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APPROVED FOR CONSTRUCTION
CITY OF TIGAIRD
P ER,', IT t 40 SITIF ADD RES3,--r/-0-;-1--11
LDATE.�-
_TITLE_ _
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must be Completed
GENERAL CONTRACTORS & SIB-CONTRAC-
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according to city codes and
fin::! inspection wade before T � r�i� �Y BUSINESS LICENSE
occupancy
ARJ ALL hH'I'"S%"ARV CITY PERM16" PRIOR
To P�ItHlii'Mc. SEDICES,
CITY OF TIGAkD
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NOTE : IF THIS MICROFILMED
DRAWING IS ' ESS CLEAR THAN
THIS NOTICE 17 IS DUE TO
THF QUALITY OF TIE ORIGINAL
DRAWING.
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OF OC
CITY OF �T'IGARD COY
OREGON �.
iTualatin Development Co. 0026O11e� ; .......PermitNo
Building Address .........�X5.�..S•Wt...�i5hla
n � prve
. ..............................
Certificate is hereby given this...... An.day of. ..November 19..7 ...
< that said building may be occupied
and
E_. i
l that it complies with all requirements of A4
the Building Code for the City of Tigard, �• ylt
as approved b the Tigard City Council.
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n,' I Building Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: a-YD-,r PERMIT NO. : �_ I
DATE: /0 may/ DATE ISSUED :_.1L
OWNERS NAME :
ADDRESS: Lw-2- D2,,,,
CONTRACTOR : -�� / go __ _ _ ---
TEST :
__._.TEST : Air ❑, Water 0 , Vieua1 ❑ , Laboratory [] I
RESULT: Approved ❑ , Disapproved , , Pending ❑
SKETCH. I
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► k' o /) v I
ti
INS'PEdtOR DATE
p][OTE: Attach supplemental test data beretI
1
ALL SPACES MUST BE ErIDOP,77D PRIOR TO l
ISSUANCE OF BUILD'MG. PERMIT
PLANNING DEPT.
PUBLIC WORKS DEPT. $
BUILDING DEPT.
�.te .�
TUALATIN RURAL
FIRE DEPT. D eta
APPIZJV; D ?;
CI`fY (J.
DATE-
wrwjusws �;•
I
City of Tigard
INSPECTION REQUEST
for
IINSPECTION TIME : PERMIT NO. : _..
DATE: DATE ISSUED:__.L_1r...
OWNERS NAME : V� C-
I ADDRESS : —v�' lgG'
CONTRACTOR : Yz 1)C—'
TEST: Air 0, Water (] , Visual Laboratory (]
I RESULT: Approved , Disapproved D Pending p
I
SKETCH:
I
I
I
I
I
I INSPECTOR DATE
E:NOTE: Attach supplemental test data hereto
a
EXHIBIT "B"
CITY OF TIGARD
ch:lUIYICATE OF OCCUPANCY AND HELE;ASE OF IMSTH.IUMON
Tile City of Tif.�ird heicby certifies that the occuixincy of
the following described structure or premises with respect to which
a restriction of occupancy was, on 5e tember 4 , 1974 ,
recorded in Book yA1 , Page 3 ra_ , Deed Record of Washington
County, Oregon, is hereby "uthorized and approved.
DESCRIPTION OF PROPERTYwo
Summerfield-lot 187
As record-d in Book 34, Page 5, Plat records of
Washington County, Oregon
OWNER: Tualatin Develo ment
BUILDING PERMIT NUMBER: 0026
1 10255 S.W. Highland drive
BUILDING ADDRESS:
This is to certify the said structure meets with the require.
mems of the Building Code of the City of Tigard and the above
referenced restriction is hereby released and terminated.
IN WITNTUS IJHEREOF, the undersigned authorized officer of the
City of Tigard has cauaed this certificate and release of restriction
to be executed this q day of , 19—
Title: ^�
STATE OF 011F=N )98.
County of Washington )
On this _ 20th_ day of November , 19 7¢personally
appeared before me the above cuimed Dor s ar ig 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.
Notary ublic o Oregon
My Commission expires: _
I
f
I
City of Tigard
I
INSPECTION REQUEST
for
i INSPECTION TIME : �•� �" _PERMIT NO. : . . .
I DATE: " DATE ISSUED:__L_ Z
OWNERS NAME :
ADDRESS : &
I CONTRACTOR �-
TEST:Air [], Water Ip , Vieual)1(1 Laboratory p
I RESULT: Approved Disapproved� DD p , Pending
np p
SKETCH:
I
I
I
I INSPECTOR r DATE
I [OTE: Attach supplemental test data heret:01
I
A .
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO.: _..
DATE: 74PULV. DATE ISSUED:__I
OWNERS NAME : ,7- U -
ADDRESS :
CONTRACTOR :
TEST: Air O, Water p , Visual O , Laboratory []
RESULT: ApproveDisapproved 0 , Pending p
SKETCH:
'Ih VECTOR r" rE
INOTE: Attach supplemental toot data heref10
1
1583'7
=11DIT "A°
CITY OF 21GARD
Residential Structure Occupancy Restriction
KNOW ALL MN BY MESE PRESENTS, That occupancy of residential
structure (r,) on thu following described lands prior to the reco'i•ding
of an occupancy permit releasin;,; the restriction in the Decc. Raeordu
of Wnchiniton County, Oragon, is prohibited by the ordiru:n,..; of the
City of Ti5ard, Oregon;
DESCRLTION OF PROPERTY; Summerfield - Lot SAGO
An recorded i.n Book -, Papa Plat records o: 1,htshin;;ton
County, Or$-gon.
