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CITY OF TI ARD/MECHANICAL PERMIT
DATE / PERMI N0. 7y ' "M RECEIPT NO. / 937
BY - - (-�2/ ('!l /I t:� i�4, . FEE
1. Permi`. shall be obtained prior to commencement of installation.
2. Permit shall be obtained for all appliances dbich are to become
a fixture to the building.
3. Relocation, replacements, s.lterations, or changes to burners and
duct work require pen.iits.
4. All work to be concealed n.ust be inspected before cover up.
New Installation Re lace rJ Relocation ❑ Addition ❑ Alteration ❑
CONTR. �[ �,� i/ /(' �'�� C/,� • OWNEP
ADDRESS � � - WORK ADDRESS
_" y� ..✓•l!. �c::, r
��l/f'•� _ APPLICANT
TELEPHONE NO. - -�
FURNACE - MANUFACTURER it 'C /'i%' L 140"11cTELEPHONE NO. - - --- - --�-
HEAT Input rati.ng (Btu Per Hour) Vent Size _ Flue Size
FUEL )IL lJ GAS W ELECT U OTHER
TOTAL .,Q. FT. Top Floor Main Floor _ _ Basement _.
— —-�
GENERAL
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _/ .00 X Boilers Over 50 Hv
New - Under 100 000 Btu ,t 4 00 A r Handli 1g 10.00 FM
New ver 1OO M -1;T —Air ing �7ver 10
Floor Furnace "rv_a�ora�3 ve C_o_oier
$us er]ded 14 -7en'L Fan
TnSTMVen sVent_ysem�
Repair - Heat &Cu - .00 licod
To-r ers 1 n er
� a ppHH _. 0 .Someer, n_c._ei—nee3r�a-—o_
r
Boilers omm.Tnc nera or
ora!> 10.00
Boilers to 50 HP _
INSPECTOR'S '-
Or
COMMENTS
APPROVED BY DATE ISSUED BY/ DATE
� _
Signature of Applicant
ElGIIBIr "B"
S431-9
CITY OF TIGARD
CERTIFICATE OF OCCUPANCY AND RELEASE OF IMSTRICfION
The City of Tigard hereby certifies thet the occupancy of
the following described structure or premises witl, respect to which
Lt restriction of occupancy was, on August 21 , 1973 ,
recorded in Book 941 , Page _275 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY:
5UMMERFIELD= Lot 26 as Recorded in Hook 32,
Page 50, Plat Records of Washington County, Oregon
OWNER: a�3, g ire 8 r;•
BUILDING PERMIT NUMBER: 73-183
BUILDING ADDRE63: :nA7� C_IJ_ rnnl,iTAL__ilnlr flrivE
This is to cui--Ify the said structure meets with the require-
ments of the Buildir,6 Curie of the City of Tigard and the above
referenced restriction is hereby released and terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigan? nas caused this certificate and release of restriction
to be exH<.ited this 4th day of December , 1973 .
Title. Cii Recorder
STATE OF OREGON )
County of Washington )�s
On this 4 q- day of �, r'Ca.,. �,oa , 19_11, personally
appeared before me the above named �j ;S tRcyr c. , who.:e
signature tvpears hereon and who a^knowledged to me tHat he executed
the same i., his offica]. capacity on behblf of the City of Tigard.
Notary Pi lic of Oregon u
!WV Commission expires:
TNOrdUM,Drava«M a�ee.d.R tlrabm
u. Ala,?'' �7Tr.....................n.i.D�pw'
som 955 14-3
07
STATE OF OREGON ss '13
County of s'.'�shlni 7
I Royer Thomssen Director of Records
and E�ectlons and Ex-Of4lclo Recorder of Com
veyonces for sold county, do hereby certify
that the within Instrument of writing was
received and recorded in book of records
No. ...__.---......_
of sold County
Witness my hand and seat offlxcd.
