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BUILDING PERMiT APPLICATION FY TIG ARD DATEtg� _
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHour
LOT NO.
OWNERJ(, 11U JOB ADDRESS10,04:3 SW 1.JL 119tVd Ur .HOML ADDRESStamy.
ARCHITECT
ENGINEER
BUILDER 6IJliI1(a ADDF;F.Sti 80MIP* DESIGNER
STRUCTURE ❑NEW ❑RFM(TDEt UADDITION ❑REPAIR, ❑RENEWAL ❑FIRE DAMAGE ODLMOI TION
❑ FR--ESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑C4R PORT ❑GARAGE ❑STORAGE❑SLAB C]f-ENCE
!_JBOND ❑MOV ING QCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY'- LAND USE ZONE.�.I�.__-_BLDG, TYPE--2,-__.FIRE ZONE_ PLAN CHECK BY___ -_ HEAT
Patio Cbwsr r all per o Rn
9C4.yQAU_�
BUILDING DEPARTMENT - SET BACKS FRONTREAR LEFT SIDE RIGHT SIDE
Permit *i,on
— — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan,Cherk REGULATIONS AND ALL APPLICABLE CODES AND OPOINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPFCIFICATIONS ARD IN COMPLIANCE WITH
tolal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE Or THIS PLRMIT DOES NOT WAIVE
—
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CIT / BUSINESS
State '"i LICENSE. SEPARATE PERMITS REOUtRED FOR SEWER, PLUMBING AND HEATING.
Total - 5.20
--- --- - - -- APPI_ICANI (lR AGFNT
Approved Receipt N(
(
A A� an �_------
PLUMBING CATE
DATE INSP. TYPE INSPECTION REMARKS ---
_�.. Contractor
Permit No.
y-
Rough-in
Fixture
Final
HEATING
Contractor _
��— Permit No.
Get or Oil
Rough-in
Final -
SEWER
Final
DRIVEWAY
Final
- — Storm Drainage
(Rain Draini Final
-- - Sidewalk
Curb lit Street Final _
Approach
CERTIFICATE OCCUPANCY Final
Jt3L DG.DEPT.FINAL PORAWY
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: d PERMIT NO. :
DATE: sL- /Z� DATE ISSUED :—/ /
OWNERS NAME :
f
ADDRESS: -� G�` c►
CONTRACTOR : .Sa
TEST : Air p, Water[] , Visual, Laboratory p
RESULT: Approved 1 , Disapproved p Pending p
SKETCH.
INSPECTOR DATE
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50TE: Attach su,.;iementni teat d0a beret ja
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JAKIL
i
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: 0 PERMIT NO. :�.
DATE: -s ILLZ-� DATE ISSUED :-
OWNERS
SSUED :.OWNERS NAME : C
ADDRESS:
CONTRACTOR : T, V°�-
TEST : Air ❑, Woterid Visual �Laborctory Cl
RESULT: Approved Disapproved ❑ Pending ❑
SKETCH:
oz' r
/ P
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INSPEC70R DATE
CNOTF: Attach fupplom9ml0l teat data hdlt
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srsaW +giMlC++rx;73+uwFlw�+�ww.wsp.pw*r.riw-vn;. ^`rP.+MwrYyMk.M►.Q'N.cw111 ;':.!A" �yIF"e.. ,»._.,-r ,v'.4;dh "�''"'Mk4iN4k•.,
1, CITY or rubruery 2676 V 0684
BUILDING PERMIT APPLICATION TIGARD DATE___ I ,s
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN 'THE ACCOMP kN`ING PLANS AND SP�C�kIC4hpNS. 7
OWNER 't ,l+l lath, (-(4ADDRESS 10045 5.W- Highlenrl CIr.BUILDER PHONE
ENGINEER 014Mw
Rlil nER some ARCHITECT DESIGNER
SSIRUCTURE _ CINEW ❑REMOO'.L ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
C] RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO I-1�CAR PORT ❑Gi+RAGE ❑STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED []SIGNS
UCt;UPANGY I—LAND USE ZONE _ _BLDG.TYPE FIRE ZONE— PLAN CHECK BY HEAT
cattetr. .l [1.d •q. rt. Free �,i�.4G #1t4 <cho yorlags. 10 asemen •
C L_nAD F1.00!� LO.+D HEIGHT NO.STORIES AREA VAL'JE
4�---- I -- -- r
BUILDING DEPARTMENT SET BACKS FRONT 1Q' REAR z,, ' t��� LEFT SIDE 6' —RIGHT SIDE _--_
Permit 'a 1w';'n•Cl❑ -
-- • THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUII.DING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILT.BE DOPIF. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
•. RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1' State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, Pr_UMBINO AND HEATING.
Total • >•!}(1 CwJ:xr I*`IIMI-,. !-1.
E
APPLICANT OR AGENT
r
Approved Receipt No.
ADDRESS �f o —
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE.
