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(n CL I '_J T -, H W f m c IK W LJ U CO =) :3 h ir) CM. fWn „. ,ir& gas� �Aa I i City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. : DATE: 7 AL3,175 DATE ISSUED : / l OWNERS NAME : 1 A 'L -- ADDRESS: ILL-1 ._ CONTRACTOR : LL)-7 " - ;" TEST : Air 0, Wotsr[] , Visual ❑ , Laborutory O RESULT: Approved , Disapproved D , Pending [] SKETCH: �I INSF .CTOR D/` fE i OTE: Attach .upp4mental +st data beret] t w.:r� aw ■er � 4 � � s t � City of Tigard INSPECTION REQUEST 3)16L,14-1-LOA-4 o r 3 16 t,1L1-L✓A-4 r,iL;Li'2t,a1 r ►A INSPECTION TIME: PERMIT NO. : DATE: E /i /7C DATE ISSUED :--- Z 1_ r OWNERS NAME : !�_ 0 � ADDRESS: CONTRACTOR : ��?� /C• _��� __`___ r TEST : Air ❑, Water❑ , Visual ❑ , Laboratory p RESULT: Approvmd � , Disc pried ❑ pending p I I I I I i.N �`F DATE Pv FNOTE . 1tft r,'4rr1@!Rf?I s?° c,, 1S1 h3r^ t- I I 71 I City of Tigard INSPECTION REQUEST for INSPECTION TIME : ' 3v PERMIT NO.: I DATE: 15 DATE ISSUED:_..1_.,L.. OWNERS NAME: ADDRESS:lltin CONTRACTOR :_— j— �- TEST:Air❑, Vater ❑ , Vieuat ® , Laboratory ❑ RESULT: A ►over PP � Disapproved D Pending D I SKETM: I I � I I INSPECTOR DATE ICQTF: Attach •upplamenta! teat dain Aarsto I r City of Tigard INSPECTION REQUEST for INSPECTION TIME : N PERMIT NO.: —. ,— DATE: O.: w. ,— DATE: _ Yz /7r DATE ISSUED:__/_ L OWNERS NAME : _ 7 ,P C_ _ I ADDRESS : Tv %6,L _ CONTRACTOR ; '��' ITEST. Air ❑, Water 11 , Visual C" , Laboratory p RESULT: Approved' Disapproved ❑ Pending ,❑ Ir I SKETCH: i I� I I j '.. N90tOOR DATE IEOTE : Attach supplemental test data hereto I I i I ' �urr v no i 1 w EXHIBIT "A" 11905 CITY OF TIGARD Residential Structure Occupancy Restrictioa KNOW ALL MON BY UMSE PRESENTS, That occupancy of residential structure (s) on the following de,cribed lands prior to the recording of en oncupancy permit releasing the restriction in the Deec. Records of Wauh.ngton County, Oregon, is prohibited by the ordinance of the City of TiZard, Oregon: DESCRIPTION OF PROPi:RTY; Summerfield - Lot 1616 As recorded in Book Pa,e _��, Plat records of Washington County, Orrraon. ADDRESC OF I11107MM JOY � .1 � 1�'7`�`" f�Ltlr:e NAME OF OWNER: c0 ADDRE`; Ur OWNER: /r (` , LJ /fir jk- Vr' - T tic.il� IN WITNESS WHEREOF, the underuigned has caused this restriction /(� to be executed this day of OWNER: t 7 Tual.ntin P.../et llnTe .oim n3n'•'. ? � iNata�;, APPROVED: Byi� !l �9' 1= /• 1+ B y s Building Official � al d In,iwcotd.,......�....,"7.G..t0��t........A M. City of Tigard RTHUM99CN. n,nnnr of pwxrlti Llwcrinn O 1 STATF. OF OREGONes. P, county of Washington ) � , l97Z. ':4personally appeared before me the above +tamed _ v J and acknowledged the fore Going inctrum to be voluntary net and decd, / Not yPub'ie for 6 n STATE OF OREGON +� TI Cnvnty of Wn.hirpt.n I, Roper ?hornst n Dlrator of Records and Elrctlons and F.s-CtEINo Recorder or Con- veyancesfor said tow 1(, do hereby certify that the within Instrw1ont Of wrn�wm 1 received and