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10395 SW CENTURY OAK DRIVE
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CITY OF •? IGA RD
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Owner:.... ....Tu-9.1ittin_q0v.4t1.aRmVn.t._G.om-?A!.Y.Termit No...Z3.-��.?........
Building Address........1..Q3.9.5...3rW, �nturY.. Uak. Qriv�.
CertificK is hereby given thia......?th....day of_.....$aptem4�� 19.31. .
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
i
BUNK Inspector
of Tigard
INSPECTION REQUEST
1
for '
A—L' -
!NSPECTION TIME . ^'1___ PERMIF NC _ _-
i
DATE .' 79 DATE i SSUED
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OWNERS NAME : --7, �—
AnDRESS: l-03PS'
C#0N fRAr,TOR -2 � -
; EST jy--ter[] , V' .,:a• e ab �et �r,, -
RESUL ,p raved .. ;;uppt).cd G
RKET(;H:
t1VSPECTOR DATE
rOTk . Attach aupp MIme nf01 t4lt uutu hereto
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WALMMAMM
,,qty of Tigard I
INSPECTION REQUEST
for !
NSPECTION TIME . PERMIT NC. . I
DATE . DATE ISSUED I
OWNERS NAME : _. 1'
4nDRESS: Lal - /
CnNTRAr'rn R
; EST N ter[] , ": _ r. , '
RESULY : s�P- rowed ' ',� ;uppt).ad G p
SKETCH:
IN PEC,TOR DATE
007E : Attach supplemental test uuta her,-tv,
of Tigard
INSPECTION REQUEST
frr
N',PECTI ON rI ME . PERMIT NC. .
DATE : _ /�B' 1 -)ATE ISSUED .—,
OWNERS NAME *
ADDRESS:
ry I-) Tcl
EST : , N .terp , `J: _,. ;; '_��,-►ct.�r,, _�
RESU!',- roved ,uppio,ad G v
S KE7CH:
--- ---_ --L J_
INSPECTOR DATE
50TE : Attach sup pie mental tost u.i i.e.r J
;;ity of Tigard
INSPECTION REQUEST
;far
+VtiPECTION riME . PERMIT A1C.
DATE : I / t '73 DATE ISSUED
OWNERS NAME : T/2. ---
AUQRESS:
O N"r R A r,T n R : -
: ES1' V ter 0 , V' .�.. I] . _ah:►et�r; ',:�
RESULT*, , ruved `� ;uppr7)•wdd G I;.]
SKETCH.
I SPECTOR DATE
[OTE: Attacn supplemental tent oats herrto�
1
City of Tigard
INSPECTION REQUEo i
for
INSPECTION TIME: _— - PERMIT NO. : ---
DATE: DATE ISSUED :--/ L—
OWNERS NAME '
ADDRESS:
TEST : Air o, Water❑ , Visual ❑ ., Laboratory ❑
RESULT: Approved V(, Disapproved ❑ , Pending ❑
------------
SKETCH:
,. Z L
INSPECTOR DATE
Cotg: Attarn supplemental test data hereto]
t s iv t
,ity of Tigard
INSPECTION eRcEQUEST
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._----------- " i -%-- _.__.._._-- -
INSPECTION TIME: -' PERMIT NO.
DATE: DATE ISSUED :—
OWNERS
SSUED OWNERS NAME :
ADDRESS:
C("N'rRACTnR
EST 'i Water[] , Visual I_aborutory 0
RESULT', Approved Disapproved 11 Pending p
SKETCH:
INSPECTOR DATE
NOTE: Attach supplemental test data beret 01
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: / j�EY 73 DATE ISSUED :— I Z--
OWNERS NAME '.
A D D R E S S:
C 0 Wr R A C T 0 R : _
a
EST : pair ;_,, Watery , V;suai ,k!!. i_aboratory 0
RESULT: Approved ' , D;sapproved G , Pendhi
SKETCH:
INSPECTOR DATE
NOTE: Attach supplemental teat data he►eta]
City of Tigard
INSPECTION REQUEST
for
� Ole
INSPECTION TIME: PERMIT NO. :
DAT : ! R3�23 DATE ISSUED :- / Z _
OWNERS NAME :
ADDRESS: --------
C O N T R A C T O R '
TEST : Air El, Watery , VisualLaboratory p
RESULT.' Approved i Disapproved Cl Pending []
SKETCH:
i SPECTOR DATE
[OTE ' Attach supplemental test data beret 01
Ml wt a w wt ■
1 '!
i city of Tigard
INSPECTICN REOULO"T
for
Q .
