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W4, I 5 \ t .____.. . .-. __ .. ___ _ _...,_._ _ _ �• ELS/, _ TIED vrITH REINFORCING ,)TEEL "(� "('I�� SI'�E-- P It , G� •1 �.'� y. WALKS TO PREYE-NT INCiL7�'-N'i'Al_ MU\/E- eNTo . ; � � ._...,..� ` C_•��c.. 24 O. r_. V L Sft"LIPIGA.TIONS - - M = . 1 26 PQ - -12aR 4e1j. K 1.(.7 9 Bx LXIr." CnNC. .' MASON"*A57 r 9v-70 Cr7NC.. e�LCX.K� MI►J� ^pE'QuATE- �� SLK.en f �1 / Usl- 3 fS Z- - e> O.C. O T R. o - Z-/b x 42 /i ZS'4/1 FILL ALL LnRt✓ 2 . coNc. SUU*' A 'L8 AAs — 7+.y 3. R C I N R. s-T c E L D L-r--4 rzr�E-c��(f�S TP'� 6/$-68 � -- C"& /i G k T 0� ?- '-D" 0.C_. WITH GC3 r,I r _ 6 T IZ" ATI SPLIC_I~•S 1 GI,rASS ¢O P- 7 C M DM 4 BAR IN BOND 4• M0XTA_R - '1 TYPE .s" FIER- AST C270-597- (.a o „ MoltTAP- / Z 1!T o.C,. PR'FAM UNIT ;SHS-AR p !. P.Z�t P. 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P�A�K v\/A-SH LINE- APPROVED FOR CONSTRUCTION OF TI ARD „ RE-TUR N� r MRIN G I N -T- SITC A ) = -S S K 1 M�M f- ._.. , OF • _.__ - - _TITLE_- r' OF l T. . 40 IT. ,�- _wAw1t ,• ���Ir�1111�I�I1111t11�1111'It+111��11111�1�11111�1(Rlil��tl'1�II�R 1111�LII�tIC�lllllillt) IIIIIIIl111IR1rIIII�IlII11t�111,II1I111I1111111I111IIIlIIIIIIItIItI1IfIIItItIIIIIIIIIIIIIIIlI111 qt�' 1 _.' _ . . _ H.;y � _ ._ ._. � 'F -- . � i NOTE: IF THIS MICROFILMED -�--- I 2 3 4 5 6 7 8 9 10 I I 12 DRAWING IS LESS CLEAR THAN --- ~' THIS NOTICE;--IT IS DUE TO THE QUALITY OF THE ORIGINAL DRAWING' OE 62 62 Lz 92 sz t►Z EZ Zz IZ Oz 61 91 LI 91 sl bl EI al II 01 6 9 L 9 s Ir E z 1 %' ^ �ntl�ullllllltnllllnlulllu)Iltlltltn{�ullulnhutblultltllu�l6tatllut�elllnltlt►Illtnl1u�1111111n�Il�lllrllln111ut11tntlli!1�1111tnlliulltlll�u1111nilllulnllltnulu11111n11111�1111��111111ullulllltllllnll11111)1111�Wuu�llull!ll�lllllliullull�1�11u11 4 MAY 7 - 19 92 . ff! 10265 SW HIGHLAND DRIVE 1 _ \a I 1 ` W Q O 1�I W w I11 h W \� Ia E N ` C (ll t W •ri •1-� .,.1 3 W C 4) N X O >1 ro (.: k c •ri C N O O C all +) O r-1 (n O .-i Ili h •.-i ri N I" (-i -I (U fa J �+ f- N r-1 O Ql O Cl (1) r O r-I ,c f+ O (ll 3 C Li rj CL r4 r_ t� U) r i r� •r1 3 0 N c C L i -1 (1) (U •r1 ro .f, (1) 41 ro Lu 't"O ,J rr ti (n ,r L- L7 O Ln (n CL LL L,_ _I tr 4 cr. W a_.) W � C W c) ♦— LJ H i= w 'j � w �n W Lel 4 tS W C 1 -i-) Q7 r-i 1 .4 M (ll w Ulc ro 14 11 Lil CL C C r- I.- 4 O' -C -n a.) O I Q (7 •r•1 N u) -1 (U �I fir, () U " Ili 1-1W ; 11 7-) +F`- ro C (-1 43 -HL.- -D C fn r , _ -4w m w L)1-0 ro H c, ,• >" roar E .n c 3 E: (4 C: 4J w (1 o N ro �"A $4 n roa) ro � W 4-) -A Laj X o o r-i i o f-( (n (u (U0 cr a I�,J L- Li_ In (Y (r) a u- I i_ _J ]_ --i H m Cr 77 r U cn O _3 I- r1 OJ n a CSI O +ter +� rwr r! e. � � ■rm u. � Mrs ,;.tom. i_lskeslee 1026, Su tiighland pr. 22.3 Lear Mr. 3 Mru alakraelea t This Is t;-r aacknuul.udge recoipt of drawing And skeetr.hes for proposed caarpurte over existing pnrking pads at yoilr apsartmerits, Sw Aash St. , Tigarel. e6l'orcr a 6uildiny Permit can be issued, ploase Ue gdvIs ed of the ral,lowinga 1. Your :apor.'t'.ment complux i- in thu ' ita orlo i. . Vhaptor 1.8. 