10420 SW CENTURY OAK DRIVE 0
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CITY OF '7-75 N° 0188
BUILDING PERMIT APPLICATION TIC ARD DATE _-, 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
54tollf Hanne 10420 :),Ue Century Oak U
QWNER ADDRESS BUDDER PHONE
Weata;rn Wood p"oducts ENGINEER
RWII B _n ARCHITECT _ DESIGNER
❑
STRUCTURE _❑NEW LJ REMODEL ADDITION ❑REPAIR_ ❑RENEW.IA�L ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOLIS❑PATIO ❑CAR PORT [)GARAGE ❑STORAGE❑SI_AB [FENCE
I ]BOND ❑MOVING ❑CONDITIONAL USE [.❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUrANCY — LAND USE ZONE----BLDG.TYPE FIRE ZONE_ PLAN CHECK BY —� HEAT_,
[►igat+,� 1„ " gyp board uallo A cef ing–insta11 vents
_—
save*--one roof—Installu own a a ruey to garage aeric
OCC, LOAD FLOOR LOAD.__ HEIGHT NO.STORIES _ ARF,A VALUE
_BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Per �—FIr Ou ---_-: — — — – -- _
THIS PEAM1T IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULAIIONS AND ALL AP^LICABLE CODES AND ORDINANCES, ANC IT IS HEREBY AGREED THAT THE
---— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
?96 Stat,. •Q® LICENSE. SEh..."ArE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
TotalBy
«•��
-- ---- AFPLICANt OR AGFN7
Approved Rr'reipt Nn
__ HONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
S n c l �LtxG- �J Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil _
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Fin—
Sidewalk
Curb&Street Final
_ _ Approach
SLOG.DEPT.FINAL TEMrORAF?Y CERTIFICATE OCCUPANCY
O 7V CERTIFICATE OCCUPANCY Final
3 . Landscaping
Zoning Final
EXHIBIT "B" 150319
CITY OF TIGARD
C.r'WIFICATE OF OCCUPANCY AND RELEA3L OF RESTRICTION
The City of Tigard hereby certifies that the o:eupancy of
the following described structure or premises wito respect to which
9- Zo 3.9
a reszriction of occupancy was, on , .,,_��,r , 19J%:
recorded in Book .9A1,1' , page7 F�" , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIYPION OF PROPERTY:
,'<i :� ✓J.LL� CQscrLts�by� �is r,( .f�L
OWNER: L 6 ,;�: L. .Q 1 0 1Cc _
BUILD_NG PERMIT NUMBER:
BUILDING ADDRESS:
This is to certify the said structure meets with the require-
ments of the Buildina Code of the City of Tigard and the above
referenced restriction is hereby released and terminated.
It WITNESS WHEREOF, the undersigned authorized officer of the
City of Tigard has causer; this certificete and release of restrict,un
to be executed this /3 day of f`�6� 197y.
Title:
STATE OF OREGON
County of Washington )ss.
On tLis i3't-L, day of �1-��` 191% personally
appeared before me the above named .�rn.c { , hone
signature appears hereon and vho acknowledged to me et he executed
the same in his offical capacity on behalf of the City of Tigard.
Notary Pub}�c of Oregon
My Commission expires:
i. a o 1� •1S
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CITY OF TIGARD MECHANICAL PERMIT
DATE—j" 7PERMIT NO. _ RECEIPT NO. _
BY l.� (:d/ !//! ~' c(' FEE �!?7
1. Permit shall be obtained prior to commencement of installation.
2. Permit shell be obtained for all appliances which are to become
a fixture to the building.
'_'. Relocation, replacements, alterations, or changes to burners and
duct work require permits.
4. All work to be concealed mist be inspected before cover up.
New Installation � lace Relocation ❑ Addition ❑ Alteration ❑
CONTR. >'r•-1 la Z/��-1/r r',/ OWNER,r
ADDRESS /`�. d ("� ll'c //�+ i 7/�Ei WORK ADDRESS /d/•�l v!l :<�f, �/
r
%���i•C�. APPLICANT
TELEPHONE NO. �'. �:Z
FURNACE - MANUFACTURER /,�r/y ll r,<<!(� TELEPHONE NO.
