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10125 SW CENTURY OAK DRIVE-1 ItO I— N) Ul U7 • I bd U) ~ �;. ct W C y O ftj < f-Al ` \I �r� IF� rll P ! t '.jLn w HH 7 t�1 LO O 49 M, h- u ` 0 I n r I � o ri c O 3 z 0 10125 SW CENTURY OAK DRIVE Ad 3ATECI 'AVO T`MIN3D MS SZTOT U Li CL Li Li 2r cr -j Lr 0 rxi to 77 7 -tj 0 0 E-4 140 rxi to rrl 9 m 1 P-1-- - -IT I IT U') N -4 C EXHIBIT °B' 9873 CITY OF TIGARD CERTIFICATE OF OCCUPANCY L" RELEASE OF RESTRICTION The City of Tigard hereby certifies that the occupancy of the following described structure or premises with rbakeet to which a restriction of occupancy was, on recorded in Book 9Gr Pa se 7'9 , ?Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRI}TION OF PROPERTY., 5ummerfinld - [-at Of As Recorded in Book 329 nage 509 Plat Records of Washington County, Oregnn OWNERS Mr_ Viira_ ilrfh,,r Arihmomig C*. BUILDING PERMIT NUMBER: _1-06 BUILDING ADDRESS: 1 125 S_LI_ rmnt�jy f1nk nr1vi4 This is to certify the said structure meets with the require- ments of the Building Code of the City of Tigard and the above referenced restriction is hereby released and terminated. IN WITNESS WddEREUF, the undersigned authorized officer of the City of Tigard has caused thin certificate and release of restriction to be executed this day of 1'u, lye ��`/r'kL.LtJ S 1-✓/OIL �i.G. Title: 11."Ognwijf STATE OF OREGON County of Washington ss. On this i% day of , 19?`, personally sppr;ared before me the above named whose sirnature appear: hereon and who acknowledged to we that he executed the same in his offical capacity on behalf of the City of Tigard. Notary blies of egon My Co�piaaian Spires: 6.4 for reeerd...(�2'..._f.._.....ie !/� '.11Mo.P ni (IXLR THOMIM.M. M. mr e1 Ramos 6 Clemians Y) 978 f,,698 (Tsrr,')IT '110 t L j M STATE OF OREGON 1 ss h -wnty of Washington It I, Roger Thomism Director Records and Elactlom and [--Of iido Rr. o} Con- veyances for sold county, do fNreay certfy that the within Instrument of writing was received and recorded In b(%* of records No. -....___...._.._ ._. _ of sold County Witness my hand and seal offs ROGER THOMSSEN, Director of Records & Elections r Deputy elw 1 12 31 mom I City of Tigard INSPECTION REQUEST for INSPECTION TIME :fir&?.__— PERM;T NO. : DATE : DATE ISSUED:—L-j OWNERS NAME : _T 'L,� . ADDRESS : - CONTRACT0R -- TEST: Air D, Water D Visual Laboratory p RESULT'. Approved , Disarproved p Pending [] SKETCH: INSPECTOR DATE COTE : Attach suppiementol test data heret� I I City of Tigard INSPECTION REQUEST { I for Z I; INSPECTION TIME: _ PERMIT NO. : _ I I DATE: �'� DATE ISSUED :__1 Z OWNERS NAME . -1 - �� c _ I IADDRESS: 0/?,✓tTI CONTRACTO R : I-PT TEST . Ai► ❑, Woter❑ , Visual ❑ , Laboratory I] RESULT- Appro,,ad , Disapproved ❑ Pending [] I SKETCH. I { I 71 I O1< NSPECTOR DATE i COLE: Vs ch s ipplomental test data beretc] I I City of Tigard I INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. : _. DATE: DATE ISSUED :-- Z I OWNERS NAME : 1-2 c ADDRESS: L� � - ��Y c.�K 1��� ✓�' CONTRACTOR : le7- A- V 6 w TEST : Air p, Water[] , V'sual p , Laboratory p I RESULT: Approved p , Disapproved 0 , Pending [� SKETCH. I I I r Z. I INSPECTOR DATE rN0?E : Attach supplemental lett date �9,etaa w ALL SPACES MUST BE ENDORSED PRIOR TO APPROVAL OF THESE PLANS PUBLIC 140r.KS DEPT. BYfes!DATE.. .