ROGER THOMSSER Director of r
Records & Elections
d A�
��14i"
Deputy
1�t
12 0%PH173
Slu aw ■w ■e
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xC
i 1
CITY OF T
1GARn
O
REGON
Owner:. . T.ua.lxU.n..Dvvj?,..,QpM9nt. .Gampsnx.. ...Pc rrnit No. _ 7.3-183 �
Building Address-1047S.- SJJ....Cantury...Oak..ori.va . �
Certificate i� horehy given this....2gth-day of ..Nauamber. . .... 19.7.3..
that sa;d building may be occupied and
that it complies with all requirements of
t
the Buikling Code for the City of Tigard,
as approved by the Tigard City Council.
.............. ........
Building Inopector
i
i 1.1M iM U •
s� r
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. ' ----_
DATE:// SAI Z—is DATE ISSUjD:�.1__L
OWNERS NA-AE : __- T-y C
ADDRESS : �7 �6 - --- �---
CONTRACT0R :__--.,_-- – - -- ---
TEST: A'r[], Water E] , ��ist:a( ] , La" ,ratory [1
RESULT: Approved' , Disannroved -1 Pending C]
SKETCH:
18PECTOR DATE
)TE Attcch supoiementoI test doto hereto?
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME :_``?' -- PERMIT NO. :
DATE : 1e- /iila DATE ISSUED:_ / /
0 NNERS NAME :
ADDRESS :
CONTRACTOR :
TEST. A r J, Water E] , visual La', ,rotary r1
RESULT: Approved Disapproved _7 Pending p
SKETCH:
1
I� SPECTOR DATE
[NOTE Attach supplementoI tort data hereto?
Jity of Tiaard
INSPECTION REQUEST
for
----_— .__.._. ��.1 �.•ate . ..,...... _.__-
!NSPECTION TIME . T ._. PERMIT NC. .
DATE .* 9 1.2-8 23 DATE ISSUED
OWNERS NAME '
ADDRESS: —104 '1
C,0N"rRAr,TCR : —
:-EST ' . Y, ter[] , V' ,.c; ', ,�� ►ct�r" .� a
RESUL',* .F roved -Uppf)wtd G L7
SKETCH:
lsci*
PECT0R DATE
[NOTE.* Attach suppiementai test uatc iie►�t0,
September 199 1973
Mr. Poy Brown
Project Manager
lualatin Uevelupment Co.
1530L1 5..,. 116th Ave.
Tignrdt lregon 97213
flea L Mr. Urown:
On September 19, 197;, a framing inspection was mads
for lot 26 (Job #5n2'')) in Summerfield. I found thc,
house to be in compliance With the Uniform Building
Code "except" for the trusses*
t find that the trusses are not a good machine fit
as roquired and I must urge you to make the necessary
corrections.
Trusses must be tightly fitted at all connections end
splices wherp m truss clip fastener is to be ised.
I did approve Job #h02.6 for cover but harAeftsr the
above is to Ug a mandatory requirement.
If you hav(, any quuatiuns regarding this matter ,
please reel froe to r.all mo at.
Sincerely,
James Brien
City Inspsctcr
Jp`fs
i
amity of Tigard
I
INSPECTION REQUEST
for
NSPECTION TIME - PERMS I NC. . _ 1
DATE : DATE i SSUED . I
OWNERS NAME ' _ - e- _
ADDRESS . _1__ 0 ;�7 _��-. . - ----_.
`a0N,rRAr'T0R . _
; EST w terp , V :�r.�AT '_ab,:rctar% r7
RESULT' ,p.-ruvedr?' pp Ll
SKETCH,
I
NSPECTUR DATE
COTE: Attach supplemental fest aata heret� I
a
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : –2 3 PERMIT NQ. : --_---
DATE: 51 M312 DATE ISSUED'_--L--L—
O W N E R S NAME : --------------
ADDRESS : -- -- - --
i
CoNTRACTOR :_ --- -- ----
I
TEST Ari, Water�f La'- .rator•i r1
RESULT: Approved-OrDisapproved 1 Fynding J
SKETCH. - ..
I
I
I
I
I
I INSPECTOR DATE
COTE : Attach supplemental teat data hereto
ty of Tigard
INSPECTION REQUEST
for
INSPECTION TI E . r'ERMI C NO—
DATE .