24 of the City ?ucair►y ruinrience, Plt,-itca th the sotbrack for any buildinra paarmitt.e d, shall be 20 Ceac:t fvam t'Ies property lino at, the front. i. -'haptur 188 ilt.01t) of thr, Cit.',, ;rali,nAfiro, fftnt.ee,�, that 4ny new construction in A Zore shall cumea before than Design Peevxrok, tonrd for approval, ttitt) proper materials, t , tirseeent for a hoarint). 4. You mny , by Ordxnarice, apply Pot n variance to rert:asin ?oninq requirements, such an n"tbar..k requi.rram jr1t:n, to the P1Rnnfny t'ummiasaain. 01'Faaso c;intaact n.+r,ncy ! dwnrdo, at thio ,arfi( q4 �n otd&ir int.iaats the j)eas.ic,ra raeview prir sdurrs. ,: i.ne«�realy Yc=r.lra1 , E.T. Parlden, Pualdiny Official City of 1'i9eard T', :b;;a 4•,n,k. .,:R:.r ^A..ppnet�...�ns�M+i/MD"!aK*'a�l*r::"U°n'A '°tt ,,. -....vww4+yMbrMY...au„su CITY O!! ;7'ing �.� No 0878 BUILDING PERMIT APPLICATION TIGARD DATE 19 THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INOICATEO 39-70" OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE - ?''!r, Richard glukplwfi; I4J..L,� :,; Hi4,;�hlUrld :I, QINNER ADDRESS BUILQERPH NE - Iumbis Pools ENGINEER 1?il1�pL;J�i �!11I Par.jra.l: t,;.� I I-L la H augl'g Im BUILDER �y ARCHITECT _ DESIGNER STRUCTURE _ ONEW LI REMODEL ❑ADDITION ❑IREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION © RESIDENCE OCOMM ❑ECIUCATIONAL ❑GOV'T ❑RELIGIOUSQPATIO ❑CARPORT ❑GARAGE ❑STORAGFFOSLA13 ❑FENCE ❑BOND ❑MOVING y` ❑CONDITIONAL USE ❑DESIGN REVIEW ❑C(,JN(„L APPROVED ❑SIGNS OCCUPANCY—LAND USE ZC)NE_ .BLDG.TYPEY FIRE ZONE_._._ PLAN CHECK BY HEAT_ _ jr;f. t.rji.vate Sw6a fig P(-)qljjuL drawinu 1/1 as plropar"d by A041a Um utraand deRna iat>ge ::tip. 14.20*030 &*0.50 w 50C. 14 T1c�arrj Citi —W' u roqui rgfito prc; roc: Lin. 'Ir . 72-37 52 1972 OCC,LOAD—_—FLOOR LOAD _ HEIGHT _ NO,STORIES AREA VALUE ` BUILDING DEPARTMENT - SET BACKS FRONT REAR LEFT SIDE r RIGHT SIDE Permit ,� ---- — ----- ---.—� _—_ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUII n4NG CODE, ZONING Plan Check �'�'• "I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGr:SF^ THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recording ALL API'LICAQLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINF;S 1%State • LICENSE. SEPARATE. PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total •� ----, -- - APPL' INT OR AGENT Approved Receipt Ne. —�_� AD[))iESS _.— GATE iNSP. TYPE INSPECTION REMARKS PLUMBING DATE Contractor Permit No. Rough-in Fixture Final HEATING Contractor AP ermit No..as or Oil Roc th-in Final SEWER Final _ DRIVEWAY Final Storm Drainage _ (Rain Drain) Final _ Sidewalk Curb&Street Final BLDG.DEPT.FINAL ! TEMPORARY CERTIFICATE OCCUPANCY Final CERTIFICATE OCCUPANCY — — Landscaping Zoning Final IMULE-m-m-nm CITY OF BUILDING PEWAIT APPLIGAtION TIG;YARD DAfE,­4?=.! THE UNDERSIGNED 1­18LBY APPLIES FOR A 'ERMIT FOR THE WORK HEREIN IrJDICATED CIV114LR PHON E&139- 7 Z OR AS SHOWN AK P APPROVED IN ME AC,,OMPANYING PLANS A;.D SPECIFICATIONS. 