�.. �1_OL- PLANNING DEPT. BY BUILDING DEPT. BY._ . ._-- COUNTY HEALTH DEPT. BY... CITY ADM;N:STR'tT')R TICA,'.D 17.;TEIt 6,,:3T. BY_ G^NErAL TLL_PHQiiC U S A BY- - t -- - N. W. NATURAL GAS E'Y- - - P. G. E. T. R. F. D. BY._ D,1TE__ woo •�;�'kr.i;�i�`�tt°'•iti' °�ij�{11�ltit ,�=�y �,w� •.�M?'�:�� s - t tr'M#'`.• 1 R P• City of Tigard INSPECTION REQUEST for INSPECTION TIME : � PERMIT NO. -. DATE : .�1y� DATE ISSUED--/ OWNERS NAME : 04 A4 ADDRESSxL TEST: Air O, Water [3 , Visual ❑ , Laboratory ❑ RESULT: Approved O Disapproved O Pending p SKETCH: C �-C � 7�_ INS ECTOR DATE [OTE: Attach supplemental test dato heret- i I City of Tigard i INSPECTION REQUEST for I INSPECTION TIME' L)1V PERMIT DATE: 2JIIV DATE ISSUED :--I--/- OWNERS SSUED :_._.1---iOWNERS NAME : - --- --- -- I ADDRESS: __-- CONTRACTOR .' __._---- - _- - ---- _ - --__-- I TEST : Air ❑, Water❑ , Visual 0 , Laboratory ❑ I RESULT: Approved Disapproved O Pending p SKETCH: e i I I I PECTOR DATE NOTE: Attach supplersental test data heat] e I V" City of Tigard INSPECTION REQUEST for INSPECTION TIME: %=/-S� PERMIT NO. :� DATE: J 77k' DATE ISSUED :_L/ OWNERS NAME : 7 ADDRESS: 7- F1,0Lp CONTRACTOR : r_?4�'�lA 6,7-V TEST : Air C7, Woter❑ , VisualJU/, Laboratory ❑ RESULT: Approved,e Disapproved [I , Pending ❑ SKETCH. I I i 1 INSPECTOR DATE LNOTV Attor.A Supplemental test doto beret] I City of Tigard INSHECTION REQUEST for INSPECTION TIME : PERMIT NO. : I DATE: _-3 DATE ISSUED:__!L_ I OWNERS NAME : _ T.D ADDRESO Z�m- CONTRACTOR :__GOT__ _ TEST: Air ❑, Water p , Visual p , Laboratory [] RESULT: Approved , Disapproved ❑ Pending p SKETCH: I I I I I SPECTOR DATE IOTE : Attach supplemental toot date heretal I City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. :- _ DATE: ^_LL_ DATE ISSUED :---/ Z . OWNERS NAME : r_ CJ,C. ADDRESS: 1--c-17 _! CONTRACTOR : ---- _---- ----____ - TEST : Air ❑, Water❑ , Visual ❑ , Laboratory p RESULT: Approved ' , Disapproved ❑ , Pending ❑ SKETCH. I 1 f INSPECTOR.•_-i DATE [NOTH: Ateach supplemental test data hereto] l; II I Cot of a Y .,T g p INSPE^TION" RE JEST c� f o r _ INSPECTION TIME: �. �''r' PERMIT 0 DATE: 31 V,'?(l DATE S U E OWNERS NAME : ADDRESS: . y, f CONTRACTOR .' �Yh-fl-(Z46O Te�T : Aid r 9��iso oryRESULT: Appro pproved (� Pending [] SKETCH: /r" 'i'� i� Roir I INSPECTOR DATE I F-rTH: Attach supplemental test data beret a] I I I amity of Tigard INSPECTION REQUEST f 0 r N P E G T 10 N TIME - 4-7M,4�n) P E P.M I-I- NC DATE . A )ATE ISSUED )W N E RS NAME ' _42. 4:1!. -- ---- A r)D R E S S 4-0— 65-. ' rR A r,rnR IN I E 13 T 'Y' tO J RESUL. 1)v0 ; :uppi �vt;d Lj SKETrH.* IN PECTOR DATE 50TE: Attach suppiemenial test wvc ijor-t2l City of Tigard INSPECTION REQUES fur —5,f-t.17�/'✓ SPECTION TIME: PERMIT NO. :— DATE: -2 DATE ISSUED : IINERS NAME : 2' — ADDRESS: )NTRACTOR : :ST : Air 0, Woter❑ , Visuals Laboratory p -SULT : AporovedK , Disapproved ❑ Pending p (ETCH: i i I I INSPECTOR OATI TE Attach supplc:.—stal test data beret] 9 CITY OF TIGARD MECHANICAL PERMIT 1%TE ' ' % PERMIT NO. RECEIPT NO. " % ! t(' FEE 1. Permit Shall be obtained prior to commencement of installation, 2. Permit shall be obtained for all appliances which are to become a fixture to the building. 