recorded book � �..._. No of snid County I Witness my hand and seat offiud. ROGER THOMSSEN, Director of Records 6 Eleetlont DMXAV • JUN Z6 10 50!tN'lta EMIBIT "A° CITY OF TIGARD Residential Structure Occupancy Restriction KNOW ALL MIN BY UIESE PRESENTS, That occupa, cy of residential structure (s) on the following described. lands prior to the recording of an occupancy permit releasing the restricticn in the Dee% Records of Wauhington County, Oregon, is prohibited by the ordinance of the City of Ti?,ard, Oregon: DESCRIPTION 0: PROPMTY: Summerfield - Lot 1c As recorded in Book '_, Page �_, Plat records of Vashington County, Or--Ron. ADDRESS OF 1'ROPERTY: / /D�S NAME OF OWNER: rjal t,�: L7P✓r/O/"t,.csc�G9d ADDRESS OF OWNER: /!-L:.-302> -11j(_ ?x•- IN WITNESS WIM-REOF, the undersigned has caused this restriction to be executed this day of 1,11�, 192,Y. OWNER: Tvai.ati;. 1'elo' nren4' ,oi7r,3n 1^r Ncn ' APPROVED: Byi L'? �'1 l� 7 E y: Building Official City of Tigard STATE OF OREGON ) Gs. Cru:ty of Washing`= •t+_ / , 19 0'. croons, ly appeared before me the above namfid rte and acknowledged the foregoing instrum n to 1,.� voluntary nct and deed. - '1t 1.:Ity ��ivli.t: i ♦ ..:rvli 1: l.Vu�li.btviuii f...0 1.1'4: ' ....ems. ...�/_•/�� .�_..-.���.—_ 1 �R . C1 FY OF TIGARD 12420 S. W. Mein StrMt TIGARD, OREGON 9722 APPLICATION FOR BUILDING PERMIT New Construction Demolish l__.1 Addition ❑ Remodel ❑ Move Ej ZONING DATE ISSUED BUILDING PERMIT DATE RE�CCEIVJED��, BUILDING FEE $_�'�" No. BY ==r, PLAN CHECK $�l�!•���� i ice. r --- _��Lj A c:✓ VALUATION OTHER /lei a/�,/..j$ 1' L�--- TOTAL/jr i1+I't $ RECEIPT No.� -2- TWO SF,TS OF PLANS ANn PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT # 1 �Ob — MAP # CENSUS TRACT JOB Architect or Engineer= Addresa.-i53vin� Phone lail_31Q1-____ Owner_,,,,„P_ Address ------ —Phone -_ Bu i l d e r ea..,.e, _ ---------- Phone`_ BUILDING USE Single Res. bd Multi Res. C Comm.. C] Industrial❑ OCCUPANCY GROUP .�� No. of Stories `I _ Total Height Area of Lot Type of Construction I II III Iv CV-) Floor Area B- 112W 2 Set Backs-. Front-A cjl _ Hack S (,�I L.Side R.Side Private Sewer Pipe Size-_ y " Y Sewer_K,.,5 64 Septic Tr 1k L� 1i _7 Water Service Pipe Size- -y 4 -� Storm Sewer ❑Y Ditch ❑ Drywell❑ Street and Curb Requirements 6riveway Width 1 _--------------------------- -_ __ of Parking Spaces 7 SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION Vic;Z.0 ADDRESS ASSIGNED FIELD CHECK BY r�r (, �. �-; DATE`r PERMIT APPROVED BY �e, �.C♦.,r1Z'-___ 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 b the City of Tigard Building Tnspector. Sig.tature of Applicat{t - - V A L U F FEE DATE OWNER F . - I E F LOT,r—4-PERfTI T ir t- ME C H A I C A L 4f--R F1 T DATE --by_ candT— X c',3 V3 L Ventilation—E-17 on joLn C, 6 u n d a t 1-0 Sprinkler system M a —---------- Firo doors exits Steel or Garans (qb i_n g. Sower ........... — A" -- !�G r m Drain b m e parkin- Q Ci L F e —sEr afk7lTal Fins ' c r r --7