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® EXHIBIT "B"
CITY OF TIGARD
C2�1tT7FICATE OF OCCUPANCY AND RELEASE OF RESTRICTION
'The City of Tigard hereby certifies that the occupancy of
the fallowing described structure or premises with respect to which
q res«riction of occupancy was, on
recoreed in Book rj_, Pam _ q G5 Deed Record of Washington
County, Oregon, is hereby atthc.rized and approved.
DESCRI17ION OF PROPERTY., �, cy�� � �s-�•�
OWNER:
ikUILDiNG PFTIMQT NUMBER:
.3IJI LD:NG ADDRESS:
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 is hereby relfased arid. terminated.
IN WITM;S WHEMOF, the undersigned authorized officer of the
City of Tigard has caused this certificate and release of rtstrictiun
to be executed this /j day of / n j, _, lye.
Title:
STATE OF OREGON )ss
County of Washington )
0n this _ � day of __L .�,= 19a, personally
appeared before we the above named r �v'% t. , whone
signa'.ure appears hereon and who acknowledged to that he executed
the same In his offical capacity on behalf of the City of Tigard,
Notary ftblic of OregonT_
MSV Commission expires:
3.3
Pat
A.W'gtM T140MASEM.DrNelm W Mradr VA018n
,.� �� s►..w. ._ ............_ ...............Draput►
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CITY OF TIGARD MECHANICAL PERMIT
DATE ��" PERMIT NO. RECEIPT NO.
BY &A4" e• r_ FEE 7--
1. Permit shall be obtained prior to commencement of installation.
2. ie.,nit 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 Installatipn eplage Relocation ❑ Addition ❑ Alteration L]CONTR. "7�a4/Fc Biu ✓c / l C OWNER
�fD.
ADDRESS _1S3F,� 'C( /�/- 4' Mllf`'• WORK ADDRESS ��.•''S fll.Cti.'. /.'
N/ APPLICANT
TELEPHONE NO.
FURNACE - MANUFACTURER TELEPHONE NO. -—-------— -
:-w
HEAT Input rating (Btu Per Hour) �• Cs'r Vent Size �a _ Flue Size - --
FUEL OIL ❑ GAS Z ELECT ❑ oviER
TOTAL SQ, FT. Top Floor Main Floor / `r' Basement -
GENERAL
ITEM NO. FEE ITEM N0. FEE
For Issuance of Permit .00 Boil.e.•s Over 50 Hp 25 0
New - Under 100 000 Btu 4.00 Air Hal idlin 10 000 CFM 1.0
ew - Over100u_ r andl ng Over 10,000 C
Floor VurnaceEvaorative Cooler _
Wall - Floor - SuspendeT +.00 Vent Fan
InsTall ens ent�yein — 0
Re air - Fieat & Cooling 14.00 Hood _
Boilers Under 3 H 4.00 Domestic Incinerator y - 0
of ers o .50 1 UOMM.�Ic nera or 20.0
—11—
0 H 10.00 Other �LYs_£_e3-=-- �
Boi ers o -- —
INSPECTOR'S COMMENTS — — --
APPROVED BY DATE ISSUED BY _ _ DATE
Signature of Applicant •l�9ll .
w w s s
City of Tigard
INSPECTION REQUEST
for
SPECTkPl T? ME : PERMIT NO. : .—
UAT E: -;' /C' L'S` DATE ISSUED:—L--L--.
NNERS NAME * —.----
ADDRE'SS ' • ------ —
JNTRACTO R : iPu —
-
EST: .A r [], Water Q , sual,E(, La" ,rotary PESULT: ,�
Approved �.3`,,, Disapproved _l , Pending T-]
KETCH:
INSPECTOR DATE
)TE : Attach supplemental teat data hereto]
P
V r lhd, 1, '�• i:la afA�' ... 'i4 IIS lk V��� /'
,.c1 Li. t '1 •�+ ,�4 N' " . 't I. el
,W,11 N! /.y� ,. - tl
�w?(, \�.w F .rv'dl' �r.� �r \•./ b•d \"j./ � �./ �•�I �1�Ir "',✓�• \'•�' ��,+' 1Vi \r•.% c t
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�,'�, .A''�� _. Vie.-�c-.a'vm:.rgi•?',q�{s't'a.^�we�+?wr+4w� .__._ -R..s,qR-7.�at'�:amxxa-_.-•.��x-•..--- - - - _ --- -- y'-''• y !` "'�i
r' GOF O
CITY OF TIGARD
ej IVOREGON
.o� f ln. pPermit
1No.-....
Building Address
.....159Z5...
s �. - Cantuyn�a-CP
-. .2....
* .
}, Certificate is hereby given this......Sth..Aay of....F-eb-r.u-ary.......... 19...7.4...
, I
K _ �;iat said bui)(fing may be occupied and � �
that it complies w44 all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
I
B lidin; Inspector
L 4M
IMF
�j-:": .��i�l ^ ^Jr1 ..^ ,^ ♦♦♦� �..'� A" ��. ���YYNIYP" ^� Y�$•�y� 77 ^ A��YYY / �,_'_
WIT
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:J! ty of Tigard
INSPECTION REQUEST
fcr
v* Z -
NSPECTION TIME . _ V_�PERMIT NC.