3. Relocation, replacements, alterations, or changes to burners and duct work require permits. 4. All work to be concealed must be inspected before cover up. NA 4ew Tnstallation.1 /Replace/Ll Relocation ❑ Addition ❑ Alteration rj 'O1gTR. i, /i %. ✓/ ✓� (l r OWNER_ DDRESS /.��J (f 5 ( � //l �' WORK AL ,r.ESS /(`/.?.S 41, APPLICANT TELEPHONE NO. URNACE - MANUFACTURER ���- TELEPHONE NO. IEAT Input rating (Btu Per Hour) Vent Size Flue Size UEL OIL ❑ GAS[� ELECT ❑ OTHER _- TOTAL SQ. FT. Top Floor Main Floor Basement GENERAL ITEM NO. FEE ITEM NO. FEE or Issuance of Permit .00 Boilers Over, 50 Hp I New - Under 100 000 Btu /4.00 Air Handling l0 000 CFM New - Over 100,000 Btu it Handling Over 10.000 CFM Floor Furnace va ora ve Cooler 3. Wall - oor - us}en e 14. Ven ari Tnstall ens 7.07— Vent System 3.0 Re a r - Heat & Cooling X00 Hood Bo ere n er 3 Hp 4.00 Domestic -Incinerator _ 0 toilers 3 to 15 H 1 7.50 omm ric nera or 20.0 Boiler s o 0 p In DO mer o s e _ Boilers n H y�•' INSPEC'.DR'S COMMENTS —_ APPROVED BY _ DATE ISSUED BY DATE _ Signature of Applican- EXHIBIT "B" CITY OF TIGARD CERTIFICATE OF OCCUPANCY AND RELEASE OF RESTRICTION The City of Tigard hereby certifies that the occupancy of the following described structure or premises with respect to which a restriction of occupancy was, on -1-Qn„Wry 2P , 19-Z.4., recorded. in Book 960 , Page 779 , Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRI17ION OF PROPERTY: Summerfield - Lot 06 As Recorded in Hook 32, Page 30, Plat Records of Uashtngton County, Oregon OWNER: (cr , nirr lrthi,r ^r BUILDING PERMIT NUMBER: 7h-06 EUILDING ADDRESS: 1(1125 S.'�. Centn�,_� ?riLG Tris is to certif.- the said structure meets With the require- ment; oC the Building Code of the City of Tigard and the above referenced restriction is he-eby released and terminated. IN WITNF56 WHERLOF, the undersigned authorized officer of the City of Tigard has caueed this certificate and release of restriction to be executed this day of ly Title: STATE OF OREGON s. Cowity of Wa-hington )J On this day of _ , 19_, personally appeared before me the above named _, whose signature appear: hereon and who acknowledged to me that he executed the same in his offical ca rarity on behalf of the City of Tigard. Notary Public of Oregon My Commission expires: 13219 EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (a) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Deed Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as s final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: ��--r c ` a <�`.. CySc �i�c�•��a a»���Oc� �4vc��y ��t• l..�b^ ADDRESS OF PROPERTY: \ �•� �� �IAME OF OWNER: rr a �� • �r ��h �k ADDRESS OF OWNER: IN 41ITNESS WHEREOF, the undersigned has caused this restriction to be executed this �� '—` day of OWNER: APPROVEN Title ByBuilding: �Pr: ,r,'a City of Tigard STATE OF OREGON as. County of Whehington 19 Pernally appeared before me the agave nem and acknowledged the foregoing instrument to be ,4a voluntary act and dead. J Notlary PubTic rD r gan My Commisoion' Expires: y'•i 9- 7y tn 7 HOMSBtN,Droom M a � ...»A.M.Pzr 2Vew�de. vet .......L-Depuh 960 X779 o A X aaf 3 d �z•� > c� i 9&v EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (a) on the following described lends prior to the recording of an occupancy permit releasing the restriction in the Deed Rer�nrsla of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as a final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: {a.1 '*A ADDRESS OF PROPERTY: -A t NAME OF OWNER: ��. �,_�, �eL_ P.