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BUILDING PERMIT APPLICATION cOF T110-ARD DATE 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 'THE WORK HEREIN INDICATED BUILDER PHONE»
OR AS SHOWN AND APPROVED IN THE ACC ;MPANYING PLANS AND SPECIFICATIONS. OWNER PbHpN L
LOT NO. —�
OWNER_ __ 1 C:iit,*,1 ua n JOB ADDRESS 114TH► .a ilk L.t-< HOME ADDRESS ax L'"L 1.75U.
ARCHITECT
ENGINEER
BUILDER fPeC'#A1 y q-MU'je"n;AUDR[SS 10495 SW 69thpPtlr+,
DESIGNER
STRUCTURE ❑NEW�0 Rl mnDEL ! ❑ADDITION_ ❑REPAIRrr-�� ❑RENEWAL ❑FIRRE DAMAGE ❑DEM^O�LITION
RESIDENCE ❑COMM COEDUCATIONAL ❑GOV'T ❑RELIGIOUS GPATIO OCAR PORT ❑GARAGE OSTORAGE❑SLAB IJFENCE
❑BOND ❑MOV ING ❑CONDITIONAL US-, ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_LAND USE ZONE BLDG.TYPE �F FIRE ZONE_3 PLAN CHECK BY HEAT
unst,ruct I:itchsn addition and remodsling in single rosily dwelliny
prix plans and cods.
O �LS2A4_ OR LOAD irJ HEICZT •••• NO.STO IES ~w AS AL-3 (1.f,h&t.Q9A&_ rvALuE )2 bOO.
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit �2 4, 1 ;
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check .12.00 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
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTPACTORS TO HAVE CURRENT CITY BUSINESS
State Tax .9L LICENSE. SEPARATE. PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ti3G.9Ci
By pl
-------�.� APPI (CANT OR AGENT- ----� �
Approved Rempt No
s as♦� wr a� �r na a;r ate'
...� .�,�r��rtnnleririiraia`w'- _ - - -- ..,..�___--.-•
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
s !/ Contrnctor
Pe;mlt No,
- Rough-in
-- - ----- T�__ _ Fixture —
Final
- -- � ---- HEATING
Contractor
Permit No.�-'
— Gas or Oil
- - -----�—
Rough-in
Final
-`--- —� SEWER
_ Final
_— --DRIVEWAY
Final
Storm Dral rage
T (Rein Drain) Final
Sidewalk
Curb$Street Final ,
Approach
BLDG. DEPT. FINAL TtMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
_ Zoning F1nnl
. r
CITY 07 August 2 76 0
BUILDING PERMIT APPLICATION TIGARD DATE- N- 0978
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 639-1613
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ADDRESS "lay aW i rook f.1w• d ILDER PHONE. 620-1234
ENGINEER U
flU1LUER t eti""''_' L�'")q�+A ARCHITECT P1t A • 6v�,l;: han
CI
DESIGNER
STRUCTURE LJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL OFIRREDAMAGE_❑DEMOLITION
❑ RESIDENCE []COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE GSTORAGE❑SLAB ❑FENCE
QBOND� ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS �'A
OCCUPANCY—_—_LAND USE ZONE. BLDG.TYPE_ FIRE ZONE_ PLAN CHECK BY—_____ _ HEAT—
OCC" LOAD, FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit A 4.OU
2 Ga THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check • 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
RESTRICTIVF. COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total "1
By
APPLICANT OR AGENT ---
Approved ReceilS, io. — -
ADDRESS PrWN'F -
wsr ww a ,Ww r
DATE INSP. TYPE IN PECTION 13EMARKS PLUMBING DATE
C9e�LContractor
) Permit No. —---
2.4 / -3�– Rough-in
-- -- — —
Fixture
_ Final
HEATING
Contractor
Permit No,
_._ Gas or Oil
Rough-in
Final _
SEWER
Final _
DRIVEWAY
– -- ------ _�� — Final
Storm Drainage
(Rain Drain) Final
—_ Sidewalk
Curb &Street Final
A roach _
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
i_ \ Z,Jg Final
E- M
=9.
EXHIBIT "B"
CITY OF TIGARD
CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION
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 July 17 , 197_,
recorded in Book _984 , Page 303 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY:
Tax Map 2S1 388, tax lot: 1700 .lot 17
OWNER: Alan Wickwlaop b a.
BUILDING PERMIT NUMBER: 74-140
BUILDING ADDRESS: 12479 S. W. Brook Ct.
