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10505 SW CLYDESDALE PLACE `Ef co cn A � cyl w1.� m. rj) Fd Aj h w 19r CEJ � 3 'tl t G7 U H tt i lam, C7 r � h � 10505 SW CLYDESDALE PLACE 9DVI i TIVOSRCN1 0 T3 SOSOT ti Q El ad Y F? I'"i41 f. E _ O � _ n IL, V, t 13 fu V ` C24 rl, to E , ,a �� LO 0 .. Ln City of Tigard Mechanical Permit Permit­- Fee- New ermit___Fee_New Installatiun Replace ❑ Relc -9tion ❑ Addition ❑ Alteration E-7 3%State _ TOTAL. CONTRACTOR OWNER ADDRrcS WORK ADDRESS PHONE +� APPLICANT________ Heat Input Rating (BTU Per Hour) Vent Size _ Flue Size FUEL OIL ❑ GAS ❑ ELECT ❑ OTHER ITEM NO. FEE ITEM NO. FEE For Issuance of Permit_ __ 3.00 Air Condition Compressor 15 to 30 HP — 10.00 New• Under '100,000 BTU _ ----4.00 Air Handling 10,000 CFM _ _ 3.00 New- 100,000 BTU &over 5.00 Air Handling Over 10,000 C_FM_—_ _ 5.00 Floor Furnace _ _4.00 Evaporative Cooler —� 3.00 Wall - Flo_or_-Suspended 4.00 _ Range Vent Fan _ _ 2.00 Install Vents Only _ 2.00 Vent System _ _ 3.00 Repair - He+it&Cooling 4.00 Hood Commercial 3.00 Air^ondition Compresso• Under 3 HP 4.00 Commercial Duct System --_ 10.00 Air Condition Compressor 3 to ,S HP- - _ 7_50 INSPECTOR'S COMMENTS_ CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS v APPROVED BY DATE ISSUED BY DATE RECEIPT NO. 774 Signature of Applicant !! „.y........... ..»..�.y.�y��.,w,.y-.�..,r-........,...r..4,n.;,�.,,,.,p1,^,1„�"""""”"K•.....w..,,�y,,,YI,w.IM„rv,.r.-o.�y,�p,.,�.�,,..,,;�bw�.�(pa�.'�"s 9�llllk wYh+:,iirinenw ar,.n:.....,:e.,�.,._ • -i'_" CITY o' �*�11 ,, N° 0145 BUILDING PERMIT APPLICATION TIGARD DATE Ig THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLIP AN9 SPECIFICATIONS. OWNER PHONE It.l Tli;�r;•�;�11lp1"1 InS15 S.W. Clydesdel OWNER ADDRESS �UILDER PHONE JWfI®f ENGINEER BUILDER ARCHITECT — _ DESIGNER STRUCTURE ONEW ❑REMODEL ❑AUDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION O RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSn^ATIO ❑CAR PONT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE ❑BOND ❑MOVING ❑CONDITIONAL.USE ❑DESIGN REVIEW ❑COUIVCIL APPROVED ❑SIGNS q_CUPANCY._._._._LAND USE ZONE_—.1. BLDG. TYPE FIRE ZONE.—PLAN CHECK BY ffa _-- HEAT_ as --- conetru'-t 1378 eq, tte freele duelling accurding to appruved plant, -Atached garage —no briaseatint. QAC, LOAD FLOOR LOAD 4 HEIGHT _NO.STORIES 1 AREA 3'��_ VALUE s013 BUILDING DEPARTMENT SET BACKS FRONT 31 REAR 18 LEFT SIDE 13. RIGHT SIDE 6-6 Permit 1 .00 THIS PERMIT IS ISSUFD SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check 101 Q0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS 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 1%State r LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HrATIN(, Total RS�14xt�Zl �i Py ----- — _------ - .._.__.— .—_--_ APPI.ICAN T i)P At, N 1 Approved Receipt No. ALIDRE55 PLUMBING DATE — REMARKS _ DATE INSP. TYPE INSPECTION Contractor AiA£<�7 Permit No. Z,01V Rou h in 00 1 Fixture Final — -- — �� --- --- �y HEATING �&•!