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i i i i i i i N
City of T;hard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: �'' �/%'� DATE ISSUED '.- I Z ,
OWNERS NAME :
ADDRESS: 04"1
CONTRACTOR : 4c> 7-
TEST :
4TEST : Air C7, Woter❑ , Visual ❑ , Laborato y U
RESULT: Approved , Disapproved ❑ , Fending []
SKETCH:
INSP CTOR DATE
[OTE: Attach supplemental test data bereto7
Y
OF O
1G
�1
G�� CITY OF TIGARD C
OREGON
Owner:....Tualetin. Development. Ca.................Permit No.74-87.... .......
Building Address....................1.0a45...S.W... Hig'OlAgq._Drive.........................
Certificate is hereby given this..29th.....day of.....wiY................... 19....7....
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
t as approved by the Tigard City Council.
..' ...... .. ............................... •--..................._...........
`4? " BuildingInspector
A
City of Tigard
INSPECTION REQUEST
for 4Ati1&
INSPECTION TIME _ ,1A4' PERMIT NO. '. ___
DATE :
n. : _..__.__-
DATE ' DATE ISSUED-.____Z_
OWNERS NAME ' --_ C'
A n:,`K E S S ' iy. AL._..4
C0N fRALTOR
TES'i. Air ❑, water U , Visual)(, Laboratory Q
RESULT: Approvedx , Disapproved ❑ , Pending (_j
SKETCH'.
[SOL- WO -SAG 7�--- APPlz OA _"Al S
f
INSPECTOR DATE
Ch OTE Attach supplemental taft data heret]
City of Tigard
INSPECTION REQUEST
for
� w oAAA �
i
INSPECTION TIME : PERMIT NO.:
DATE: DATE ISSUED:_.Z
OWNERS NAME : •
all
i ADDRESS : " 2
CONTRACTOR :--,'r,—&L IC j
i TEST:Air 0, Water p , Visual , Laboratory ❑
RESULT: Approved, Disapproved p Pending p
SKETCH:
I
INSPECTOR DATE
COTE: Attach supplemental test data heret:01
I
City of Tigard
I �
INSPECTION REQUEST
I
for
I
INSPECTION TIME: — PERMIT NO. : I
DATE: _L1— DATE ISSUED :--I--Z--
OWNERS
SSUED :--1--Z-_OWNERS NAME : Z,
ADDRESS:CONTRACTOR : - I
TEST * Air [I, Water[] , Visual [3 , Laboratory ❑
RESULT: Approved Disapproved ❑ , Pending ❑ I
SKETCH.
I
I
I
INSPECTOR DATE
5077: Attach sur ilemental test date beret]
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. ?4 IV& g°
Permit fee g—ti ';18
r Water Closets Toilets Permit Issued 16I 7
Bath Tubs Approved by4
Lavatory_(Wash Basin) Building Perm
Shower ?Z! Receipt No. nloF
in s, DishwasRng
Sinks Kitchen
Sinks_Ordinar Location .of Building
Sinks. Bar____ _ ;�f l ."r-/ _( ,t i,r
Sinks, Slop
_ Automatic Dishwasher /�1 ��►- z .ir�i./ _ �,r�a:��
Disposal
_ Laundry Trays Namg do Address of" (wner
Drains Floor
Drains Area _ -
Drains. Refrigerator
Rain Drains
Au+_�ma is Washer %> Name' & Address o Plumber
oun alns, Drinking ( „r: ✓ 'i��y,.
Fountains, Soda — �;•� '
t. Hut Water Tangy—
Water Service Size 1
Urinals Building Old or neiw) (Alter, Repair or
-7-a7-M--Basins --Yarm ns a l)
Lawn Sprinkler S stem `- s
Swimming Pool
Sprinkler System _
This permit becomes null and void if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended 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 $1,000 bond.
I hereby certify that I have read and examined this application and know the same
to be true and correct. All provisions of laws and ordinances governing this typ
of work will. be complied with whether specified herein or not, the granting of a
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
3 , ,
- -----'— Signatdre of 'Applicant
City of Tigard
MSPECTION REQUEST
for
INSPECTION TIME' _ PERMIT NO. :
DATE: DATE ISSUED :
OWNERS NAME : L - V• C
ADDRESS: 4-QT lG !?
CONTRACTOR : -
TEST : Air 0, Water L7 , Visual [3 , Laborotory o
RESULT: Approved Disapproved 0 , Pending p
SKETCH: 4
I PECTOR DATE
5019: Attach fuppiefnental teff data beret]
i
City of Tigard
INSPECTION REQUEST
for
qll
INSPECTION TIME :- _ PENMIT NO.: _
DATE: -(- Z1,Q& DATE ISSUED:_LL.
OWNERS NAME: -r.0 C .
ADDRESS :
CONTRA;;
t
1MMIT "A" 119()$
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL 1,2N BY THESE PRESENTS, That occupancy of resldent'.al
ctructure (c) on the following described lands prior to the recording
of an occupancy permit releasing the reetrietion in the Deco Records
of WachinScon County, Oregon, is prohibited by the ordinance of the
City of TizArd, Ore Son;
DESCRIPTION OF PROPERTY: Su¢rerfteld - I.ot 1��9
An recorded in Book 9_, Paue , Plat records of Washington
County, Oregon.
