13735 SW 114TH AVENUE ^� 13735 SW 114TH AVENUE �-
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FMIBIT "B"
CITY OF TIGARD W10
CERTIFICATE OF OCCUPANCY AND RELEASE OF REsTRICPION
Vie City of Tigard hereby certifies that the occupancy of
the following described structure or premise:, with respect to which
a restriction of occupancy was, uu December j=1973 19_.,
recorded in Book 955 , Fuge 4111 Deed Record of War,hington
County, Oregon, is hereby authorized an;t approved.
DESCRIi110N OF FRO1'ER17:
Tax 'slap 251 3DD
Lot 28
OWNER. Columbia Custom Homes
BUILDING PERMIT 1401U-t:R: 73-259
BUILDING AUDRF,i: i3," , ..t�
Thi, - to certify the Said structure mee a with ttu require-
.ner.ts of the 1 ,ild)nk; Cutie of the City c,f Tigarl Rud the above
ref•,renced rer.triction i:, hereby released and terminated.
IN OTWU—, Nt4::OlUF, the undersigned authorized officer of the
City of Tig;:rd ha; cau:;ed this certifionte anu relea:.e of restriction
to be exec ted this �4 day of , 1'3 •
STATE OF OREGON )sn,
County of Washington )
on this 1-& 1 day of May____ lice, personally
appeareo before me the above named use, , whore
signature appears, hereon and who acknowledged to me tint he executed
the same in his offical capacity on behalf of the City of Tigard.
Notary r :c of Oregon
My Commisr,lon expire^: _
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EXHIBIT "B"
CITY OF TIGARD
CERTIFICATE Of' OCCUPANCY AND RELEASE OF ilE6 RICTION
The City of Tigard hereby certifies :he* 'he occupancy of
the following described st.,ucture or premise:, with respect, to which
a restriction of occupancy was, on DeaemLcr 5, 1972 09
rer_or7ed in Book 5i5, Paige 419 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIMON OF PROPERTY:
Tax May.) 2S1 3DD
Lot 26
OWMR: Columbin Cuaton I101nn:e
BUILDING F&PHIT NUMBER: 73-259
kUIL'JI,'IG AUDRE:i:i: 13715. : BI i441-1.
This in to -ertify the Said structure meets with the require-
mer.t� of the Building Code of the City X Tigard and the above
referenced restriction it hereby releaseu nnLt terminated.
IN WITN.;S WHEREOF. the undersigned authorized officer of the
City of Tigard ha:• caused thin certificate ana rclea:.e of restriction
to be executed this day of 1;4.
Title:
STATE OF URkMN
County of Washington )s�
On this _I L` day of 01s;� , lye, personally
appeared before me t,;te above naumd curie Har Gin , whu:,e
signature appear, hereon and who acknowledges to we that he executed
the same in his offical capacity on behalf of the City of Tigard.
�YY M V
Notary E ; lc of Oregon 0
May Cunnisnion expires:
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME * PERMIT NO. : �.
DATE:,4 11232-71 DATE ISSUED: ZL_
OWNERS NAME .' -- ---
ADD RES S :�3 � � `' - `c
CONTRACTOR : —
TEST: Air [3 , Water [] , Vinual ❑ , Laboratory ❑
RESULT: Approved Q' , Disapproved ❑ , Pending ❑
SKETCH:
iG l U/—,
I SPECTOR DATE
NOTE : Al tach supplemental test data heret7
............ ..... ..
ALL SPACES MUST BE ENDORSED
PRIOR TO APPROVAL OF THESE F=LA! S
PUBLIC WOR
DEPT. BY
PLANNING DEPT BY_ DATE �S
....r•
BUILDING DEPT.
BY- 1 --
COUNTY
HEALTH DEPT. BY ___.----
CITY ADMINISTRATOR
TIGARD WATER = ST.
DATE
BY _
GENERAL TELEFHONF.
USq
N. W. NATURAL. GAS
P. G. E. -- DATE
BY - - -
T. R. F. p• DATE_'_--��
DATE-
,
Tigaira
INSPECTION REQUEST"
to r.
NSPECTION rimE Uq,.�4u. LaE.EP.MiT NC.
