I have road and examined this application and know the san
to be true and correct. All provisions of laws and ordinances governing this ty
of work will be complied with whether specified herein cr not, the granting of e
permit does not presume to give authority to violate cr cancel the provisions
of any other state or local law regulating construction or the performance of
r
corstruction.
It
Siure 0 App licant
gna
V
City of Tigard
INSPECTION REQUEST
for
SPECTION Ti, PERMIT NO. : --
DATE: _'���--_ DATE ISSUED : L
INERS NAME .'
ADDRESS: .
)N T R A C T O R : -
.ST : Air Cj , Water El , Visuul ❑ , Laboratory (i
ESULT : Apnroved d Dieapprcved ❑ Pending E]
"ETCH:
INSPECTOR DATE
TE . Attach supplementnl test iota hereto,
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : "' `LI PERMIT
DATE: Oa //l / DATE ISSUED
OWNERS NAME :__7- U C
ADDRESS: ," �, / 0 11
CONTRACTOR
`i E ST : IN U, Wo for G ; Vi-ual p , Laboratory ❑
RESULT: Apnroved �' , Disapproved ❑ , Pending p
SKETCH.'
INSPE&T--OR
KETCH;
INSPECTOR DATE
[NOTE Attach supF pmentol tes rtoto heret�
/e
V
City 0f Tigard
INSPECTION REQUEST
far
INSPECTION TIME : PERMIT NO. : __ I
DATE :/Z6-1;Y DATE ISSUED :__!.__1•_._
OWNERS NAME : _Z7°9 G.--- - --- ----- - _
ADDRESS.-
CONTRACTOR :
DDRESS:CONTRACTOR : -_ - - -------_ — I
TEST : Air Cj, Water❑ , Visual ,', Laboratory ❑
RESULT: Apnroved Disapproved ❑ Pending r]
SKETCH.*
`
I
L'_,4/6,l7 3
' 71V:iPECTOR DATE
[OTE: Attach supplemental test data htret]
City of Tigard
INSPECTION IREGUEST
for
INSPECTION TIME : f,e _ PERMIT NO. : . _
I DATE: // 1�i73 OATS ISSUED:__1_ I
OWNERS NAME : ZEP14 '
I ADDRESS : —C-T_-Z-_—SQL �
I CONTRACTOR
TEST*. A r J, Water � , Vistsol�, La'- ,ratory [1
RESULT. Approved",IE , Disopproved 1 Pending
I
SKETCH:
I
I
I
I INSPECTOR DATE
1 [0TE Attach suppierrentoI test data he ret]
1
NMI �
EXHIBIT "A"
CITY OF TIGAdO
Residential Structure Occupany Restriction
KNOW ALL MEN BY THESC PRESENTS, that occu, ancy of residential
structure (e) on the following described lands prior to the recording
of an occupancy permit releaf, .ng the restriction in the Deed Records
of Washington County, Oregon, is prohibited b7 the ordinance of
',he City of Tigard, Oregon: (The City will issue a release
a3 soon as a final i; .pection determines that the construction
is satisfactorily completed)
DESCRIPTION OF PROPERTY:
lik
ADDRESS OF PROPERTY: )� NI it—
NAME OF OWNER: Ct.. � rhr !��• �� � C� � C_« a' ,...\
ADDRESS OF OWNER:
IN WITNE55 WHEREOF, the undersigned has caused this
restriction to bre executed this �L � day of
OWNER:
Name
=- r
APPROVED:
el
uz din-g l0- a,
City of Tigard
STUr OF OREGON )
County of Washington ) no. October 18 lg 73
Personally apprared before me the above naned
_ Aon+ Brown and acknowledged the foragointrI
instrument to be voluntary act and dead.
Notary Public for Oregon
My Commission Expires: 1/1/75
o�
�I� rm
ni.d Im neetd..1. ... pppp0000,do 6�1.r,11nM
140cC11•rF10M98EN�ar
01 A
IF •.. 4,A•,.OV
9-55 f-, 415
H
tl
STATE Off
OREGp�' ;
County of Washlnytnn as n7
1, Roper Thomrsen Director of r
�'I and Election. Ond F..Ofhelo Recorder of Cons
veyonces for sold county, do hereby certify
that the wllhln Instrument Of writing was
received aril reeordeo In buck of records
No,
Q of sold County
Witne%s mY hand and teol offl>,ed,
a�1 Sy ROGER THOMSSEN, C Ytor of
r, Records 3 Elections
���t t c'� 9�d•i.7
5 12 os �T3
CITY OF TIGARD
12420 S. W. Main Street
TIGARD, OREGON 97247
APPLICATION FOR BUILDING PERMIT
New Constrirtion ❑X Demolish ❑ Addition ❑ Remodel ❑ Move❑
J,)NING �- _ DATE ISSUED --2(-73 BUILDING PERMIT
;- ; BUILDING FEE $ ny.UU No. . ,
DATE RECEIVED /� 1J"I
1tY — PLAN CHECK $
--- " - J OTHER $ lu.uu VALUATIO14 $ 24,,)A.w
TOTAL $ ;y.Uu RECEIPT NO. T ,L%-3
TWO SETS OF PLANS AND rLOT PLANS MUST BE FURNISHED WITH APPLICATION
L()T M '4 MAP # 2.11 IUD CENSUS TRACT 1,.; JOB N
Architect or Engineer—_ TualaLir. Develuptcelr Cun,,,any ----
Address-______ ��,. 6.W. iLLn Avc , Phone,— _
(vnrr
Address _ —Phone _
Builder e4"
Address _ -___Phone
1V11I'DI'1G Single Res. ❑ Multi Res. ❑ Comm. ❑ Industrial
r)CCUPANCY GROUP i No. of Stories ?- Total Height to - Area of Lot
I.Ype of Construct io V Floor Area b _ 1 2_ 4�Yi
set_ Backs: Frr:.c_ _- '_ Back l41 _ L.Side ; R.Side
Private Sewer Pipe Size 4' Sewer hiiu� CiLf _ Septic Tank ❑
Water Service Pipe size j!4" Storm Sewer o Ditch ❑ 1)ryweII❑
Street and Curb Requirements Exi:;Ling
nriveway SidthaV _`_ _No. of Parkinq Spaces` 2
SEPjkPATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
AI'Ut2ESS ASSIGNED`` CenLu y Llan Dr.
E'IrLh CHECK BY---- -- hC -- ^---_ __---- DATE` �-2(-7j / _—
PERMIT APPROVED
it is undet9toud that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, ar:•1 that the building will
not be occupied until a Certificate of occupancy has been issued by the City of
Tigard Building Inspector. _
c n`
gn$ ureof p icent