13300 SW VILLAGE GLENN DRIVE WIN
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13300 SW VILTAGE GLNN DRIVE
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EUIBIT "B" 15520
CITY OF TIGARD
WrrI.FICATL OF OCCUPANCY AND ttElX. A;E OF RFLTRICTIt,N
The City of Tigard hereby certifies that the occupancy of
the fol-loving described structure or premi.et, with req*ct to which
n restriction of occui,antly was, on 8-31 073 ,
recorded in Book 943 . Page 39 . i)ee'i Record of Wanhington
County, Oregon, is tiereky authorized anu apjlruved.
D&3CR11'tION OF PROPERTY:
Lat 29, Section Map 251 2CA, Tax lot 928 Village Glenn
OWNER: �_s+ra. L'tllir►w.bale - _._
BUILDING PERMIT NUNS �-
BUIL'JI30 ADDRE.;S: 13300 S.N. Village Glenn Drive
This 1•- to certify the said structure meet--. with the require-
ments of the Building Code of the City id' TSvArd and the above
referenced restrintion i:'• hereby released and terminated.
IN WITHMS WHEKEUF, the under:aigned authorized officer of the
City of Tiganl Iia; cau:3ed thin certl.ficate aria relea::e of restriction
i
to be executed this ,;. , _r clay of ,/,L , 1970
Title:
STATE OF UREGUN
R fi.
County of Washington )•
on this day of �,�• -----.' ll!�v persunally
appeareti; before me the above na!red �j C'—.r.. whore
signature appear:: hereon and who acknowledged to we tfat he executed
the same in his offical eepaclty on behalf of this City of Tigard.
of egon
My Cumm s>1. ofts:
is ry g
AC'OtA 7NrMt:1.N to..+,. .1 M+«•rf. ti h.,nni,
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KWIM W,
CITY OF TIGARD MECHANICAL PERMIT
1 DATE - PERMIT NO. �11,/-%/`��n RECEIPT NO.
S/
` ._---_-- 7�FEE _ ~� � u-d
i
BY — _ -
1. Permit shall. be obtained prior to commencement of installation.
2. Permit shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation., replacements, alterations, or changes to burners and
duct work require permits.
4. All work to be concealed must be inspected before cover up.
New Installation-M Replace ❑ Relocation ❑ Addition ❑ Alteration ❑
CONTR. 4 i:z 0 G i C• OWNER -,,L' �' n.
ADDRESS 114 -7(2 WORK ADDRESS u-'
L:
APPLICANT : _-
TELEPHONE NO. - - 7-7 6- L
FURNACE - MANUFACTURER i_ e TELEPHONE NO.
HEAT Input rating (BtuPer Hour) / .=, *7 c c Vent Size Flue Size _^ _
I FUEL OIL LI GAS ❑ ELECT ❑ OTHER
TOTAL SQ. FT. Top Floor i` Main Floor Basement
GENERAL
ITEM NO. FEE P ITEM NO. FEE
For Issuance of Permit .00 Boilers Over 50 H
New - Under 100,000 Btu 4.00 Air Handling 10,000 CFM _
New - ver 100 0 0 Btu it Handling Over 10 000 CFM
Floor Furnace 4.00
Evaporative Cooler
Wall - Floor - usU e _ -T.00Vent Fan Z.
Install en s _ _ Venoms em 3.01
Re air - Heat & Cooling .0o Hood •
oilers n erg 4.00 Domestic Incinerator 50
Boilers o-35 H 7.50 Comifi, Incinerator OCI
Bogs o Hp- 10.00 ter MoFLisled 510-1
Boilers 30-to 50p • r
j INSPECTOR'S COMMENTS
APPROVED BY DATE 7-/ ISSUED BY DATE
Signature of Applicant
�r w ar w yr ar w w w
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: -i�--9ZLZY DATE ISSUED :
CWNERS NAME : Q,
ADDRESS:
CONTRACTOR :
TEST : Air ❑, Woter❑ , Visual ❑ , Laboratory 0
RESULT: Approved , Disapproved ❑ , Pending ❑
SKETCH:
INSPECTOR DATE
5')TE: Attach supplemental test data beret
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :--
DATE.-
O. :—_DATE: 6 DATE ISSUED Z Z—
OWNERS NAME -. - Z), LIC14- --- —.
ADDRESS: '�
CONTRACTOR : ___._.._-�----
TEST : Air ❑, Water❑ , Visual CJ , Laborotory ❑
RESULT: Approved Disapproved CJ , Pending ❑
SKETCH: c„ -, " s
4//' INSPECTOR DATE
IrlZ Attach supplemental test data bereta� I
1
ALL OAAPPROVAT
ROF THESEPLANr3PRIOR
DATE
PUBLIC WORKS DEPIII•�-
C
7PLANNINIG DEPT. BY------ DATE--.-------
DATE
BUILDING DEPT.
