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13245 SW BURNHAM COURT F- LA N A U, � E I i ' �~� 5j 'Al S �b y r+ j G] J VA r' o v� g � 'J1 ♦ F-i r� �j F� �Ea ti d� C d � I I I I v 13245 SW BURNHAM COURT 4.��u 1 ; noo WfIHlJ ne MS SbZ�i J LLJ c Li iY P, _H O Gr1 H " C) 0 O U .a W U7 W4 m � 0 M N � i N c0 U U £ ] ! < p W H cs h� n OP `, I 3 ul U) d N r') EXHIBIT "B11- 4063 BI'4063 CITY OF TIGARD CIRTIFICATE 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 12-5 , 19—U, recorded in Book _y S_, page i47 , Deed Record of Wnr•hington County, Oregon, is hereby authorized and approved. DESCRIPTION OF PROPERTYi Tax flap gal 1208, lot 13, Burnham Park Subdivision OWNF,R: Art Pruitt Builder BUILDING PERMIT NUMBER; 73-261 BUILDING ADDRF,,S; 13Z4S.W. Burnhgm_Cour This is to certify the said structure meets with the require- ments of the Building Code of the City of Tigard and the above refdrenced restriction is hereby reler,sed and terminated. IN WITNESS MIEREOF, the undersigned authorized officer of the' City of Tlgard has csu:;ed this certificate and release of rest-;.ction to be executed this o_S day of :`� � 1 � 197V Title: _ STATE OF OREGON County of Washington �rs. On this �'? (� day of 1924, personally auncared before me the above named , whose st&nature appears hereon and who ackno edged to me that he executed the same in his offical capacity on behglf of the City of Tigard. N ry Pu is o! 0 gon My Co o -expires; oc .t. ra,A Ior_erA...._ .. _ W..._..„........A M."W: IIOCIA THOMSRCH.rhjr.TW of N0ee,Aa` t1 0.6 I .,. ; YA e <r a000. 994 OU 954 �.b �4 A! . -�;ww, t31sF ,i6�n�fi- „r '7� .�ii:�i .�I�NMiflu+yashYtaWr •..•... 3,063 r .J2 . STATE OF OREGON 1 County of Washington I, Roger Thomsen, Director of Records and Elections and Ex-Offir-lo Reeoroer of Con- veyances for said county, do hereby certify that the within Instrument of writing was received and recorded in boo4 of records No. of sold C linty Witness my hand orwi seal affixed. f ROGER TNOMSSEN, Director of 4_'u— Rec_xds & Elections n f 41- -7­7 +fix r SeP City of Tigard INSPECTION REQUEST for �J INSPECTION TIME :_ PERMIT NO. : ._.._. _ DATE: _ � /1'd//V DATE ISSUED:.__.1_ L OWNERS NAME 4L� A D D rR E S S : :__-- CONTRACTOR TEST' Air 0, Water L7 , Visual ❑ , Laboratory p RESULT: Approved, Disapproved 0 , Pending p SKETCH: IN PECTQR DATE CNOTE Attoch supplemental test dato hereto, ALL SPACES MUST BE ENDORSED PRIOR TO ISSUANCE OF BUILDING PERMIT PLANNING DEPT. PUBLIC WORKS DEPT. BY BUILDING DEPT. By r TUA-LATIN RURAL FIRE DEPT. APPROVED F3" CITY OF i j PEUI T # ----- ku1)i2fffS --_- ,Y-- ---T I TLL- -- -- -----------DATE I i i City of Tigard INSPECTION REQUr' ��T for INSPECTION TIME :,R,:/-(/, PERMIT NO. : _. DATE-. DATE. ISSUED: OWNERS NAME . �- IADDRESS : y>� .S'•! .• ,a'a..,it'.