)ATE . 4 L7_/ DATE iSSUED f
VNE RS jAME ' _ J r , C �oY„� *4 _
A r D R E S S — 1 ,32A.57 -
- 13 '7JSsa-sZ_a qi4_— ---
'.',N r R A r r r) R lv T ? —— — — —------ !
EST s,* iter❑ , � pct ► ,
RES0. t,:Vdtf v uppt ,. .n Li
S KETCH
INVECTOR DATE
jNOTE: Attact, supp,ementai test uuac, i.m► -tJ
WWWRX191w-�wMMwxw-x-m- MUM
ALL SPACES MUST BE ENDORSED
PRIOR TO APPROVAL OF TH SE PLANS
jle
PUBLIC WORKS DEPT. BY �D.ITc
PLAt:Ra?1G DE:PT. til' r DATC.�—.`_-
BUILD• G D!:k i
COUNTY H�
...i'-TH DEPT.
CITY AD:.hitdic i Pn'C:�!7 CY ..
GEN:i?:tiL 1'CLr'F'hfC>i�E � El`i..-.- --
U S n
N. %Y. NATUR.AL GAS; BY_- .-. C• �' --
1;
T. R. F.-�D. BY•- ---- BABE— --
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Uity T ; gard
INSPECTION REQUEST
for
INSPECTION TIME :, .'/ ,jF'RMrr NO. . ..
j DATE _ ')A-r F- ISSUED'_._L-r
OWNERS NAME '.
I WDRESSlie
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T 5 ! ;-
SKETCH:
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I INSPECTOR DATE
IE )TE : Attach yuppie menta !vii tu•r. neret]
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CITY OF TIGARII MECHANICAL PERMIT
DATE •J` � PERM IT NO.. d� �"' RECEIPT NO.
BY .��. FEE ---_____----------__.__—.
1. Permit shall be ohtai.ned prior to ccrnmenc:ement :;f instal.lattor..
2. Permit ,,hall be obtained f car° all. appli.ancos which are to become
a fixture to the building.
3. Relocation, replacements, alterations, car, rhanges tcj burners and
duct work require perm7.ts.
4. Al 'I works to be concealed must: be InspecteJ r..r?fnre: r-1,ver up.
New Install.ati.on I�ReplacE:� Reloc-rt;iryn Adli tl Jn Alteration
CONTR. _ _ OWNER
771
ADDRESS � WORK
I',PH. IC.A INT
T11EPHONF; NO,
FURNACE - MANUFACTURER '1'E1..;EPHONE NO ,
HEAT Input rating ((Btu Per Hour) _ _ Vent. 'Jze _ �,._ Flue S1ze
FUEL OIL , GAS U,XLECT LJ OTHER
TOTAL SO. F'T'. Top Floor Main Floor Basement
GIENERAL
ITEM NO. F I:H' ITEM W. FIRE
For Issunnge of Prrmi t. �c)() Bo:ijor� t)Over �, 11, _� r
New - Under 100 000 Btu Al l r Firrd11.i rel O DM
oo c I
ew - ver a _ -fillx nncl'[�r�; l�vr.>r
Floor Furnace .v Ev�avorr`a 1 coo or _._ _ y
r
Wall - Floor .�u s .enc e ..rx i -"Dent, F qn..... _.__._
Install Vents
ate
sir � �.m�
__ 1!!_
o Firs n car° __ �~___ -�t C)r) I'),rig, ," r" TF-CT l� --77 '01`4` r C)t
rollers�'�Zc ") If , ._.. _. ��i1� �`:•nim.r'�r�c�iii � � 1 �r `�U Oj(.
Boilers _..� Tit i, +Ti _Li � ,
o era T. t -----------------
INSPECTOR 'S
____ ________INSPECTOR 'S COMMENT'S
APPROVED BY DATE ISSUE") BY DATE
SignRtur°e :i f Applicant
Address /373 ` x_ (/ �w . Permit No.