13kil I) R.PHONE NER /v L&-I -jj�e� eatDEEIGNEIr [:]ADDITION REPAIR CIRENEWAL FIRE DAMAGE DDFM`6LITION STRUCTURE- RESIDENCE [1comm EIEDUCATIONAL EIGOV'T ORELIGIOUS,DPATIO (:3CAR PORT DGARAGE [I STORAGE EISLAS []FENCE OVIONDCICON21TIONAL USE CIDLSIGN REVIEW []COUNCIL APPIRIDftD []SIGNS QMOVING COUP Y----LAND US E 411--EIL!�G.-LXPE— ZONE LAN CHECK BYe D FLOOR LOAD NOT__NO.STORIES__ / � 16) RIGHT SIDE BUILDING DEPARTMENT 10NV:;�A -A HEAR_ 9— LEFT SIDE SET BACKS Pei mit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check REGULATIONS AND ALL APPLICAHLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE wonK WILL BE DONE !'N ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recording ALL AMICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS 2 .W-.R,0L State LICENSE. SEPARATE PERMITS REQUIRED I-on Sr PLUMBING AND HEATING. Total APPLICANT OR AGENt Approved nerripi No, Nt �, a k r1+.��44�t .,�4'll+�'4Y''"',1�F .. ,',� �� i.�w�� � �' `sl ,�,p�•Y.; OF O�C.� CITY OF TIGARD �O , OREGON Owner:....Tualatin...Deve.lo.pment..Co....................Permit No........7.4-.ag...... ;. Building Address...........1.02.65...S..W, ..Hi.QhLek n.d..D.r.I.va................................. ' Cvrtificate is hereby given this........6.th..day of...Mal;.ah.................. 19..7.5.... that said building may be occupied and that it complies with all requirements of the Building Code for the City of Tigard, as approved by the Tigard City Council. Building Inspector R�..+..eee UtMOM Y.1.1►. EXHIBIT "B" IL 7688 CITY OF TIGARD CLiiTIFICATE OF' OCCUPANCY AND RELEASE OF RESTRICTION The City of Tigard hereby certifies that the occupancy of the following described structure or premise., with respect to which a restriction of occupanc- was, on _dune 7 , 19--L4 recorded in Book 978 , Page 692 , Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRIPT:oN OF PROPERTY: Summerfield — lot 186. As recorded in 13ook 34, Page 59 Plat records of Washington f_ounty, Oregon OWNER: Tualatin Deve. Co. BUILDING YEIMT NUMBER: 74-89 BUIIdIINO AUll!tE.>S: 1D S S_1.1. Highland Drive Thi: i•; to certify the said structure meets with the re4uire. ment,, of the Building Code of the City of Tigard and the above referenced restriction i.• hereby released and terminated. IN WITNESS 'WHEREOF, the undersigned authorized officer of the City of Tigard has caused thi<; certificate end rclease of restriction to be executed this (� day of ,�/I , 19 . Title: GIIY STATE OF OREGON )E� County of Washington ) On this IIjl._ day of _LJ&jLh , 1975 , nersonally appeareu before me the e.bove named Doris Hartig , whone signature appears, hereon and who acknowledged to me that lie executed the same in his office]. capacity on behalf of the City of Tigard. Notary Pub is of Oregon My Commission expires: 7f INDEXL0 5� le, 5 �C .w. pout&T11U041REN.bhw"w d 03we6 tlMlen h..,.,... _ .........�.��........_._ boat 500 1013 PAU 55'3 ` ! k 41 � cli COM \ q 2 ƒ 413I )} \ \ b , })��l � E Olt City of Tigard INSPEcriON REQ(..JE-I."--.. T for INSPECTION TIME' -...