1
DATE . JATE i SSUED
OWNERS NAME ' . Z � G-' i5"9Js-" S �r,' �c>^�N�rL1GkC'
ADDRE S S
^ N �RAr'. rOR --
EST ter❑ , `Jjh-►ct�r
RESUL' 1,;ve:1x Supp, a G
SKETCH:
�m
�NSPE6TOR DAVE
IYOTE: Aft ace suppi ementaI test unto 1»r tJ
.1 Y
ALL SPACES MUST dE EIVIID0 D�
PRIOR TO APPROVAL OF THESE PL,%NS
PLIOLIC WORKS DEPT. BY.d.dL��
BUIL:7ING DT:PT. EY—_- -----
COUNTY HEALTI-I DEPT. C3Y.
CITY l .1. ----T., --0R Et. DS.7 Z
TIGARD s:..i'rR D13T. EY� D'
G.!7::7RAL TELEPHONE BY_,. DAT
U �- A BY— 46\T"—_-
N. W. NATURAL GAS BY— DATE-
P. G. E', BY_ DAT-. _
T. R. F. U. BY—....__..._ ____ DATE`.
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City ) .f T gard
INSPECTION REQUEST "
for
NSPEC'TICIN TIME : PERMI i" N0-
DATE . /1-2
n .DATE . / ,i ,. ,'Ari` I SSUf-D' --
OWNCRS NAME ' Ti!�� - -- - -
E 40DRESS :
E
PEST . ',tinter � , `' �. �� ;, Ln �•r.�
E RESULT Appruved d�n�;
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INSPECTOR DATE
I �Na7E : Attach supplemental !o . i1r; nerei]
1
it ()f Tigard
INSPECTION REQUEST
f�
NSpF-CTION
TIME-PERMIT NG. . -
AT E : � 3 DATE I SSUED
JWNERS wAME :
,,ON rRA" To7 R I
"E ST : = N:ter O , '• .,:ct: '� , _u b:ret�r:' '=� ,
RE5UL" d G � Idi, c; Lj
r. -
5 KETCH:
INSPECTOR DATE
LNOTE: Attach supp1er^entol test uutc " -t—o
ity cif Tigard
INSPECTION REQUEST
for
N_;PECTMN riME . PERMIT NC. . _
SATE: _11/1:x.3 DATE ISSUED .--,---/—
,q
Ar)DRESS: _!� �__>5u�.-Gr�:vj��U'�' dr►�_C'
r q TRA r,T O R _---
E ST ' ti,:.ter 0 , V: :a °-abs:►ctoru ❑
RESUL,I +p ruved , ,;;uppto.ad G ;=endioq ❑
SKETCH.
INSPECTOR ATE
r
LN OTE Attach suppiemental test data herrta�
MTN-46
*,V:
PLUMBING PERMIT kPPLICATION
Jurisdiction of
0. Type of Fixture_7 F�-p Permit No. 13
Permi-.'- fee ;j q
Water Closets MilNt5— Permit lssuc-d
Bath Dibs Approved by
Building Permit'
1.2ry �'Wash Baslr,-L-
Shower 1.eceipt No.
I n s Di shwa
Sinks K i tch(-n
Si rik s, Ordinary Locatt f Builder
^g o g
Sinker. ":11 G P
Aut-iritic Dishwasher 7_7 T 7
W�� � W
Disp
Laundry Trays,--- Namp- ,& Address
Drains, Floor,
n.i , Area
-
)rains
Drai ris . Refriger_�it.)r
Drains
Rain Drains
Automatic;
Automatic Washe, Name & A-4dr-st, of P1 imbeT- ,1,_
0 T1 T a I n F 9 --------
Fountains, Soda
Hot Water Tank
Water Service �Size'
Urinals V Buijd1n& (Old cr New , (Alter, Repair or
-7577-7-7—as ins - Y a TT_ Lin
Lawn 'prinkler System
Swi'mming Pool- =e r
n
'"Elis permit becomes null gnu void if work or construction -,iiAthorlzed is not
commenced within 60 day , ' :)r if construction or w: o
;rk is ru.;pend -d r ab;-indoned
!',,t- a period of -.20 day: at any time afte- work is c.-.mmenced.
All. plumbing firms must be licensed by the, City of Tigarl and post a $1,000 bond.
I herroy certify that I have --ad and examined this appll,:ation and 'Know the same
to bo, true and corrt. Ail provisions of laws and ordinances g .%rerning this type
of vork will be, complied with whether specified herein cr not, thF• granting of a
pen,iit does not presume to give authority to violate - i cancel the provisions
of any other state or lo,,al law regulating constructi , t. :-r the performance of
construction.
Ali
SigrAtiu e of App. i -_ant.
