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9980 SW CENTURY OAK DRIVE �o w CD C! N E • �iInc,i : ft-74 3APM x40 XHnINSO MS 0866 0 U Z w n � o � J � w W W z Q1 N rn I J, L cr E-1 f"1 0 ct} � i•� ry� v cL, cy :7N I kl [v N ci "�► •` � � \ CJ L7 H � E- ti c m rXIMT "B" 8`7 ki:,CEIVEC1 S CITY OF TIGARD 14AR Z 8 197q • CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION C{'TY OF TIGM) The City of Tigard hereby certifies that the occupancy of the following described structure or premises with respect to which a restriction of occupancy was, on -i,.5 U—'-, 19�1 recorded in Book )�/ `/ , Page (o , Deed Record of War,hinGton County, Oregon, is hereby authorized and approved. DESCRIPTI01? OF PROPERTY! OWNER: GlA/1°TcJ ✓J6F1.�6Lt�p/l�c G� . !/u= BUILD---HG PERMIT NUMBER: LD 110 ADDRESS: 9962 S uJ CAM JT(-,,& 6/9K L)R.I_ This is 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 WHEREOF, the -idersigned authorized officer of the' City of Tigard has caused this certificate and relea-e of restriction to be executed this day of �[w c� 192J-- Ti 92J-. Tile: STATE OF OROGON County of Washindton )ss. On this dhy of personally appea_ed before we the above rvained iii . k y whose signature appears hereon and who acknowledged to me/ hat he executed the same in his offical capacity on behalf of the City of Tigard. Notary P611c of Oregon My Commission expires. INDEX[ riled fm mood./ �.![. ../., .1.7 N PA M P M ROGLR THUMRREM, (hm�er'A br.tr.4 riw -'s 39 o� INDEXED STATE OF OREGON M C C.ouity of Washington Roger T%rwrtsun, Director of Records and Elections and Ex-Officio Recorder of Con- veyun es for said county, do 'hereby certify r'J that the within Instrun wro of writing was re,-eivea and recorded in book of records N. of c id County Witr.ess my hand and seal offixed. ROGER THOMSSEN, Director of Records & Ehctioro �1 1 Deputy Mas 19 1?. 5 PN 174 PLUMBING PERMIT APPLICATION Jurisdiction of No. Type of Fixture Fee Permit tin. Permit fee 3� 2 Water Closets (Toilets Permit Issued Bath Tubs n Approved by �L a,,atory _ Wash Basin _ eo_ Building Perm.. Shower Receipt. No. _j VPt i-r s. Di.sf)wa'Ting � Sinks, Ordinary Location B d Pig _ 1n= dr_____—_ - Sinks�Slop Au omatic DT7i-wa�ie_Y — Ch�rr� _ La dr ss Tra r _ Name , Addre. s t Drains, Floor .— _ rains Area _ _ �� �`�____. DrainT3i-erator _r______ Rain Drains 7— Au 77m-a i c Washer Name A- Ares n'-Fu n t a i n 3r n rg_� __ ----- Fountains. nda 1L �' -- Hot Water Tank --.- �_ Water Service Size U- irtals Buil n Uld or ' w A1t:^F_s', Repair or _ �� c: -Bas ins x•ink�ei S stem - Sw-Tawn Sp immin Pool _v This permit becomes nul:'_ and vuid if work or construction auth,,rized is not commenced within 60 devs; or if construction or work is su5penoed or abandoned for a period of 120 days at any time after work is commenced , All plumbing firms must be licensed by the Cite of Tigard and post a $1,000 bond. I I hereby certify that I hav read and examined this applization and know the same to be true and correct. All provisions of laws and ordinances governing this typ of work will be complied with whether specified herein or not, the granting of a permit does not presume to give authority to violate or cancel the --rovisions of any other State or local law regulating construction or the performance of construction. b AUC city ��� �� 1A gr t; ure o Applir,ant jo. v i City yard of TI r INSPECTION REQUEST for SPECTION 'TIME : PERMIT DATE ' DANE ISSUED :__-C 1_ iMEFAzi NAME ' ADDRESS!— )NTRACTOR : 7,k4cc .0 f — =ST : Air u, Water❑ , Visual ❑ , Laboratory ❑ ESULT: Aporoved Disapproved ❑ , Pending ❑ (ETCH. NI SPECTOR DATE TE: Attach supplemental test data hent] City of Tigard INSPECTION REQUEST for FZ INSPECTION TIME '. , PERMIT DATE: DATE ISSUED :--j _ OWNERS NAME : 7- 42- C ' �- ADDRESS: 4-07 CONTRACTOR : ____ i E S T : Air U, Water❑ , Visual [3 , Laboratory ❑ RESULT: Apnroved K, Disapproved ❑ , Pending ❑ SKETCH.' INSPECTOR DATE [OTE: Attach supplemental teat data hereto] i City of Tigard I INSPECTION REQUEST for SPECTION�TIME* rY_ ,—vwPERMIT NO DATE . _ / / DATE f SSLJED :_.___1__ /__ INERS NAME ' ADDRESS: 1 ' �< . s -4-4 )NTRACTOR : �— -- ST : Air 0, Water[I Visual p , Laboratory I] =SULT: Apnroved 0 Disapproved) Pendl ig p :ETCH: wtV 4,04V I I I I _ � I INSPECTOR DATE I TF- Atlorh supplemental test data beret I CN �J City of Tl �jard INSPECTION REQUEST for INSPECTION TIME: "ERMIT IAC. : DATE:C� -� iY?