13545 SW VILLAGE GLENN DRIVE 13545 SW VT .LAGE GLENN DRIVE M
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b=LPIT "B"
CITY OF TItlAFU:
CIs7iTIFICATE OF r.C.''Uf'ANCY "D RELAASE OF RMTHICTIOP
The City of Tigard hereby cortlfle% that the occupancy of
the following described structure or premises With !'aspect to vhi^h
a restriction of "cupra:icy sag, oo September 27 �, lq_
recoidnd in Book , fags '�3❑ , Dred Record of Wacnington
County, Urepon, it hereby authorise-' and approved.
DI;1CRI111ON OF PROW a'Ya
i
Lot 11, Tax Map 291 2LA, Tax Let 911
V1.11age Glenn
OWTW' K j:i 1Ard iAIlsazn --
BUILDING F"ERNIT NUM FR: --I .
BU1IDIYG ADDRE.�9: 1S.W. Village Glonn Dri.
This in to certify the said structure masts vl:h the require-
sects of the Building Code of the City (;f T:gard and :.he above
referenced restriction in hereby released and terminated.
IM WITmiR WIff.M)F, the undersigned authorized officer of the
City of T:gard has ns.,aed this certificate and release of restriction
to be execute i this _ day of flay 19,j"•
Titlet ict
3TATR OF AEDON )ss
County of Ashington )
on this -, _ day of J�. 19__1A personally
appeared before me the above named „QL Ls ii�r Lj a whose
signature appears hereon and who acknowledpd to me that he executed
the same in his off:,-R! ca}acity on behalf of the City of Tigard.
Notary Pu orp6 ....,...�..
My��r+oeis ettpitrees Z'"hC�"""'�"
Yti4•Vr `X 1 /• /
1
975 .697
Iill
STATE Of OREGON
Cavar o/ W',
(shim" ./2..L
IActa/ f`Kt.netnt. Olr�fp d RK'.rdt
and E ectglw and I.Off oo RMtr of C—
"Yam" by loJ county, do HMy cett,fy
Owl the W-1 n "tt mwtl of oiling .70
hIn
of twd Cev*y
WIIneu my M7rtd rtd t al vllt*�d.
ROGER MOtwSSEN, d..c,et of
Rece.A� A Elrewrr ,
�II'l1
L1�M�
Jm t 12 .31N'74
qw 1w
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City of Tigard
I
IN PECT'I® N REQUEST
for
INSPECTION TIME : PERMIT NO. : �_. �
I DATE: 11-iPL DATE ISSUED-
OWNERS NAME :
IADDRESS : .cls 4tiL
CONTRACTOR _._
ITEST. Air ❑, Water ❑ , Visual O , Laboratory []
RESULT: Approved Disapproved ❑ , Pending
SKETCH: -
I � n
dwy
--�Cll�l ►►2-cam-,. Q/F'' . ,�;,,,,�.r.,I�'
r6rl►!s!� L`ac�''�'�7 v �
SPECTOR DATE
i
[N:OTE : Attach supplemental root data heret]
a
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: DATE ISSUED :- Z
OWNERS NAME : "4�1?
ADDRESS: Jl y_4 `1
CONTRACTOR :
TEST ' Air ❑, Water[] , VI..-til 0 , Laboratory [j
RESULT: Approvad,14-'� , Disapproved O Pending p
SKETCH.
i
N'1 SPECTOR DATE
[NOTE Attach supplemental fast data beret a]
1
City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME ' PERMIT NO. : _
DATE : l 1_�L DATE ISSUED.— Z Z -
OWNERS NAME ' _--� p-
A D D R E S S _S W
CONTRACTOR :
TEST .A r Water Q , Visual [1 , La'• .ratory h
RESULT' Approvedx , Disapproved _1 Pending ❑
SKETCH'
-INSPECTOR DATE
[NOTE Attach ' ,pplementOl test data heret]
i
I
City �of Tigard
INSPECTION REOUEST
for
INSPECTION TIME : PERMIT NO- : _
i
DATE : 1 DATE ISSUED:__1__L_.
OWNERS NAME : 44
I
ADDRESS : S X S-�L, -
CONTRACTOR : wt�--tee, — jnt 66ZA&"�---
TEST . A r J, Water 0 , ��iscai O , "La' .rator j r
IRESULT: Approved;< , Disapproved 1 , PNnding 0
I
SKETCH'. _
I
41 L
i
I
I
I
I 6 IN0PECT0R DATE
C07E : Attach supplemental test data here,]
1
Address /3545 4-J 6LU&e,e,, permit No. 4V 3
Permit charge
Owner Connection fee 45-o
Paid by 1 0-6- to CL �----
Type of building M-L.4.icktti cr- Date connected
/ c
Service rate 4J,' d Inspection fee
"1 _��..