� TRC Lr ST�L'Ca �p7a1 /Trt�S ie l Contractor <� �— Permit No. /S� - ��-7S �a6ereIZJV�e j`pt' � �; � ~�N Gas or Oil - 3 7 S ,4 S TeS� cros -- ;G'v n l- FT Rough in - -- Tb -C44i t 4wle?v /Z6 t7�! I� R S c 1 Final —_�—_— — SEWER /n.7S OKE-��"f' iNs/aCli�� �s UIxX� Final_ - DRIVEWAY -11' �� /lt �- �• ,,.2��fr�c✓' � , E,v`._�_ PC Final -- -��. Storm Drainage - •.7 `� �-�—�z�'-`int (Rain Drain) Final _— - -� Sidewalk CVTeloe C'(- Curb Ai Street Final L e _ Approach SLOG.DEPT. FINAL TEMPORARY CERTIFICAI E OCCUPANCY . Final C!_RTIFICATE OCCUPANCY -- `� -75 Landscaping Zoning Final _ EXHIBIT "B" CITY OF TIGARD 15521 CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION The City of Turd hereby certifies that the occupancy of the following described structure or premises with respect to which a restriction of occupancy was, on 12-5 _, 19—D recorded in Book 955 , Page 431 , Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRI17ION OF FRUPERTY: Lot 8, Clydesdale OWNER: Daniels, Wigging L n-nimis, Gentractnra BUILDING PERMIT NUMUER: 73-273 BUILDING ADDRE3S: 10505 S.W. Clydesdale Place This ii 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 WHEREUF, the undersigned authorized officer of the City of Tigard has cauaed this certificate and releaae of restriction to be executed this �_S' day of / , 197/. Title: STATE OF OREGON rr County of Washington ) ' On this _ day of 197 , personally appeared before me the above named\)11„�� � _, whore signature appears hereon and who acknowledged to me t'hnt he executed the same in his offical capacity on behalf of the City off Tigard. /^ 1L o ary ubl(ia_o, regon 1 My Coor xpires: ..23,/J;�757 1 UMI d.....,G...t°��.......:..IYI1.m !e.A M lift 1„U HOMSSM. Thm'.,ftf%*_top 0 l:I.cnan. pyo BoosX87 EI �L fi �x 13E 0 .0, a. CITY OF TIGARD MECHANICAL PERMIT DATE I., -7 PERMIT NO. 7y-_ _ RECEIPT NO. BY _ FEE _ 1. Permit shall be obtained prior to commencement of installation. 2. Permit shall be obtained for all appliances which are to become a' fixture to the building. 3. Relocation, replacements, alterations, or changes to burners and duct work require permits. 4. All work to be concealed must be inspected before cover up. New Installation Replace ❑ Relocation ❑ Addition ❑ Alteration E] 'ONTR. ,' Q. OWNER T ) ADDRESS J► 7C < <L c'..:: �� i"= ,. ,1 i_) WORK ADDRESS 1�:, c,•S u t � 7•= 7,��c j7�Ac� APPLICANT TELEPHONE NO. ?_-1(- -7 -7 1,. FURNACE - MANUFACTURER t _r 'i ►j c n TELEPFONE NO. _ HEAT Input rating (Btu PerHour) 1 ?'7 c,r c • Vent S12.e Flue Size FUEL OIL [A GAS ELECT U OTHER TOTAL SQ. FT. Top Floor 17k Main Floor Basement GENERAL ITEM NO. FEE ° ITEM NO. FEE 1 For Issuance of Permit .00 Boilers Over 50 Hp New - Under 100,000 Btu 4.00 Air Handling 10,000 CFM New - Over 100,000 Btu_ nn Air Handling Over 10,000 CFM Floor Furnace 4755-- Eva ora ive Cooler Wall - Floor - us en aT {.00 VentFan Install ens 2.07 ---TenI ysfemFqi5.O Re a r - Heat & Cool.in� .G. Hood Boi ers Under Ip00 Domesc nc nera or Boilers 3 to 155 N 4.50 Comm. Incinerator _ 20.0 Boilers 1t 0 0 10.00 er oListedi -'3T o 5- INSPECTOR'S COMMENTS APPROVED BY DATE -7-j,7-?l ISSUED BY _ _ DATE _ Signature of Applicant i t City of Tigard I INSPECTION REQUEST for I INSPECTION TIME: PEPMIT NO. :----- DATE: O. : _DATE: slg- 0/12'Y DATE ISSUED OWNERS NAME :ADDRESS: _ 7 �__� CONTRACTOR : r ' `�- ------ __ TEST : Air 0, Wafer❑ , Visual p , Laboratory [] RESULT: Approved 0 Disapproved ❑ , Pending g' SKETCH. INSPECTOR DATE 1N07F - Attach supplemental test data beret] ALL SPACES MUST BE ENDORSED PRIOR TO A PROV L OF Tl- r-SE PLANS D PUBLIC WORKS DEPT. By i� ATE -- PLANNING DEPT. BY DAT:: BUILDING DEPT. DATE COUNTY HEALTH DEPT. BY------- CITY ADMINISTRATOR TIGARD WATEZ 915T, BY GENERAL TELEPHONE U S A N. W. NATURAL GAS T. R. F. D. V City of Tigard INSPECTION REQUEST for l' INSPECTION T14E: PERMIT NO. : DATE: l> /)X/22 DATE ISSUED :___L_L_ OWNERS NAME : ADDRESS: ("L /L' CONTRACTOR : TEST : Air ❑, Woter1❑ , Visual ❑ , Laboratory ❑ (RESULT: Approved LJ Disapproved ❑ Pending SKETCH: INSPECTOR DATE C01H : Attach supplemental test data beret City of Tigard INSPECTION REQUEST for INSPECTION TIME: / 'r4Z� _ PERMIT NO. : DATE: 31�-ILZy DATE ISSUED :--J- Z I OWNERS NAME . ADDRESS: _f_L_ — - Z--�/DE5-od44�1- CONTRACTOR : TEST : Air p, Water❑ , Visual1L.aboratory p > I RESULT: Approved , Disapproved O Pending p SKETCH. I f I I I I INSPECTOR DATE NOTE: Attach supplemental test data berets i City of Tigard N i SpECTioN REQUEST for INSPECTION TIME: PERMIT NO. :— DATE: O. :— DATE: DATE I'S-,SUED : I Z OWNERS NAME : ADDRESS: — is sC �_ Ll"_ cL�_ I CONTRACTOR : TEST : Air 0, Watarp , Visual p , Laboratory p RESULT: Approved , Disapproved O Pending p SKETCH. i I I fI I I I L9SPEC70R DATE UTE: Attach supplementnl test data beret a] i City of Tigard INSPECTION REQUEST Q ST for INSPECTION ''TIME. PERMIT NO. :--- DATE: O. : _DATE: DATE ISSUED :—.,L-/-_ I OWNERS NAME : ADDRESS: f 0 S o S' S C,,,/ CONTRACTOR : --D _k1D I TEST : Air ❑, Wnter❑ , Visual ❑ , Laboratory ❑ RESULT: Approved,,$ Disapproved ❑ , Pending i❑ SKETCH. I I I i I INSPECTOR (DATE I [OTE: Attach oupplementol toot data beret] I 1 I City of Tigard INSPECTION REQUEST � Q for INSPECTION TIME: PERMIT NO. : DATE: 2 126 1 DATE ISSUED :-- Z I OWNERS NAME DLL' r ADDRESS: CONTRACTOR : �_ I TEST . Air p, Water❑ , Visual p , Laboratory p RESULT: Approves' , disapprovsd O , Pending p I SKETCH; INSPECTOR DATE I EOTE: Attach supplemental test data be►etio I City of Tigard INSPECTION REQUEST for INSPECTION TIME. __ PERMIT NO. :— DATE .- O. : _DATE : DATE ISSUED : I Z OWNERS NAME '. . 'J ADDRESS: Nur CONTRACTOR : TEST ' Air u, Water[] , Visual C] , I_abo—tory RESULT: Apnroved� , Disapproved ❑ 'ending p T SKETCH. I INSPECTOR DATE CUTE: Attach implemental test data beret] It I C y of Tigard INSPECTION REQUEST Q ST for INSPECTION TIME : - PERMIT NO. :_, I DATE.' _� /'�/ DATE ISSUED :- Z_ OWNERS NAME : ADDRESS: 7- CONTRACTOR TEST : %ir Lam, Water❑ , Visual ❑ , Laboratory 0 i RESULT: Apnroved � ' , Disapproved O Pending p SKETCH.* I i NSPECTOR DATE [NOTE: Attach supplemental test data beret] d PLUMBING PERMIT APPLICATION Jurisdiction of No, Type of Fixture Fee Permit No. y-' Permit fee -j -L Water Closets (Toilets)_ fc Permit Issued :2-�9 Bath Tubs .l Approved by >� Lavatory ash Basini- ,, Building Permit Shower _- - •5 Receipt No. 96- Q Sinks� D .shwashingi_ Sinks' Kitchen Sinks, - — — Location of Building _Sinks:_Bar _Sinks, SSllo _---------------�__—___.