�' N`J✓ f�;>/>-- Contractor
Permit No. c 3 6 q 3S .3/,7171
Rough-in
2 -7Z Fixture
y-/ -7� Final
c(-?'v 6 HEATING
yg9O 76 • Contractor
Permit No.
Gas or Oil
Rou h in
Final _
SEWER
_ Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
_ _ Curb&Street Final
A roach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Finel
CERTIFICATE OCCUPANCY
/d , 76 Landscaping
(, Zoning Final
4
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February 25, 1976
Roger Thoinesen
Washington County Courthouse
Hillsboro, Oregon 97123
Ret Occupancy Release Rlcordl"
Deer Mr. Thomsse-as
Enclosed aN two Exhibit B's (Occupancy Release of Restrictions) for
recording, they are as follows
Tualatin Development Company - 10045 S.Ii. Highland Drive
Tualatin Development Company - 10035 S.W. Highland Drive
Kixclosed also is a check to cover the recording coots.
Thank you for ;your asrsistsncs in this matter.
Sis♦erely,
1
Doris Hartig
City Recorder
"M I lw
Enclosures
2'749
EXHIBIT "B"
CITY OF HGARD
CERTIFICATE 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 ri3strictiun of occupancy was, on June 14 , 1.9 74 ,
recorded in Book qp1 , Page ^352 Dood Re :ord of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPLRTY:
Summerfield - Lot 206
As recorded in Book 34, Page 5, Plat records of Washington County,
Oregon
OWNER: Tualatin Develroment Co.
BUILDING PERMIT NUMBER: 74-109
BUILDING ADDRESS: 1.00455. W. Highland Drive
This is to c3rtify the said structure moots with the require-
ments of the Building Code of the City of Tigard and the above
referenced restriction it, hereby rolr,ased and terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigard has caused this certificate and release of restriction
to be executed this _ 24th day of etruary., 19 76
T.i tle: City R -bder
STATE OF OREGON ss.
County of Washtngton
On this 24th day ofbruary , 19 76 , personally
appeared before me the above named _ Doris Hartig , whose
signature appears hereon and who acknowledged to me that he executed
the same in his official capacity on behalf of the City of Tigard.
Notary I4oOr.9on
My Commission expires:
; 0 ;l ,r, 11/6/78 _
r
u
Roan TNQM.Mr,".01me- t N Mwrft k tio-b a "�C
.
R(A070 070 t 415
STATE OF OREGON
County of Washington ss
I, Roger T bf}�y�r of Records
and Electlo ntyi Bri+bfif'i , "corder of
Conveyan Ppr'Said county,!do reby cer-
tify that a within .Itnarlfinerlt writing
was race dllnd racoMhti inbdult o ecords.
No.
of sold ty:'
Witness h tnd it bill offlxk*.l
04 R YHb0SSP' hector
o 4%ofr l Ai s
�S7
3
FEB 30 AN'76
It(III\, )to
CITY OF TIGARD
P. O. Sox 23567
12420 s. w. Mair
Tigard,Oregon 97223
EXHIBIT "13°
CITY HF' FIGARD
CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION
The City of Tigard hereby certifies that the occupancy of
thu iollo;.rtng described structure or premises with rospect to which
a restriction of occupancy was, an June 14 , 19 74 ,
recorded in 3ook .901___., page 354 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY:
Rumniorfield - Lot 207
As recorded in 0ook 349 Page 59 Plat ror;nrds of Washington County,
Oregon.
OIJNER
131JILD1NG PERmIf NUMOLR: ---
BUTI.DIPIG ADDIiESS: .3S S• y_q_LJChland Drive
Vile is to certify the said structure Insets with the require-
ments of the Building Code of the City of Tigard and the above
referenced rnstriction is hereby rel.onsed and terminated.
IN WI [NI-55 WHLRI OF, the undersigned authorized offit-orof the
City of Tigard has rausod this certificate and release of restriction
to be 1?XaCUted this _ 2.4th _.__day of February___, 19 76
Title: Cit corder
SPATE OF OREGON
County of Washington ss.
On this ��q}h _day of _ FebruaFy___, 19 76 personally
appeared before ins the above named _pprAj Ngr.tiqwhose
signature appears hereon and who ocknowledged to ins that he executed
the same in his official capacity on behalf of the City of Tigard.
fJriLary PUhl��ir. o cogen � �
My Commission expiros•
-- -
11/6/78 _ _.
o a W
Tualatin Devewkew Co., Inc.
MEMOED JAS; - g 1975
To Date 1-2-75
Nick Heibert Y Job #
Director of Public Works, City of Tigard
Tualatin Development Co., Inc. will furnish access agreements at
the Summerfield project for:
Job 5184 (10285 SW Highland Drive) and Job 5185 (10275 SW Highland Drive)
Job 5205 (10055 SW Highland Drive) and Job 5206 (10045 SW Highland Drive) �^ i
—— Tualatin Dev opment 90.9 Inc.
