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EXHIBIT "A"
CITY OF TIGAFJ) RECEIVED
APR 1 y 1974
C2WIF'ICATE OF OCCUPA14CY AND RMEASE OF RESTRICTION
CITY CIF TIGARD
The City of Tigard hureby certifies that tre occupancy of
the following described structure or Iremises with respect to which
a restriction of occupancy WB'., on /.; = _S 19�,
recorded in Book S; Papp „y , Deed Record of Washington
Coanty, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPI::,,YY
SUMMERFIELD - Lot 11
OWNER., Tualatin Development Company
BUILD--NG PERMIT NUMBER: 73-278
6ILDLNG .ADDRESS: 10225 S.W. Century Oak Drive
This is to certif,; the said structure meets with the require-
menti of the Building Cale of the City of Tigard and the above
referenced restriction is hereby released and terminated.
IN WITNESS WHEREOF, the undersigned authorized officer of the'
City o: Tigard has caused this certificate and release of restriction
to be executed this day of iJ192Y--
Title-
STATE
9Y` .Title:STATE OF OREGON
County of Washington )ss
Un this A I day ofy, / _r 19 7 Personally
appeF red before me the above named; , _ — whose
signature appears hereon and who acknowledged to met t-he executed
the same in his offical capacity on behalf of the City of Tigard.
c
Notary Oublic of Oregond
Nay Commission expires:
rUod for n-Ofd A 1-1
�»1O`3tt:HpMRR �h+w�rnr�1 P}�Jonr��+ti FI.,•„o.*
bow 970 v%F G95 ('/(
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MIBIT "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 resWrieaion of occupancy was, on
recor3ed in Book ;-;• Pape , Decd Record of Washingtrn
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY:
SUMMERFIELD - Lot 11
OWNER: Tualatin Development Company
(IBUILDING PERMIT NUMBER: 73�-2TB
BUILDING ADDRESS: 10225 S.W. Century Oak Drive
'phis is to certify the said structure meets with the require-
ments of the Viilding Code of the City of Tigard and the above
referenced restriction is hereby released and terminated.
IN WITNESS WHEREOF, the un,?ersigned authorized officer of the'
r
City of Tigard has caused this certificate and release of restriction
to be executed this �� day of
Title:
STATE OF OREGON )
County of Washingy,,,1 )as
On this /,_ day of 1. 19 Zy personally
appeared before me the above named whose
signature appears hereon and who acknowledged to me lheft 4e executed
the same in his offical capacity on behalf of the City of Tigard.
Notaryblit of OregonO
My Commtsion expires:
amity of Tigard
INSPECTION RE® UEs^r
for
INSPECTION TIME : PERMIT NO. : --
DATE: GATE ISSUED".--Z--L—
OWNERS
SSUED:_LLOWNERS NAME : 7
ADDRESIS : LST ---
C O N T R A C T O R :_- _--
TEST: Air J, Water Cl .Visual ® , Laboratory [3
RESULT: Approved , Disapproved CI Fending Q
SKETCH:
INSPECTOR DATE
L"'YE ' Attach supplemental test data hetet]
i
ALL SPACES MUST BE ENDORSED I
PRIOR TO APPF2OW L OF THt PANS
PU9LIC WORKS DEPT. By DAT�__ __�.J.�/
F L'. C, D-PT. D T
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' �..;TU,...L _.,:; is •. -- --
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CITY OF' TIGARD MECHANICAL PERMIT
OA`I EPERMIT NO.
RECEIPT NO - —
�•- i 4 y
FEE -- -.
1. Permit shall be obtained prior to commencement of installation.
2. Permit shall be obtained for all appliances which are to become
afixture to the building.
3. Relocation, replacements, a'.t.•rations, or changes to burners and
duct work require permits.
4. All work to be concealed must be inspected before cover up.
New Installation IRep .ace ❑ Relocation ❑ Addition ❑ Alteration ❑
CONTR. de �Qc yt;� OWNER_ . :Z ill t —
ADDRESS tl�'_.. • C =%�!��_ `� -- _— WORK ADDRESS 1< ' '�v•e
APPLICANT �
_a��
7� -
TELEPHONE NO, _ ��? '--�%•='j
FURNACE - MAIv'UFACTURER j � r2;�C � c%_ TELEPHONE NO.