>,�. . � '.... I C O N T lR A C►'OR :— TEST . R :_TEST. Air ❑ , Water ❑ , Visual ❑ , Laboratory [] I RESULT: Approved ❑ Disapproved` , Ponding ❑ SKETCH: JAI SPECTOR DATE fNOTE Attach skip plementaI test data heret] 1 i I , City of Tigard I INSPECTION REQUEST for Ir /� INSPECTION Ti E : 1 PERMIT NO. : DATE: U79, DATE ISSUED:--LL OWNERS NAME : ADDRESS : 3-� 5- � I CONTRACTOR :_._-s_k.. TEST` At► ,^_,, Water (� , Visual , Laboratory ❑ RESULT: A rav ' pp ed , Disapproved O Pending p i SKETCH: I I � s I INSPECTOR DA E [NOTE : Attach supplemental tett data hereto City of Tigard INSPECTION REQUEST' fo INSPECTION TIME : PERMIT NO. : DAT_: _E , ' DATE !SSUED:--L_LL OWNERS NAME : — ADDRESS : AME : _ADDRESS : CONTRACTOR : TEST. Air ❑, Water, ❑ , Vieua! E! , Laboratory !D RESULT: Approved ❑ , Disopproved lZ , Pon ilnq (] SKETCH: aLc: ,�7f --4 P 44� �,,�/ � Cee.-,•a,�:. � L w..4� '�-•�.� . -�3 -7y JNSPECTOR DATE COTE : Attach supp!emental toot data haret� J City of Tigard INSPECTION RE® UEST for INSPECTION TIME : ��""a'�'"' "� PERMIT NO. : . DATE: DATE ISSUED:—I--Z— OWNERS NAME : ADDRESS : —L-jz„__l CONTRACTOR : ,01- TEST: Air ❑ , Weter p , Visual 11 , Laboratory ❑ RESULT: Approved ❑ Dieapprovedki� Pending �] SKETCH: "1// vvrlLL tits7V t O A' a 6 �s N t. v 7g �� L INSPECTOR DATE [OTE : A11ach supplemental taet data hereto PLUMBING PERMIT APPLICATION -Jurisdiction of No. Type of Fixture Fee Permit No. Permit fee8 �� �- Water Closets Toilets S°0 Permit Issued =,�q �L/ 1. Bath Tubs _ LJ2o Approved by :- Lavatory Wash Basi_ do Building Permit Shower Receipt No. b� Dishwashing_ _ 1 -Sinks, Kitchen _ -o'o Sinks Ordinam, _ Location of Building cinkLL -_-_ "q�5ie� ��l+�t _-- - -- Sinks, Slop � -_�_^--- I _J_ _Automatic Dishwasher DisPosai --_ Laundr•.: Tragi__- � me & Address of Owner Drains, Floor Drains Area " c 64J _----_-- Dr�ins�-Rei`-r �erator e �T:�u �o�•� __-___- __ Rain Drain:. - _ pn _ Automatic Washer Dame & Address of Pltimbex�-_---_-R-_^- ou.ntalns� rin ire n�_ 4e Li "M 1-1, 14C. - Fountains, Soda C.-,5 A- > 7- Hot Water Tank cer� — Water Service Size c_o -� 1��ii�_ !��r� Urinals Buildin Old or New) (Alter, Repair or _ CatcF—sins -�ar3Ins al�L � _ — Lawn Sprinkler Sstem _ Swimming Pool / Other - -^ Sprinkler System _ --- - - - -- -- �_-_ - This permit becomes null and, void if work or construction authorized is n---t commenced within 60 days, or if' construction or work is suspended or abandoned for a period c,f 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 same 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 press-me to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of. construction. Signature o.f Applicant �A'anw I I City of Tigard INSPECTION REQUEST' Far 4. INSPECTION TIME:-Ai , PERMIT NO. : DATE: . ( DATE ISSUED :_L Z OWNERS NAME : L� t..�- ADDRESS: CONTRACTOR ��.:� y'�';;y'''k'lN�r- Sw. B•�s.., TEST *. Air 0, Water 0 c Vieuaaboratory p RESULT: Approved , Disapproved 0 , Ponding O SKETCH. INSPECTOR DATE COTE: Attach supplemental feet doth beret Addles• �'� �.«• � ��.�►._._ Permit No. Permit charge Owner Connection fee Paid by Type of building �i ,��_x� Date connected I ;,/v Y', Service rate nrngInspection fee Contractor V�Oc_ '1sl�ik ..� - Paid by date Size of connection Assessment paid A +dre• /3:3. � c- Za Y, C' Permit w,, J , F-rmit charge �!` Owner �� ��,�.-��,.