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OF oce
OITY OF TIGARD Nc a.
�. Y � tib
OREGON
0,,mer:.........Tualatin.-Qeu.elnpmen.t........... .........Permit No..74-165 ---•--, {4
Building Addres ...0rtve.... ... _......................... +
jot Certificate is hereby given this...fith.. _day of....Mgr.(;.h............... . 19.....7.5.
that said building may be occupied and
that it complies with all requirements of
r K:' the Building Code for the City of Tigara, '•�
' as approved by the Tigard City Council.
/
zn-
{
Building Inspector
VAN
t C'r. fl% 'r 'I� M'.'t (� '� � ���: �.%l,�°'. `tel'' �v1�T e.;,�,�i�� �rG�ti�' •�r�
u NY WI M.
6
EXHIBIT "B"
CITY OF TIGARD 17594
CERTIFICATE OF OCCUPANCY AND RVJAASE OF RESTRICTION
The City of Tigard hereby certifies that the occupancy of
the following described structure or premises with respect to which
a restriction of occupancy was, on 111nm , 192A_l
recorded in Book 981 , Pap 353 , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY.,
Summerfield - lot 205
Ao recorded in Book 34, Paga 5, Plat records of Washiny.�on
County, Oregon.
OWNER: Tualatin 0avel,ngment En.
BUILDING PERMIT NUMBER: 74-115
BUILDING ADDRESS, IOQ5z5 4.W. Hi ahland ❑riva_
This is to certify the said structure meets with the require-
ments of the Building Code of the City of Tigard and the above
referenced restri:tion in hereby released and terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the
City of Tlgsrd has caused this certificate and release of restriction
to be executed this ''ay of /�1�,-C,l 19..
Title: CIIy IFncn /
STA'i, OF OREGON rued tot rnaa,d...J::-7..........,
ns. Roots TMMM M.WncMx N p«w"6 kleften.
County of Washington )
On this 4th day of. Match , 1975, Fersonally
appeared before me the above named Dario Hart g _, *Wne
signature appears hereon and who acknowledged to me that he executed
the same in his offical capacity on behalf of the City of Tigard.
Notary Pdblic of Oregon
My Commission expires:
U•G•79
eooK1013 KEW
/
\
ui
� / f|!■ !, »
City of Tigard
INSF-lEc"nON REQ(.JEr.,,,.'. T
for
INSPECTION TIME'
DATE' a J'?.12-5-- D AT E 'S.-
OWN F -t$ N A M E : 7 , -
ADVRL,:;S: -LQP
.14L
CONTRACTOR -o�
I
TE 7 s r Cj v f su 0,
RESULT' C ;lisv pprcwt,11 IJ C]
.........
S kr:q C.
C.—
tl
TE
F- r
*at 3.bs#Att
%IT, SPACES WEST 'B7,1 ENDORSTM PRIOR TO
ISSU.U,jCE OF T31JILDIT�G PEi'l.!IT
PLANNING DEPT.
t7e�C.
B
I
PUBLIC WORKS DEPT.
By Date
BUj1,rI14G DEPT-
By
TUALATIN RURAL
D"'t e
FIRE DEPT. By
App'ROVED !-OR C'0'S, 6 Gil,
CITY OF TjGAliD
YfRMIT ,ADDRESS
TITLE —DATE-----
M12 FTualatin Deve t Co., Inc.
� mED .
'. MO
M
r
JAN - 6 1975 Date 1-2`75
Nick Heibert CITY OE J4Q o�n� Job q
To --
Directcr of Public Works, City of Tigard
Tualatin Development Co. , Inc. will furnish access agreements at
the Summerfield Project. for:
-- — - PP
Job 5184 (1020 SW Highland Drive) and Job 5185 (10275 SW Highland Drive)
Job 5205 (10055 SW Highland Drive) and Job 5206 (10045 SW Highland Drive)
– _ - Tualatin Dev opment Ce'*.q Inc. i
Signed l�'�
FILEI
C,C�PY I
City of Tigard
INSPECTION REQUEST
I
for
INSF.C�fCIN
c •�� r� PERMIT NO. : I
TIME.
DATE: 13LAY DATE ISSUED :_
OWNERS NAME : / »
ADDRESS:
CONTRACTOR :
TEST : Air C7, Water❑ , Visual
Laboratory [)
RESULT: Approved ❑ Disapproved Pending ❑ I
I ,
SKETCH: ,f/,��1�' /'��' �'� Ape
��
�S
� ) Sb
INSPECTOR DATE
01E: Attach supplen.entai test data beret] I
C II
w w w w w w w w w
I
City of Tigard
INSPECTION REQUEST
I
for
s FEZ:/S PERMIT NO. :_
i
1NSPECTiON TIME: �:._.