This ie to certify the said structure meets with the require-
ments of the Building Code of the City of Tigard and the above
referenced restriction 13 hereby released and terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigard has caused this certificate and release of restriction
to be executed this 19th day of "February , 197_.
Title: City Reno -da
STATE OF OREGON ss.
County of Washington ;
On this 19th day of Februar , 19 76 , personally
appeared before me the above nsm3d Doris Hartig , whose
signature appears hereon and who acknowledged to me that he executed
the same in his official capacity on behalf of the City of Tigard.
a
o ary uhlic 'br Oregon
My Commission expires
11/6/78
OMER THOMRBCN.D('6,4 r Of gta +tds a 21"."
R► ...., (-/)L-r p.puh
em 1069 rw 713
Y
i
STATE OF OFlFGON
9S
County of Washington
I, Roger Thomssen, Director of Records
and Elections and Ex-Officio Recorder of
Conveyances for said county,do hereby cer-
tify that the within instrument of writi.
was received and recorded in book of records.
No. . — ---- ---- -
of said Bounty.
Witness my hand end seal affixed.
ROGER THOMSSE=N, Dirpctoi
of Records X F_IpCtionti
Deputy �
FEB Z3 ij 41 pro lk
City of Tigard
INSPECTION REQUEST "' '
for
' �,��
INSPECTION TIME :_ PERMIT N
i
DATE: -Z.113126 DATE ISSUE?:--..j
OWNERS NAME : �,�G�iy n� ,G i<ad, So,er
ADDRESS : L2-,Z71
CONTRACTOR :---
TEST'
ONTRACTOR :_ _TEST: Air 0, Water ❑ , Visual 0 , Laboratory ❑
RESULT: Approved , Disapproved ❑ , Pending ❑
SKETCH:
i
I
1
i
76
)'��ETOR DATE
I COTE : Attach •u
pplcmental test data he retoJ
I
i City of Tigard
INSPECTION REQUEST
for
T
NSPECTION TIME :_ PERMIT NO. : --. —
DATE : / J2;Lrs _ DATE ISSUED:_-Z.- I
1WNERS NAME : /AL 1-7-7,c '1cz,<,..'
A D D R E S S : / -:? t 2 f C.'T --
'O N T P A C T O R :--------- -- -- ----- -- —
"EST: Air U, Water p , Visual O , Laboratory ❑
IESl1LT* Approved 0 , Disapproved ❑ , Pending ❑
;KETCH: ILL SP MUST RE ENDORSmD :PRIOR TO
I Cr OF BUILDING PERMIT
PLANNUG
PUBLIC ;O iK VrT. By D 0.n
BUIT, � T. EY
V
yT— ^L
BY-- - - T )
INSPECTOR D"
OTF. AttacM1 supplemental test data hereto
City of Tigard
INSPECTION REQUEST
for
sL� wQ /k , io
INSPECTION TIME: ,10�5 /??PERMIT NO. :
DATE: L'.5 DATE ISSUED : Z
OWNERS NAME .
ADDRESS: -407'
CONTRACTOR :
TEST : Air 0, Water[I , Visual , Laboratory U
RESULT: Approved Disapproved [] , Pending p
SKETCH: /U ; s5
INSPECTOR DATE
�N01F, ' Attach supplemental test data beretaj
Z
City of Tigard
INSPECTION REQUEST
for f
INSPECTION TIME' 'rid PERMIT NO. : _
DATE: /-�'-/3/2741 DATE ISSUED : I L_ I
OWNERS NAME : _._._.L)ti
ADDRESS: 1�y7y
CONTRACTOR : `---�.
i
TEST : Air ❑, Water(] , Vieualx� Laboratory p
RESULT' Approved ❑ , Disapproved , Fending 0
SKETCH: I
r# R600112--W
INSPECTOR DATE
CNOTE Attach supplemental test data beret I
I
pw_
City of Tigard
Rz� -INSPECTION REQUEST
for
INSPECTION TIME ' PERMIT NO. :.—
DATE ' ,
- DATE ISSUED :,--/-
OWNERS
SSUED :.._L_OWNERS NAME :
ADDRESS: 4.2-`t7> S.(.C� �_ -►`
CONTRACTOR : 11- 4-9011%
TEST : Air Q, Water[] , Visual Laboratory U
RESULT: Approved , Disapproved ❑ , Pending O
SKETCH.
I
I
�► 1 / 4
INSPECTOR DATE I
COTE Attach toot data beret a] I
i
LIP
1 .
1 Cify of Tigard
INSPECTION REQUEST
1 for
INSPECTION TIME . ����OCAPERMIT NO. : _.,
DATE : M/-L Z7 DATE ISSUED. I L
.