I
City of Tigard
INSPECTION REOUEST
for
'NSPECTiON TIME : LO%,1_ PERMIT NO. . .._
DATE : DATE ISSUED'
f OWNERS NAME : l// 2D. (.-
` ADDRESS : a%95 w G>e—v �
C-)NTRA ---
I
TFS 1 r -3, 'Noter .;J�, La rc
RESULT Apprv. ea , t i.,r F;pr��re� 1 tinding ,]
I SKETCH:
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INSPECTOR DATE
OTE: Attach supplemental test ,:a# heref0J
I
r,� ty of Tigard
INSPECTION REQUEST
for
N'-5PECTION TIME . _1:^� PEpM�l' NC. . .
DATE : r %i3 e JATE ISSUED
OWNERS NAME '
A D D R E S S
-.,nN TPArT0 R : —
EST tarp , `1' . .. !• !� , '_abrJ
RESULI' ' ' P- L7 --
SKETCH. 1G,7 G'
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I SPECTOR DATE
COTE : Attar.n sipp,ementol test Uatc he—tol
CITY OF TiGARD
12410 S. W. Main NnN
TIGARD, ORNOON 17447
APPLICATION FOR BUILDING PERMIT
New Construction ® Demolish Addition Remodel Move
ZONING P-A DATE ISSUED 8-8-73 BUIW W P 114IT
BUILDING FEF. $ Op No. �� _ 1 µ
DATE RECEIVED --rjt
I3Y PLAN CHECK $
OTHER $ in nn VALUATION S 17.8T8-ja_
TOTAL $
00 RECEIPT No. gL• 7
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT #-.-- 66 ` MAP A 481 101)- CENSUS TRACT W.8_—_ JOB
Architect or Engineer TmUtin Dewloymnt Oo.
Address _ 15300 3.14. 116Aye'lt, pPhone
Owner.— -------
Address phone
Builder
Address _ _ Phone ff
BUILDING USF. Single Res. lJ 'Multi Res. Comm. 11 Industrial!—,
OCCUPANCY GROUP I No. of Stories 1 _ Total Height �17 Area of Lot
Type of Construction t vlm,M r V Floor Area B---- -- 1 1208 2
Set Backs: Front 171 r Back_- L.Side ,- 9- - P..Side__jQj—
Private Sewer Pipe Size 4 Sewer us* Kin6 Oitgeptic Tank
Water Service Pipe Size 3/40 Storm Sewer 0 Ditch ❑ Uryi•reII C]
Street and Curb Requirements_ xxietiug
Driveway Width- _ 89^ -� _v No. of Parkinq Spaces V_ -
SEPARATE•. PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFOP"'\TInN
ADDRESS ASSIGNED_ 15925 B.W. Oenttry
FIELD CHECK BY JB DATE 8-8-73
PERMIT APPROVED BY_
It is understoud 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 -iccupancy has been issued by the City of
Tigard Building Inspector.
S gnaturp,-elf Applican�t�
I
,�48t33
E)(HIEIT "A"
CITY OF TII�ARD
Residential Stru.ture Occupancy Re3triation
KNG,! ITT. K,61 By THESS 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 i'ROPERTY:
��� �cc'r+r,�: u.♦ �.�.��r i•aq!'rf C."!rH•���� QlrgCrr.
ADDRESS OF PROPERTY:
NAME OF OWNER: VL a
��.
ADDRBGS CF OWNER! Svc. tt� a�� _c• �- �c �:,,.�
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed this day of 1
OWNER:
,.�� /Jl. Na
APPROVED: By: !�/(' f.�
T.tle
By:
Building Uffici !1blkewaeN•._—•�•�j u.�•+��•„J1N',1S1�t
City of Tigard Roanw ae'” d A.uerd� CI-0611,
STATE OF OREGON )
County of Washington ) ss. _ August 7 , 1973
Personally appeared before me the above named Roy Brown, Vice President
of Tualatin development CO-,Inc. and acknowledged the foregoing instrument to be
his voluntary act and deed.
:
Nota Public for Oregon
t1y Comm',,sion Expirer. January 16, 1975
Boar ��� rnoEB -
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EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MCN BY THESE PRESENTS, That occupancy of residential
structure (s) on the following described lands prior to the recording
o: 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:
\ �C �o
Q`S refcc v oerk 'v, �4.� k,- 3nC.
D PA"C'
aeu:; n .kAoO ,rrkl Frr—y ,C�fteca +�
ADDRESS OF PROPERTY:
NAME OF OWNER: ti_ *ty_�
ADDRESS OF OWNER:
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed thio day of
OWNER:
APPROIED: By:
Tule
By:
Bu1.ldinc Official
City of Tigard
STATE OF OREGON ) ss.
County of Washington ) August 7 l9 73
Personally appeared before me the above .,arced AOT SPOw'. WAS President
of Tualatin ID4welopnett Coo 0 toes, and acknowledged the foregoing instrument to be
� it volw.�.ary act and deed.
Notary ublic for Oregon
rfy Comm'ssion Expires: January 16, 1975