COUNTY HEALTH DEPT. BY-- DAT-,
CITY ADtAIN;s,rRATO ? SN'
TIGARD wi-%*rE:n DY
GENERAL TELEPHONE BY
.------
U S A
T
U
0
IT
TIG
UN. �v. NATURAL GAS BY----,
N Z
G. E.
T. R. F. D.
W w Il w w! #! w
I
City of Tigard I
INSPECTION REQUEST
for
INSPECTION TIME:I ?° PERMIT NO. :----
-� -�
DATE : In /�`', /,L� DATE ISSUED :
OWNERS NAME ' -- ML2.2, --
CONTRACTOR '__. —
TEST '. Air L), Water D , Visual 0 , Laboratory (]
RESULT: Apnroved 0 , Disapproved ❑ , Peridiog p
SKETCH.'
INSPECTOR DATE
LOPE : Attach supplemental test data hereto]
City of Tigard
INSPECTION REQUEST
for
Al
INSPECTION TIME ' PERMIT NO. *
DATE iy��S�7�' DATE ISSUED' 1_.1__
OWNERS NAME ' D
ADDRESS * 3c`() __ ZUL-
CONTRACTOR :---------
TEST
ONTRACTOR :____TEST A r J , Water [] , k/ist,al O , l_a'- ,rotors [I
RESULT: ApprovedW , Disapproved 1 , fending
SKETCH: k'tays q)/,- Ooec7-(C."
/3usiti�st
i
INSPECTOR DATE
[OTE : Attach supplemental test data beret
-10
9
City of 1- igard
INSPECTION REQUEST
f o r
NSPECTION TIMU.—Eat-2 PERMIF NO. -
DATE ' ')ATF
S S U ED
OWNERS
C,)NI RA CT�j R
TFSJ &-ter
Lj
RESULT Appr etj ro,iO J ,ndip,j
SKETCH:
To -7-1-c .4 L L
INSPECTOR DATE
0
EMOTE: Attach supplementol test ion nerat
i
it Y. of Tigard
9
INSPECTION REQUEST
for
;NSPECTION TIME. f0.' PERMIT NC. . _ --
DATE:, �" DATE ISSUED
OWNERS NAME : W -
ADDRESS: 13300
N r R A r'7 n R : _ � ------ -
EST ' . N, ter[] , V .
RESUL. .p ►UVed Sapp- iwe j 0 srldl IC; []
...��
S KETCH:
t'
M
INSPEC'TOR � DATE
[OTE: Attach supplemental test aata her e-t01
CLkAxe 19-74
�jboo . ay
permit No.
Ardtos• 135lDO •
permit charge
Owner _ ,!(� Y., _ connection fee
Paid by
Type building -° _ _ Cate connected /O 5`73
Service ret•.. - ' ,,.,.,�.,�.....�.....�- Inspection fee
Contractor �k•Yf �� paid by
date
size of connection 5'�' Assessment paid
:-lity of Tigard
INSPECTION REQUEST
far i
'�ti�E'CTIO�i TIME . PERMIT NC
DATE: /a 4 73 DATE ISSUED.-, i
OWNERS NAME ' __ D, w
ADDRESS: 64 -k-3
"()N TRpr,T0 R
EST ' , Y tercl , rj
RESUL'i ' q, roved 0 sUppr ,gid Li
SKETCH:
1
I SPECTOR DATE
NOTE: Attach supplemental feat uota her-:1uJ
(1
of Tigard
INSPECTION REQUEST
f 0 r,
-
,NSPECTION riME. PERMIT NC. .
-
DATE: DATE 13 S U E D .
OWNERS NAME
AnVRESS*.
,ON rRArTQ R :
NEST4,-.t e r* .. V 1-ab-Dratory r7j
RESULT*. ,vroved �uppr),ad 0 Lj
SKETCH:
INSPECTOR DATE
[NOTE Attacli supplemental test uutc her-7t
w w IK
City )f Tigard
! INSPECTION REOUEST
for
NSPECTION TIME : —;5r 0 PERMIT NO. -
DATE .