Contractor paid by date
Size of connection � I ` Assessment paid _
II
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CITY OF TIGARD MECHANICAL PERMIT
i
DATE__,' - //� PERMIT NO, - RECEIPT NO,
BY _ ---- - - FEE ---- -7, 0 _-------__
t
1. Permit shall be obtained prior to commencement of installation. r
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 co,,,,-er up. '
New Installation L:xA Replace ❑ Relocation❑ Addition ❑ Alteration ❑
CONTR. Dick Hal I OWNER— Dick Hallberg
ADDRESS 584 4th Street WORK ADDRESS 13545 SW V i I I age GI en DR+ve
Lake Oswego, Oregon 97045 APPLICANT Imperial Pb I g d Htg. 1 nc.
TELEPHONE NO. 777 3801
FURNACE - MANUFACTURER Genera I Electric TELEPHONE N0. __n6 1161
HEAT Input rating (Btu Per Hour) 80,000-�-_ Vent Size4'10 Flue ,Size 50 2
FUEL OIL ❑ GAS'S ELECT ❑ OTHER
TOTAL SQ. FT. Top Floor Main Floor _120 _ Basement 504_-��
GEF?ER.AL
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit xx_ x`-00 " Boilers Over50_Hp
New - Under 100,000 Btu xx 4.00 Air Handling 10.000 CFM 3-D
New - Over 100.000 Btu~ __ � Afr Handling Over 10,,000 CFM_
Floor Furnace . _ Evaporative Cooler _ _— TO
Wim—Floor+-` uspenTe E7Vent' an
Inst- en s __ _ __ entSjr tem 0
Re air - Heat & Cooli.n_g _ _7705--Hood-
Boilers
70 Hood-
Bo ers Under 3_Hc-- 4 00 Uomes�_�fTHcTfiera or �O
Boilers 3 to l5 __ 7.50 omm. TnaTor20.001
Bo ers-157370HP 10.00 �gTer� io �i sed---_�_ _ _ 3•
B_oIle`r30 to 50-Hp_� _ o _. ---------------------------- -----
INSPECTOR'S COMMENTS
i
APPROVED BY DATE _ ISSUED BY DATE
- �
Imperial Plumb ng & Pea i ng�1'nc.
Signature of Applicant Htg Supv.
i
City of Tigard
INSPECTION REQUEST
for
SPECTION TIME: _i /;) a) PERMIT NO. :_
DA-IE: .,--I-: . /''/ 2 DATE ISSUED :
/NERS NAME : `
ADDRESS: 1.2-�_
)N TRACTOR :
_
=ST : Air 0, Watery , Visual ❑ , Laboratory []
_SULT: Approved 0 Disapproved � Pending []
:ETCH:
I SPECTOR DATE
TE : Attach supplemental feat data bereto]
i I
City of Tigard
INSPECTION REQUEST
i
for I
SPECTION TIME ' ��`�=`�^ PERMIT NO. '.--
DATE .
O. '.DATE . /,;1- /4' /7 DATE ISSUED :.._I Z I
INERS NAME : --
ADDRESS:/` s
WrRACTOR : _- - --- ---
=ST : Air U, Water ❑ , Visual ❑ , Laboratory ❑
-SUI_T : Apnroved)W , Disapproved ❑ Pending ❑ I
(ETCH: f
I
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I
INSPECTOR DATE
TE Attach supplemental test data beret I
1
FLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No.
Permit fee
CO- Water Closets�Toilets _Off_ Permit Issued
Bath Tubs Approved by
Lavatory (Was h_Basin)__ �,� Building Perrrii _
Shower ?�00 Receipt No. = 1 -
Sinn _Di=hwashing
Sinks_,,_ Kitchen__
Sinks, Ordinary_ - -__ Location of Building
Sink sz Bar_-_ -
_ SinkslSlop - ----- ---------__- __----- ------------
_Automatic Dishwasfier _ -_0 -- ------•----__._---_--------.--._-_---__--
visposa.l __--
------ Laundry-Trais _ Narae & Address of Owner - -_------ ---.-_ --
Drains, FloorY - &
_ Drains , Area ___.. �7/en 4 f -At U'0 �-- -----
Drains ,-Ref _ -__ -_-
Rain Drains
/ Automatic Washer _ OQ N7me & Address of Plumber
ountainssDrinking _ -
Fountains, Soda
Hot Water Tank
- Water Service Size S~ _
Urinals - - Buildin Old or New)(Alter, Repair or
7a FF-Basins - ard- _ install �?L�.t-- _---
Lawn Sprinkler_System ------:----- ------------------ ---------
SwimmingFoo-1-- _ Other
Sprinkler System— __
-----_..-.___..__L ---
This permit becomes null and void if work or construction 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.