ADDRESS OF PROPERTY: j C),j,y -j- W
NA14E OF OWNERS N► Mrs G. �dn .___
ADDRE53 OF OWN01. —z L 0 , {
IN WITNESS WIIEREOF, the Undursigned has caused this; restriction
to be executed this �tao r` day of
' OYiNER;
s �
Tuni.a.t}.tt P.w .00:r,en !' t,�n•:. Trc.
Nwma rj
By: kwilding Official
City of Ti(�%rd
STATE OF OREGON
County of Washin8ton )
Personally appeared before me the above named Roy Brown
_ and acknowledged the forc�;oinLi instrument to be
i`'_—, vol ronry net and aced,
Lotary Public for Orci ch
3CU� Jl�ll ,1Li l)Il� `-I?SfiiS?�er.��,
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AA T14OM9REN,yrm,., .0 e1 Sbvn�di}EI*n1en.
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MULIBIT "Au
CITY OF TICARD
Residential Structure Occupancy Restriction
YNOW ALL PUZ BY TIMSE PRESEIN S, That occupancy of residential
utructure (s) on the following described lands prior to the recording
of nn occupancy permit relensina the restriction in the Dcee: Records
of WaGIiington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon%
DESCRIPTION OF PROPERTY: Summerfield - Lot 1G10
As recorded in DoOk Page _ , Plat records of Washington
County, Oregon.
AD.D.RESS OF PROPE:ZTYt
NAME 0:' OWNER:
ADDRE93 OF OWNER:_Z?I 1 �_Lj, t
IN WITNESS W1MREOF, the undersigned has eau;;ed this restriction
to be executed this day of �`�_, �9 •
OWNER:
s
Tualatin Dev .,.o nt Co _ . Inc.
. Nana /�
Al'litOVED: Dyi ��'"
jitl
By: ,-
iilding Official
City of Tigard
STATE OF OREGON b6.
County of Washington ) July 2� , l9
Personally appeared before we the above named Rov Hrown
and acknowledged the foregoing instrument to be
his voluntary act and deed.
hotnry Public for Oragdh
ivr i.vw.u�nniOA yn�.ur.rY.
l--ot /�o CITY OP L: � ° 0026
BUILDING PERMIT APPLICATION TIGARD DATE is
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER C*E* Edgington ADDRESS '102A.!' ".- sligtilend LfX'iV111UILDER PHONE
F.NGINEER a
BUILDER Tualatin Deyelopmnr X RCHh'ECT Art" DESIGNER
STRUCTURE — ®NEW ❑REMODEL �—❑ADDITION _ ❑REPAIR ❑RENEWAL `DFIRE DAMAGE ❑DEMOLITION
I3 RESIDENCE ❑�ICOMM ❑EOUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND OMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED ❑SIGNS
OCCUPANCY —I—LANDUSE ZONE BLL1 TYPE--1---FIRE ZONE_ " PLAN CHECK BY HEAT—
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA YVALUE '11 s s'.ii1
BUILDING DEPARTMENT SET BACKS FRONT 2711 6" REAR 6 LEFT SIDE 10 RIGHT SIDE 4
Permit 1 4e 110 �_�— _ ---- --- --- ----_
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ' F';•0Q REGULATIONS AND ALL APPLICABI.E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording !I.00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State 424 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 1"19.2a
By
--- -- -- APPLICANT OR AGENT
Approved Receipt No.
—. — --- --- ADDRESS - 40N
sir s• ss is s w s r.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
ContractorW,.,"C.cP
AA A ap Permit No.
c7 172 Rough-in
Fixture
_ Final
HEATING
Contractor ¢2dt
Permit N, 7
Gas or Oil -y--41 8317
Rough-in
_ Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Fir-1
A proach
BLDG.DEPT,FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY _
Landscaping
Zoning Final
It
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EXHIBIT "A" U908 ` I
CITY OF TIGA/iD
i
Residential Structure Occupancy Restrictioa
KNOW ALL :W:: BY TIMSE PRcSE:M, That occuiwicy of residential
structure (s) on thu following described lands prior to the recording f �
of an occuiiancy permit releasinG the restriction in the DCC6 Racords
I I
of S;ashingtoa County, Oreron, is prohib:.ted by the ordire:nee Cf tiA I
City of Turd, Oregon:
DESCRIPTION 07 PROMITY: Surnerffeld — Lot 107
An recorded in Book -3—Y _, Pace , Plat records of Washington
{ County, Oregon.
I
ADDFW__._. ._.5 OF I'ROPr nTy:
0? OWNTI, I .zn�r 7�1� nr-'���r�r t7•
I E
ADnn?---�35 OF Ow:IMI t5 Too :2C.J 1& _77J dee r �
IN WITNESS V40REO:, the undersiGned 'ras cauced this restriction
a p
to be executed this. day of_)Llae 192Y.
eo o co
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." fuil.ding Official F d 1 to7v4tI�
AM.PA.
ni ��..
r� City of 'Tigard NoOra 11tUMARW.D--44 R.ro.a.
�. ...•. '' STA L. OF OiiEGON ) ss.
' County of Washington )
�►►yv%M'ror'41r,i Xyr5cnallY appeared before re th3 above narcd
,r,,,,�', and ackrow;.edaod the foreGoinG instrule to bo
�'— �1altu"tary act and deed.
:oL ry lzublie a` 4.u„ua a,
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