Permit charge
Owner Connection fee '94)
P a i d b y_ �L�
Type of building Date connected /-3/- -7
Service rate Inspection fee
Contractor _ '""'o Paid by date
Size of connection 's Assessment paid
3 I "714
City of Tigard
INSPECTION REQUEST
for
,
SPECTION TIME: �`Y' PERMIT NO. :
DATE. / / DATE ISSUED :___11-
JNERS NAME : --
ADDRESS: —
)NTRACTO R _—.._ ----
ST : Air Watert3 , Visual EI , Laboratory C
_SULT : Approved L3 , Disapproved Q , Pending LJ
;ETCH:
INSPEC10R DATE
7E Attoch suppiementol tee' clot hereto
i
City of Tigard
INSPECTION REQUEST
for
&m/l Y Arn
IINSPECTION TIME . PERMIT NO. .
DATE : DATE ISSUED:_1 L_
OWNERS NAME . - '
I ADDRESS : — Lt)–. 1.1.-(4 —
I
CONTRACTOR ' >
Om t1?l
J TEST'. A-r 1,I , Water p , visuol,x�, Lah ,rotory [t
I RESULT, Approved 12(, Disapproved --3 , Pending Q
I SKETCH:
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I INSPECTOR DATE
OTE : Attach supplemental test data heret:01
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pity :�f
INSPECTION REOUE. ST
f(,r
NSPEC TION TIME : P)ERMI r bio. . _
DATE . ,2,5"7 'SATE ISSUED
OWNERS NAME ' . �lu•T .���� t l��-�* -
I ADDRESS '► l3fi .J• w ' ��= 7� ,
C.WI RAGT',PR . ----- - ----- - ---
RESJ�-T rPr J LrU,a,4
I SKETCH. _
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24)
.7111
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NBPECTOR DATE
Ct:JTE: Attach supplemental !vtl -i Or. r•erat]
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City of Tigard
INSPECTION REQUEST
for
a
L
i INSPECTION TIME : PERMrr NO. . � �
DATE , Lr'/�"7 ')ATE ISSUED'_._`_%
I OWNERS NAME '
ADDRESS '.
CONI RA(;T'iR ..�v
TFS ] 17
RESJIT
I SKETCH.'
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INSPECTOR DATE
f : TE : Attach supplementa� 'o-st •.a•o reret]
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j3I NG PER14IT APPLICATION
aiction of
b Fee Permit No. ;7 -P
Permit fee -
Tcile is Permit Issue i -i -79
Approved by
i
{ Wash Basn Building Permi
Receipt No.
ksqy_
s Dishwashing
,nks ' Itchen
a s r inar Location of Building
Sinks. Bar /373s_�- T
. in .s Slop _ _ — -
i Au- toma c_is iwas er _
isposa _
dryTrays Nam & Address c
Drains Floor
rams Area
airs e1z'i�erator
Ra_Lt1 Drains ar
/
Automatic Washer Name Address of '� ber
ours a nst r n nT�7 �
_ Fountains Soda
Hot a to r Tank
Water ServiceSize _
Urinals (Old c ew; Alter Repair or
Catch-Basins - arr ns a
Lawn Sprinkler stem
Swimml.ng Pool
Sprinkler Sys em
This permit becomes null and void if work or construction authcrized 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 cummenced.
All. plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that I !-Lave 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'-Applicant
1
City of Tigard
INSPECTION REQUEST
for
SPEGTION TIM ;� •4el ° — PERMIT NO. —
DATE: Z/ DATE ISSUED :--L—Z —
M E RS NAME
ADDRESS . -- —- = 1--L-
)NTRACTOR :
ST ' Alt u , Watery , Visual W , Laboratory ❑
=SUI_T . Apnroved ❑ , Disapproved ❑ Pending []
(ETCH
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/ INSPECTOR DATE
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TE . Attach supplemental test data her eI
Mr
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UNIFIED SEWERAGE AGENCY NO. 49i9_-____�__._
WASHINGTON COUNTY DATE ._ 11-13-73 _-__
CITY --
APPLICATION FOR SEWER CONNECTION PERMIT
OVAER: - --Columbia -Gua-tom Ham a,
OWNER'S ADDRESS: 7- P4t,- 3a€Fereon ITREETREETT
-- - -
(, BqEt STATE YIP
BUILDING SITE: LOT 28 BLOCK ADDITION Viewmount
TAX LOT NO. L ' _. TYPE OF OCCUPANCY residence
ADDRESS _ -_13735 S.W. -.114th Ave.