--- PEHMA47 PATE: DATE LL. OWN F -?S NAME : 12, CONTRACTOR ' TE `;'• ' Alr ; ter Lj , Visua. RESULT' Ar-,7 Ij 0 AT E i ALL SPACES MUST BE ENDORSED PRIOR TO ISSUANCE OF BUILDIRG PERMIT PLANNING DEPT. PUBLIC WORKS DEPT. D7 25- BUILDING DEPT. By TUALATIN,RURAL "J FIRE DEPT. L,f j D. o APPROVED CITY OF 'i.L, _.J I _ � BY _TITLE- ----- - _ DA'T'E t k f - i wnr s w es ew e• � .� � � City of Tigard INSPECTION REQUEST for INSPECTION TIME ' r PERMIT NO.: - - DATE. r DATE ISSUED: OWNERS NAME : -ADDRESS :CONTRACTOR :_ r /-rto *�• - - — _.. TEST' Air Cl, Water p , Visu4, Laboratory [] RESULT' Approvoi!X, Disapproved ❑ , Pending U SKETCH: INSPECTOR DATE CNOTF: Attach supplemental toot dote herst:01 CITY OF ; Nu 0042 RUILG„NIG PERMIT APPLICATION TIGARD DATE THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SHOWN AND APPROVED IN THE ACCO-APANYING PLANS AND SPECIFICATIONS. UWNERPHONE _ r.o*cs, inc. lutlau OWNER ADDRESS .'G2,G� _ +'��'�C�4"�"� ��,. 9UILDER PHONE— ENGINEER DILLL121a •ANI1 — ARCHITECT DESIGNEN _ STRUCTURE. ❑NEW r-t❑REMODEL ❑ADDITION REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION ❑ RESIDENCE []COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PA'110 ❑CARPORT ❑GAPHGE ❑STORAGE❑SLAB ❑FENCE OBOND []MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW LJCOUNCIL APPROVED ❑SIGNS _ OCCUPANCY LAND USE ZONE —BLDG.TYPE=— FIRE -ZONE_ PLAN CHECK BY_ 4 HFA1 _ retsining wall QCC. LOAD FLOOR LOAD�_. HEIGHT y� NO.STORIES �V.__ AREA e'4LUE --- BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit ,I? ` -- -- THIS PERMIT IS ISSUED SUBJEC' TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check REGULATIONS AND ALL APPLICABLE 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 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE ^IIRRENT CITY BUSINESS I%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total By -_- nrni_icANT oR Ac;FNT Approved Receipt No. ADDRESS Pfu7NE DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE _ Contractor Permit No. ROu h-in Fixture Final HEATING 1 Contractor Permit No. Gas or Oil Rou h-in Final SEWER _ Final_ DRIVEWAY Final Storm Drainage (Rain Drain) Final Sidewalk Curb i-Street Final Approach BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY Final CERTIFICATE OCCUPANCY Landscaping Zoning Final PLUMBING PERMTT APPLICATION Jurisdiction of No. Type of Fixture Fee Permit No. Permit fee Water Closets (Toilets) Permit Issued Vi Bath 'rubs _76A Approved by LavatWssh Basin - Building Permit o� i Shower -- ,;'� Receipt No. 1nG9 SL S.in .s,Dishwashin _ ( Sinks Kitchen Sinks Ordi.na Location of Building n2 Sinks, r :_------ _ Sinks, Slop - -Automs wa atic Dishe - r Di spo�al Laundry Trays Name & Address of Owners Drains, Floor - - -drainsArea Drainsriger_ator :— Rain Drains Automatic Washer �aU Name ,Address of P1 f t�j� ouri tains =r n .in —fid- Fountains] Soda 777E—Water Tank I Water Service Siz ".;►- � Urinals Buil _ Old or 3Qew� A:,'_ter, Repair or _ Ca_ttc,- asins -Yar ,_ =ns a — — _L3wn S�rinxlerstem — — Swimming Pool _—_ TT her Sprinkler SystemThis perrnit becomes null and void if work or construction