Certificate of Occupancy CITY OF TIGARD
WASHINGTON COUNTY OREGON
VOLUNTARY COMPLIANCE AGREEMENT AND
TEMPORARY CONDITIONAL CERTIFICATE OF OCCUPANCY
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RE: Tax Map 1S135DA Tax Lot 01400 Brahmapremananda Ashram
11515 SW Hall Blvd. 11515 SW Hall Blvd.
Tigard, OR 97223 Tigard, OR 97223
I, Amarish Patel, Project Manager and person responsible for the above
property and project, 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:
---,Permit BUP2002 -00002 and permit SIT2002 -00001 must be completed and
approved, including all outstanding conditions, corrections, ancillary permits
and fees.
I understand that with this agreement the City will withhold further legal or
enforcement action regarding these conditions until 5:00 pm on Monday,
December 8, 2003.
Upon compliance with all the above conditions, this case will be closed and
this Temporary Certificate of Occupancy will become permanent. 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, December 8, 2003.
Signed: Date: Thursday, November 6, 2003
ca ner /Representative
Signed: / Date:: Thurs ay, November 6, 2003
Owner " - prese /-- /
Signed: / / / /, j� — Date: ' D 5Titl: a
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HOUSING /BUILDING COMPLAINT RECORD
CITY OF TIGARD
BCE 200P - q o o —
** Complete Confidentiality Form If Appropriate ** File Folder? Yes/No
Closed/Referred /Declined
Housing
' ? /C �� Building
Da Rece Time Received Received by
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I/17 2-23
Property Address [Street, Unit, Tigard ZIP]
Property/Complex Name [i any] Relationship of Complainant [nt, etc.]
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Complainant's Nam \ Complainant's h e Number
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• Complainant's Address [if different — Street, City, State, ZIP]
Descri , tion of Co t 1, int: _ /
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Owner Name Owner Phone Number
Owner Address [Street, City, State, ZIP]
Manager Name Manager Phone Number
Manager Address [Street, City, State, ZIP]
Contractor Name & CCB# Contractor Phone Number
Contractor Address [Street, City, State, ZIP]
Complainant's Primary Contact (if tenant) Owner Manager N/A
Type of property: Apartment House /Complex [3 or more Units] Single Family
Duplex Hotel/Motel Social Care Facility Commercial/Industrial
Activity Record: [Initials of Inspector, person verifying] Yes No Date Initials
Has Tenant/Complainant contacted owner /manager?
Is tenant in arrears /is court/eviction action pending?
Has Inspector contacted owner /manager?
Was an On -Site Inspection conducted on complaint?
Self- Certification — did tenant verify compliance?
Was a Compliance Agreement signed?
Was a Summons & Complaint issued?
Was a Court Appearance completed?
Was Compliance verified by inspection? _
Resolut' n of complaint:
0l (403AMS