O .DATE . — 'SATE ISSUED'__�_r
OWNERS NAME ' _
AD DR E S S :
CoN1 RACT0R :.—_— _
I
TES I , -j . Wnter La . rr,l
RESUL'► Hppr,�,ed L7 :,(:xpproveo,
SKETCH:
--rte
14 3
INSPECTOR DATE
C')TE ' Attech supplernentcl 'r;. u'f• neret]
�r
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : _ PERMIT NO. :
DATE : //aLZ DATE ISSUED : I
OWNERS NAME : �C_ <-'-- _ _
ADDRESS : _4,0 $- ►�> ��,ec/�
CONTRACTOR :
EST : Air �. Noter❑ , V;suaix, Laboratory G
RESULT : J',p. roved , ai3gpprovad G �Jerldirta ❑
SKETCH,
INSPECTOR DATE
NOTE Attach supplemental test datn a-;etol
ar �r
PLUMBING PERMIT _PPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. 73- 7 If
Permit fee —12 h U-1,�
Wates Closets Tcilts Permit T:;s _.�
1► Bath Tubs"" Approved by _
Lavatory Wash Basin Building Perm
Shower _ Receipt No. _
1n s D;shwas ing—
in sJ Kitchen
Sin3 Crdinary Location of Building K1
Sinks. Slop _
Au (.)rna�j.c vis washer
Laund,_r'v Trays Name & Address of Owner
Drains, Floor
is, Area
----.------
Draill:i, e r era tor -
Rain Drains
0096 AutomatiE Washer Name ,ac` Address of Pl :tuber
-roun:Fains Drinking
rountalns�Ta - -- —
Hot Water fank -
Water Service Size_
l-Iringls Building Old or New) (Alter, Repair or
Ca cfi-Ta ns mar -
awn
in er System'
Swimmir Pool Me
5 rinklEr ays 'em V i _
T,,1s permit becomes null and v:)id if work or constnicti^ri authorized is not
c mmpnced within 60 day.-. , or' if cors+ruction or work is suspended -r abandoned
r a period of 120 day:, at .iny time after work i-- c-mmenced .
A ! l plumbing firms must b- licensed by the City of Tigard and post a $I ,,-)00 bond.
1 !Hereby certify that I havF, --ad and examined this applianon arl know the same
t -) be trus- and correct. All. provisions of laws and �:rd .nances g-.v.�rn1ng this typ
of work will be complied with whether specified herein cr not, thf, granting of a
permit does not presume to give authority to violate - r�arncel t.h, pro',ii,ions
of any ether state or local I.aw regulating construct-lor r the � -.rformance of
const action.
Signature f Apl . . ,n
1
City of Tigard
INSPECTION REOUEST
for
N,113 PEC'T ION TIME :-_ PERMI,r NO
DATE '. L //7/23- ')ATF ISSUED'—,..'
)WN)ERS NAME ' . TQ1 C,
9 - ��&
AODRES
G- Wl R ACTOR
TFS] Writer — "I,
LJ t La W.
RESULT
SKETCH:
INSPECTOR DATr
[N:,)TE ' Attach supplementer
CITY OF TIGARD
17120 IL W. M.In PrOW
TIGARD, OR23M V=
APPLICATION FOR BUILDING PERMIT
New Construction FX]U De.toli.sh EJ Addition 171 Remodel El Move
ZONING`)gip DATE ISSUED ?IV BUILDING PERMIT
BUILDING FEE $ 77.00 No. ,73 1:93DATE RECEIVED _ __ -
PLAN CHECK S 10.00 VALUATION $
OTHERTOTAL $ 18,2D4 —
B' —
$ RECEIPT No.�
TOTAL
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
IAT N 26 MAP NCENSUS TRACT � ,� JOB A
Architect or Engineer Tu&letin Dwftlopwnt 00.