Signature/of pplicant
City of Tigard
INSPECTION REOUEST
f o r
INSPECTION TIME :. PERMIT NO.
DATE /O ')ATF ISSUFD----L,'—
OWNERS NAINAE .
CONI RACTfiR
TI=S'l , r j , Wnter
RESULT Approved I Dkvpprov0 -1 tinding
SKETCH:
JN SWIF C TOR DATE
)IE : Aticch supplemental test ,iutcl hereto
CITY CY TIGARD
ChZMrICATS (a OCCUPANCY AND HELFA3t: OF Ht:;l'kI('1"T 011
The City of Tigard ?x reby cerilfies that ttie of
the following degaribed structure or premises with respect to which
a restriction of occupancy wag, on Septomhor 27 , 19 71
recorded in Pook r , (' , rase 9�p , heed Record of 4a:shington
County, Oregon, is hereby authorized and approved.
MCRIYTION OF I'HOeWrY%
Lot 11, Tex flap 251 ?CA, Tex Lot 911
Village Glnnn
OWWR:_H,L aid Hail + urn _
BUILDING FUMIT NIlh4it:Rsl;,-1'?[
BUILDING AUDRtd92 13545 S.W. Village Glenn Drive
This is to certify the said structure meets with tt,e rcyuire-
mfltis of the Building Code of the City of Tigard and the above
referenced restriction in hereby released and terminated.
Id WITNPSS WG;RPOF, the undersigned authorized officer of the
City of Tigard has cr. this certificate and release of restriction
to be executed this day of 19
Title: _
STATE OF OREGON )s n
r!ourty of Washington )
On this day of �, i.9__, yerecnally
spl:eared before me the above nat»d _, whose
signature app"re harem and who acknowledged to we that he executed
the saw in his affical capacity on behalf of the City of Tigard.
Notary Fjb11c of Oregon
My Ccxmleelon expires:
2593
13011PIT "A"
CITY OF TIGARD
Residential Structure Occupancy Rentrictiun
KNOW ALL WX 13Y TH=E FREUENT5, That occupancy of reaidential
• tructure (a) on trc following described lands prior to the recoiding
of an uccupancy permit releasing the restriction In tte Dre- Recor•ia
of Wesr,hington County, Oregon, In prohibited by the urdi,.,nce of the
City of T1,7srd, Oregon:
DESCRIPTION OF VROIOTY:
v r LL A6 t
ADDRIZ.1; OF VH01 OiTY: /3 % yS L w
'Am& JF OGYF:I: k'ec t/1feL!i1 yVmLLMkh e-
ADDRb;; OF O4(4t7i: /GSLcc', Yov—VAE+F' k'uN0
IN WITMMS WH61", the undersigned ha) caused thl,s restriction
to be executed thi.. 27 day of
OWNER:
Na -
A'PAOYED: by: 'w, e•/c
T.tle
'Building Offlcial
City of Tigard
STATE 0/ ORMON ss.
County of Wwihington ) _Auxua t 27,L 1 .
Per-,o:al.ly appeared before we the obove tamed Richard
Hallberg__ and &zxwvledged the foregoing instrument to be
,_hie volur.t.ary act and deed.