DATE: ,12 13 /'JDATE ISSUED :
OWNERS NAME ;
ADDRESS:CONTRACTOR : 7-1-
TEST :
LTEST : Air O, Water O , Vtsual el Laboratory p
Disapproved O Pending I
RESULT. ApprovedK, pp O
t' n I
SKETCH: �4#*rwoAJ M4� S o40i I
i
INSPECTOR DATE
5016: Attach supplemental test data Ye-ete]
EXHIBIT "B"
CITY OF TIGARD
CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION
The City of Tigard hereby c-• tifies that the occupancy of
the following described structure or premises with respect to which
a restriction of occupancy was, on _liine �9 A , 19Z4—,
recorded in Book 9B1 , Page 353 , Deed Record of WaF,hington
County, Oregon, is hereby authorized and approved.
DESCRIITION OF YROYEF.TY:
Summerfield - lot 205
As recorded in Book 34, Page 5, Plat records of Washington
County, Oregon.
OWNER: Tu31attin UrVD-U=ant Cn.
BUILDING 11EIMIT NUmIER: 74-115
BUILDING ADDRESS: l0055-3,U. L gbLgnd_Qrjve
This is to certify the said structure meets with the require-
ments of the Building C(x1e of the City of Tigard and the above
referenced restriction in hereby released and terminated.
IN WITNESS WHEREOF, the urrlersigned authorized officer of the
City of Tigard has caused this certificate and relePse of restriction
to be executed this day of _ 19—
Title:
STATE OF OREGON
County of Washington )•;s.
On this 4th _ day of March _, 1975 , personally
appeared before me the above named Doris Harti 2 _, whose
signature appears hereon and who acknowledged to me that he executed
the same in his offical capacity on behalf of the City of Tigard.
Nutary FdAblic of Oregon
My Commission expires:
a � awe wan frr w w � w
1
I•
' FiGiIBIT "/,' 11910
CITY OF TIGARD
Residential Structure Occupancy R�strictioa
KNOW ALL MEN BY 7IMSE PRESI2�G, That occupancy of residential
i
structure (a) on the following described land, prior to the recording
of an occupancy permit relcanina the restriction in the Deei. Records
of Wanhington County, Oregon, io prohibited by the ordinance of the
City of Tifprd, Oregon:
DESCRIPTION OF PROPERTY: Summerfield — Lot
AG recorded in Book, Page _, Plat records of Washington
County, Oregon.
t
E
ADDRESS OF PROPERTY:
I . ti' WNGR: �
AvvRMs of oWMR:
IN WITNESS 141MI-AEOF, the underGigned has caused this restriction
4to be executed this day Or `,lfJj1r 19A•
A D
a �
OWr I S
Tunl.ntin 1).�aa rrr�nt n�r,an�. Inn.
r PPROIIED: 01
Bye i/
wilding Official .1�, ,� fo,, , ,:...�a.. .�.-.:9Ta�.......AM f•r
City of TSGnrd 1i n'niam n".D1 omw of Ike"01 8 6 El�e�,�ni
er._..o............_»....1, �:�5, '... .......... .......
STATE OF OREGON ) too
gt
County of Washinon ) �t�u - / , ]9 •
rsonally appeared bofore ne the above named
% and acknowledged the foregoing inctrumc �to be
voluntary act and dccd. .—
...:.Sec.
r. ry ruIr fa
1. 081 e.-,,A53
EXHIBIT "At' 11910
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL 14CII BY 1IMSE PRESENTS, That occupancy of residential
structure (6) on the following Iiescribcd lands prior to the recording
o: _n occupancy permit releasing the restriction in the Dcec. Records
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTY: Su+nmerfi.eld - Lot
Ac recorded in Book 3q Page Plat records of IMvhing"on
County, Oregon.
ADDRE;3 OF I311OPERTY: l(?0'h`7 . C
NAME OF QwNER: %rr�G :4i nt'✓ j�rx.,r., 1
ADDRESS OF OWNER: / 5�� 5C� /J(�^ �� A �
IN WITNESS MRLOI', the undersigned has caused this restriction
to be executed this _L(. day of -J,,j e 19Z.
O��iYER:
Tualatin
i1fCme
APPROVED:
Title
$Uildiug Official
19 R
ilwd lot tnrntd .......".�..._..... .�.....at........AM 11•
City of Tigard WR T110MASM.Dyyvomw of Nanoid@& Elwc—e
P4'..f11'C..... ......__.L./I C t ........................1..D*cwv
STATE OF OREGON 613.
