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LJ F_ m cz oc: JL.1 ct r•, _1 ri LL G7 !7 JILwr .. wt wr er s W { City of Tigard INSPECTION REQUEST for INSPECTION TIME. — PERMIT NO. : DATE: } 12126 DATE 13SUED :_!_L OWNERS NAME : Z y/ C ' - I /G AUDREss: z CONTRACTOR : c" t.t n let •t'._.o __ r TEST : Air L7, WatcrLI viaual,19, Laboratory I] RESULT' Approved V , oieapproved U Pending p SKETCH: Al-7 7G INSPECTOR DA r F-rTE : Attach suppoamentelf data hereto] FILE Copy- City of Tigard INSPECTION RE70UEST for � �e►.Nz�ko �r►ve�wzw - INSPECTION TIME : Pi PERMIT NO.: — DATE: '¢' ISl74 DATE ISSIJED:_..� OWNERS NAME 714e— ADDRESS ' ' I2a4 , '� CONTRACT(.)R :_- < - r CoHC, I TEST: Air ❑, Water ❑ , Visual, Laboratory ❑ RESULT: Approved ❑ , Disapproved)( , Pending L] SKETCH: /1 ; so AM crl(?E 0 Pep 77t l i i IFIL-E cicw. : y INSPECTOR DATE COTE: Attach supplemental test data neret] i City of Tigard INSPECTION REOU EST for 0 I INSPECTION TIME : PERMIT NO.: _._. I DATE: I-Z,21<� DATE ISSUED:--j OWNERS NAME : ADDRESS : I CONTRACTOR - TEST: Air O, Water A , Visuat.0 , Laboratory ❑ RESULT: Approved ) Disapproved O Pending ❑ SKETCH: 1 �ik, IN PECTOR DATE IOTE: Attach eupplementol test data hereto /�� . ,. .. .....y...y;.y��l..'{dR '!��-+Fir.w.M"r.r.MM+i'I•nCPp1....pR/w...�.�.. CITY OP BUILDING PERMIT APPLICATION TIG ARD DATE 19 17-1 ? , o . 061 . ' t THE UNDERSIGNED HEREBY APPLIES FOR APERM!T FOR THE WORK 1-117AEON INDICATED OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS #tASFMjfIGATj@Wr s ?}HONE QWNER ; LT3�EJ,C3.t3 'JI')III `_'"A'DDRESS .10615 S.U. I"f.4,.ghland Dr. BUILDER PHONE A� la ENGINEER BUILDER nn _ ARCHIjf�^T DESIGNER O _ STRUCTURE NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE []DEMOLITION ❑RELIGIOUS OPAT10 ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE ❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOVT - QBOND ❑MOVING ❑CONDITIONAL USE �QDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS O CUPANCY _ LAND USE ZONE 2 11 BLDG.TYPE FIRE ZONE PLAN CHECK BY--L'4MEAT runstXjct 11210 sq, f't.b f Liame dwejljnW w&ll.h et~t.kitchuj:} ,4Iilrat�lE no bassinant .� bedrooms O211,971 CC LQAD FLOOR LOAD HEIGHT NO.STORIES _ AREA _ VALUE BUILDING DEPARTMENT R I•e I . '' =� g3�� - - 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 THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recordinn ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE ;5 iju RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS 1`X,State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total 1�.7MQ�a I/�,`Ir ilf l t4t� !F IfIspec tl on By , APPLICANT 04 AGENT -' Approved = — Receipt No. ADDRESSPHONE DATE ' INSP. TYPE INSPECTION REMARKS PLUMBING DATE ntracto l2el,Permit No. D1 S Rough-in .,2-> Z Fixture Z1, Final HEATING Contractor Permit No. Gas or Oil > ?ap Rough-in _ Final SEWER -2-776 Final DRIVEWAY Final Storm Orainage (Rain Drain) Final Sidewalk Curb 6 Street Final _ Approach BLDG.DEPT.FINAL TEMPORAPY CFRTIFICAIE OCCUPANCY CERTIFICATE OCCOPANCY F'nal _ JLandscaping Zoning Final t, i t i3 1i i 3 IsXHIBIT "A" 1.1203 CITY OF TIGARD Residential Structure Occupancy Restriction KNOW ALL VaN BY TI1:SE PIMSENTS, That occupancy of residential structure (a) on the following described lands prior to the recording of an occupancy permit releasinG the restriction. in the Deet. Records of Washington County, G:efon, is prohibited by the ordinance of the City of Tigard, Oregon: DESCRIPTION OF PROPATY: Summerfield - Lot As recorded in Book 3 qPaSa 5 , Plat records of Washington County, Oregon. ADDRESS OF PROPMITY: H lg4l1CA1 A Dr, j C"i-( NAME OF OWNER:—t�Zi a 1 c, \L)e vc It,��i,a e.:T Cc--> ADDRMS OF MMR: I"i IN WITNFSS IULREOF, the undersigned has cauaed this restriction to be executed this y I. day of Ow;�s miln}.7.t�.11 !:r'.`l P.I. .•Tint Co ^.. t.,q• Name / APPROVED: pys t'3 G� Title By: .� . (r•-� I_ � �i,�,Tltr�mgsr.N.nw,oe d� d Building Official . City of Tigsrd `fJ ....,.:............«.«..... .... •........_...........:...Deputy STATE OF OW' Or.