Notary PUblic for Oregon,
ra ,over cion Expires: 12/23/75
946 nw 0M,..�., 1-41_,e Waifs—&,
WwAs T1 14 Mows d%Mrar&UNIUM
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4
Sir
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1143*6
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Ril�.Trrr y'yr�
UNIFIED SEWERAGE AGENCY NO _._ ._4$83__
WASHINGTON COUNTY DATE 8- .27-71
C1 I y ()I I -�;., - -- -
APPLICATION FOR SEWER CONNECTION PERMIT
OWNERLt�lL�n_�(wtl,L ..—..__
( OWNER'S ADDRESS
Co.._w
ctry
BUILDING SITE LOT .. Il BLOCK ADDITION
TAX LOT NO TYPE OF OCCUPANLY T
ADDRESS / �S"NS ... ...� k' 11r/14C•E Clvva' l7eli'f - ---
DWELLING UNITS - FIXTURl KNITS
,
SURCHARGE IF APPLICABLE___ ____ - --- --•---
0
000 �I
PERMIT FEE___Y,60_ — INSPECTION FEE TOTAL DEPOSITED Z
(NEWT IEXISTING) BUILDING SEWER SYSTEM
The AppllcaM ,groes to comply with all rules end regulations of the Unified Se"fatIe Agency
APPLICANT / ��tiLx�Lsr .�
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZF I/ INSTALLER 6,11111119" e11#,9A1A V
RECEIVED BY ><rs* 014.>_+-
tl1Ncy 004 Its A01,01
COMMENTS
This Applor.alton and permit expires in ninety 1901 days The amount pard will be fnrlelted
should oxpl►ebon occur
SMUT "A"
a l3 CITY of TMARD
A*%Idential Structure Occupancy Restriction
K.10W ALL FCN BY THME HMENTS, That o"upancy of re:;idential
:tructu^e (s) on the folloving described lands prior to the recording
of nn uccu}on_y pamit releas ing the restriction in the Det, 1lsoordu
of itn.hinr;ton County, Oregon, is prohibited by the ordinance of the
City of TIFord, Oregont
D63CR1i'f1(j}1 Or 11tp1OTY:
"o r // "•s•wtoor a,51 - a c A TAX
L. ikNi[ G'GLww _
h.J✓71 }' H101EHTYA- V
;iAM: }_ _r'it H: 11 i( /heal V LL HtA-e
A:)' F L W'id_t:
:T. WILLREOF, the undertiigned has esuwed thi,: restriction
to m emcated thi 27 dny of �AUKU St
OWNER:
A1111RUM: By: _ Ott' . ►.
1'.tie
1}uildint; Official
C,tr of Tig,rd
STATS OF Oi WOM ) s s.
Cuunt� of wti.:hlfigtu: ) Auxuat 27, , lqL.
Perr,onal_; -,F•peared trfore we the stove gated Richard
Hellber� etv, s_.:,ovlenged the f,-reguing inutrumec:t to be
vvlw..ary s_t and deed.
Notary F' lir for Oreoo
.'ua.� ion F-Virea: _ 12/7. 7
C
CITY OF TIGARD
:420 s w. hull sti"
riGAaD. oasaoN rasa
APPLICATION FOR BUILDING PERMIT
New Construction Q Demolish ❑ Addition ❑ Remodel ❑ Move❑
204IN6 R'7 DATE ISSUED BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ ►.Qp _ No. i,S '•
BY PLAN CHECK $47.00 -• --
�— OTHER $ .�" (�riivu..v�• /hr VALUATION S 26,Wb.00__.
TOTAL RECEIPT No. 974
TWO SETS OF PLANS AND PLOT P►.ANS MUST 13E FURNISHED WITH APPLICATION
1.0T 1 11 MAP 1_-- 2C► CENSUS TRACT _W. JOB 1�
Architect or F.ngineecysLlBert Homo, Inc.
Acid rens f £5�.19�.$f13�__ -.-_-- Phone_
Pwner ..,..
Address------- ---Phone -._-.
Builder aaae
Address _ _ _Phone
BUILDING USE Single Res. ❑ Multi Res. ❑ Y- Comm. ❑ Industrial❑
OCCUPANCY GROUP I No. of Stories 2 Total Heiqht 21 Area of Lot
Type of Construction �a�Q V Floor Area B__ — I 2 —
Set Fucks: Front 23 Hack_ I^Side`_3pp_ R.Side__a__
Private Sewer Pipe Site_4" — Sewer usa Ti rd Septic Tank ❑
water Service Pipe Site___ _V4" Storm Sewer ® Ditch ❑ DryweII C�
Street and Curb Requirements
Driveway Width 181— _ -rNo. of Parking Spaces-__-&-_ --�
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED___—._11t4.ZIaY�Y111�
FIELD CHECK BY sec DATE. �-17=tj
PERMIT APPROVED
It is understood that all work will conform with applicabli codes and ordinances
of the State of 0regon and the City of Tigard, Oregon, and t:iat the building wil:
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
gn 0T Appl scent. , ___.._....