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CITY DATF 5-24-77 Is
BUILDING PERMIT APPLICATION OF TIGARD 289-2362
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOM THE WJHK HEREIN INDICATED DUII_DERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
�.� -
LOT PPO. —
OWNER hlk'w Lymw JOB ADDRESS L i36 i JW L uL f1h4 it L yiOME ADDRESS —_
t — ARCHITECT
Jim Paoli 2436 N. 1,ggantp Paitlalyli{VGtNEER
BUI LDE:R ADDRESS
�, �jESIGNER
��S++Tyy9��ucx,rURE ONEW ❑REMODEL _LA blTiON ❑_REPAIR- LIRENEWAL ❑FIRE DAMAGE r 1 []DEMOLITION
0"RESIDENCE ❑COMM ❑EDUCf,TIONAI _❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ -]SIGNS
OCCUPANCY LAND USE ZINE,_ _BLDG.T',PE —_—FIRE ZONE.—.- PLAN CHECK By______ HEAT —=======
to construct a 161 x 201 woou patio duck w/4x4 po,;,' yuppo; t6o not more than 4 fto
o/c epaced not more than 4 f t. O/C w/ISx4 floor u w/max span of 41 o/c. All wood in
con;)Zm t wgrouno to be preseur*, trestsid. if patio cuver is desired at latax data
a we:iance would be req fired. -- -- ----
OCC.LOAD fLQ.QFLLOAD NO.STORIES___NNR1A —NQ BEQ)3OOM_�^---YAL�� i*l1iW�
BUILDING DEPARTM5NT SET BACKS FRONT REAR LEFT SIDE _ _-- VIGHT SIDE
Permit 117.011! — — -
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONfA1NED IN THE BUILDINo BODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED �n'T THE
— - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APP;-ICABLc CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO NAVE CURRENT CITY BUSINESS
State Tax •3[I LICENSE, SEPAR'1TE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
't
111.31} _ ----- ------ -----
By
_ -__.-____ _ APnI iC ANT OR AGENT
LAproved < Receipt No.
DATE INSP, TYPE INSPECTION REMARKS T PLUMBING _ DATE '
Contractor
---��— Permit No. --
-
Rough-in
Fixture
Final _
HEATING i
------ _ Contractor �V
----- _� Permit No.
- Gas or Oil
- Rau h•in i
------- — Final
SEWER
--- e Final
DRIVEWAY - _----
-- - Final
Storm Drainage
-- — (Rain Drein) Final
Sidewalk
Curb&Street Final
"k jpach _
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
i
� ' Zoning Final ti i
�tf .�fn�'����pl•'�ih,G}��,yfitwg�y per, �
�✓ /' V, -;•• �',. ' • t•.. !!�u'+� ah' '�Y�=Y';
... .. �a^:s'.Mr r-�..., �.......x^r.... .:..;,r...r;r�awS �?:nR���' �TA.�s;�x'.mtsa_ �i•�. _ � �
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OREGON
=a CITY OF TIGARD Y�'�
OREGON
a
Owner:......Art...Prui_tt. .. . .. . �................... Permit No... ......73-262
4
Building Address....... ,S.W._.8urnham Court ........................ .............
Certificate is hereby giver, this.2,3rd......day of..9P.Y. ................... 19..'x'
r that said building maj be occupied and )
that it complies with all requirements of
the Building Code for the City of 'rigard,
as approved by the Tigard City Council.
...........................
Building Inspector
�',:'�, x•14"� dR'�y.�.. `' '1 ' ' '�x!'� �' ''�e�'�� "E`iQP�' '`�2P,'� '�Wlk �"Fq�7t '�k� � y,,��l� '��'i
5883 EXHIBIT "B"
CITY OF TIGARD MAY
CMTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION CITY OF
The City f ' ,•%rd hereby certifies that the occupancy of
the followins uescrioed structure or premises with respect to which
:L-corded
restriction of occupancy was, on 12-5 , 1973,
in Book 9S5 , Page 438 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DE13CRIIJTION OF PROPERTY!
Tax Map 2S1 12D8, lot 12, Burnham Park Suhdivision
OWNER: Art Pruitt aufldbr .
BUILDING I1ERN11T NUMBER: 73-262
3UILDING ADDRESS: 1323'j S.W, urnham Court
This is to certify the paid 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 W1TN&9S 1,11EREOF, the undersigned authorized off'.cer of the'
City of Tigard has caused this certificate and reicas, of restriction
to be executed this 23rd day of April , 19 75.
