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10155 SW CENTURY OAK DRIVE-1 0 Ln Ln bd CD r+ �f 6 y + LAh L0 ti �9 to J 77 + l w :cc .j ti yy� (tri Qj M h; Cn tm 8 - r Ell Ln z H €i G i r + m � _ m J w 1- 0 v N 7 fi n O 10155 SW CEN'T'URY OAK DRIVE RAMC C NVO XHn lNgO MS W OT 0 U 4-) C E Q O CD ' I � � v o r rti, E: A 1 4J N f a r- co [z, c3n fcnw [s, i to .y O J o c, ►��ii c3 �4 < r R• W I T - o ►, I I W V 114 o: - ~ n � IN Ln f=1 -1 Mk-IJ!' S-r r it CITY OF TIGLRD MECHANICAL PERMIT sip-,/-Iy DATE— 2�� 7 PERMIT N0. 1 y /-� RECEIPT NO. BY i FEB — 7- --� 1. Permit shall be obtained prior to commencement of installation. 2. Permit shall be obtained :or F.11 appliances which are to become a fixture to the building. 3. Relocation, replacements, P.Iterations, or changes to burners and duct work require permits. 4. All work to be concealed must be inspected before cover up. New Installation ep-lac�' Relocation ❑ Addition 4"? Alteratior L] CONTR.V �..���:jai ,, OWNER z:�{ ADDRESS /✓.�l'l� �•l F�./!6 WORK ADD ESS �`/ r 4✓•i[ .,�fC�/e/?r 4,, APPLICANT l Vier (Zile.. �i �- TELEPHONE NO. V FURNACE - MANUFACTURER ,l 41�1r.LlLGL TELEPHONE NO. HEAT Input rating (Btu Per flour) le,,(.a,mi• Vent Size y Flue Size FUEL OIL ❑ GAS® ELECT❑ OTHER TOTAL S0. FT. Top Fluur .-+ Main Floor 1 1Ba:,ement - GENERAL ITEM NO. FEE ITEM N0. FEE For Issuance_ of Permit 3.00 Boilers Over 50 HD 95 0 New - Under 100,000 Btu 4.00Y,_ Air Handling 100,000 CFM 75.0 New - Over 100,000 to -Air Handling Over i0100 CF Floor Furnace Ova ora£ive Cooler Waw—hoar - Suspended 4.00en an nsns�Taye-As -,.uD eni- sem 3.0 Repair - Hea —& Cooling .0U Hood Boilers n er3 Hp Domen£ ci"THHHerator 5.0 .—Innrao 2U.0Boilers tom comm Boilers-to 0 H 10.00 _ OtherNoMsTeT_ Boilers 30 to 50Hp _ INSPECTOR'S CfjPU4ENTS APPROVED BY DATE ISSUED BY DATE We''Ir e-I et (1, L Signature r ��' Nl i City of Tigard INSPECTION REQUEST for INSPECTION TIME : PERMIT NO. : _.__.._ LATE : 3 04'�'L� DATE �SSUEIU: .. 1� OWNERS NAME ' ADDRESS : �v C014TRACTOR :________.__. «-+(c . TEST. Air 0, Water [] , Visual U , Laboratory C7 RESULT Approved , Disapproved 0 , Pending 0 j SKETCH' S I SPECTOR DATE LN )7E Attach supplemental test date horst] ALL 5a `+ t TO �-,t-� hC+.<<+it �_ 0- c " i t t:XIiIBIT "B" 17090 CITY OF TIGARD ClIoMIFICATE OF OCCUPANCY AND RELF.ASF OF RESTRICTION 'The City of Tigard hereby certifies that the occupancy of the following described structure or premises with respect to which a resl.riction of occupancy was, on �--/•!7 __, i9_, recorded in Book cptr�- , Page y/Z , Deed Record of Washington County, Oregon, is hereby authorized and approved. DESCRF ION OF PROPERTY: �.c) 7 e OWNER: �G{N�/�/i K� [�L-(J.'��Gf'E�17t7C 7 1�'• _ BUILD_NO PERMIT NUMBERS 73 IBUILDLNO ADDRESS: /U/S S. cU. Y OAK pe vC This is to certify the said structure meets with the require- ments of the Building Code of the City of Tigard act the above referenced restriction is hereby released and terminated. IN WI'T'NESS W11EICEOF, the undersigned authorized officer c: the' City of Tigard has caused this certificate and release of restriction to be executed this _1 day of f�a�. _ L9 IV. air Title:— STATE OF ORMON ))ss. �od to//.a+rd-•.