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CITY OF YIGA RD
September 14 , 1987
OREGON
25 Years of SerNce
1961-1986
Morey Williams
10275 SW Highland Dr.
Tigard OR 972.24
RE: Permit N 4885
A0dress same as above
Dear Builder:
Our records indicate the above described building has not received
;6 _ any inspections inspection, nor has had any activity for an
extended perioe of time.
Please uoti.fv us as to the status of this permit so we may clear our records.
If you have any questions, please contact this office at 639-4171.
Sincerely,
Brrid Roast
Bujlding Official
BR:cn/3407P
I
13125 SVM'Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171
BUILDING PERMIT APPLICATION TIGARD DATE.- _.__- ie�'1y__._ 4 8, 8 5
THE UNDER,E,IGNED HEREBY APPLIES FOR A PERMIT FORT HE WORK HEREIN INDICATFD BUILDER PHONE —2 �
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.__ 1
OWNER- !ur y di'li ns —JOB ADDRESS Iiij75 SW dialilgad Jr.
,�. 97222 ARCHITECT
ENGINEER
BUILDER 61rian, 1411irltiADDRESS I'r`,56 S.. balitton -DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL El ADDITION CI REPAIR O RENEWAL ❑ FIRE DAMAGE 17 DEMOLITION
U RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS O PATIO ❑ CARPORT ❑ GARAGE-0 STORAGE ❑ SLAB FENCE
OCCUPANCY - LAND USE ZONE _ i1U11 BLDG.TYPE )ii.- FIRE ZONE PLAN CHECK BY k j"' HEAT —
l.uuatruct :taiditiov to sir&l* fancily dwelling all per
—_ --- approve(i :pjaMB h 03de Ithquire-myita. 4" t'.uncf*4 Slab FI(por --
SEWERPERMITM
OCC.LOAD FLOOR LOAD 4!1 _HEIGHT _ Io+ NO.STORIES I AREA Ir, NO.BEDROOMS VALUE ��Vt1+%•
B_UIL_DING DEPARTMENT SET BACKS FRONT REAR � .5 LEFT SIDE RIGHT SIDE l_
FPermlt — +>2.5 THIL PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 7.0NING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND ITIS HERi BY AGREED TAAT THE
Plan Check _ 4'1.b9 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total Iuj. 13 _ RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITN BUSINESS
LICENSE.SEPARATE VERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
S1efATax ?•`►t�
SDC- (�
Total -
- PDC11 APPLICANT OR AGENT
By ft.
Receipt No. ADDRESS;
Approved ���
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-, Permit No.
—A c—, A'x
Rough-in
Fixtuic
Final
HEATING
Contractor
Gas or Oil
R,ugh-in
Final
SEWER
67�
Final
DRIVEWAY
Final
Storm Drainage
Rain Drain)Final
Sidewalk
Curb&Street Final
Apprn!ch
'IN V TEMPORARY CERTIFICATE OCCUPANCY
BLDG.DEPT. FIN V CERTIFICATE OCCUPANCYFin.1
I
Landscaping
Zoning Final
u.Aj S
s
(U. eec.L)
I�
�xiL� InJ
- �0►Mc
G'A 1+ 1011)
(164J-41- PdfC4)
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IN�- 4"
-- -- -
APPROVED FOR CONSTRUCT101'' ,
CITY OF TIGARD Scdlc
i
PERMIT NO. q f f) .q E ADDRESS
9Y _..__ l/f. _TITLE-- _ I: A T
[Hi 4 ctu"o Roo Tit,,"cs --- --
y X 4e,*cl t v
Z,v(jA- 1ON -ova
ki"COIN Piywr Zp
SLt K+.