� DATE ISSUED :--./ OWNERS NAME '. — ADDRESS:CONTRACTOR : — -- - -_-- TEST : )%ir U, Water 0 , Visual ❑ , Lnboratory [j- RESULT: RESULT: Apnroved_o , Disapproved Cj Pendhig ❑ SKETCH: INSPECTOR DATE NOTE: Attach supplemental test do+a beret] r City of Tigard INSPECTION REQUEST for INSPECT.'ON TIME : — PERMIT DATE: ''k DATE ISSUED:--Z--Z— OWNERS NAME : ADDRESS . CONTRACTOR ------------ TEST: A r J, Water 0 , �Iisual tY, Lao ,rotory Et RESULT: Approved tYDisapproved Pending p SKETCH: INSPECTOR DATE [OTE : Attach supplemental test data heret] I i -�,o City of Tigard I INSPECTION REQUEST I for INSPECTION TIME : PERMIT NO. : DATE . 116 DATE ISSUED'_ l_L_ OWNERS NAME : i A D D R E S S : _4 T t�- I CONTRACTOR :--r-ID-16 TEST , A r J, Water Ei , visva ix, La' ,ratory [1 RESULT. Approved )25�1 Disapproved _1 , Pending I SKETCH: I I I I INSPECTOR DATE F7NvTE Attach supplemental !est data heret] 1 I I City of Tigard INSPECTION REOU EST I for INSPECTION TIME : PER T NO. : DATE: 10/131 73 DATE ISSUED: OWNERS NAME : T, �7.0 I ADDRESS ' AU ' i CONTRACTOR TEST. A:r 10, Water p , Vi3uQPj l La'- .rotary [► { RESULT. Approved, Disapproved -1 , Pending p I I SKETCH: I I I I SPECTOR DATE INOTE : Attach supplemental test data heret-10 453'7 EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residenti ' structure (a) on the following described lands prior to the recording of an 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 a final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: 1�a RLce .\►tia� \r. �aoe� ti.�,, `''��ti SG! E`\�+�'C ADDRESS OF PROPERTY: ��hA,ry�, NAME OF OWNER: 'c \sem . ._ d \. ._._..�•c �e _ �.�� ADDRESS OF OWNER: �•c��., �..� ���.� �... .�_,� IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this �-,'Tday of o OWNER: \•.c • 4 APPROVED: • By: Building Official City of Tigard STATE OF OREGON ) as. County of Washington ) October 11 , 19 73 Personally appeared before me the above named Ray Brown and acknowledged the foregoing instrument to be his voluntary act and dead. o sr� Public For Oregon My ammi••ion Expires: },[1/75 !!:x:ER Tito SUN.D!�6oc1ft of Itevade 6 ElecMnn ao��. 949 ,,L,.566 � u u p� t All" Ew3.9 � y[ Y O r tJ a t • •I EXHIBIT "A" CITY OF TIGARD Residential Structure Occupony 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, Oregon: ('rho City will issue a release as scon as a final Inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: P -a Fi�LarA�a \r. lath.rs� ADDRESS OF PROPERTY: \ �. v NAME OF 1)WNER .lb\% a!1a..� t7_ ADDRESS ADDRESS OF OWNER i ��S�oo\ �'�w ����` 1.-�►`�+�a�- IN WITNESS 6IHEREO1', the undersigned has caused this restricti.on to tie executed this 1-vlw' day of nc-Je , 19�� OWNER: IL �e 1 APPROVED: • By, Building Official City of Tigard STATE OF OREGON County of Washington ae' October 11 , 19 73 Personally appeared before me the above named T.oy Brown and acknowledged the foregoing instrument to be ,hie_. voluntary act and deed. Notary Public for Oregon My Commission Expires: 1/1/75 CITY OF TIGARD 17420 s. W. MWn slnM T16ARD,ORIG M ASA APPLICATION FOR BUILDING PERMIT New Construction EJ Demolish Addition Remodel 13 Move ZONINGP.D DATE ISSUED 10-11-73 BUILDING PERMIT DATE RECEIVED BUILDING FEE $� _ No. ►'3 • 237 BY — PLAN CHECK $ _IJI, recording 6llAUATIOti -19,448 "--� OTHER $ _74-1!$ state TOTAL $ 88.74 RECEIPT No. J /O-//_ 1 3 TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LUT M jam_ MAP �'c� inn CENSUS TRACT _W JOB Architect or Engineer- - Address 16999 ve. .----Phone _ -� -S�m� Owner Address —_ ___ ____— Phone` _— B u i l d e r -------------------- — sere Address ___ _— _`— Phonei— BUILDING USE Single Res. ❑X Multi Res. LJ Comm. 1-1 Industrial[-] OCCUPANCY GROUP I No. of Storie.4 1 Total Height___j7 ___ Area of Lot Type of Construction X%XX)j%Xx­TRXX.jyXXV Floor Area B ___ Set flacks: Front___jRL Back fin, L.Side_ cit R.Side Private Sewer Pipe Size 4,, SewerSeptic Tank Water Service Pipe Size Storm Storm Sewer Ditchl_J Drywell Street and Curb Requirements as reguired by 8ubd;.yjjll2UaSdiance nriveway Width 18, _ _ No. of Parking Spa.:es—_ ? SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED ggRn S L rX, t,,nf, nn4 n r i y- FIELD CHECK B'f - --____ DATE- PERMIT APPROVED BYE It is understood that all work will conform with applicab1cod do ordinances of the State 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. Signature o Rplicant