DWELLING UNITS FIXTURE UNITS
SURCHARGE IF APPLICABLE 50-_dzr_y Atoll,
-
PERMIT FEE - 450- INSPECTION FEE 25 TOTAL DEPOSITED 475
% EW`l (EXISTING) BUILDING SEWER SYSTEM Tigard
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
�✓ "
APPLICANT Q1� '414A--JL.- � e A?4�
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _ _ _ - - INSTALLER
RECEIVED BY.. __ -- }'C-t�
1 NC p It8 AGENT)
COMMENTS: J_-? .115- &Iez
i
This Application and permit expires in ninety (90) days. The amount Laid will he forfeited
should expiration occur.
CITY OF TIGARD
12420 S. W, hUin Strut
TIGARD, OREGON 97227
APPLICATION FOR BUILDING PERMIT
4
New Construction Fx� Demolish Addition Remodel Move
ZONING R-7 DATE ISSUED_ -111-71 BUILDING PERMIT
BUILDING FEE $ 131.50 No.
DATE RECEIVED 5 75 73-259 _
PLAN CHECK $
BY —"" 47D'0--recording VALUATIO14 $ 41,602
OTHER $
TOTAL $ 202.57 RECEIPT No. 2,4& L `
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WIT11 APPLICATION
LOT N 28 MAP # 251 30C CENSUS TRACT W-�,Q-- JOB N
Architect or Engineer Columbia Custom Homes—
Address 7 Mt. Jefferson Terraggs Lake Oftuapo Phone
Owner same
Add ress_i _ _ ---Phone
Builder samA -•------_____ ---
Address Phone
BUILDING USE Single Res. [;] Multi Res. Comm. r-1Industrial C
OCCUPANCY GROUP 1 _ No. of Stories_ Total Height_ Area of Lot
Type of Construction XXXXXXXXXXXXXRXXXV Floor Area B -- 1 1712 2.152 _.
Set Backs: Front_.20 Backer � L.S.if1F _7, R.Side-7
Private Sewer Pipe Size 4n _ Sewerl,VH_ligatd Septic Tank L_J
Water Service Pipe Size_ VAS Storm Sewer 0 Ditch ❑ Urywell
1
Street and Curb Requirements RVIAting —__� ----- -
Driveway Width_, 16' _ No. of Parking Spaces 2
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDPESS ASSIGNED 13735 S.W. 114th Ave.
FIELD CHECK BY JB __— _ DATE_
f
PERMIT APPROVED By
a l.icable odes and or inance
It is understood that all work will conform with pp
of the State of Oregon and the City of Tigard, Oregon, and that the building wil
not be occupied until a Certificate of Occupancy ha V een issued by the City of
Tigard Building Inspector. _ C�
Si nat�f A licent
9 PP
b915
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 ordinance of
the City of Tigard, Oregon: (The City will issue a release
as soon ss a final inspection determines that the construction
is satisfactorily completed)
DESCRIPTION OF PROPERTY:
ADDRESS OF PROPERTY: 13735 S.W. 114th
NAME OF OWNER: COLUMBIA CUSTOM HOMES
ADDRESS OF OWNER: 7 MT. 3EFFERSON TERR. SW. LAKE OSWEGO
IN WITNESS WHEREOF, the undersigned has caused this
restriction to be executed this 13 day ofNovember , 19 73.
OWNER:
A Iia
Name
APPROVED: Title
By
,ffluilding OFF1,181
City of Tigard
STATE OF OREGON
County of Washington ; se' LXt;�fi2��G'4� 13 , 19
Personally appeared before me the above named
klt�ruc�� and acknowledged the foregoing
instrument to be lit voluntary act and deed.
/J
l yns�i� L w A 1 •i�_
N 'fiT�ub is a'regon
STATE OF OREGON (__,��/ M► Commission Expires:
County of Washlrtylon
I Rnger Thomssen Director of Rec-els
and E�ecNuns and Ex-Officio Recorder of Con-
veyonces fn, mid county, do hereby certify
that the wlth,n instrumerst of writing was
recrivrd and recorded in book of records
.1 1INDEXLQ
of sold County 955 ._419
Witness my hand and seal offlwed.
ROGER THOMSSEN, btrectnr of
Records & Electiws
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