authorized is not commenced within 60 days, or if construction or work is juspended 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 bo I hereby certify that I have mad and examined this application and know the s to be true and correct. All provisions of laws and ordinances governing this i of work will be complied with whether specified herein or not, the granting of 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. d �� p•_ �t Ce _ Signatu e�of Jpplicant 'j - ' r I City of Tigard I INSPECTION REOIlEST for INSPECTION TIMEL- PERMIT NO. : DATE: 4,zLyzzLDATE ISSUED:.._! .L OWNERS NAME : ADDRESS : I CONTRACTOR :-- TEST' ONTRACTOR : -TEST:Air 0, Water ❑ , Visual ❑ , Laboratory ❑ RESULT. Approved O Disapproved O pending p '70 INSPECTOR KETCH: �3 �v- 8.' I S G I ) I I I I IJ INSPEC TOR DATE CNQTE Attach su9Dlemental test dabs heretu1 City of Tigard INSPECTION REQUEST for INSPECTION TIME: J"' PERMIT NO. :�� DATE: DATE ISSUED : OWNERS NAME : I'LL _ ADDRESS: � ^ CONTRACTOR : TEST : Air ❑, Woter❑ , Visual [] , Laboratory [] RESULT: Approved ❑ , Dieapproved ❑ Pending ❑ SKETCH: (, - /0- 7cl - 3v a`f -5 J INSPECTOR DATE CO?Q' Attach supplemental test date Meet] EXHIBIT "B" CITY OF TIGARD 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 restriction of occupancy was, on __111n _j , 19L4 reco-ded Ln Book 978 , Page 692 _, Deed Record of Washington County, Oreton, is hereby authorized and approved. DESCRI1TI03 OF PROPMTY: Summerfield - lot 186. As recorded in Book 34, Page 5, Plat records of Washington County, Oreyon OWNER: Tualatin Deve. Co. kUILDING F'ERNIIT NUMd3ER: 74-89 _ BUILDING ADDRL3S: "1DGFi 9_ii. Niobh�fl—Drive !_ This ie to certify the said structure meets with tha require- ments of the Building Code of the City t,f Tigard and the above referenced restriction it hereby re.lcased and terminated. IN WITNE;S W1IEREUF, the undersigned authorized officer of the City of Tignrd has caused this certificate and rclea!,e of restrictio-i to be executed this day of , ly_ Title: iTATE OF URiZON )Sr' County of Weshington ) On this fith Y_ day of Mar cb _, 1975 , personally appeared before me the above twined Doris Hartig , whose signature appears hereon and who acF.nowledged to me that he executed the same in his offical capacity on behal:' f the City of Tigard. Notary F at,lic of Oregon My Commission e,cilires: 986'7 EXHIBIT "A" CITY OF TIOARP Residential Structure Occupancy Restriction KNOW ALL M1N BY TIC:SE PRESENTS, That occupancy of residerrcial structure (s) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the DeeL Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: DESCRIPTION OF PROPERTY: t;ummerfield - Lot As recorded in Book fate fir, Plat records of 'Washington County, Orap-on. ADDRESS OF PROPERTY: I�l.L�'� U/ I-1 1fi��� NAME OF OWNER:`l , i�,1 c. _ �c ✓ Lc . ADDRESS OF OWNER., IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this A. 4, day of r1,,, OWidER; APPROVED: By= /j By; _ Building Official City of Tigard STATE OF ORLON ) s s. County of Washington ) 19&. rsonally appeared before me the above na:•ed V „, _ and acknow.led34d the forcuo:ng ins`r,;me t Ao be voluntary act and deod,_--- I(o uyPublic o O.