Title:
*TATE OF ORWON
County of Washington )
On this 23rd d-y Of —_gp,ril _ , 19Lr , per.>onally
apt eared before me the above named Doris Hartin _, whose
signature appr_ars hereon and who acknowledged to me that he executed
the same in his offical capacity on behalf of the City of Tigard.
-U , _
Notary+u lig of Oregon
My Commission expires:
/7 1lf1�A/ 1 +/1 ,.�,f lut •rrtd ..... .../........19 ....Dl.......��F M.
1 L b BQQhiVIiFr P�bt61 / R7CER THOMASM ENT.OM d R*Mrdo•tuerba.
Milt irs Its 14f i� if
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STATE OF OREGON 93
County of Washington
I, Roger Thomssen, Mreator o: Records
and Elections and Ex-Officiu Recorder of Con-
veyances for sold county, do hereby certify
that the within instrumein of writing was
received and recorded in book of rlcords
No. _.._. .. _._ .._.__. ..
of sold CAwrtY
Witness my hand arwl seal affixed.
ROGER THOMSSEN, Director of
Records & f,Metkno
�x
MAY 9
12 a°bM t(5
City of Tigard
INSc, ,E(;"riO,N REQ(.) Erbl-' -r'
f o r
It8PECTION TIME A0.
PI-1 E : J A�1/ 7.� DATE M.;0* Z
OV,NF -tS NAME : AeY. Pv
A D 0 R 1—3 S. j��, BVe
c wrk ACTO R
TIF IT * A i r vo ter 0 vt su a
RESULT: NeapprovOl I') t.j [3
S
f F.
4
All SPACES MUST PE r"Dors,,-D P''T_OR TO ,
7.SSTJA:i-r, or
i
F1_... A.'
PERld
BY
t
--j 1 !
FILE COPY
City of Tigcrd
INSPECTION REQUEST
for
INSPECTION TIME: • 3�' PERMIT NO. :.
DATE: �2LI DATE ISSUED :-- Z
OWNERS NAME
ADDRESS #la J) 1. Z,
CONTRACTOR : --- 4 ' cvc ,(
TEST : Air p, Water 0 , Vieual,t� Luboratory
RESULT: Apprcved ❑ , Diaepproved, Pending �
SKETCH.
DISAPPROVED -`
CITY OF TIGARD
6Y ------ ,._DATF _
INSPECTOR DATE I
EOTE Attach supplemental toot data best] I
J
R
t
I
Cit of Tigard
gcard
INSPECTION REQUEST �
for
I
INSPECTION TIME: PERMIT NO. :- � P
DATE: -z-k4rL�1' DATE ISSUED :-- I Z
OWNERS NAME : 40/// NA-ALL- I
ADDRE9S: �o7--
CONTRACTOR .'
'"CONTRACTOR :
TEST : Air p, Water[] , Visual 0 , Laboratory p
RESULT: A i
— Approvedo, Disapproved U Pending �
SKETCH. ,tk-
NSPECTOR DATE
ENOTV Attach supplgmtntoi test doto bereta 1
1
w
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME " PERMIT NO. :
i DATE . -2 - l�L( DATE ISSUED'---I'
_
0%,NNERS NAME '
ADDRESS '
CONTRACTOR ;_ :Z24
EST . A r J , Water Al" Visvol 0 , La', ,ratory (�
RESULT.' Approvedx , Disapproved 1 , Ponding Lj
I SKETCH:
P
I I
I
I
I
NSPECTOR DATE
COTE : Attach supplemen•al teat data heret]
9 - � v
Address �� -�ti Permit No. _� �%:1
Permit charge
Owner � p �// �,,,, Connection fee fJy���
Pa i d b
Type of building Date connected > 7y
Service rate _ ���,,,� Inspection fee
Contractor 11Y ��js�1 �. Q,r ,, paid by � date
Sizo of connection
Assessment paid
I K
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : 3:6 PERMIT NO. ' 02—
DATI': A l-1-/ 7s/ DATE ISSUED:_..._L_L
OWNERS NAME :
ADDRESS : r L77,
I
CONTRACTOR : 0- INr
TEST' A r 'LJ, Water, VisualA , L.al• ,ratory Ll
I _RESULT: Approve , , Disapproved J Pending
SKETCH*
I
i
I
I
I
I INSPECTOR DATE
ICOTE : 'ttach supplementnl test data heret:01
J(
1
1 i
I �
City of Tigard
INSPECTION REOUEST
or,
IINSPECTION TI M-E ::`' ,' � PERMIT NO. : ---
I DATE: _1 Zai DATE ISSUED'.--L.L—
OWNERS NAME :
A D D R E S S :CONTRACTOR .