I INSPECTION TIME : PERMIT NO. '
DATE: _ZL/G17� DATE ISSUED
OWNERS NAME ' _ T ►�
ADDRESS : IU3 95 Dery-7vizy a4✓,
i CONTRACTOR :-
TEST
:_TEST .4 r LJ, Water, I/181-cl*, Lo'- ,rotor, rl
RESULT, Approved , Disapproved 1 r►;nding
I SKETCH:
I
I
I
71ZP ECTOR DATE
NOTE : Attach supplemental test iota hereto
1
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City of Tigara
I
INSPECTION REQUEST
for
I INSPECTION TIME : XL;I 1r7 PERMIT NO. :
f DATE: -6 DATE ISSUED'-
--,'_1--OWNERS NAME . 7 C• �___ _�
IADDRESS : la,T -2/
I
CONTRACTOR : _
ITEST A r J, Water �] , %lisval O , La'- .ratorj (l
IRESULT: Approved , Disapproved 1 Fending 3 _
I SKETCH:
407,7 torp % M7i 0,04e' of
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INSPECTOR DATE
I �N iU Attach supplemental tes' data hereto
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PLUMBING PERMIT A"LIC TION
Jurisdiction of
S
fo. Type of Fixture Fee Permit No. _jj_ 41�P x
Permit fee ''_ —
Water C] sets (Toilets� "'''' Petmi is Tseued Ci�
ath Tubs Approved by
Lavatory a.g as n Building Perm-TV -ly/
shower Receipt No. --i____
a n s Di shwasi
Sinks. Kitchen
Sinks. Ordinary LcTction of Building /-�
iks, Bar
Sinks Mop
U
omatin Disriwasher.,.,
s osa 'W
un3�ra s T Name g Address of Owner �GA
ains Fl(,or . Agr:a jo (�4
Drains. Area
1'a ns. Rer] U'y r .2
Rain Draiiis
Tu -oma c Washer ^v,.: Name & Address of Plumber ,�„�bcj e-.
Fountains. Drin n 1
Fountains, Soda
Hot Water Tank
Water Service (Size "ori
Urinals Building Old or w Alter Repair or
ac - asns=- acrd" n ,�
,� r n �er aa�,em
mm. n Pool Other
n er System
2 —
e1
is peniit becomes mill and void if work or construction authorized is not
ommenced within 60 days, or if construction or work is suspended or abandoned
or a period of 120 days at e.ny time after work is commenced.
11 plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that I have read said e:,%mined this application and know the same
to be true and correct. All provisions of laws and ordinances governing this type
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 camel the provisions
of any other state or local law regulating construction or the performance of
construction.
Applicant
S ature o7
NG
CITY OF TIG,ARD
11410 S. W. (Main ffrpf
TIGARD, OREGON W=
APPLICATION FOR BUILDING PERMIT
New Construction ® D(Imolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING PD DATE ISSUED BUILDINGPERMIT
DATE RECEIVED 4-12-73' BUILDING FEE $ 6t,,Op No. 73_117
By
PLAN CHECK
OTHER $ 1D.00 VALUATION $jL7,97()
TOTAL. S 782,00 RECEIPT No. �� ___—
TIRO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICA"f ION
LOT -,21 MAP N_281 11C CENSUS TRACT - 41-8 ,- JOB A
Architect or Engineer__ mu.'..tin ihwt^ •�t Co. _—
Address— . ..... Phone—
Owner ---
Address —.-----Phone--
Builder
Addr-e s - —Phone _
BUILDING USE :tingle Res. Multi Res. ❑ Comm. ❑ lndustria.l❑
�x..LYANCY GROUP� Nu. of 7 Gii6bi� %,ta: Ileiy^ht- Area CSR !-=t
� ^
Type of Construction LU V Floor Area B_ 1 1,208 2
Set Backs: Front 10 _ Back 1 0 L.Side__X 5---.. R.Side 5
Private Sewer Pipe Size_ _4" SeweKumL _ Y_ Septic Tank ❑
WatQr Service Pipe Size Vfait Storm Sewer ❑ Ditch ❑ Drywell❑
Street and Curb Requirements existing
Driveway Width is , _� No, of Parking Spaces`
SEPARATE PERMITS LEQUIRED FOR SEWER AND PLUMBIN.;
SPECIAL INFORMATION
ADDP.F.SS ASSIGNED 10395 S.W. 0entury Oak Dr.
FIELD CIIECK AY� --_� ` _ --------`DATE_ -73— M-
r -
PERMIT APPROVED BY f_-w
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 will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
S gnaturee o"plli ant