HEAT Input rating (B Per Hour) �_� Vent Size Flue Size -t----
FUEL OIL ❑ GAS W ELECT ❑ OTHER
TOTAL SQ. FT. Top Floor __ . �' , ' Main Floor 5 �- Basement -�-�
. ..___�.
GENERAL
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _ .00 Jr Boilers Over 50 Hp
New - under 100 000 Btu }.00' ___ Air Handlin&10,000 CFM _ _�8Q
New - Over�,0-OOBtu _ A r and i _O-VEtr 0.000 CFS! _4
Floor urnace - - . Evaporative Cooler _ �_ _ 0
Wa - Floor - �_us`e-nc`�ed _ --4-�_. ---ifen t-F�n ---------------- 2-001
Ins t a 11 Ven s— �--- � - _._Ys e----- ------- -L0
II
Repair - Heat & Cooli_nHood
g `
Boilers Under 3 H �- 4.00 --Bomes�ic 1n;..�ncrator _- 0
Boilers—3 15- . —Lomm.y�nciiiera-torp-___Y
Bo er. s 15-10 3O�+D� 10_00 --6Mer-got-`�`istecc7 _
'3oilers 30 to 50pY�___�_
INSPECTOR'S COMMENTS
APPROVED BY DATE TSSIJED BY _ _ _ I)ATTEJ
Signature of Applicant �� �1 ,
City of Tigard
INSPECTION REOUEST
for
/w -�--( _-------
INSPEG i,Jil TIME : PERMIT NO. :
DATE: -2/ :k,/ ZV DATE ISSUED'._L_I
OWNERS NAME :
ADDRESS
CONTRACTOR :--
TEST .
ONTRACTOR : —TEST . A r 0, Water � , Visual 0 , La', ,ratory n
RESULT: Approved C7' Disapproved 1 Pending p
SKETCH:
1
INSPECTOR DATE
I [c'1E Attach sup h;emental test data hereto]
I
I
i
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME :-"'�_ PERMIT NO. :
DATE '. / / % DATE ISSUED----Y—' -/—
OWNERS
SSUED_---Y—' _/OWNERS NAME ' _ T /�• �– • _
ADDRESS : )iy �Ficc:..n
I CONTRACTOR
TEST A t ` pLa'- ratory C-1
RESU' : Approved , Di
Disapproved
_:1 F'rndlno Lj
SKETCH.
I
I
I
I
I
INSPECTOR DATE
ICN TF AttaCh cupplemertoI test Batu her0t11
1
�i�
City of Tigard
INSPECTION REQUEST
for ,
SPECTION TIME: PERMIT NO. :-
DAT E '
q. ._DATE: 11,' DATE ISSUED :_1 L__
dNERS NAME : -T' C
ADDRESS:)- __ -__--
)N T R A C T O R : _ L CL' ckt-
;ST : Air C], Watery[] , Visual [7 , Labiratory
ESULT. Approved ,F�, , Disapproved O , Pending p
(ETCH.
V 7�
INSPECTOR DATE
TE � Attach supplemental tell data heretol
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: &--`!4��PERMIT NO. : I
DATE: L //O/7� DATE ISSUED : J --
OWNERS NAME :
ADDRESS: /07
I
CONTRACTOR
I
TEST : Ait G, water '; Visua�, Laboratory ❑
i
RESULT: Apnrovedg , Disapproved ❑ Pending ❑
SKETCH:
INSPECTOR DATE
[OTE: Attach supplemental test data beret]
City of Tigard
INSPECTION REQUEST
for
JI
INSPECTION TIME :! PERMIT NO. '
I DATE: ! / / DATE ISSUED*—, L_
OWNERS NAME :
I
ADDRESS ' "L'
I
CONTRACTOR '-
TEST .
ONTRACTOR :_TEST. A r ,_], Water ❑ , ��is�;al p , La'- ,ratory [l
RESULT: Approved ' , Disapproved 1 , Pendtnc, p
I SKETCH:
I
I
I
I
I
INSPECTOR MATE
TE !Attach sipplementoI test data hereto)
L
1
City of Tigard
I
INSPECTION REGUEST
for
I
INSPECTION TIME : PERMIT NO. .'