��Drl. 1 SCJS�fA NtuOl S�11 -�
S X ILS/ Fop^h A+l
I Vq. SD '
LOT 185
SU
MMERFIELD 4
sE,so'
ADDITIONLl
,\
y�.5550'
15�
so
s wie M a
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5�
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N
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17'
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BUILDING PERMIT APPLICATION CITY TIGARD DATE July 25 _—, 19 77 1617
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13UILDERPHON%;Iq.lqj#jj% —
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF
LOT NO_
OWNER Morey IK* 'HULL s JOB ADDRESS 10275 iW Highland Dr. HOME ADDRESS
ARC ITECT
A. °• Deader & A**OC• ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE LJi,LW EIRE-MODEL ADDITION ❑REPAIR ❑RENEWAL. ❑FIRE DAMAGE []DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSbPATIO ❑CAR PORT DGARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
11,01 3 Mu wmmmm�_
---
OCCUPANCY_LAND USE ZONE_ BLDG.TYPE FIRE ZONE— PLAN CHECK BY_ HEAT_
ans ruC on Mpprox.—.30101 square feet PALO CoVer • oil per plans,
QCC-LQAP?-T._.FJ QQP_LQAD $900 00.e HEIGHT------ -.._._._._NQ,.�RIE$.----.�A�A NS?,.@lr..Q3Q4.M$_ VALU.E____._._�_
BUILDING DEPART;,t SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
.. THIS PERMIT IS ISSUED SUBJECT 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 IM Pr'CORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb-total ALL APPLICABLE CJDES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
_:'.14RESTRICTIVE COVaNANTS. CONTRACTOR AND SUB CONTRACTRS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBINIAND HEATING.
Total
V - �
APNT OR AGfN T
Approved -- Jr- Receipt No.
ADDRESS
� ...�..... .,...._.._......,..,..,...x....,...a.,_w..»....a....w,...w...—�_. _.....Fwfy.Faw... ... _. ,.,.... ,. .... .. . .a.4.ry i..
M11EMO
Tualatin DeveiRkLU duo., Inc.
JAN - 6 1975 Date _ 1-2-75
To Nick Heibert _
CITY � r�� )on #
Director of Public Works, City of Tigard
Tualatin Development Co., Inc. will furnish access agreements at
the Summerfield project for:
Job 5184 (].0285 SW Highland Drive) and Job 5185 (10275 SW Highland Drive)
i
Job 5205 (10055 SW Highland Drive) and Job 5206 (10045 SW Highland Drive) �!
Tualatin De
v io ment Ce.7Inc. '
Signed_ �':'�' j �• a7� ``, .Cs�
i
I
EXHIBIT "B"
CITY OF TIGARD 12120
CERTIFICATE OF OCCUPANCY AND PELEA01B 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 _ane 'J , 19-L4
recorded in Book q�q , page _,
g7 _,, peed Record of Washington
County, Oregon, is hereby authorized and approved.
DESr'RI1TION OF PROPERTY!
Summerfield - lot. 1.85
As recorded in Book 34, Page 5, Plat records of
Washington County, Oregon
OWNER: Tualatin Deve. Co.
BUJ LIl I XG PERMIT NUMBER:
BUILDING ADDRESS: 10275 -Highland Drivu
This is to certii,; tl,e said structure meets with the require-
ments of the Building Ccx'.e of the City of Tigard and the above
referenced restriction :s hereby released slid terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigard has cau;,ed this certificate and release of restriction
to be cxenuted this _ .�.__ day of
Title;
STATE OF OREGON
SE.
County of Washington
On this da of o
Y „�[ ' �r c , 1, rf�, personally
appeared before me the above named _ _, whose
signature appears hereon and who acknowledged to me the executed
the same in his offical capacity on behalf of the City of Tigard.
Al
ry _
Notary M lie of Oregon
My Commission expires:
—1
_ �� ��'-
rl4d ler rweetd.... .�...,. ..._1l......a1_......A M P M.
Penep T11oM4.11f.N,hr•eto,of Memde A. C10c06of
B:JO�. Of
1005 FAcE093 ��� � Det"O,
}
s
}
S
i
STATE OF OREGON
Cotmty of Washington
11 `WI
I, Roger Thomsen, Direopr of Records
and Elections and E.Officlo Recorder of Con-
veyonceo for said county, do hereby certify
that the r-ithm Instrument of writing woo
received and recorded in book of recnrds
Nn. _.�._....�............
of said Cotxtfy�
Witness my nand and "of offfturd.