O. .DATE . `SATE I SSUED'-- -- —
I OWNERS NAME '
ADDRESS
I
ES I winter 7 , `';c .,;j 'r Ln
RESULT Nppro-,ed) isr,)pro'. 30 1 :ndjn�i
SKETCH:
I
I
I
>3
I
13P+ECTOR DATE
Ld
]
1E : Attach supplemental 'eut .. o•!• eret
I
WWWkTVq
6P• ni
PLUMBING PER141T APPLICATION
Jurisdiction of
o. Type of Fixture Fee Permit No. 73-
Permit
3 Permit fee .3�� �—
Water Closets (Toilets) 7Permit IsoliFT 5 7i
Bath Tubs Approved t:,y
Lavatory Wash Basin Building Perm
Shower Receipt No. � 7y
'. Sinks. Dishwashing
Sinks. Kitchen
SinksOrdinary Location of Building
Sinks, Bar_� _� �., c1r�,E� (�►�_ 1 1r u '
Sinks. Slop
ut oma tics lwasher
Disposal � 'J
Laundry Trays_ Nam & Address of Owner,
Drains Floor
Arear _
Drains 7-7ri–erator
Rain Drains 1`Wo
[9Autumatic Washer Name & Address of Plumber
7ountains, Drinking T'�'
fountains , Soca
Hot Wager Tank
Water Service Size T `'
Urinals Buildin Old or New Alter Repair or
7aTT1- a�3 sins----7-arc7—
Lawn S rink er stem
Swrmm i nPar,l .
Sprinkler• System
This permit becomes null and v�diif work or constructi�zi authorized is not
commenced within 60 uay_,; or if construction or, work .s suspended or abandoned
for a period of 120 days at any time after work is c,_mmencec?
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 s
to be true and correct. All provisions of laws and ordinances governing this
of work will be complied with whether specified herein cr 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.
Signature of Applica
1
J
City ')f T igard
' INSPECTION PEOUEST
i for
i
NSPECTION TI PERMIT NO. ,
DA _ 'BATF I S S U E D '.
W 111 E R S N A M E _+_ L _ L-... -_
1'ES I inter ' _ ;
IRESULT iNPPr,,�ed L7 ;;i:,r�p►'o=..��__...._ r,d�n ,
SKETCH:
I
i
INSPECTOR DATE
I L ATEAttcch su
pplemental test so<<+ neret]
k=IBIT "B"
CITY OF TIGARD
CERTIFICATE OF OCCUPANCY AND IWLYA-33E OF RL'JTHICTION
The City of Tigard hereby certifier, that the occul.oncy of
the following described structure or premiser, wl+: respect to which
a restriction of occupancy was, on B-31 , 1973 ,
recorded in Book 443 , page 39 , Deed Record of Washington
County, Oregon, lr hereby authorized and approved.
DLSCRIITION OF FRQFERTY:
Lot 28, Section Map 251 2CA, Tax Lot 528 Village Glenn
OWW: _ sass & M u.+r. die _ ---
BALDING J%FM1T NUMBER: 7!1-191
BUILDING ADDRESS: 13300 S.W. Village Gbnn Drive_
This is to certify the said structure meets with the require--
marts of the Building Cute of the City of Tigard and the above
referenced restriction is hereby released and terminated.
IN WITNMS W11F:10;uF, the undersigned authorized officer of the
City of Tigard has cau:;ed this certificate and release of restriction
to be executed this day of
Title:
STATE OF U11?1GON ) r
County of Wa!;hington )
On this day of ly_, personally
np;eared before me the above nand _ , whose
signature appears hereon and who acknovledged to me that he executed
the name in his offical capacity on behalf of the City of Tigard.
Notary Public of Oregon
My Commission expires:
t' 17134 `` RECENED
EXRI1'IT "A" Ue 13 191:3
CITY uF TIGAn CITY OF TIGARD
Residential Structure Occupancy Rentriction
KNOW ALL WN BY THME 11RFZENTS, That occupancy of residential
Ltructure (a) on thre following described lands prior to the recordinE,
of an occupancy permit releasing the restriction in the Deet. HOCOrdt;
of Washington Count;;, Ore Lon, is prohibited by the ordinance of the
City of Turd, Oregon-
DESCRIPTION OF 11ROYERTY:
40T -4 9 S Et— ma? .49, XCO 7-,aX Gar V`2
L/' i( _ A 6 L:Lfn.nJ
AADDDH450 OF PROPERTY: /3-'SOC7 n. 9 LEn�v iJZ
NAME OF OWNER: M! }- h"E s 1P, 4 L/6w: Lal E _
ADDR%i:i OF UWNER: /3 7, �. L ,t C�IEA' f' iKn ,v_ 0 I
IN WITNEIS.; W]WREOF, the undersigned has caused this restriction
to be executed Lhi / day of RIJb(iS j 1y
OWNER:
Name _
Al PROVED: by:
T.tle
By: -
Buliding Uf cial
City of Tigard
STATE; OF OREGON
County of Washington ) �fs�q_ _ 19z-,—.
ir.r-onall) appeared before we the above named (,e, o/d <• r.�i,
and a:knowledged the foregoing instrument to be
volw,tary act and deed.