✓ ---- Connection fee Paid by Type of tu.Uding �fsL- Date coruiecte(l ;�er,:ice rate Inspection fee ('o,itrac'it Paid by Date Size o1' oruwetioll �� � � Assessment _ F'e► , r ,QP,;✓►"'' City of tigard INSPECTION REQUEST for INSPECTION TIME' PERMIT NO. : DATE: = Z12iU DATE ISSUED :--L-/- OWNERS SSUED :--L.!OWNERS NAM,!--- ADD AM"ADD CONTRACTOR TEST : Air n, Water❑ , Vieual ❑ , Laboratory ❑ RESULT: Apprt:vsd Disapproved ❑ , Pending CJ� SKETCH: a 1 i NSPECTOR DATE NOTE Attoch tupplomentol test Aato hereto CITY OF TIGARD 12420 S. W. Main Straot TIGARD, RECON 97227 APPLICATION FOR BUILDING PERMIT I;ew Construction Demolish Addition Remodel Move L� 9 Ffe i:UN 1 NG DATE ISSUED 3 — I/- 7 S,t RUILDING PERMIT BUILDING FEE $ G No, BY PLAN CHECK $- �''?-7, 00 — - --- OTHER $ "` VALUATION $�----- -- TOTAL $ - RECEIPT No. �j 7lo a T'4r) SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION MAP N CENSUS TRACT JOB Architect or I'ngineer Phone Address--. Ac3clrc,s3-- RUILI)ING USF ingle Res. ❑ Multi Res. lJ Y Comm._ Industrial s r1CCUPANCY GROUP__ _ of Stories-- Total Height --- Area of Lot Type of Construction I II 'r-L IV V Floor a B---^ ;;et. tracks: Front _ _ Back \ de_ __ R.Side__ __— Private Sewer Pipe Size i Sewer - Septic Tank U ivat(,r Service Pi ze _ Storm Sewer D F1 Drywe11❑ !;f reot�aIe Curb Req,jirementa nriveway width- —_ No. of Parking Space SEPPrATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION I !;I.I) 1'lll'CR Ny DATE PEW4IT APPROVED -- it ira unuerstood that all work will conform with applicable codes and ordinances ,,t 1ho State of Oregon and the City of Tigard, Oregon, and that the building will n,,t I-e oocupi.ed until a Certificate, of Occupancy has been issued by the City of Pr,a.ai-i cruilding Inspector. .Signature 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 Waiihington County, Oreqon, 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: Tax Map 251 1208, lot 13, Burnham Park Subdivision ADDRESS OF PROPERTY: I3JG, Cl_W_ Ilurnham f nkirf NAME U' OWNER: A,% Pv4dy wi-14®v ADDRESS OF OWNER: 6339 5.1.1. Peyton Rd. , Portland, Oregon _ IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this /S fy- dad of, 19 / 5. OWNER: Name APPROVED: Titla- By I /Building Official City of Tigard STATE OF OREGON County of Washington °°' _ �7 19 �{ Personally appes'red before me the above named %/(_ end acknowledged the foregoing instrument to be "4/L-- voluntary act and deed. Notary Public orregonr,_ 7 Fly Commissior. Expires: Lyf 7 1 ROOt.R rHOMSUN, D"..*a of 1wV1.14 a I1-opme BM 955 M 437 1 M �(lf� STATE OF OREGON 61 County of Washiryton I, Roger Thomee��-Director of Records and Electlons and Ex-Officlo Recorder of Con- treyances for said county, do hereby certify shot the within Instrument of writing was received and recurded In book of records Nr, of sold County Witness my hand and seal affixed. ROGER THOMSSEN, Director of Records & Elections Depwy Inc 5 12 os Ph'73 01 1 EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE 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 Deed Records of Washington County, Oregon, is prohibited by the ordinarce of the C'_i,y of Tigard, Oregon: (The City will issue a release as soon as a final inspection