County of Washington ) y �,� , 19 •
•sonally appeared befwe me the above lutimud r�
y and acknowledged the for~goin3 instrutnc to-bo
voluntary nct and deed,
N ,:Lry Public ,o peon
• �:. t.VYIJI.ht.iV. Lnl%J rbl1�
v,,.[353
i
Qu i'
�v p
STATE OF OREGON �4s IF
County of VYashlrgton
I, Roger Thnmssen, Dlrectnr of Records
and Elcdlons and EK Ofliclo Recorder of CO"-herebe certify
veyonces for sold countda
y, nf writing was
he within Instrument of Acords
that f
received and reeordod in book
No.
f sold GotrttY
Witness my hand and seal affixed.
M*IR T HOmSSEN, DlrectOf of
1lKards 6 Electians r 11
Deputy
EYMBIT "A°
CITY OF TIGARD
Residential Structure Occupancy R%striWun.
KNOW ALL MENI BY TIL^•.SF. PRa3EINiS, That occupancy of residential
structure (s) on the following described lands prior to the recording
of ran occupancy permit releasing the restriction in the Deet: Racords
of Washington County, Oregon, is prohibited by the ordinance of the
City of Ti,Ard, Oregon:
DESCRIPTION OF PROPERTY: Su,nmerfield - Lot
Ao recorded in Book � , Maga �, Plat record: of 4:'aahirgton.
County, Orngon.
ADDRESS Or PROPERTY: 1/'J l . Gel. Q�,�� �✓ ',L l�
N/1MT
E 0 O4yNGR:Tzn 1 JYk,j
ADDR:LSS Or OWNER: _/ ,� c� Cf. A vC — 5
IN WITNESS WHEREOF, the undernigned has caused this restriction
to be executed thio ; doy of .-)�,.e_ 19 .
04+NER i
Tu�i.n.ti.n D„/e rent sn:. Tno.
Name
APMOVED: By
Title
By:
Building Off i,ial
City of Tigsrd
S'T'ATE OF OREGON )
sa.
Cuunty of Wauhinaton ) -- ,•� _�„ _, 19,75/
'rconally appeared before me the above immeri _
j,dk)rL-' _ and acknowledged the forogoints instrumcn o be
voluntary act and deed.
Pio try 1'ubl.i.c -A-4^ro-gon
CITY OF TIGARD
14140 S. W. Main Street
TWARD, OREGON 97323
APPLICATTON FOP BUILDING PERMIT
New Construction MJ Demolish ❑ Addition Q Remodel ❑ Move IA
XON ING DATE ISSUEDA� BUILDING PERMIT_..
DATE Rh:CEIVf;D f,/ `�> > BUIL,DING FEE $ (=/, `' No. �-
by ` 1j��(�. PLAN CHECK $�
- OTHER /�•�•,./, y `-�- VALUATION $ -9- 3 f,Z�
TOTAL Vire. $�_� RECEIPT No.l j y�-
=- - _- _--- T,i__
TWO SETS OF PLANS AND PLOT PLANS MUST BE 711RNISHED WITt! APPLICATION
i.o N -- ' — MAP #-- ,-- —, C17NSUS TRACT -- JGB
Archi.te_t or Lng1*.ieer=-C!_�aA
jy�
Addressh
,s 1. _ `�" `--- — Phone_ . q__3jC)
Owner
Arldross
Phone
BUILDING USE Single Res. LV.I Multi Res. ❑ Comm. ❑ Industrial❑
nc.'CUPANCY GROLP Z No. of Stories--- Total Height I Area of Lot_
Type of Cor,9truction I II III IV CW Floor Area B_ _ 1� j0 2� _�-
.,et Backs: Front t Back L.Side I:;,: _ R.Side fp 1 y
Private Sewer Pipe Size lSewerxi%a5 C1�- Septic Tank ❑
iiater Service Pipe Sire_ 3�* Storm Sewer LJ Ditch ❑ Drywell❑
t
Street and Curb Requi rementsal-
Drivawa Width_LP
y � � of Parking
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
le
ADDRESS ASSIGNED�IG-(4 .1`f` Sle"
;�'z I tet/ �� ,'•�,
FIELD C11T-XX BY DATE /-1
PERMIT APPROVED BY
It is understood that all work will conform with appli •able codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, ind that the buildirg will
not be occupied until a Certificate of Occupancy has bec� _.isaed by the City of
'rigatd Building Inspector.
Signature of Ap licant
dor o5
� ho�� foo k