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City of Tigard I
INSPECTION REQUEST
for
INSPECTION TIME . _ r ` _ PERMIT NO. : � I
D. fE: . VIAS DATE ISSIrF^ :_1Z_
-RS NAME : 7
ADDRES
CONTRACTOR : -
TEST
ONTRACTOR : _TEST : Air C7, WoterL'4 Vieu^t-] , Laboratory []
RESULT: Approved Disapproved 0 Flendlna
SKETCH:
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INSPECTOR DATE I
NO—, F, Attach sujpiernental test data beret]
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EXHIPIT "B"
CITY OF TIGARD
1:;03i
=IFICATF, OF OCCUPANCY AMID RELEASE OF ItF:,TRICTION
'The City of Tigard hereby certifies that the occupancy of
the following described structure or premises with respect to which
9 •.� a
a restriction of oc^upancy v;,s, on , 19
recorded in Book _,-j-,_, Page -;zL j , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRiII'ION OF PROPERTY:
Tax Lot # 86 Summerfield Subdivision
OWNER: cis.
BUILDING PERMIT NUMBER:
(BUILD:NG ADDRESS: yfi e t.i. , [1�.�i dL�►.. c
'^'his is ':o 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.
TIN WITNESS WHEREOF, the undersigned autho,ized officer of the
City of Tigard has caused this certificate and release of restriction
to be executed this 1 j day of 19 .
Title: 6
SPATE OF ORr73ON
ss.
County of Washingtor. )
Gn this —�� t _ day of a�-w ct �tome
19�hat
, personally
appea-ed before me the above named S twhose
sip,:vA.ure appears hereon rind who acknowledged heexecuted
the =:�Lxe in his offitml capacity on beWS of the City of Tigard.
Notary F4blic of Oregon
M4 CoLm�i�ssign-,�expires: _
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STATE OF OREGON
ss
County of Washington
Roger Thomssen, Director of Records
and Elections and Ex-Officio Recorder of Ccn- �n+
veyonces for sold county, do hereby certify
that the within Instrument of writing was
recc;ved and recorded in book of records
No.
of said County
Witness my hand and seal affixed.
R0.-ER TPOMSSEN, Director of
Records & Elections
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OF O CU
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CITY OF TIOARD
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OREGON
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OWT1Pr........Ll.,s.].a.i��n..Dsv.ego.Rmen.�...C.4mPVn.X....Permit No..-..:.7.��.2�..G-....
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Building Address........9.90...S.1J......Cen.tU.r'Y...Q1 ..ArA.VQ ........
Certificate is hereby given this of• 19...2.4-.
that said building may be occupied and 4'
' w that it complies with all requirements of
y` x• I the Building Code for the City of Tigard, ' "
as approved by the Tigard City Courit;il. `w
......... ................
Building Inspector
`♦y ` .:.1'.L 1fd.�1YEi�7' ...y.:,.-.L'TY7.—
t� / / •� / /
����A�V�A! 44'"V\N'1RRV1NHIITLL++�� A"
unw in u.u•
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pity of Tigard
INSPECTION REQUEST
for
,NSPECTION TIME . PER.Mil' NC.
DATE . %-2 SATE iSSUED
OWNERS NAME
ADDRF:�s .
nN rR A r rr)R
:-EST ct ori 'T )f
RESUL. uppi
S KETCH:
IN P�EC T 0 R DATE
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ALL SPACES MUST BE ENDORSED
Pf-',IC)R TO APPROV IL OF THESE PLANS
PUBLIC 1'dORK5 DEPT. Br,
PLWIINI,:G oz7pr.
Cl:ALI)ING D;PT. By
TIGARD By
GENERAL TL:L-PHCNE
N. W. NATURAL GAS y
P. G. E. By DA r
T. R. F. D. By___ DATIZ—
r . .., •:a .. !;4:i.d1� i gip.
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fe Penni t No. 73 iyi r'
" 0, % Permit fee �
J Water Closets Toilets Permit Issue
Bath TubsApproved by _
12 avaattor� Wash asir-11 I
Building Perm
Shower Receipt No.
n s Dishwashing
Sinks Kitchen
Sinks, Ordinary Lo • tion Bu i ding .Sc
Sinks, slop _
u ��rna ticti—chi:��was-ger ��
Disvo3al _
curl ry Trays _ Name Address of Owner
Drains Floor
rains. area
r
raAns - iera for
Rain Drains /T
u un oma ti c Washer Na ress :f Plumber
oains, r n ink m - dd ,, _
[Eountains
Hot Water Tank
l Water Service Size
Urinals B,.Iil SOi d (Alter, ReLair or
Ca tP 3Sins--� Tns a
T,awn Cprink er Syste,.n 0 _717T,17_ —
Swimming roc _ Mer
S r�nk� er ystem
This pewit cecnmr?_, null and void If work or constructicn authorized is not
commenced w_th.n 6 ' days , or it construction or, work is suspended tir abandoned
for a period of ?.? day; at any time after work is c-)tnmenced.