Address 15300 s•W• 116th0v*•. mrd
Timrd Phone --
--- - -- -._
Owner-
- .—Phone-
Builder------ .�
Phone
-- -
Builder _ _ T
BUILDING USESingle Res. a Multi Rea. U COMM. Industrial C
OCCUPANCY GROI'P—I No. of Stories 1 -- Total Height__j6 Area of Lot,
Type of Construct,.nn V Floor Area 11 -- 1- 1230 2—
Set Backs: Front 10' Bac4�t�! L.Sidei�l!_ _ R.Side` 1
Private Sewer Pipe Size 4" Sewei jj C"y Septic Tank Li
water Service Pipe size— 4" - Storm Sewer Ili Ditch ❑ t :ywell
Street and Curb Requirements esieting_ - ---
Driveway Width Igo __i__�__ No, of Parking Spaces___��
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPF.''IAL INFORMATION
ADDRESS ASSIGIJF.D_`
FIELD CHECK BY—---- __ _�- _.. __ .�- -_-- -------DAT£,�a'g-T3
PERMIT APPROVED BY
It is unfif.rstood that all work will conform with applicable codes and ordinances
of the FLate of Oregon and the City of Tigard, Oregon, and that the building wil
not be occupied until a Certificate of Occupancy has been issued by the City of.
Tigard Building Inspector.
S gna "ure c,T^ plicant
EXHIPIT "A"
CITY Of' TIGARD
Re, ' 'ential Structure Occupancy Reetrictiun
KNOW ALL MCN BY ^".' -SE PRESENT:;, That occupancy of residential
tructure (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Dee" Record:;
of Wa!,hington Cuunty, Oregon, is prohibited by the ordinance of the
City of Turd, Oregon:
DESCRIPTION OF PROPERTY:
�'<',,.K,. . ., \,.•«,N�\riCjw.+ CC.,ac Y, L'1 ftF C10f-,
ADDRES5 OF PROPERTY: NN&
NAME OF OWNER
ADDU-.5S OF OWNM:
.N WITNESS WHEREOF, the undersigned has caused this; restriction
to be executed this day of 1>,
OWNER:jRLyrrN �"GOir Awr C�.
Name
AHIROVEU:
T_tle
by:
building Official
City of Tigard
STATE OF OREGON ) es. August B 71
County of Washington ) R' graMn—yVicley.iseeident
of Tusistln Development Co.,Inc.
gjsonally appeared before me the above named
and acknowledged the foregoing instrument to he
volw:Lary act and deed.
Notary Public for Oregon 1�7!
My Comm'ssion Expires:
I�S�ZF ffiXFIIHIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MGN BY THESE PRESENTS, That occupancy of residential
tructure (n) on the following described lands prior to the recording;
of an occupancy permit releasing the restriction in the Deet Record:;
of Wlvrhington County, Oregon, is prohibited by the ordinance of the
City of Tura, Oregon:
DESCRIPTION OF PROPERTY:
v — •.--• qL- \ , \--
v , r-r( n' -4.4 M Qee E -32 P.0 Sn X3/0 Re
r�t^rnq�n l� �Otli7�r � O�'e NOh ,
ADDHl:O:1 OF PNOPERTY: S_.,l
MME OF OWNEF: ^
J
ADD.rb-.ij OF OWNER: �\
-V
IN WITNESS WHEREOF, the undersigned has caused this restriction
r.0 be executed thi; Tv day of. b
owNF'r: W,06vr..v �EVELo�e►K.� �1n� .
n
Name
APPROVED: By:
T.tle
// G
By: /. s,L.1 2_ iu.e rw r.enre......RF.'. .C._....a;.74.11� �R-r,m
ldi 6ffi al ROCcs1.p a IMoae•b ci.nron.
1ty o d Pr ...._._.............._. r.
STA E OF OREGON ) ns
Count,, of Washington ) August 8 ) 73.
Personally appeared before me the above named Roy Brown, Vice Prasident
i l +ialalin Development Co. Inc. and acknowledged the foregoing instrument for b—e
his rolw,:.ary act and deed.
Nota;; Public for Oregon ^
by CUI..T';;sion Expires: January 16. 1975
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