DATF:!--� DATE ISSUED'---Z---/—
OWNERS
SSUED'_._1__LOWNERS NAME : _ _- 0
ADDRESS : / ''T
I CINTRACTOR -- _--
TEST . A r D , Water ❑ , Visual ❑ , La', ,rotary [I
RESULT. Approved ;8�, Disapproved 1 Pend!ng
I SKETCH:
I
I
I
INSPECTOR DATE
e.mentaI test data hereto]
77
Aoiw
PLUMBIK, PERMIT APPLICATION
Jurisdiction of -
Fee Permit No. 7 5-1'7v'1"`
No,
Type of Fixt�:rP Permit fee °t'
II Co Permit Issued i�_ ;r�� •.,..
Water Closets Toilets i Approved by
Bath Tubs
�C Building Perm
Lavator 'Was Basi.r� Receipt No. 9
Shower
shwa t`= u
Si.nks�{itchen ----- /� .���
Sinks . Ordinary - Loc ion of Duil n
Sinks S1cP
-- Automa i.c MEwash_e_r ---_---- A
Dis Naape be Addres OxIe h�
Laund_-ry__Tra s
_ Drains F lccr _ __.�----------
D -a,ns
----
Ura,ns , Area .-- _ -
afns�_Rer ire.a t r ,
1 Rain Drains ]dame & ddress of' Plumber _
Automatic Washer
ount7 rl 7n
Fountni oda ate. - - ------
Ho
Ho ester ank
Water Service Size �- Bui' (Ol.d c r ew (P.iter Repair or
Urinals ark ins a
- -� �• ; �. ,.
LawnSprinkl r S _,tem - 7T,er — --
S A.
rink +em _
This ppe
permit becomes null and vuid if work cr constructi^n auth:riled is not
wi}.h.n t ) ddY>> or if construction or work
1:jsuspendedcr abandoned
fforr a period of 1," ) days at anv time after work000 bone
All plumbing firms must be licensed by
the City of Tigard and post a Sl,
he
am
I herebycertify thst I have read and examined this application and know thisst!
nverning
the granting of
:;rdinances
to be true and correct. All provisions of lava heaein cr not,
of work will be complied with whether ityctfi' -he provisimance of
permit does not presume to give authlatir tconstruction oro violate or nthe pprovisions
of any other state or local law regu
construction.
c �
• l I,dGt, LL/�itl
/ Sign u f A -,1 ant
,,I/ 3/
CITY OF TIGARD
11420 L W. Mein a•..r
TIGARD, 0111800141 "
APPLICATION FOR BUILDING PERMIT
New Construction ❑x Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING P-D DATE ISSUED 11-27-73 BUILDING PERMIT
BUILDING FEE S tno_np_ No.
UA^,R itECEIVED 73-270 I
PLAN CHECK S 10.00
BY �.47.0—recording VALUA" 'ON $ 32.6
"— OTHER $--i.89 state RECEIPTIo. EI/Y
TOTAL $iae,n4 �.
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT A 11 _ MAP N CENSUS TRACT __._ JOB A
Architect or Engineer Tualatin D yA1npman* Co-
Address Phone,639_3=
Owner eam• __ —
Address Phone _
same
Builder ---- --
Phone _
Address
BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ industrial❑
OCCUPANCY GROUP I No. of Stories 2 Total Height—_^— Area of Lot
Type of Construction IXXXXXXIIIXXIVX V Floor Area B - -- 1 13866�—
Set Backs: Front 10' Back 11110"L.Side 6'2"_ R.Side p!
Private Sewer Pipe Sizes_ Sewer kine r.i ._ Septic Tank ❑
Water Service Pipe Size___," Storm Sewer Ej Ditch ❑ Drywall❑
Street and Curb Requirements subdivision and P-D --
Driveway Width - 18' — No. of Parking Spaces
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATTON
ADDRESS ASSIGNED 02W�._.;.