ROGEF THOMSSEN, Director of
Records & Electiors
ft 'Aft t 09
t'
EXHIBIT "B"
CITY OF TIGARD
CERTIFICATE OF OrCUPANCY 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 .7ur;s
recorded in Book U7p , Page un , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF rAuPERTY:
Surrimerfield - lot 185
As recorded in Book 34, Page 5, Plat records of
Washington County, Oregon
OWNER: Tualatin Deve. Co.
,'1111,1'17", PERMIT NUMBER: 7A-A.5
BUILDING ADDRESS: 10275 S.W. High and Drive
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 restriction is hereby released and terminated.
IN WITNE3S WHEREUF, the undersigned authorized officer of the
City of Tigard has caused this certificate and release of restriction
to be executed this day of ly
Title:
STATE OF OREGON ) s
Colony of Washington )
On this ,-X1.1 t-f, day of ly; , personally
appeared before me the above named j� whoL.e
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 Public of Oregon
My Commission expires: _
IOWA MWI L w W = � w
I
i
E
4i. .,I „dN
V, 0 F
XC
I
��yy CITY OF TIGARD CY
�1 ''W C OREGON
�,..
74-85
Owner:.--,Tualatin Development Co.. ... _..Permit No..------.................
+ Building Address............... 0275... ......... -- .............
�) x Certificate is hereby given this....26tti...day of.Q-Qcomber...........
,
that said building may be oreiivied and
that it complies with all requirements m
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
14
---
Building Inspector
mnuew
I
i
I
f . .
i city 9 of Tigard
a rd
i IN
SPECTION REQUEST
for
INSPECTION TIME :►gti� PERMIT NO.:
DATE: DATE ISSUED:—J—L-
OWNERS NAME : C?
ADDRESS :
CONTRACTOR '
I
TEST: Air❑, Water p , Visual ❑ , Laboratory p
IRESULT: Approved , Disapproved ❑ , Pending ❑
SKETCH:
I
l J
I
I
iySpECTOR DATE
eCOTE : Attoch supp1eTentol test dote hersl:0)
ALL SPACES MUST BE
ENDORSED
ISSUANCE OF BUILDINPERMITOR TO
PLANNIIJG % gym
IUBLIC WORKS DEPT. By - _ -at
-
BUILDING DEPT. Ay
TUALATIll RURAL
FIRE .DEPT. D !t �-
BLT
APPROVEDCITY
PERMIT ------- - -___
#
BY
T I TLE
___.'------•-__-__DATE :.
.�w
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: `1: 4L PERMIT NO. :-
DATE:
O. :-DATE: '/ DATE ISSUED :— I
OWNERS NAME ;
ADDRESS: /C-S- �#i�c-1 %T `
CONTRACTOR : %t // X3-A--) Af-7JF,
TEST : Air ❑, Woter❑ , Visual Laborotory ❑
RESULT: Approved, Diaepproved ❑ , Pending ❑
SKETCH.
INSPECTOR DATE
5019: Attach supplemental tate data beret]
.w
CITY OP
BUILDING PERMIT APPLICATION TIGARD DATE _ N2 0041
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE—.--
11.
C. E Inc. ADDRESS !!.'4 F;R ��_`. �/d� 7S •�dlGNlu�/1 02
TOWNER _ BUILDER PH NE
'd.a C. Inv* ENGINEER
BUILDER AF CHITECT DESIGNER
STRUCTURE ❑NEW UREMODEL ❑ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PA'110 ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANC/--_LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY—
OCC, LOAD FLOO''A LOAD —_ HEIGHT Y NO.STORIES AREA T VALUE
M —
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit —
�" — THIS PERMIT IS ISSUED SUBJECT 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 TPE 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, PLUMBING AND HEATING.
Total °
By
-- APPLICANT OR AGENT
Approved Receipt No.
ADDRESS PHONF
.w..r•J..�.wLiY - w+...rr.. .. w,._......_..aa.......Yww•«.L•a..ya.a•+.urr•..a... ...nwir..w•Y•r.rW...i.ar.W.,
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
r :e _ Contractor___
Permit No.
Rough-in _
Fixture
_ Final
HEATING
Contractor
Parma No.