determines that the construction i3 ratisfactorily completed) DESCRIPTION OF PROPERTY: Tax Map 2S1 1208, lot 13, Burnham Park Subdivision ADDRESS OF PROPERTY: 372rm trntit— NAME OF OWNER; rPru u er — ADDRESS OF OWNER; IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this day of 19 OWNER: Name APPROVED: — —True— Py: Tr ?iRy: /City of Tigard STATE of nRFGON ) a A ,,� I�� /Y 73 County of' Washington ) °°' 19 Personally appeared before nye the above named ' -71 and acknowledged the for-going instrument to be _/ voluntary act and dead. ota y ubli-c`for Orngon M► Commission Expires: �Lc/�7 -.. 73 t UNIFIED SEWERAGE AGENCY NO. 4921 WASHINGTON COUNTY DATE i11-13-73 CITY OF _�—-- - —L`•^,a r-d_ - APPLICATION FOR SEWER CONNECTION PERMIT OWNER: _ - - -A t-Rrultt_Aldr- OWNER'S ADDRESS STREET `Portland — -- - CITU -- - - - -- - STATE ZIP BUILDING SITE. LOT__ 1-3 Burnham Park BLOCK ADD) fiON TAX LOT NO. _- TYPE OF OCCUPANCY ReaidAc�ca ADDRESS 1I�� 1324;�g�(,��Burnham Court DWELLING UNITS ] _ FIX 1 HRE UNITS SURCHARGE IF APPLICABLE PERMIT FEE _ _450 INSPECTION FEE _. 25 TOTAL DEPOSITED _ 475 (NEWI) (EXISTING) BUILDING SEWER SYSTEM Tigard !' rhe Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. 1 I APPLICANT ' �¢- SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE qn . INSTALLER RECEIVED BY C1., cENCV OR I AGENT) COMMENTS This Application and permit expires in ninety (90) days. The amount paid will he forfeiter) should expiration occur. "1 CITY OF TIGARD 12420 S. W. MUIn Street TIGARD, OREGON 97123 APPLICATION FOR BUILDING PERMIT New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move❑ ZONING R-7 DATE ISSUED 11-13_73_._ BUILDING PFRMIT DATE RECEIVED BUILDING FEE $_ 74.00 No. BY PLAN CHECK $_ ?4— __ 73-261 _ VALUATION OTHER $ 6_00 recording RECEIPT No, SaGs� TOTAL $ TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITF' APPLICATION LOT M 13 MAP A;� � CENSUS TRACT JOB M Architect or Engineer_____ Address Qoauorton, brogan _ Phone Owner Art p­itt_lildr Address 6339 S.W. Peyton Rd., Portland Phone 246-5395 Builder Address Phone BUILDING USE Single Res. u Multi Res. ❑ i` Comm. ❑ Industrial OCCUPANCY GROUP I No. of Stories ; Total Heioht Area of Lot Type of Construction 4XX"XXMXXMX V Floor Area B --- 1 1237 2_ --- Set Backs: Front 30 Back 25 L.Side _ 10 R.Side 8 _ Private Sewer Pipe Size 411 Sewerusa Tigard Septic Tank ❑ Water Servs-e Pipe Size_ 3/411 Storm Sewer © Ditch ❑ Drywell❑ Street and Curb Requirements` Existing Driveway Width _ 171 _�No, of Parking Spaces l SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED 13245 S.W. @urp?I& Ct. ..... FIELD CHECK BY DATE PERMIT APPROVED BY de stoo?. that all work will conform with applicable codes�a�d ordinances It is un r Pp of the State of Oregon and the City of Tigard, Oregon, and that the building wil not be -ccupied until a Certificate of Occupancy has been issued by the City of Tigard Building Inspector. w _. � S gi natur of App4icant yrz a IMOD W'VHNdnq MS SbZET •J .J J{ y M >4Q � � Z H y `Y ^l H u A- o cn _ ( Ei H N O \ F o w � nc�7cn i nimLnwc~Z, Q o- n >4 rl I [2 ►� o Ca 7 O u H C� U M. H C7 R; 1 1 r7 00