FIELD CHECK BY OB DATE
PERMIT APPROVED BY Spurr
it in understood that all work will conform with applicable codes and ora nancea
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
1tgnrd Building Inspector.
nn-ute^ Applicant
X939
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 issur ruleaae
as soon as a final inspection determines that the construction
is satisfactorily completed)
DESCRIPTION OF PROPERTY:
RLC6Fa�c� \ �aeo� ?,�� P SOAR
" o Was�,r.��to- �o �., G• %—eN
ADDRESS OF PROPERTY: — r �
NAME OF OWNER: -, 1 . cL Xr,, z „%i _—n
ADDRESS OF OWNER;
IN WITNE55 WHEREOF, the undarsigned has caused this
restriction to be executed this , day of
OWNER:
-- ame
.. .� /
APPROVED: , e
1
By: lyLc. z
Building Official
City of Tigard
STATE OF OREGON
County of Washington 8e' 19 1�
Personally appeared before me the above named „"MLGE
MAR::HAII and acknowledged the foregoing
instrument to be hi; _ voluntary act and deed.
N to y Public far regun
My Commiecion Expires:
J� -19-74
fV k-1 CU-d for O.MfA �.��....: .... .....1f17"�04.
_ tiIGEA THOMRSEN. D�llo~of Mw„1s 6 iHinn�
Ri l)� 955 rnf_ U
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STATE OF OREGON
SS
County of Washirryton
I, Roger Thomssen Director of Records
and Electlons and Ex Officlo Recorder of Com
veyances for said county, do hereby certify
that the within Instrument of writing was
received and recorded In book of records
No.
of sold County
Witness my hand and seal affixed.
ROGER THOMSSEN, Director of
Records d Elections
4�
t .
{
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 prinr 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 construction
is satisfactorily completed)
DESCRIPTION OF PROPERTY:
'Z&
ADDRESS OF PROPERTY: �o ��4 r',V
NAME OF OWNER: �r
ADDRES5 OF OWNERS
IN WITNESS WHEREOF, the undersigned hao caused this
restriction to be execut9d this ._., day of
OWNER:
Name
APPRr '_0: Title �:
By: _
Build—ng Official
City of Tigard
STATE OF OREGON
County of Washington as. NOViJIBER 27. 19 1
Personally appeared before me tho above named GtX1}7aE
1-ALL. and acknowledged the foregoing
instrument to be his voluntary act and deed.,
N `t ry Pub is f r rsgon
My Cominisaion Expires: 2-19-74
CITY OF TIGARD
11410 S. W. Main &treat
TIGARD, OREGON 9711:1
APPLICATION FOR BUILDING PERMIT
Construction ER Demolish ❑ Addition 0 Remodel El Move ❑
ZONING DATE ISSUED BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ /d`1- c'0 No.
BY — PLAN CHECK $ /c' USI -
�__� OTHER $ 00 ettINVu70wc:- VALUATION
�HT.A•1:, -�7ATc $ RECEIPT No.
TWO SETS OF PLANS AND PIJT PLANS MUST BE FURNISHED WITH APPLICATION
LOT M � \ -,� MAP q— CENSUS TRACT W_ JOB # c 45 \
Architect or F gineer
Address-. .c_- I:, eta-_11 = p�•�Q _ Phone
Owner
Address Phone
Builder
Address Phone
BUILDING USE Single Res. Multi Res. ❑ Conlin. ❑ Industrial❑
OCCUPANCY GROUP Z No. of Stories__ Total Height___- Area of Lot
Type of Construction V Floor Area B -- 1 %,y 2y--
Set Backs: Front \CBacke' �r�' L.Side b' j1 R.Side '�►' ((����'' � �
Private Sewer Pipe Size Sewers V:, ptic Tank l_J
Water Service Pipe Size_L Storm Sewer ``D`'i'tch ❑ Drywell❑
Street and Curb Requirements- e�_ ���y
Driveway width �_' _- — No. of Parkinq Spaces ^
SEPARATE PERMITS REQUIRED FOR SEWER AND Pu(JMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED 1(J,Zj S Z c C'/ __� GE• _
FIELD CIIECK BY DATE
PERMIT APPROVED BY
it is understood that all work will conform with applicable codes and ordinances
(if the State of Oregon and the City of Tigard, ore,jon, and that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
rigard Building Inspector.
S-ig cure 9AApplicant
i