15625 SW OLD ORCHARD PLACE m
15625 SW OLD ORCHARD PLACE
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City of Tigard
REQUEST-
for
INSPECTION TIME :_ ` .' 4t-a--r-, PERMIT NO. :
DATE: 17 DATE ISSUED:___L__L_.
OWNERS NAME : -__ 11_)C_
At ~R ESS
TEST ' Air ❑ , Water ❑ , Visual ( Laboratory ❑
RESUL"i': Approved C Disapproved ❑ Pending p
SKETCH: 3 .' S-
INSPECTOR DATE
1N07E : Allach supplemental lost data hersta
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Mumma
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Cid of Tigard
Bard
INSPECTION REQUEST i
for
INSPECTION TIME' � A ;ERMIT NO. :--
DATE:
O. :—DATE: _ i-) Z V DATE ISSUED :—/--/--
OWNERS
SSUED :__L_L._OWNERS NAME :_ r _
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ADDRESS:
CONTRACTOR :
TEST : Air p, Water[I , Vieuoi ❑ , Laborotory ❑
RESULT' Approved ❑ , Disapproved ❑ , Pending C]
SKETCH. �. ' �, 3 3 0 � �i- -7y
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INSPECTOR DATE
NOTE Attach Supplemental test dntn bereto]
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City of Tigard `
INSPECTION REQUEST
for
INSPECTION TIME' PERMIT NO. :�.
DATE: DATE ISSUED :.- Z
OWNERS NAME" : %f� '•�'ADDRESS: LaT/!f' f --- --- ----��_.
CONTRACTOR : -7,:�?(-
TEST : Air E), Water[] , Visual (] , Laboratory p
RESULT: Approved E3 Disapproved O Pendinp p
SKETCH:
INSPECTOR DATE
F-rTE: Attach supplemental test data be►etQ
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City of Tigard
INSPECTION REQUEST
for �
INSPECTION`TIME: �_.._.._�`�`�' PERMIT N0. :�_..a�.
DATE : _._ L.L+�F DATE ISSUED :,_.__1_.L___ I
AW N E RS
ADDRESS: .�: - L _
CONTRACTOR
TEST : Air L1, Water (] , Visual C] , Laboratory p I
RESULT: Approved , Disapproved ❑ Pending p
SKETCH.
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SPECTOR DATE I
NOTE: Attar;l supplemental teff data oereto�
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City of 'Tigard �
INSPECTION REQUEST �
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INSPECTION TIME' �` 't'> PERMIT ftp.
DATE.- / ISSUED :--L../,—
�L-- DATE
OWNERS
ADDRESS: --
CONTRACTOR :
DDRESS: __C0NTRACTOR :
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TEST Air p, Water[) , Yisua%t<'Laborotory C7
RESULT: Approved'", Disapproved 0 I
, Pending p
S KETCH.
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110— 1�C
INSPECTOR DATE _ I
NOTE: Attoch supplemental ;est dots htret01
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City of Tigard
INSPECTION REQUEST
for
OPECTION TIME: --2�. PERMIT N0. : I I
DATE: ,3 hf�/ � DATE ISSUED :-- Z Z I
VNERS NAME .'
A11(QRE3'S -i-et
'EAir:T . ❑, yVo?er❑ , Visual p , Laboratory p
tE.SULT_ Approved , Disapproved 0 , Pending U F
KETCH.
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INSPECTOR DATE
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STH Attach Supplemental test data beret] ! E14c
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City of Tigard
INSPECTION REOUEST
for
,NSPECTIQN TIME : ./", _ PERMIT NO. : --.-
DATE:
A. : __._�_.
DATE: �'/// 7 DATE ISSUED-4-1—
OWNERS
SSUED-1_LOWNERS NAME:
ADDRESS': t-x� 1�l q
CONTRACTOR : T�
TEST: Air p, Water Ii , Visual p , Laboratory p
RESULT.* Approved�14'" , Disapproved ❑ Pending p
SKETCH:
?UPECT�10;R DATE
NOTE : A}tach supplementol fast date Reret0
PLUMBJNG PERMIT APPLICATION
Jurisdiction of
INo. Type of Fixture Fee Fear iit No.
Permit fee
Water Closets (Toilets) Permit Issuje
dJt�
Bath Tubs Approved by -g�j y
Lavato Wash Bas ��y Building Permit
Shower Receipt No.