HEAT Input rating (Btu : rr Hour) (<< e l Vent Size _!< " Flue Size
FUEL OIL ❑ GAS® ELECT ❑ OTHER
TOTAL SQ. FT. Top Floor Floors r' Basement
_ GENERAL —
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit 3.00 Boilers Over 50 Hp_,
New Under 100,000
100 000 Btu 4.00 Air H_and
vel-ing• "10.0`00 CFM
New 1�f0 u r an�Iin aerr4 nr
Floor Furnace Evaporative Cooler
wa, i - Floor - e� Fan
Install ens mm
de
Repair eat bCoolie {.0Hood
`
_
_ .
Boilers Un er _ 4.00mimes sic Znc nera or 5.0
Boilers to 1 4 ' .50 omm. Incinerator _ 20.0
Boilers 1 10.00 Other Not Listed
Boilers 30 to 50 Hp --
INSPECTOR'S COMMENTS
APPROVED BY DATE ISSUED BY DATE
Signature o Applicant �j�(
I
�
City of o . Tigard
INSPECTION REQUEST
for
I INSPECT!ON TIME : PERMIT NO. : _� ^
i DATE: /Z RbY25— DATE ISSUED'_ Z —
OWNF RS NAME ,'
7-'. O C , --
ADDRESS : � aL.6CONTRACTOR :____ _. .. .
TEST'. A r 0, Water [❑ , Visual ❑ , La'- ,ratory [I
i RESULT: Approved Disapproved 1 Pending p
I SKETCH:
I
I
I
INSPECTOR DATE
OTE Attach supplemental teat data heret-10
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City of Tigard
INSPECTION R;'QUEST
for
INSPECTION TIME : PERMIT NO.:
DATE: /1)4::/� DATE ISSUED'—__s'_—/
OWNERS NAME : 2' J7, C
ADDRESS :/--e—,T -- - —
CONTRACTOR —
TEST'. A r U , Wat,:r ❑ , vist:aX Lo'' ,rotary p
i
RESULT: Approvedfi( , Disapproved _1 Pending ❑
SKETCH:
I
I
INSPECTOR DATE
[:N0TE Attach supple-nentoI test data heret]
I
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of Tigard
INSPECTION REQU E-S T
for
NSPECTION TIME . _ PERMIT NC. .
DATE * Zd/ '-2-.-? DATE ISSUED .—,--/
OWNERS
ADDRESS: �Z_r `-�!
(aON rRA(-,Tf)R
EST re►Cl , '�='�' ►:' '_�
RESUL`," .vroved ;uppra,ad G .•Vidioq U
SKETCH:
i SPECTOR DATE
NOTE Attach suopiementai test aata bar(-
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of Tigard
INSPECTION REQUEST
f c-, r
!NSPECTION TIME. l�w�'7>w�c_ PERMIT NC
DATE: /0 / x '73 DATE ISSUED
OWNERS NAME :
Ar,DRESS: " i I04?v-IS,w C
0N ERA " Tr) R ---- - --- —
"EST
- \ j
RESUL.!_ * k ruved = uppr�vad G y
SKETCH.
l�1-3 L
10P -CTOR DATE
�N01E: Attach supplemental telt cote here to
I
City 9 of Tigard �
�
INSPECTION REQU ES 1
for
INSPECTION TIME : _ PERMIT Nd. :
DATE : DATE ISSUED :—
OWNERS
SSUED :_OWNERS NAME '
ADDRESS: _� 91lo_
CONTRACTOR . —_ _ I
TEST ". Air G, WaterO , Visual W, Laboratory r]
RESULT: Approved Disapproved 0 Pendiog C]
SKETCH.
" INSPECTOR DATE
NOTE: Attach supalemental test data here,]
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Y
PLUMBING: PERMIT APPLICATION
Jurisdiction of i
No. I Type of Flx ' itr � Fee Permit Nc.
Permit fee
-2 Wdtr2 C10.3vl._ 4."l'�___i.1.�t.s _ Permit. Issued
Bath T lbs a._ Approved by
Lavat-,�_,�ttia�•hrB:. irk_ �,' Building Per mi .__
Receiat No, r
Sink�� K i t:;r_'a�____.___ ,• i ,
,ocatior:f Ara.Idlri --
;,
A 77
T' ':L'� A,
�ram� �g adrV�•. � . .," ._—_rfN �•-
--T'
d 77
-- - Buil �� `t --?? � f 1,erA.