OWNERS NAME : _
ADDRESS x r
CONTRACTOR : �
TEST: Air O, Water p , Visual), Laboratory p
RESULT: Approved, , Disapproved O , Pending p
SKETCH: Oej 4&4Y
AvAwlkc or-
;P'�VrwS,
INSPECTOR DATE
fNOTE ' Attach supnlerrental test data hereto,
ADDRESS /a U7y .�<-u^�2v�� - ---- PEi*lIT N0. -- - �
PERMIT CHARGE
OWNER _ _ CONVCT ION FETE
PAID BY
1 YPE OF fiU I I.O I NG DATE: CONNECTED /O -:.�L
SENVIr.E_ RA IE �.�� -�
INSPECTION FEE
CONTRACTOR — PAID BY DATE
SIZE OF CONNECTION _ �'� ASSESSMENT _ _ PAID __r_
i
(
City of Tigard
INSPECTION REQUEST
I
for
I N TIME: I
INSPECT PERMIT NO. :0 ,.�1�---.
DATE.: J"P-ZJZZ DATE ISSUED :._._L1--
OWNERS NAME ' -
ADDRESS:CONTRACTOR :
----
TEST : Air D, Water, Visual , Laboratory C)
RESULT: Approved . Disapproved O Pending p
I
SKETCH. I
de�
i
I
I
I
INSPECTOR DATE I
C01V Attach supplemental test data hereto
1
September 24, 1974
To Whom It May Concern
This letter is in reference to the shakes supplied to the
Alan Mickelson ,fob st 12479 S.Y. Brook Court. Thsso shrker
are entirely unacceptable to the Tigard Building Department
and Will not comply with the Uniform Building Cade require-
ments nor Will they comply with thn Rod Cedar Shingle
Bureau grading rules for the following reasonst
1 . Shakos are too short
2.. Do not meet the thickness requirements
S. Too many shims
d. Too narrow Shingle
Tn my opinion they aro re i^c: 3hn!:ec in —iory respect.
°incerely,
Russel Austin
Building Official
F3
i
I
City of Tigard
I
INSPECTION REQUEST
2 or
YX, A0Fis '
INSPECTION TIME: `�IPERMIT NO. :
DATE: "'
A-132f DATE ISSUED I /
OWNERS NAME . �? f �reta-+Y—
ADDRESS:CONTRACTOR :
�
TEST : Air 0, Woterp , Visual U , Laboratory C]
RESULT: Approved Disapproved Q Fending p
i
SKETCH.
INSKE CTOR DATE
EOTE . Attach supplemental test data Soret]
1
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE _'�jig _ N�
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APP V D IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF__-.____
W L,
0 NER ADDRESS ��/'� CG ' er BUILDER PHONE _
ENGINEER
BUER _- -_ ARCHITECT �I _ DESIGNER
STRUCT ��(( ^^
URE tlJNEW ❑REMODEL _ _L,ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT_❑GARAGE O STORAGE(]SLAB ❑FENCE
C�BONO ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW -❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE _:_��BLDG.TYPE_ FIRE 20NE PLAN CHECK BY r_7 l HEAT
_'D"-Y
QC.f, LOAD FLOOR LOAD _ _ HEIGHT _ NO.STORIES AREA VALUE yJ�t
_
BUILDING _E—
DEPARTMENT SET BACKS FRJINT REAR LEFT SIDE RIGHT SIDE
Permiti ----_ _�
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 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. -HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State LICENSE_. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
APPLICANT OR AGENT ---
Approved Receipt No.
- AODAFSS ---
w
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
c Contractor
Permit No. '7 -oOo
�1/('c Jr Rough-in
Fixture
1 •,7 •7 �y4�� DJC ----HEATING
•1 /� �C:S/ ��S .iJ�_ lo luAlk!2 Contractor _
A6 it I Peri merit No.