---------- Automatic biwasher - n Disposal. _--- - ---- _ _Laund_'ry_Tra�s Name & Address of Owner _ Drains, Floor__ ___ _Drains Area _______ ------- ---------------- - _Dra i n�R f ri ge ra to r ___ -------- ---�-•- ---_.___.._ -- �1 -Rain Drains 1 Automatic Washer a1, �� Name & Address of Plumber —__— oun ains r n in _ _Fountains• Soda ----- L !lot Water Tank _ _��_--------------_ _. —._. _i Water Service Size Urinals -- c.� Buildin Old or New) (Altera Repair or_— a�7fi=Bas1ns and _ �� �'nstM Y Lawn_Sprinkler_ System _ I� - ---`--_ L-------.�- --�—_ Sw i.mm i n—Pool --- Derinjer System - -- - --------------------____,..--- -------- This permit becomes-null anti vold if work or construction auth":'rized 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 bond I hereby certify that I have read and examined this application and know the sam to be true and correct. All provisions of laws and ordinances governing this ty of work will be complied with whether specified herein or not, the granting of a permit does not presume to give authority to viol-ate or cancel the provisions of any other state or local law regulatint; construction or the performance of construction. --------------- Signature of Applicant— City of Tigard INSPECTION REQUEST f o rn INSPECTION TIME ' //' : r1� r'ERMI r NO. . . I DATE . ')ATF ISSUED' ---j-' OWNERS NAME 2W'c _ A D D R E S S ' S, C4.YLMLiIIr 9 IG�1(i Nnter ; RE51! :T HNpru,ar' _1 c„ t I I I I NSPECTOR DATE ! [NOTE : Attach supplemental 'est Or. neret-10 J s of Tigard INSPECTION REQUEST far ' NSPECTION TIME. PEP,MI I NC. _. DATE:,/ -� ' ? -)ATE iSSUED ;)WNE RS NAME ADDRESS . niv rP4,, TCR . RESU.L_r ._� :Je:! G :upps ,.gid G .-widioq u I SKETCH: I i —75 I R i 1N6PECTOR �+ DATE r- I NOTE: Attorm supp emental teat uut❑ '.,e►rtJ I f UNIFIED SEWERAGE AGENCY NO. _ 4935_ _ WASHINGTON COUNTY DATE 1 1 13, 3 4 CITY t APPLICATION FOR SEWER CONNECTION PERMIT t OWNER: OWNER'S ADDRESS: PA. -aoY--23151 STREET ZIP- -- - 57ATE BUILDING SITE: LOT -_ BLOCK _ ADDITION Glydeedalw --- TAX LOT N0. .-- — TYPE OF OCCUPANCY - pesidene-e — - l1 ADDRESS 10505 --S.W. Clydesdale Place --- — DWELLING UNITS .1 _- — FIXTURE UNITS ----- I SURCHARGE IF APPLICABLE - PERMIT- FE E 450 INSPECTION FEE 25 TOTAL DEPOSITED 4 (NEW) (EXISTING) BUILDING SEWER SYSTEM Tigard_ _ The Applican' agrees to comply With all rules and regulations of tie Unified Sewerage Agency. APPLICANT -- SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION 10 THE SEWER SYSTEM. LINE SIZE 4" INSTALLER -- RECEIVED BY (AGENC OARS AGENTt COMMFN15 _ This Application and permit expires in ninety (90) clays. The amount paid will he forfeited should expiration occur. CITY OF TIGARD 12420 S. W. Main •heW TIGARD, ORIGON WW APPLICATION FOR BUILDING PERMIT New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move❑ 7c-iNING g-7 DATE ISSUED 11-13-73 BUILDING PERMIT DATE RECEIVED BUILDING FEE $ 94.00 _ No. BY _ 4.80 r PLAN CHECK $4 .0 73-273 OTHER $— 94 :hatginy VALUATIOtJ $ 26,389 TOTAL $ IA91.CIA RECEIPT No. 917 7 �1 7 TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT M 9 MAP # CENSUS TRACT _!