�,- /L R06EA TTtOMl6EN,pincret d Awe.d�6 tinerlons County of Washington ) \aQ�c�� � on this _ day of arc i , 1971/ personally appeared before me the above named _ , whose signs pure appears hereon and who acknowledged tcme that he executed the same in his offical capacity on behalf of the laity of Tigard. Notary Pub is of Oregon 0 My Commission expires: C ^r r $ a \ . �r � C City of Tigard INSPECTION REQUEST for cL INSPECTION TIME : PERMIT NO. DATE :_ DATE Ic UED: OWNERS NAME : ��• �' ADDRESS I CONTRA!'`rOR :—,L TEST. A'r J, Water Lj , Visual I_a±• ,ratory [1 RESULT: Approved 911", Disapproved W7 Pending J SKETCH: I 71 I I I I INSPECTOR DATE ILNOTE ' Attach ;upplemental test data hereto 1 City t of Tigard , i Y INSPECTION REOUEST for IySPECTION TIME : PERMIT NO. : I DATE: / DATE ISSUED:___L� OWNERS NAME . —ZD� -C _ I b-- / « S ADDRESS ' ��� �—y I CONTRACTOR :— �N S, TEST . .4 r ;.] , watier [ , Visual O , l.0" ,ratory 0 —RESULT_ApprovedW , Disapproved 1 , Pending I I SKETCH: I I I I I INSPECTOR GATE IOTE: Attach supplemental test data hereto 1 1 t City of Tigard INSPECTION REQUEST for r 1 0 SPECTION TIME ' ^A.. PERMIT DATE: DATE ISSUED :__/ / INERS NAME : )-, ,--)-c ADDRESS: )NTRACTOR ST : pair U, Water[I Visual p , Laboratory p 'SULT: Apnroved ,4. , Disapproved ❑ , Pending ❑ (ETCH -p) ''z e.0 oz— INSPECTOR DATE 7E: Attach supplemental test data beret d�� City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO- :.- DATE ' O_ :._DATE: 11-1111;;7 ! DATE ISSUED :--L Z OWNERS NAME : i:l- (' ADDRESS: Veo Y - F- CONTRACTOP : I Irte, TEST : Air G, Water❑ , Visuuj , Laboratory [] RESULT: Approved , Disapproved ❑ Pending O SKETCH.' U INSPECTOR DATE 50TE : Attach supplemental test data berets, City of Tigard INSPECTION REOUEST for i INSPECTION TIME : -? PERMIT NCS. : __ IDATE : ,r227L DATE ISSUED:_1 L_ OWNERS NAME . D,,-, ,.1 I A D D R E S S ? /D/ 5 5 I CONTRACTOR : TEST . A Water [] , `.visual La' ,rotary Cl i RESULT: Approved, Disapproved _1 , Pending ❑ I SKETCH: I INSPECTOR DATE OTE : Attach supplemental test data herstj 1 i I City of Tigard h"ISPECTION REQUEST for INSPECTION THAE : PERMIT NO. : _ DATE:& 7 72 DATE ISSUED:_ Z OWNERS ;ME : ADDRESS : .4 CONTRACTOR :---------.- TEST: ONTRACTOR :_—._ _TEST: A r J, Water ❑ , 1lisua1 0 , l.a!• gyratory [I RESULT: Approved EJ Disupproved\>�T , Pending E] SKETCH: INSPECTOR 'DATE E : Attach supplemental test dntn hereto v 41 -WORMN 4 1 MKIT APKICATICO Ably AO Nfult _ � .� Pe7 r kr e3 pt No. at ft f BU3 ins / S ._._._._- r �totr u oma c ne un er_. .. M A Address of lumbe s Pr __ �..,....�a..� _ 1�tor ery ceY&ff re � ti • - s �— -- aAZIer, R air or, III r rmit becomes null KM volE! if 'wO�Y'ic or oonstruct4on authorized is not obm�ft ced within_ 50 days, or i�f C4"' rvction or work is Suspended 01- abandoned -far a period of 120 days at 011Y W" 44%, er work is comence kl plumbing firms must be 1100"04h by the City of. Tigard and post a 1.1,000 -boad. I hereby certify that I have twOlMd anti VWRmined this application and know Ve ewe to be true and correct. All, prOVIslona of 'lOws and or�tiinanr.es g$overkn this tY3x of work will he COMPlied wi*h Obe�ther Specified herein or not, the grantingdf e permit does not presume to ,(ffive suthoriey to violate or cancel the provisns bf any other state or IMP'! law roguloting construction construction. or the perform�oe of cOO 'pA�-K t V l fi,�lr'e a tican - 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 a final inspection determines that the construeticio is satisfartoriiy completed) DESCRIPTION OF PROPERTY: p ` ] t �!