/ a•! n �t1q L _ 7C3•i 12 A;C4 vA0aLCu 11>J9rLyual] ra`
"� y'tly S «J �.�tA►�t� rr. Rou h•in -- - -- -
, 1z 9, a [fir_ 12C 2Q /0 ilkM•ps.),1rD It oOn Final — ----
Pi��lAi�l 040,0 SEWER
SOUyeA)'T riy IUla �� {vIQ�L/r,Acc. "�notf �2 Final —� -- -- --._�__-.--
» DRIVEWAY
p �••-
7#1 r" Piat S <ici 0 v i 7RAe1J1,,Jd Final
r " 6xF][t l SiiDC o l�'�L Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach _
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
)/ CERTIFICATE OCCUPANCY Final
r/ / : /� ` y •� Landscaping
Zoning Final
1
� o
UNIFIED SEWERAGE AGENCY NO. -____- 4984__
WASHINGTON COUNTY DATE June 28,_1974
CIT-Y OF-----
APPLICATION
F_---APPLICATION FOR SEWER CONNECTION PERMIT
OWNER- J.._-11-axe-RL.Br q on
OWNER'S ADDRESS: 1=0_a...W—Pacifir—Highway
STREET
Ti ard --- --0reg;,n -
CITY STATE ZIP
BUILDING SITE: LOT 17 — BLOCK _ _ ADDITION _ ar-a.akw_ay
TAX LOT NO. _ ____- TYPE OF OCCUPANCY _ rR;j gdjC_a_
ADDRES:, -------12-479 S.W. -Bok--Ct_A-__._
DWELLING UNITS _-1 - ______ — FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE 500 INSPECTION FEE 25 -_ TOTAL DEPOSITED 525
r(,NW� (EXISTING) BUILDING SEWER SYSTEM - ---- Tigard -
The Applicant agrees to comply with all rules am r (t-;y s o?"The niiied Sewerage Agency.
��� �.
APPLICANT ��'--_-
SEWF_R PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE 411 INSTALLER
RECEIVED BY _
I Q Y OR ITS AGENT)
COMMENTS
This Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.
1492
EXHIBIT ??At'
CITY OF TIGARD
Residential Structure
k'IVOW ALL Occupancy Restriction
f1EN BY THESE PRESENT,
that o
structure (s) on the followin ccupancy of residential
ing of an occu g described lands prior to the record_
pancy PF�rmi.t releasing the
Record; of Washington Count restriction in the
Of the Y, Oregon, is Doad
Pity ,°f Tigard, Oreg .onProhibited by the ordinance
soon as ' ( The City Will is
a final inspecj*;ion sue a relea:;, as
satisfactorilydetermines that the construction
completed) is
DES—_CRIp_TION OF PROPERTY ;
Tex Ma 2Si see tax lot 1700 lot 17
INIXA?XKNNIXxkiux4xxmxxt4xox2sxx3eg
ADDRESS OF PROIDERT,y,_�,
NAME OF OWNER:
IV (V
ADDRESS OF OWNER; �-----
IN WITNESS WHEREOF
the undersigned has c
to be exe=cuted thl �._`�f"day of aused this restriction
19 -71-/
i
— IVame
APPROVEbr, Titer""'
/ y'
By: 1�• , l
B 11 ding— is 177/7
City of
Tigard .�``0 t3 k,8 THUM33LN. f —4,11 nl 1ka—, � N 13601,
STATE
Of OREGON - R............... . _.. .�COP ....... . ...
Cuuntyof Washington ss
19
Personally appeared before me the
and acknowledged above namLed �j/,
t:a be ged the forego. n
voluntary act and deed. g instrument
No ary Pub .rc or Greg n
My Commission Expire-, *
Boa 984 PAA03 ..�,. --_._.
j
t ,
t
1
U W
►n M�
0
U
x ,
( A 1
,{ 71
IL4092
EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MEN BY THESE PRESENT, that occupancy of residential
structure (s) on the follouing described lands
prior to the record-
ing of an occupancy permit releasing the restriction in the peed i
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 daterminns that the construction is
I satisfactorily completed)
DESCRIPTION OF PROPERTY:
Tax Mia 2S1 3BB tax lot 1700 lot 17
xmlxit f xgiixlxmmiii sxlmf(X10xpxzzlxzlg i
� ADDRESS OF PRQPERTVy-- � r��•1 j�� Jam' (�(� �7� �en r Ft C
NAME OF OWNER:
ADDRESS OF UWNER: �'
Rk
IN W'TNESS WHEREOF, the undersigned has caused this restriction
to be executed thisHday of vYl� lg L/.
�i
t2
s
b Name i
1.
APPROU�At) or
By: —L.�l-�rt?—I T �Lia1 C— �_ ..•.w.•n11 anl 1�w•rrl�RIMS
B ng O cta��
,','�, �L11 7114MaM1IN. P
City of Tigard
r�....._.........
STATE OF OREGON
County of Washington ; ss h . 7 7 19��
�
Personally; . Y a Ppeared before me the above named��1 �
and acknowledged the foregoing inetrumnnt
to ba-111-1 voluntary act nid doed.
Nbtery Pub sc or -�Ore
i
n A n My Commseion Expires:
BOOK 984 rnE303
1