er _Repair �r
Other
�_—�i_.-ter.`—.-t-='--- - --•-- ---- �_—_. —��__.---___._
, t.. / r7 V 1.f work (..r rrir ', . t. ,-}: d 1 , n f
.ns1.ruc +"l cn _ . w !, ; n 1-d - abar.dcmed
_d l my gime a` + ..r• wrlx
All plumbing 1.; r-i. 1Icensed by the City .,`. T. isd and pest a $1,000 bon
I herebv cert 1' ,, Y!. I neve r-ad .end examined t.tu :.it �.� tc a+_ : :'n and knew the s
t.� be true Pii I pro,.,i n i ons �f la•n,t? ind _ t ' :,inrA!-; -i-ming this t
f work w, 11 '-')o tii whc,ther ^peel fieri o;.n t- .. + _h . granting of
perms ' rj , s nr;• ,r c rrtvo authority to t' :r;c#,.1 1,h— prc % .Lsi'ns
f .gym.' r,+.hpr s t i + , 1 law rPgul.atlr g ;o.i t:r!�c. t.: , t, c , t.};� r fcrmance of
on .'
l
Signattl 'e~`f Applicant.
City of Tigard
INSPECTION REQUEST
for
NsPECTION TIME : ,415,4f PERMIT N0_ - __—
DATE : ')A'T'E ISSUED'--L'—,/'
OWNERS NAME '—
WDRESS
1N1 RA CT I'.. R
TE S'l -1 &mier L—] , Ln er:4
RESULT di-;xpprovO 1 :j.di7,J
SKETCH:
INSPECTOR DATE
5 )TE . Attach supplemental test ..i utr: neret
01
1814
E)GUE.IT "A"
CITY OF TIGARD
Residential. Structure Occupancy Restriction
KNOW ALL MCN BY THESE PRESENTS, That occupancy of residential
structure (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Dee" Records,
of Washington Cuunty, Oregon, is prohibited by the ordinance of the
City of Turd, Oregon:
DESCRIPTION OF PROPERTY``:
P\ y �� a r�5.
1
ADDRESS OF PROPERTY: I
.P74ME OF OWNER: ♦a.�- _��a e.w �-•�- ,.�c \' u e�r.e�a
ADDn S OF OWh ER:
M.\w e�ver_. e� Com. ��r�-� �`1'�.•ice
IN WITWZS WHEREOF, the undersigned has caused thl, restriction
to be executed this i � day of
PWIIER:
- r
'APPROVED:
,tie
Dy
• M.A In,r-mrd.....rC..-LY...."..::s 1I/. .ORS ;.►m
Building Official ROOM rt+oMARM,Mtemor of iw*41 fk Er-�Irnr+
City of Turd
STATE OF OREGON
County of Washington ) _ September 5 , 19.13 .
Personally appeared oefore me the above named Rohr Brown,
Vice Fresident and a:knowledged the foregoing instrument to be
his voluaa&ry act and deed.
NNot&ry Public for Oregon
My Comr'ssion Expires: January 16, 1975
f BOOK 945 mE765
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CITY OF TIGARD
12410 IL W. Maim$he*
TIGARD,oR1111OON WM
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APPLICATION FOR BUILDING PERMIT
r1 r
New Construction Demolish ❑ U
Addition ❑ Remodel Move U
ZONING DATE ISSUED BUILDING PERMIT
BUILDING FEE $6,- No.
DATE RECEIVED �� •205
RY PLAN (':iECK $ .3L
OTHER1� aO s,.�o, 17 VALUATION S
44D I&. RECEIPT No,
TOTAL
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # _ MA° / zs,- r _ CENSUS TRACT _ .I- F JOB /
Architect or Engineer �-
Address Phone
owner % D• Sam ---
Address Phone
Builder --
Address _ Phone
BUILDING USE Single Res. Multi Res. ❑ Comm. 1:1 Indstriel❑
OCCUPANCY GROUP _L•• No. of Stories_L_ Total Heights f _ Area of Lot
Type of Construction I It III IV (�C)Floor Area B
het Backs: Front_ Q_ Back aO L.Side / _ R.Side
41 tic Tank ❑
Private Sewer Pipe Size Sewerj66L Septic p
water service Pipe Size_ Storm Sewer;K Ditch ❑ Drywe1 ❑
Street and Curb Requirements ii' (Ad
Driveway Width 18 No. of Parking Spaces _
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED /4 D ._ :S.w ,LIIsTV 1llLl�_ `Art ss
FIELD CHECK BY _ � _ _DATE_r�—�•7l
PERMIT APPROVED BY
It iE understood that all work will conform with applicable codes anddinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be -3ccupied until a Certificate of Occupancy has been issued by the City of
Tigard Building inspector.
ffl#-nature.aWpplicant