_ Gas or Oil
Rough-in
_. F wal
SEWER
Finol _
DRIVEWAY
Final
Storm Drainage
yRain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT,FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
P
1,
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: IS DATE ISSUED :- I
OWNERS NAME :
ADDRESS: Z-07-
CONTRACTOR :
oTCONTRACTOR : 7 .9-c'.'
TEST : Air ❑, Water[] , Visual"*- Laboratory p
RESULT: Approved , Disapproved O Pending p
SKETCH.
i
I
i
� I 1
INSPECTOR DATE
501IF: Attach supplemental test data bsreta]
J
i
i
I
City of Tigard I
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: l%11/'13� DATE ISSUED:--LJ.
OWNERS NAME : _ 77710-C _
AUDRESS : 9s•� /,P5
CONTRACT 0 R :—_—__.—__ __ _
TEST: Air 0, Water a , Visual 0 , Laboratory p
RESULT: Approved,,+ , Disapproved U Pending p
SKETCH:
z ess
A
t lee af'
3PECTOR DATE
(NOTE : Attach supplemental test data hereto
PLUMBING PERMIT APPLICATION
Jurisdiction of _
No. Type of Fixture Fee Permit No.
Permit fee215-W 9&
Water Closets Toilets Permit Issuec.�_ ,
i Bath Tubs Approved by k
Lavatory—�sh Basin _ Building Permit'
_ Shower Receipt No. �—
Sin s, Dishwashing_
Sinks rdinary Location of BuiWin gSinks Bar ti --
-- -Sinks
Slop -- "' y r'
Automatic Dis was_er�
Name & Address of Owner ..,�%� � �=?�Laundry
. Trays
ains Flog
ains. Area _ _
Refrigerator "4,- "'
ains, -
rains Name & Address of plumber �-�.tomatic Washer,ains. Dr n iuntains SodaTater Service Size _ Buildin Old or New) Alter, Repair or
Catfi-Basins - Yard_ _ nsa�- _ -
Lawri__ Spri71Z!erSvste_m
Swimming- Pool _ Other �_-
-Sprin7k5er Sy_stem____.._—_ - —
This permit becomes null and void if wor+ or onst construction
is authorized spended or isot
commenced within 60 days, or if construction or
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 bon
I hereby certify that I have read and examined this application and know the s
to be true and correct. All provisions of laws and ordinances governing this t
i of work wail be complied with whether specified herein or not, the granting of
permit does not
stateeormlocalglaw regulatingtconstruction orcancel
the performanceons
f
of. any other
construction.
t ,� , Signatur6�of Applicant
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIMIk` 14»1 PERMIT NO. :
DATE: 14ei /y' DATE ISSUED:�1-1
OWNERS NAME : '7; ').C_
ADDRESS : -
CONTRACTOR : -----
TEST: Air D, Water [] , Visual D , Laboratory []
RESULT: AppiovedDisapproved D Pending p
SKETCH:
i
I
I
I
I INSPECTOR DATE
I [NOTE : Attach supplsmental test data horst]
I
1
City of Tigard
INSPECTION REQUEST
for
IOPEC TION TIME'. PERMIT NO. :—
DATE:
O. :_DATE: L A, /_zi DATE ISSUED :- I
OWNERS NAME :---L t _
ADDRESS: lu,2- 1
CONTRACTOR : ------
TEST :
ONTRACTOR : _____—_TEST : Air [3, Water❑ , `disuof ❑ , Laboratory ❑
RESULT: Approved ❑ , Disapproved ❑ , Pendinq ❑
SKETCH. (o e 1 V
SPECTOR— DATE
IN-07V Attach Supplemental test data keret]
9866
EXH113IT "A"
CITY OF TICARD
Residential Structure Occupancy Restriction
KNOW ALL MLN 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 Deec. Records
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTY: Summerfield - Lot 1E!L:1.
An recorded in Book � �, Page ��, Plat records of W'ashingtoc,
County, Or,�Ion.
ADDRESS OF I'IZOPERTYi
NAME OF OWNER:_
ADDRESS OF OWNER: �C)t ,L ►14, c�
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed this da of
Ow-DER:
,
Neje /f�
APPROVED: Dv10
T.tle
By:
Building Official
City of Tigard
STATE OF OREGON ) ss.