-C..V r- da ADDRESS OF PROPERTY: NAME OF OWNER: Mr t3. !fie .r ADDRESS OF OWNER: t IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this �= day of x,)L o , 19—N OWNER: l a Ipb APPROVED: Title By: /Building Official Cit-; of Tigard STATE OF OREGON County of Washington as. _ November , 19 73 Personally appeared before me the above named Roy Brawn and acknowledged the foregoing inetr::ment to be voluntary act and deed. r ' Notary- Public for Oregon STATE OF OREGON My Commission Expires: 1/16/75 � — ss County of Woshinyton f, Roger Tbotnssen Director of Records and Elections and E■Officio Recorder of Con- veyances for sold county, do hereby certify that the within instrument of writing was received and recorded in book of records No. - - ..... NnE of sold County Witness my hand and seal affixed. ROGER THOMSSEN, Director of Records b Electlary 6;�' NII,:I Qac EXHIBIT "A" a CITY OF TIGARD Residential Structure Occupany Restriction KNOT: ALL MEN BY THESE PRESENTS, that occupancy of residential structurq (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 ralsaae as soon as a final inspe^tion determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: S v a..T-�4 . V-,\c1 - ca % VX Q�.Lba'�y'a G� �1+a L\�. •��*e b•. ��a..�e��'(V � t�l.�Oh ADDRESS OF PROPERTY: NAME OF OWNER: ADDRESS OF OWNER: r N IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this day of N d" 19 OWNER: APPROVED: J Tit1s 8y: Building Official City of Tigard STATE OF OREGON County of Washington ea' November 6 19 � Personally appeared bufore me the above named Roy Brown and acknowl,90, ' the fnregoing instrument to be him voluntary act and dead. i Notary Pub is far Urogon My Commission Expires: 1/16/75 .. ...rte.. . ._._.�,..W } CITY OF TIGARD 11410 L W. NH1n Nnrt TIGARD, ORIGO" 9=1 APPLICATION FOR BUILDING PERMIT New Construction Demolish ❑ Addition ❑ Remodel ❑ Move❑ — p-D - 11-6-73 BUILDING PERMIT ZONING DATE ISSUED_ � BUILDING FEE $ 90_Dp No. 7- 2,1,E DATE RECEIVED_ -- _ PLAN CHECK $ 10.00 BY OTHER $ ��pediny VALUATION $ 21.300 iECEIPT No. y X3 TOTAL1 TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT N Z 8 MAP M CENSUS TRACT W-6 JOA M Architect or Eng-neer_jUejatln Development Co Address 1a__S,-W..11bth Avg ----- --.— Phone- 153D — - — owner aamo Address ---- Phone —�.-._------- - -- __ ------- -,_..—_ Builder same -- Address BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUP I No. of Stories I Total height_, Area of Lot mype of Construction D(X)"XXMXXAb V Floor Area B--- 1 1323 2 -- Set Backs: Fr:)nt10' Hack 12' L.Side_ 4' R.Side 4' Private Sewer Pipe Size_- 4".__ Sewer_k"g ig v_-Septic Tank ❑ Water Service Pipe Size3/4" Storm Sewer © Ditch ❑ Drywell ❑ Street and Curb Requirements^ subdivision and p_D Driveway Width 1p' M No. of Parkinq Spaces—___ SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING, SPECIAL INFORMATION ADDRESS ASSIGNED—_- 10155 S.W. Century Oak Drive` FIELD CHECK BY_ _JB —��-_ _—_- . .__-___ DA1'f;_11-6,73 PERMIT APP'ROVEu BY-(" 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. ' Sgnature ` Applicant r r