� '�'��"� •ems ol�s.��� �v ADDRESS OF OWNER: . IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this day of 19' OWNER: Na APPROVED: Title 1 By: ui ng 0 c e City of Tigard STATE OF OREGON ) I County of WRahington ) as' 19 L:,/ Personally appeared before me the eve nam~!rd A0' �//�19JIS2>-11 and acknowledged the foregoing instrument to be volur4ery act and deed. a 2 to-t tt z e j r, o ery Public fcVr -Dragon My Commission Expires: �— / 9 i S� CITY OF TIGARD 12420 f. W. 1Mde i1rr0 TIGARD, OREGON W, APPLICATION FOR BUILDING PERMIT New Construction a Demolish ❑ Addition ❑ Remodel ❑ Move❑ ZONING DATE ISSUED I-ZIy _ BUILDING PERMIT DATE RECEIVED BUILDING FEE $ _OV No. PLAN CHECK $ 1A. SV ©Y'- 7 OTHER $,y P o iPlcoPo,�r /� VALUATION $�7,�,`j 3 S 0 �J7►TC RECEIPT No. 2 _ �t 'rw0 SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT N MAP N CENSUS tt TRACT - JOB N Architect or Engineer- - I j-:� L �`JtticS�tMc�c� oj Address l;3c�(' �� („1 1� (o�~ T� _3.c�Lt. r 17, 2 3- _Phone�j� - S� � Owner r� v Address --_-�_ -_ _Phone _- Builder Sn.., ----- — ---- -- Address _- #_ _ Phone---- BUILDING hone_ _BUILDING USE Single Res. Z Multi Res. ❑ Comm. E Industrial❑ OCCUPANCY GROUP No. of Storiec�_ Total Height--_---_ Area of Lot Type of Construction I II III IV (V Floor Area 8� _ 1 Lyob_ Set Backs: Front _y 0 Back e/O L.Side�-LD R.Side l/ -� Private Sewer Pipe Size_y p Sewer 11i,. ��_� Septic Tank water Service Pipe Size__ _ Storm Sewer Ditch ElDrywell❑ Street and Curb Reouirements `__.__ 0 Driveway Width___ IPA ~ ^---.-,No. of Parking Spaces__. SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNF.D�J FIELD CHECK BY DATE_ PERM17 APPROVED It is understood that all work will conform with applicabYe codes and ordinances of the State cf Oregon and the City of Tigard, Oregon, and that the building wil e e.::u ied until a Certificate of Occupancy has been issued by the City of PLUMBING PERMIT APPLICATION Jurisdiction of No. Type of Fixture Fee Permit No. '-d f-e Permit fee _yam Mater Closets (Toilets Permit Issues Bath Tubs _ -� _ Approved by _ Lavatory(Wash Basin Building Permit "power Receipt No. q _ Sinks-, D.shwashing _ Sinks Kitchen ___ Sinks. Ordiia kation of Building _' _ .--1.__ -_- - �- in si Bar — Sinks,-_blop 1 Automatic Dis lw'-F a—B er .c A ni�csal .,..�_ _ _LaundryTrays Name 1k Address of Qvmer _— _Drains, Floor Drains Area Drains-1 R.ei"riaerator Ra-'n- Dra iris Automatica� sher Name & Address of Plumber Fountains cin int _ _ Fountains, Hat ',rater Tank Water Se_r_vice Size _ __ Urinals Buildin Old or New) Alter, Repair.or_ a t^.h-�3asins-Trd nI sTI Lawn Sprinkler System Swimmy nR- Pooh_ ��er" -�_ 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. Al]. plumbing firms must be licenced by the City of Tigard and post a $1,000 bond, I hereby certify that I have road and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing. this tyF 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. r Signature of Applicant