* ) ss. County of Washington 19 7 J/, rnorulll.y appeared before no the above nava d _ and neknowledged the forel;oing instrumc , to be voluntary nct and deca, Lt�+�-- 'V►4wr io try Public .or opM n STATE OF OREGON (� ss County of Washington I, Roper Thomsse. Olreetor of Records and Elections and Es Off-lo Recorder of Con. veyances far said corms) do hereby certify that the within Inhume.r of writing was received and recorded In b vk M records of sold Ceuny Witness Pry hand and seal affixed. ROGER THOMSSEN, Director of Records & Election ._I)0 F aPrs►Y Jux 26 10 so AN'1a EXHIBIT "A" CITY OF TICARD Residential Structure Occupancy Restriction KNOW ALL MEN BY MESS PREGENTES, That occupanc,.* of residential structure (n) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Deec: cRacords of Wauhington County, Oregon, in prohibited by the ordinance of the City of Tigard, Oregon: DESCRIPTION OF PROPERTY: Summerfield - Lot & As recorded in Book 3�� , Pa;;a ^! , Plat records of Washington County, Oregon. ADDitPSS Or PROPERTY. ��1c'�1`i cJ 1§4`11S�i?�l���i V e-- T214, HAM 0? OWNER:` ).akg %N-% ADDRESS OF OWNER: 00 �•(�J• IL(g�� ��. T:� r rrP IN WITNESS WHEREOF, the widersigned ham caused this restriction to be executed this LA day of J,a�.e 19 . 04+i'�FeR i Tuc,i.a.tin, lhw.el .rnent C� n^. T;�a. APPROVED: By: "`-7 T _ ..s Title By: Building Official City of Tigard STA'a OF ORFOON ) us. County of Wauhingcon ) ' 19.7 G one 1.y appeared before me the above calmed and ncknowledgecl the foreCsoing instrumen to be volur,tnry nct and deed,_ d r Iio Try Public f Or..gon i EXHIBIT 11903 E CITY OF TICARD r nesidontial Structure Occupancy Ruatrictlon KNOW ALL fw= BY TIESS Pn-SEN"13, That occupancy of residential structure (a) on the; following described lands prior to the recording I of on occupancy perm". relem ing the restriction in the Dc.CL Rccordr. of Wachiniton County, Oregon, is prohibited by the ordinance of the City of Tirard, Orcgon: DESCRIPTION 07 PROPi7AM Srunnerfield - Lot An recorded in Nook 3qPaye , Plat records of Washington County, Orpgon. f, AD-,)anSS or FROPP.I M NADii? 0? OWNER ADnz sS or MUM: 1�ice_/ cam. LIGE T gar IN WITNESS WHBREo , the undersigned has caused thin restriction i to be executed this Lsl �- day of _1,,��.;_ 19 • o I Un rb �, rL S rD r, c� o "u�l��tia ..•:vr•1 Zont ^. -nn• 7rn. V c� ff Nana II " hpPiiOYEDt Ay: •�, � � a:t10 L �~ Bye / /� �1 . . �/�� ,1 r»r.eetd._�°... ..10ot..� building Official F1 p HUMSfF,N.O,r«»e�d M^o,F�6 Eleenoe� 1� City of TiGnrd e.........`f..._.........._ bac/t�._............._..a.,,,.<T STATE of oRSOON ) ca. Count)• of Washington ) / l9 /. YTracnally appeared bofore no thi above nnmed & and acknowledged the foregoina instruL to be voltu,tary act and decd. ' �w Loy,,iryyl'ublic ford 0; U n 7 . . 351 1346 t `ice e! rA, Loi X41 CITY OF TIGARD 12420 S. W. Main SIrNf TIGARD, OREGON 97223 APPLICATION FOR BUILDING PERMIT New Construction NJ Demolish Addition Remodel [] Move L J ZONING _ DATE ISSUED— __ BUILDING PERMIT BUILDING FEE c. L, ['✓ No. ��✓' DATE RI:CEIVED�/ PLAN CHECK $ /!' �'�� - v / -- /1 �,_• BY �_<l - VA LUATIOtJ $ ',3-j1Y OTHER/I r` /r>S� C BY_ ( - RECEIPT No. TOTAL 'rWO SE'T'S OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT # r MAP # — CENSUS TRACT _ JOB Arch tect or Enginee rZ)a( , _V�>'�zt�r�,-T--��fL-�s�t- -- T Phone - Address Owner r Phone Address __—.— - - --- —.— ----- —.^ - Builder de-,C � -- — ---- --- — -- ---_ --------- Phone - Address_ BUILDING USE Single Res. © Multi Res. 0)inm. Industrial❑ No. of Stories Total Heiyht Arra. of Lat OCCUPAPiCY GROUP-� _, -_�� -_--_ ------- ��Floor. Area B l, L2__ Type of Construction I II III IV Set Backs: Front �(�r_ Backe L.Side }_� R.Side_'-- i)Lvate Sewer Pipe Size—�____— Sewer�tiA C��� _ Septic Tank Water Service Pipe Size )���i_ Storm Sew er Ditch Drywell❑ Street and Curb Requirements-0 ,,­jrc Drivewa Width 1 No. of Parking Spaces Y -__-] -- -- ----- -- SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMA`rION ADDRESS ASSIGNED 1� ) �v 1 r� r1-sem-- �' r ")ATE FIELD (:HECK BY— PERMIT APPROVED 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 wil not be occupied until a Certificate of Occupancy has been issued by the City of Tigard Building Inspector. Si nature of Applicant