County of Washin&ton ) ) n 19
Y sonally appeared before me the above named
r and acknowledged the foregoing instrumen b0
voluntary act and deed.
ho ,ry i'ublic for r Z;o.
r�,• .,• ,.,..,,._�-..�c........�......_.ip i.X..,JdLL girt,i :.:
��)UR THOMMEN,lw.enx at.11ww a a M�++��, Vy Commission Exp res:
97S
cA
STATE OF OREGON Il
ss UUU
County of Washington
I, Roger Thnmssen, Director cf Records ec
and Eltiuns and Ex-Officia Recorder of Con
veyances for said county, do hereby cer!ify
that the within Instrument of writing was
received and recorded In book of records
No
of sold County
Witness my hand and seal offixed.
ROGER TNOMSSEN, Director of
Records $ Elam"
De"
IN 7 12 31
EXHIBIT "A"
CITY OF TIGARD
Residertie.l Structure Occupancy Restriction
Y.NOW ALL K214 BY THESE PRESENTS, That occui,ancy of residential
structure (s) on the following described lands prior to the recording
of an occupancy parmit releasing the restriction in the DeeQ Rocords
of Washington County, Oregon, is prohibited by the ordinance of the
City of Turd, Oregon:
DESCRIPTION OF PROPERTY: 6mmerfield - Lot a
As recorded in Book r� , Page Plat records of Washington
County, Oregon.
ADDRESS OF PBOP1:RTY: ICO`�-7�^ �l/ �,,�►��t„�rC ;, :
NAME OF OWNER
ADDRESS OF OWNER:�
IN WITNESS WHEREOF, the underiiLrnod has caused this restriction
to be execated ;his 7 ` I dry of ��-►�•,��_ 19 .
014NER:
TMiai.•iti^ �!r•ent of/.
APPROVED:
Title
Bys
Building Official
City of Tigard
STATE OF OREGON ) ss.
County of Washington } .` 19-2.(
Personally appeared before me the above rx.med s,
and acknowled ed the forgoing instru t to be
voluntary act and deed.
A2 y Pub=i c
My omm:ssion Expires:
CITY OF TIGARD
12+20 E. W. Main Street
TIGARD, OREGON 97223
APPLICATION FOR BUILDING PERMIT
New Construction ® Demolish ❑ Addition ❑ Remodel ❑ Move ❑
7.ONING DATE ISSUEDBUILDING PERMIT
DATE RECEIVEDBUILDING FEE_$ y/ ,)"'Ll No. -7
HY PLAN CHECK $! J) )' _ ---- _--
OTHER/F"•'•'J•-J $ tl, 9) ' VALUATION $-
TOTAL SYv'c $_�2.2 RECEIPT No. /Oo2/S
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # Vej MAP #� - CENSUS TRACT _^V JOB
Architect or Engineer=AAi%m 1"-A-- _,le,
Address j5 3oG 5 ,L �`�,Z li.r�_ TGA Phone� _3�Q��
Owner
Address--.----- --__ —Phone
Address
BUILDING USE Single Res. 141 Multi Res. ❑ `~ Comm. ❑ industrial❑.
OCCUPANCY GROUP_ No. of Stories,_1— Total Height Area of Lot
Type of Construction I II III IV l" ) Floor Area B 1_15 2�
Set Backs: Front-177 _ Hack �C,"2 L.Side-_:�Cj� - R.Side S_ _
Private Sewer Pipe Size- n — Sewer Septic Septic, Tank ❑
Water Service Pipe Size 3 '' Storm Sewer Ditch ❑ DrywelI❑
_ ---
Street and Curb Requirements
_may_
Driveway width , I of Parking Spaces`
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED0.2 7J~ f lf/
FIELD CHECK BY DATE J--';Ll-%Y
PERMIT APPROVED BYZ,.,
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
S"tu,� of Appl ant -
VAN DOMELEN & LOOIJENGA. Inc. Structural / Civil Engineers
Project: v L �.J'10�.1 By: J7 Sheet No.-L9-?-L-
Client:
o.-L9-?- ._
Client: _ Date:—_____ Project No.___-
T~ w G A 2 PL. i'
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