141 �AlAl,Eati -
NotAiry ublic for Oregon
My Comrr'c;sion Expires: &�.tt ,
Wo J�� PAGE 3J nw w..�.�+.� .. _.I_.- 73a
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ebb C-1���� � tl rl
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4L
fes++ibsDtial �MlM prM�QY Alrstric4iam � ';
K" ALL NO U IN 000upg sy of reelAWtial
i atructure to) on tAe lbll(7" 4A prior to tAs rrlo4idtn4
r
" of wi uccupssocy yerslt 7414MOAft LM r"Irietios in the DssL IMWf�s
of iishlaCton C+.iunty, nrVWP 1Y prodlbit" by the ord-lnsnoe of tlw
r
City of T'Prd, rh'fWm',
ON Cf t'ADP !t
r 7AW
(s i L L Z sArM/
M
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KAl1( (1/ UMIlM: ARE _YZ�C ILLiLLL/Ir! SGLL
IN VITMM . WN s06rs19ysd ISO osuisd :.his rvstrictioo
r > a executed this .•�� Asy of ��/6[i11�_ 19.z�
Al1�s
BMW
ATIToYET): hl •...Q��• flus
Huilding
City of Tiogard
STATI OF MOON ) .•.
County of vs4hitvita+
Ivreons:-ly avyeored berms se tde sbom nenwl e/a( A. .s/s
_ sod eekwwlsdWd the foregoing instruwnt to bs
voluwairy art sd daed,
ry fublie for O"Fm
,� My oomission R*iress .�klL •__
A
CITY OF TIGARD
11 420 S. M W. aIn u...►
"GARD, 0R&0ON
APPLICATION FOR BUILDING PERMIT
New Construction a Demolish ❑ Addition C� Remodel 13 Move 0
ZONING R-7 DATE ISSUED BUILDING PERMIT
No.'+•i
PATE RECEIVED$�f� BUILDING FEE S_jgj,�_ _ /•
PLAN CHECK S 76.81
BY `_-C —_ y. '0
OTHER nr�nJ • � VALl1ATION S�r516•�
OTHER $ /J RECEIPT No._�7 rg
TOTAL Ste_. fjl•� p
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT I gQ MAP 1 2�•1_2CA __ CENSUS TRACT 4. JOB A
Architect or Engineer James R. Chauncey ----
Address_ �. ----- �._ �__ --Phone --
Owner Mr. 6 Mrs. William OoU --_-- -- _
Address_ l4c� B.M._Village Glenn Dr. ,___ �_.—._Phone —
Bui lder D.W. D.
Phone
Address__ p_Y`liurnh�e s rent.,_
BUILDING USE Single Res. ❑ Multi Res. Comm. ❑ Industrial❑
OCCUPANCY GROUP I No. of Stories--.?-- Total tteight_24 Area of Lot
Type of Construction 1CIX,XZ10(RIQ=x-UY V Floor Area 8,--� 1 1651 21765
Set Backs: Front 75 _ Back 27 _ (,.Side_ 7 _•(R.Side 7
Private Sewer Pipe Size 4" Sewerusa Tigard Septic Tank ❑
water Service Pipe Size___ ii" Storm Sewer D Ditch 13 Drywe11 ❑
Street and Curb Requirementsi__
Driveway width_ 141 No. of Parkinq Spaces`_ ;,
SCPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED— _13300 S W• VilLp 01ean Drive -- ---__�
I ELD CHECK BY _ __._ _. •__ -.____
DATF. 8•,i7�73
PERMIT APPROVED BY
it :s understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oreqon, anal that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tiqard Building Inspector. o
gnature AAtFplicant 'r
1
UNIFIED SEWERAGE AGENCY NO 4882
WASHINGTON COUNTY DATA
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER ____Sl�s•51_>_�__. ��tM '� W/Gc/4�►r (�-Q��_—.
CWNER'S ADDRESS: ------
�- arnsr T
CITE •TwT� _._.-- il►
BUILDING SITE LOT BLOCK _. . _ ADDITION 044A6-10",d?Gi[�w
TAX LOT NO TYPE OF OCCUPANCY '51.vbcE
ADDRESS 1''?�30C) S. w V/LL�GC tge'es'Pw ASC
DWE'.LING UNITS FIXTURE UNITS
SURCHARGE IF APPLICABt.E
PERMIT FEE +5704u INSPECTION FEE02S TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEMThe Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT ..
SEWER PERMIT'
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE S " INSTALLER
RECEIVED BYCrT1� OF Tt6A*at)
(Ani[NCY UH ITS AOI-NTI
COMMENTS I
This Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.