ADDI=5 OF I ROPL:RTXi l,�/ y''j� � G✓ 1�,a�,�A.-�.1�' a,,c/C IJ
NAITS 0: OMER: i„1 L7t✓c�a�r.*nl�C°y 1
ADDa , uF owcm: i s:?�. 11Ca..LIr:._c�uc neaz --...
^' ro
IN WITNESS I-IM EOF, the undersijned has caused this restriction
N _
3 to ba oxrcuted this __-_�� day of }�a,n P 19 .
C-) -�
1 0
v O4MI R
,k -�
N I O cc
°° 71aT.ntin P.el•. n C omr,gn T,.r,.
,t ro Nc>a�
I
Building Officinl ”►I4I I I�f YRMTd... .' _f0,....,aT....._.AM.CAA,
Pity of Tieard P4;N1iOM9RCN.yOy~ot.1 14&e tda Ik Clwelien, �
STATE Or 09MMI4
sa.
County of Nauhington ) 197
1.
p rsonally appeared bufore me the above named k,7 w
ovoluand acknowledged the foregoing{ instrur> to i-()-
voluntary
ntary act and decd. i
F"
Y,ota y Public
081
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_BUII-DER
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�:;�t,G' S1�HTL
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CITY OF TIGARD
12120 S. W. M41n street
TIGARD, OREGJN 97137
APPLICATION FOR BUILDING PERMIT
New Construction Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING_T - _y DATE ISSUED 'u,3_7l� BUILDING PERMIT
DATE RECEIVED BUILDINGFEE �1J✓ /_- No. 97
PLAN CHECK $
BY /J) ,r•JJ's„r --
-_ �. OTIIER�rt•._a. $ y./ r VAi,UATIOti
TOTAL/%ST1rr $ %1RECEIPT
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT N ��� MAP I!V ` CENSUS TRACT JOB N /Gail
Architect or Engineer-T-,
AddressJ-57300T.�
Address
---Phone----
Bu i W
honeBuilder -SCI , I.
Address ___.Phone _
BUILDING USE Single Res. [X] Multi Res. L_.J Comm. ❑ Industrial❑
OCCUPANCY GROUP--= No. of Stories-1 Total Height _- Area of Lot_
Type of Construction I II III IV �jV Floor Area B- f -
Set Backs: Front__ Back_ a, L.Side jj _ R.Side_-5
,1
Private Sewer Pipe Size y Sewer_L-,,C Septic Tank ❑
water Service Pipe Size_ 31c�„ Storm Sewer Ditch ❑ Drvwe11 C�
Street and Curb Requirements_jnty__r
Driveway Width No. of Parking Spaces___Z__
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED )'/^yJ-
FIELD CHECK BY DATE`1
PERMIT APPROVED BY •d_�`
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 Occupan(., has been issued by the City of
Tigard Building Inspector.
r ��SignfAplican -----
9864
EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL ICIN BY 7-HESE 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 TiZard, Oregon;
DESCRIPTION OF PROPERTY: :;uminerfinld - Lot 1(('1
hr, recorcied in Book -SN- , page y7.,,t records of W'Rshington
(:aunty, OrnRon.
ADDRESS OF PROPERTY: l[.1_1 'f 7 ,�A/ 1 A V,
NAME CF OWNEii:
ADDRESS OF OWNER:
IN WITNESS WR:.REOF, the undersiLlned has eaubed this restriction
to be executed this ` J
_ L-? day of
0WIM:
"mlatin v. ' nt (;
APPROVED:
T:
By:
Building Official
City of Turd
S'T'ATE OF OREGON
i County of Washln rton ) Q , 19P,
ersonally appeared before me the above :"med _ 1
_ and acknowledged the fors Ding instrumen off' be --
voluntary act and. deed.
"'41neetd
Aw / Pl�tn y Public i or z egon
...,(.7,
Anattl K-"t�' -�+� • �� MY Comm. seion Expires:
x i _. _ •_71_..._
57s 1,U6b5
F
e
u�
C)
2
Ci
STATE OF OREGON
u UUU
County of Washington
I, Roger Thomson Diret�pr of Records
and Electluns, and Ex Offlclo Recorder of Con-
veyances for sold cou,., do hfeeby cerhfv
that the within Instru nent of writing was
received and recorded In book of records
of sold County
Witness my hand and seal affixed.
ROGER THOMSSEN, Director of
Records b Elections
Deputy
jM, 30`til'711
4
,;torr
EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MLN BY THESE PRESENTS, That occupancy of residential
structure (s) on the following described lands prior to t.ie recording
of an occupancy permit releasing the restri ;tion in the Dee" Roco.-ds
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tikard, Oregon;
DESCRIPTION OF PROPERTY: Summerfield - Lot lcl
As recorded in Book S Page _, Plat records of Washinrton
County, Oregon.
ADD1=3 OF i'ROPI:RTY: 1[ q 4`i S
HAMA: OF OWNER: '� �..�r, �-;r 1`�c y`,
ADDRESS 0: OWNER: j i fir-?r:)
::+ WITUSS WHEREOF, the undersigned has caused this restriction
J
.o be executed this Z-7 day of
OWNER:
".~Latin rye7, .rent r
NCG70
APPAUV>;Ds By; t�
By;
Building Ofi'icial
City of Tigard
STATE OF OREGON ) as.
County of Washir_,ton ) R. , 197
Perronally, appeared beforr: me the ar,ove nr.mcd-'-_Y-`
1, / and acknowledged the foregotng inotrument be
voluntary act and deed a
No pry Publ.c So re
My Comm!.ssion Expires: _ _