Sin s, Dishwashing�—
Sinks Kitchen
Sink. Ordinary- Location of Building
ins Bar _ •�=.�__��.�..__..____
Sinks;_Slop
Automaic Dis washer --_� / �" :�✓`� N'� ✓�L -_--,._ _.
isposal �
Laundry Trays _ Name & Address of 0�ner4._J,.Y,4.w_(1,r_�
Drains, Floor i ;;, ✓�.f_�r., , ,,,� fit. - -- -
Drains Ai ea -------
Drae ra to r -"---� ---------Rain Drains --
j Automat c asher r �- Name & Address of .Plumber . ' '
oun ,ains Drini
n _
Fountains oda
Hot Water Tank
--- ' / r'
Water Service Size'
Urinals Buildingatc - Old_or few) Alters Repair or
Basins -Yar3` n a -
awn Spri�Sstem
swimming Pool _ Umer --
S rin ler S stem- -'- --'-- -----
This permit becomes null and void if work or construct-Lon authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 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 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 provisions
of any other state or local law regulating construction or the performance of
construction.
r�
Signa re of .applicant
a
135'71
EXHIDIT "A"
CITY OF TIGARD
kaeidouLiul Structuro Occupcny Rootrirtinn
KNOLL ALL FiEN BY THESE PRESENTS, that occupancy of rooidontial
structure (s) an tho following deacribod lands prior to tho rocor~ding
of an occupancy pormit releasing tho roatriction. in tho Dead RUcorda
of Washington County, Orogon, is prohibited by tho ordinance of
the City of Tigcrd, Orogon: (Tho City will ioauo a ro.loaao
no soon no a finil inopoction detorninoo that the construction
is satisfactorily conploted)
DESCRIPTION OF PROPERTY:
t a t� �.ta.a a��.V �>�r •\Ci��
ADDRESS OF PROPERTY: 3.r� a�a �
NA 1E OF
ADDRESS OF OWNER:
IN WITNESS WHEREOF, the undersigned has caueod this
restriction to bo oxecuted this day of
OWNER:
l
APPROVEC: _..Title
r By:
'Building Officio
City of Tigard
STATE OF OREGON
County of Washington ss' January 29 lg 7A
Cursonally appeared bafore no tha abovo namod
Roy Brown � and acknot.rlodgod the faragoing
instrument to bo his voluntary act and dood.
Notary Public for Orugon
Fly Cor miaaion ExpiroL: 1/16/75
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a F�(Mi THOM98CM. Mtr.jnr of A��.qd�R Elwrr,nv
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MiiwIT "A"
CITY OF TIG"PRD
Rasidontial Structure Occupcny Restriction
KNOW ALL MEN 3Y THESE P"ESENTS, that occupancy of rssiciontic;
atructure (s) on tho following daacribod lands prior t,o the roco.7dinc,
of an occupancy permit roloasing tho raztriction• in tho Dood Rocor�:
of Washington County, Orogon, is prohibitud by tho ordinance of
the City of Tigard, Dragon: (Tho City Will isoua a :ola&aa
as soon as a flocl inopuction dotarninoa that tho construction
is satisfactorily complotod)
DESCRIPTION Or PROPERTY:
kzt
VJ �•a.�.n ci;c u c� C..�c>..,��•�� C%�. r �<,�
ADDRESS OF PROPERTY: .3y ��� _ i •�\����
NAME OF OWNER:=�L,=\
ADDRESS_ OF OWNER;_� = ._��,C
1N WITNESS WHEREOF, tho undersigned hoe cauood this
restriction to bo executed this — day of _ r, , 1g`��•.
OWNER:
APPROVED: "� _ itla
By= ,43 u
uz zng OF'Fzcia
City of Tigard
.STATE OF OREGON
County of Wnohington 3 aa' January t9 19 74
Personally oppocrad bsfure i-,-.o the coov;, namod
Roy, Brown and ack•loulGdgOd the foregoing
instrument t:a ba his voluntary act and dead.
Notary Public for Oragon
My io:;ion cxpiros: 1/16/75
w 112 9/7 V
CITY OF TIGARi]►
12420 S. W. Main Str"t
TIGARD, OREGON 97123
APPLICATION FOR BUILDING PERMIT
New Construction Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING F- 0 DATE ISSUED /-2 2- 1'/ BUILDING PERMIT
DATE RECEIVED BUILDING F1 No.
PLAN CHECK $ /L'� c�0 r'-/SSvr 4
BY-- OTHER. $---ef•Q(� [_ e,,y,&Ti►,. VALUATION
TOTAL $ ://`/h' S7A7e RECEIPT No. 9S -7
- 7`Z>NL �. 1-�.- -
TWO SETS OF PLANS AND tTnT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # \y`�i MAP #r� CENSUS TRACT JOB k
Architect or rngineer_�„
Address
Owner n
Address Phone
Builderti
Address _ _ _Phone
BUILDING USE single Res. Multi Res. ❑ Cc-I=, L._1 Industrial❑
OCCUPANCY GROUP- :-X- No. of 5tories___)I,_ Total Height Area of Lot
Type of Construction V Floor Area B 1 v%.N% 2
Set Backs: Front xO Back �'.O L.Si.de_y' R.Side�%.v�
Private Sewer Pipe Size yt1 sewer*;,,. G, '\-,Aeptic Tank ❑
Water service Pipe Size .�"_ Storm Sewer S Ditch ❑ Drywe11❑
'Rk,W% �
Street and Curb Requirementso«, -L���c.r=c,_.
Driveway Width 1�------)�—No. of Parking Spaces ':::k,
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED
FIELD CHECK BY DATE
PERMIT APPROVED BY
It in 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 will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
signaturp fApplicant +