^cgon May Comm'seion Expires; 6��� 978 .-,,UM STATE OF ORMN Q u County of Washington I, Roper Thomison, Clnetpr of Records and Fit, and E.-Officio Recorder of C'm veyonces for fold crunty, do hereby rerttfy 'hot the within Instrumer'f of writirq was received and recorded In beck of rieords No. ...... ..�._�.._.. _..._ .__._..«_..._....... of fold Ceunly WIMM my hand and feel oflbfeel, ROGER TNOMSS[N, Alneror 01 Records b Ewxtiory in 1 12 31 PM 7q EXHIBIT "A" CITY OF TIGARD Residential Structure Occupancy Rustrictioa KNOW ALL M'sN BY T11ESE PRESENTS, That occupancy of residential structure (a) on the following described lands prior to thr, recording of an occupancy permit releasing the restriction is the Deec Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: DESCRIPTION OF PROPERTY: Summerfield - Lot Ae recorded in Book '�(/ , Page Plat records of Washington County, Oregon. ADDRESS OF PROPERM NAME OF OWNER: .`J. ADDRESS OF OWNER i V—)—3cp CC) =� `U 11� �• ,r c IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this `� day of 041"MR: l'o 7 c n r',-1n APPROVED: T.—c 8 By: Building Official City of Tigard STATE OF OREGON 66. County of Washington ) reonally appeared before me the above named ?ti >t—"% _ and acknowledged the foreCoing instrument tj be .,. voluntary act and dged. No pry Pub! c ; r Oregon My comm.Fe:on xpires. CITY OF TIGARD 12420 S. W. Main street TIGARD, OREGON 97223 APPLICATION FOR BUILDING PERMIT New Construction ® Demolish ❑ Addition ❑ Remodel ❑ Move ❑ ZONING DATE ISSUED_--�� � BUILDING PERMIT DATE RECEIVED -- BUILDING FEE $ :� --- No. 7p� PLAN CHECK $ JCS `'' /l r jS�"r 1 O - BY to VALUATIO14 $ f- TOTAL RECEIPT TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT MAP CENSUS TRACT ---_-- - JOB N 5'IE�< Architect or Engineer�c -'ata-k ---A---��*--ycc___ p Address �_ 1 >-� 5��_ ���- --- j.--> ,�.Q:11._ Phone_( ` Owner _1a�_ - --_._-- - _--------- -- -- ---- Address Address _ _ _ ---Phone---------- BUILDING ._.-_Phone -_-__`__-BUILDING USE Single Res. Multi Res. ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUP _.__ No. of Stories I _ Total Height-V Area of Lot- Type of Construction I II III IV( �Floor Area B------- 1A! Set Backs: Front-Z__ Back) V7 L.SideA- R.Side�_(�� Private Sewer Pipe Size i� `- Sewer k Septic Tank ❑ water Service Pipe Size` 3 Storm Sewer Ditch ❑ Drywell❑ Street and Curb Requirements^Ce,__-i- Driveway Width-1 - _� _ ______-___No. of Parking Spaces__ SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED 0.2 j.. J, t4; ��.��L�:•, � r. -_ FIELD CHECK BY /..��c�l �a�Z-= DATE- PERMIT APPROVED BY It is understood that all work will conforn with applicable codes and ordinances of the State of Oregon and the City of Tigard, Oregon, and that the budding will not be occupied until a Certificate of Occupancy has been issued by the City of Tigard Building Inspector. '�,� Si nature of Appl cant - _