Signed - - --
IYAj
CITY QF TI ARD
12420 S. W. Main Strwt
TIGARD, OREGON 97223
APPLICATION FOR BUILDING PERMIT
New Construction Q Demolish ❑ Addition ❑ Remodel ❑ Move
ZONING _ _ DATE ISSUED _fl.-14-7�4 N�ILDING PERMIT
DATE RECEIVED t• /,'J �// BUILDING FEE $_f t
PLAN CHECK $ ------
i r
BY /',{� .�� ^ ./I VALUATION $y J_
OTIIERA ••'("-i $ / "
TOTAL/%3;j Ie $ r RECEIPT No._�3.7
TWO SETS OF PLANS AND PLOT PLANS MUST 13E FURNISHED WITH APPLICATION
1'0 #_� _ MAP # - - - CENSUS TRACT -- - JOB
Architect or Engineer-
TLn I a- _�c4Stc�C�. t �1 _— _� _-
Address__A- �'"7C-rJ �. (•.7�i.�,'I_____�!-���_S �c:rr�_—_ -- -_ Phone�rj3.�'�1_
Address Phone
Builder
Address
13UILDING USE Single Res. Multi Res. ❑ Comm. ❑ Industrial��
OCCUPANCY GROUP �_ - No. of Stories_J_-_-_ Total Height �- Area of Lot —
Type of Construction I II III IV Floor Area B_-- — 1 �Z6� 2__-
Set Backs: Front l(� Back 44'_(," L.Side �- R.Side
Private Sewer Pipe Size_ _ _ Sewerd��', Septic Tank U
Water Service Pipe Size_ 3 I Storm Sewer )itch ❑ DrywellL_I
t
Street and Curb Requirements__a,5__rg
Driveway Width____` _ No. of Parking Spaces -- Z,
SEPARATE PERMITS REQUIRED FOP SEWER AND PLUMBING
/t `SPECIAL INFORM/A-TION
re-
ADDRESS"ASSIGNED J c/{i A,x I. . 'r /i�•�'- -- --
FIELD CHECK
PER141T APPROVED BY/ ,.q�''( C ••�-Z='
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigar(:, Oregc-n, and that the building will
not be occupied until a Certificate of Occupanc,r has been issued y the City of
Tigard Building Inspector.
*i &tureGcf(p
EX1{IA1T 11An
11909
CITY OF TIGARD
Residential Structure Occupancy Restriction
Y.NOW ALL MIEN BY THESE PRESENTS, That occupancy of residential
ctructurr. (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Deep Records
of Wacliington County, Oregon, is prohibited by the ordinance of the
City of' Tigard, Oregon:
DESCRIP21ON 0.^ PROPERTY: Simmerfield - Lot
As recorded in Lloolc �� Paga _ plat .records of Washington
County, Orr?Ron.
ADDRESS OF PROPERTY; j� , �.�, 11��1
NA14L 0^ OWNER:--7—,c
ADDRESS OF OICNER:
M WITNESS WHEREOF, the undursigned has caused this restriction
to bo executed this
day of �),•,J 19�i ,
OWNER:
TII(11.:1.;].l flA`�T? ;i Oiq;'^.r•;, ?, r
1V^D8/�
BUilding Official
l,,or rerori....%'....:..»...._.......IY_... ..01.........A.M.iW
City of Tigard RO OTIIomsrr . mmaror o; Romms h El—f,onf
STATE OF ORF,GON ) Gar
County of Washington )
Il .rcorz y apficared before me the above named
-7 and ncknowledged the fore.goint5 in:;truroe t�b1o
Voluntary act rind deed. /
JAat..
/Mota
y Publlic for G
pF pFEGpN s
SY'tE of 1.�+�t^� for of olcr'r
1rK a
fcnmtY er 9'h°rrr.lpy%,0 6.wIco` l�N',n9�wOs
t, Fog and Ex
�oamtY.M 04 roc
OVA lot so it's', 6004L
ah°r °nd root
re ei
N`w4d CP Y Kot f1 QtrK nl
°� for
^Y
h°nd Hp►JSSEµ, ,meg
FKGdaN;'^ess �1
�I11
EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy ResLriction
KNOW ALL MN BY TIFESE PUSEN S, That occupancy of reside.itial
ntructuro (a) on the following described lands prior to the recording
of an o,;cupaney permit releasing the restriction in the Dcec: Aacords
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTY: Summerfield - Lot
As recorded in Book _, Pa e t) —, Plat records of Washington
County, Oregon.
ADDRESS OF PROPERTY i
NAME OF OWNER:`T—u
ADDRESS OF OWNER i J S:3Cxi i 14 /x ' T;t o �
IN WITNESS WHEREOF, the undc•.^signed hao caused thin restriction
T�1-
to be executed this day of
MMR:
NarJe
APPROVED: �, � /X',,[/
By:
Buildiag Official
City of Tigard
STATE OF OREGON 6s.
County of Washinuton ) , 19-26w ,
71
Personally appearad before we the above named
and ocknowledged the foregoin3 inscru;en to be
IuJ vL'iuntary act and deed,
Nott ! Fublic f,'oP Or gun