—
I
TEST: Air J , Water ❑ , Visual ❑ , Laf ,rotary [1
RESULT. Approved , Disapproved - , Pending ❑
SKETCH'.
u TG)is v
I
I
I INSPECTOR DATE
ICOTETttach supplemental test data heret]
7
City of Tigard
INSPECTION REQUEST
for
LZO C11V 0, 9 Z / 6; /L)
INSPECTION TIME: ZL'�' 7�Q _ PERMIT NO. :___
DATE: �� DATE ISSUED : I Z .
OWNERS NAME " _ _
ADDRESS. �r — /�'c 1�f.1L!gf —
C O N T R A C T O R : ____�1
TEST : Air u , WoterU , V'Isual �(, Laboratory G
RESULT : ApnrovedA , Disapproved O Pendhig O
SKETCH.'
INSPECTOR DATE
[NOTE: Attach supplementol toot data hereto]
JIi r.
City of Tigard
INSPECTION REQUEST
for
•f' h /I.?L 44
- - -
IINSPECTION TIME :� PERMIT NO. : ___�
i DATE: i/-tet/ 2:1 DATE ISSUED: Z
OWNERS NAME : -)) _ _+
ADDRESS : l '�- /.3.c c.�•� �.,, , ('
CONTRACTOR :_ }TLlu
I ,
ITEST. A;r O, Water ❑ , �!isu�l [ LaF ,ratory p
RESULT. Approved , Disapproved _1 , Pending Q
I SKETCH: ,+ _
8f,
Ie,45`G
I '
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`INSPECTOR DATE
I [NOTE . Attach supplemental test data heret:01
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UNIFIED SEWERAGE AGENCY NO _ _4922_
WASHINGTON COUNTY DATE 11-13-73_____
CITY
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER:
OWNER'S ADDRESS: - -6339 s.w. -Peyton Rd.
STREET
�_ ----- - - -- -
STATE ' ZIP
BUILDING SITE: I.OT 12Burnham Park
BLOCK _ _ ADDII ION
TAX LOT NO. ___ - TYPE OF OCCUPANCY x r AX Residence
ADDRESS 13235 S.W. Burnham Court
}I DWELLING UNITS 1 - - _ FIXTURE UNITS __.
SURCIARGE IF APPLICABLE
Il PERMIT FEE 4517 -- INSPECTION FEE 25 Al 475
TOTAL DEPOSITED
, I
1 ( EW) I (EXISTING) BUILDING SEWER SYSTEM Tigard
The Applicant agrees to comply with all rules and regulations of thr. Unified Sewerage Agency.
APPLICANT _Lt-_�
SEWER PERMIT
,i
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _- 4" INSTALLER
RECEIVED BY.. Qwu�_� C�_� ` �'
EN OR ITS AGENT) �-
I
:i
COMMENTS- --
This
OMMENTS: __This Application and permit expires in ninety (90) days. The amount Maid will he forfeited
should expiration occur.
CITY OF TIGARD
12420 S. W. kWIn Strwt
TIGARD, OREGON 9)113
APPLICATION FOR BUILDING PERMIT
New Construction xa Demolish ❑ Addition ❑ Remodel ❑ M,3ve❑
ZONING R-9 DATE ISSUED 11-13-73 BUILDING PERMIT
BUILDING FEE S No.
DATE RECEIVED
BY PLAN CHECK $ 41.50_ --7326:
OTHER $ VALUATION �
$ 2,gln
•93
TOTAL $ 4.OU RECEIPT
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT M 12 MAP N 251 1208 CENSUS TRACT X2 W-7 JOB N
Architect or Engineer - Ch'*las Shepard
Address -_ _ Phone
Owner Art Pruitt Bldr.
Address 6339 S.W. Pelton Rd. , Portled Phone
Builder
Address_ _ Phone
BUILDING USE Single Res. El Multi Res. ❑ Comm. ❑ Industrial
OCCUPANCY GROUP I No. of Stories 1 Total Height — Area of Lot
Type of Construction XXJ(XXISXXS"XX* V Floor Area B__ 1 1423 2
I
Set Backs: Front 25 Backe L.Side �n R.Side�_`((_��
Private Sewer Pipe Size _._-41L Sewer-k#"_T. Septic Tank l,l
Water Service Pipe Size 3/4" Storm Sewer x Ditch ❑ Drywell❑
Street and Curb Requirements Existing
Driveway Width_21' �No. of Parking Spaces- 1
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED 13235 S.W. Burnham Court
FIELD CHECK BY 38 DATE 11-13-73
PERMIT APPROVED BY .l.