- _ JOB # Architect or Engineer D.W.D. Address P.D. Box 23551 -----------Phone Owner_ Q.W.D. _-- Address same Phone Builder Address-------------- - -__-- --- ---Phone BUILDING USE Single Res. x❑ Multi Res. ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUP_ No. of Stories 1 Total Height__ Area of Lot Type of Construction 2XXXXXXXXXXXXIX V Floor Area B_. -. - 1 .1639 _ 2-.=-- Set Backs: Front— 20 Back 27 _ L.Side 7 R.Side_ 7 _ Private Sewer Pipe Size` 411 Sewer Laa Tiaafgptic Tank ❑ Water Service Pipe Size 3/411 Storm Sewer © Ditch ❑ Drywell❑ Street and Curb Requirements Exeitino Driveway Width 19' No. of Parkinq Spaces 2 SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED JnSn% 9_W_ FIELD CHECK BY JB DATE 11-13-73 PCRMIT APPROVED BY 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 an issued by the City of Tigard Building Inspector. qna ure of Applicant EXHIBIT "A" CITY OF TIGARD Residential Structure Occupeny 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, Dreg..,: (The City will issue a release as soon as a final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: AL f; ! AM 111 A i i i i 'Ali ADDRESS OF PROPERTYt / C)SL-�, �,�✓, CLKID"- I:i/�1 NAME DF OWNER: t)Anlle l �Ll!G�=�I�S -+ I�An/!k<,`� ACL /1-K1)C iu1CS ADDOESS OF OWNER t 1 sub IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this 13 day of A/o 1/ OWNER: Name 1^ g-IA/C- APPROVED: • B3+ diBuilding ��cfl`-' City of Tigard STATE OF OREGON County of Washington •a' 11\cv 19 I y Personally appeared before me the above named and acknowledged the foregoing instrument to be voluntary act and dead. .9 Notary Puc for Uregon �— My Commission Expires: Lit irI I i�i � 15 . d ROGER THOMRREIV. blt"Gr d ww 055 iI Ol •a STATE OF OREGON / County of Washington I Roger Thomssen Directnr of Records and EIcctions and Ex Officio Recorder of Com veyances for said county, do hereby certify that the within Instrument of writing was received and recorded in book of records No. _ .. of said County Witness my hand and seal affixed. ROGER THOMSSEN, Director of Records & Elections 1,-1�e� Deputy �+c 5 12 o7 PSI'"l3 EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (a) on the following described lands prior to the recording of on occupancy permit releasing the restriction in the Dead 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 u final inspection determine@ that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: ADDRESS OF PROPERTY: o L �,-✓. L����I=S�AL� ID�h��L NAME OF OWNER: �-LA(,G,rVj LAVIt-1..5 y �-_n/iIc/�CILF•S ADDRESS OF OWNER• I"�L7 h�'� - �,/�k'l� IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this _ - day of A/ j OWNER: ame l�2 AILfe APPROVED: Title By, Ouilding Of • City of Tigard STATE OF OREGON County of Washington ae' lac 19 Personally appeared before me the above named _ and acknowledged 'she 7oregoing instrument to be voluntary act and dead. NoMy t ugtc for rsgan LA`)-) MV Commission Expirees 1y F, kddres4 la S`G j SSV' Permit No. 3 Y" Permit charge Uhnier Connection fee y G� Paid by • Type aJ!,h 'r e _ ../`Ldp:�--�.• ,,. Date tonne�•ted d ",ervi rube _ ` � W, `� 1,G__�Y_ Inspection fer S J P%id I'y a gate Size of ct.c, ' i n .. Assessment �__� _ pari