Report „a__ > 1 _ 1 CI
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opt 99
CITY OF TIGARD
WASHINGTON COUNTY OREGON
VOLUNTARY COMPLIANCE AGREEMENT AND
TEMPORARY CONDITIONAL CERTIFICATE OF OCCUPANCY
RE: Tax Map 2S101AD Tax Lot 03200 Dale Thompson
12909 SW 68 Pkwy ,*t.10 7 Mortgage Design Group
Tigard, OR 97224 12909 SW 68 Pkwy.
FIE COPY Tigard, OR 97224
I, Dale Thompson, tenant at the above property and responsible person for
permits BUP2004 -00199 AND MEC2004 -00407 regarding the above
property, agree to the conditions set forth below and promise to fully
comply with them.
This is a Temporary and Conditional Certificate of Occupancy issued today
for a period not to exceed thirty days, by which time the following conditions
must have been met and approved by the City of Tigard:
Permits BUP2004 -00199 and MEC2004 -00407 must be completed and
approved, including all outstanding conditions, corrections, ancillary permits
and fees.
understand that with this agreement the City will withhold further legal or
enforcement action regarding these conditions until 5:00 pm on Monday,
July 26, 2004.
Upon compliance with all the above conditions, this case will be closed and
a permanent Certificate of Occupancy will be issued. I further understand
that if these conditions are not complied with fully this Temporary and
Conditional Certificate of Occupancy will become void at 5:00 pm on
Monday, July 26, 2004, after which time I and any occupants of the
premises may be served with a Summons and Complaint without further
notice for violation of requirements set forth in the Oregon Structural
Specialty Code inal ins,,,. '. approval required prior to occupancy).
1P
Signed: / 1 le -te. '•a June 25 2004
Signed: /I” , Dat- - 2 D itle: /. I i • ip�
it f .r' //- •
tice,/ ,
CITY OF TIGARD
13125 SW Hall Blvd.
,:I Tigard, Oregon 97223
° 'L. (503) 63 9-417 1
Receipt #: 27200400000000002769
Date: 06/25/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
BUP2004 -00199 [BUILD] Misc Fee 245- 0000 - 432000 90.00
Line Item Total: $90.00
Payments:
Method Payer User ID Acct /Check Approval No. How Received Amount Paid
Cash DALE THOMPSON BB In Person 90.00
Payment Total: $90.00
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