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 wil
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector. / -7 -7
S gi nature o1i A plicant
���3`�• EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupany Restriction
KNOW AL'- 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: (The City will issue a release
as soon as a final inspection determines that the construction
is satisfactorily completed)
DESCRIP'. ION OF PROPERTY:
Tax Map 251 12DB, lot 12, Burnham Park Subdivision
ADDRESS OF PROPERTY: 13235 S.W. rnham Court
NAME OF OWNER: Art Pr"itt Hiii 1 dgr
ADDRESS OF OWNER: 6339 S.W. Payton Rd. , Portland, Oregon
IN WITNESS WHEREOF, the undersigned has caused this
restriction to he executed this r �` day of f'(. %%n-fl L , 19 /5.
OWNER:
Name
APPROVED: litle
4t f f C a
City of Tigard
STATE OF OREGON ,/
County of Washington °°' i1�r2T .,t 2 /� 19 7 3
Personsily appeared before me the above named
Z,_ " ,,-ti.(( and acknowledged the foregoing
instrument to be voluntary act and dead.
Notary Public for Oregon
My Commission Expires: 7 7
R MR 140M°RCN, Du.:r,v m fius.,n 6 I ,. :. :..
Bon, 0.55 PALr 436
LC=D
e
STATE OF OREGON ss
County of WoshinLton
!'L' of Records
I Roger Thomssen, Director
do hereby certify
and Elections and Ex-Officio Recorder °f °r'�
Veyances for said
county' of reby 0 wos
,hot the within instrument of r�tords
received and recorded in book
if said Cotx►tY
Witness my hand and seal affixed.
Director of
ROGER THElect'or's
Records 6e�4
O^r
DeputY
Permit Issued CITY OF TIGARD, OREGON /)�J
- PermitNo.
City Hall
Application Approved Building Department Cost of Installation—__
A,aP �,
Ry_ - Fee for Permit .22 Z
Applicant shall fili in cost. of installation only,
Date above this double line. Street Sewer Permit
repairplumbing Pipes or l'ixtures according to plans and specifications and
Application is hereby made to descriplron as given below:
nstal�
LLocation of building—Number and Street._._.—__Ls1����_J_�!J
L,oL__— --_- _.__ -- --- Block— _-_ Addition_._____,,//
Name and Address of Owner__ l &— ;, �J7'.]�' I �_ �
L ` ��.
Name and Address of Plumber �1 G �y - �C � ����C�7-, _
Building (Old or New) �1f __ Height in Storiea _— Occupied as L c'
SCHEDULE OF WORK
NUMBER I NUMBER
FIXTURES New (Move I R'pl'ce FIXTURES New i Move I R'pl'ce
Water Ciosets___ Fountains, Drinking-
-Bath shower ___ _I __- __ Fountains, Yard___—_
Rath Tuh Fountains, Soda --I --i
I
Yasins ____�_�___J `—_ _ Ilot Water Tank__
Sinks, Ordinary Sinks, Bar
� __!_
Sinks, Dishwashing ._..-_I i __ Sinks, Slop__
Automatic Dishwasher _I __ i Drains. Refrigerator`__ I ..
Laundry Trays__- _I Drains, Iee Boll—_____ _I-
Drains, Floor- -_li_ ( Urinals _
fra#iT n_ t;, 4 I
Catch-Basins, Yard—
Rain
ard _Rain Drains-- ! Catch-Basins, Curage__ I-
I
Automatic Washer _ - __�—_, Catch-Basins, Sub Soil_
Water Permit No.—__ - - Bldg. Permit No.
REMARKS: --. .� -- - -----
IMPORTANII-Plumbing shall not be installed In any building, (either new, altered, or repaired), except as shown or designated i
on the cos responding building plans as filed with, or required by, the Building Department in accordance with the
provisions of the Building Code .e.d Ordinance 62.19 of the City of Tigard.
repair I the plumbing system according to this de-rription. Mans and specs cations and t e Plum g Code of the
I agree to lter s a i C)ty of Tigardt
Plumbing Firm-�
Supervisor