All plumbing firms ,vist be licensed by the City of Ti.gard and post c. $1,000 bond
I hereby certify t},at INeve r-ad and examine) this application and know the sam
i to be true and correct. All provisions of laws and ordinances governing `his ty
` of work v.ill be complied with whether specified herein cr not, the granting of a
permit dyes rot presume to Al-,re authority to violate or cancel the provisions
of any other state or local law regulating construction or the Performance of
construction.
,jU
Sign tore f Applicant
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City of Tigard
INSPECTION REQUEST
for
SPECTION TIME '. PERMIT NO. : —____.-
DAT E : 1-z �� rte' D AT F I q S'_;(E D :
INERS NAME :
ADDRESS: _—
)NTRACTOR : __ - GG6------- -- ---
.ST : NI. " , Woter[1 , Visual ❑ , l-aboratory
�SULT . Approved X , Disapproved ❑ , Pending []
(ETC 4;
INSPECTOR DATE
TF : Attach supplemental test data beret!]
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME ._ PERMIT NO. : _—
DAIE:U' ,F t'1,�3 DATE ISSUED:._L1
OWNERS NA,.t' : _ ,0, c
ADDRESS : T
CONTRACTOR :
TEST Air J, Water �] , Visual O , La'' rotary [l
RESULT. Approved ,., Disapproved _1 Pending $J'
SKETCH:
� L S?
s�T
INSPECTOR DATE
ih supplemental test data heret01
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City of Tigara
INSPECTION REQUEST
for
AMA rq.A
IINSPF_CTiON TIME .-3L-0—c:!--- PERMIT NO. :
I DATE '. -a--Lt-Z2.2-- DATE ISSUED:—L--f-
OWNERS NAME . T%p c__ - ---._--___--
I A D D R E S S - ---
00NTRACT0 R : - --- - --- -- - -- ---.e.
I
! TEST'. A r [-J, Water ; , \iisualo,/, Lc' ,ratory [1
RESULT. Approved '�, Disapproved 1 PNnding
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SKETCH*.
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SPECTOP DATE
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[NOTE : Attach supplemental test data ho-retii
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C � fy of IIgard
INSPECTION REQUEST
for
IINSPECTION I IviE�/�i S-__ PERMIT
I DATE'. 02-2/91 DATE ISSUED'-1:-
OWNERS NAME . - ------
ADDRESS ' -Z,,-
CONTRACTOR
-----ADDRESS : _Z,"CONTRACTOR
TEST A r J , Wct, rL] , N/isi-cl y1, La' rator.i p
i
RESULT. Approved, Disapproved 1 , F'Nnding �I
SKETCH:
INSPECTOR D,A7E
COTE : Attach supp!emental test data here,]
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of Tigard
INSPECTION REQUEST
for- '
NSPECTION TIME. _ _ PERMIT 14C, -
DATE : X J 12 JATE ISSUED i
OWNERS NAME : -T .C'
ADDRESS:
t,ON rRArTOR' EST ' ti' ter[] , ��. '.ab-►Ct')r.' ':.j J
� 11
R,ESUI. .p ruve:l upps „-d G �di��c; LJ I
SKETCH: I
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INSOEUIi0)R DATE
NOTE: Attach supplemental test uuta hereto]
CITN OF TIGARD
11410 S. W. M mIn afrMf
TIGARD, ORIGON f M
APPLICATION FOR BUILDING PERMIT
New Construction ❑j Demoli:lh ❑ Addition ❑ Remodel ❑ Move❑
ZONING p-p DATE ISSUED 4-1 BUILDING PERMI'P
I BUILDING FEE $- ni, k No. J216
DATE RECEIVED r "73
j PLAN CHECK $ 50.75 --BY _ VALUATION $ 29.600_ __
! -�-- OTHEe. $ 6.00 recording
TOTAL S .57—one percent RECEIPT No. ��
d;r-7 -77
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNTShED WITH APPLICATION
LOT N 06 MAP A CENSUS TRACT — JOB M
Architect or Engineer`_Tualatin Development. Co.
Address^_ 153PO S.U. 116th A g,-Tigard _._ __��_--Phone
()wner G. F. Neils —_--
Address s ___Phone_____
Builder_ Tualati-1 Develupment: Ca. --
Address _ same as above —Phone----
BUILDING USE: Single Res. ❑ Multi Res. ❑ Comm. ❑ Industria.l C]
OCCUPANCY C'ROUF__l_ No. of Stories— Total Height______— Area. of Lot
i
Type of Construction AX)=XX>7C0(C(.XM V Floor Area B___
Set Packs: Front Bac,,—_— L.Side_ R.S:de`__
Private Sewer Pipe Size b" _ SewerK nn Lit.,,- Septic Tank ❑
Water Service Pipe Size3/4" Storm sewerlJ Ditch ❑ 1)ryweII❑
Street and Curb
Driveway Width 19�-- — �Uo. of Parkinh Spaces 2
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNEp 9900 S.W. _Century 0 k Dr--------
FIELD
r — _FIELD CHECK BY_ EWC __ _ -DATE--9-11-13_
�a
PERMIT APPROVED BY�1
4 It is understood that all. work will conform with applicable codes and ordinances
of the State of Oregon ,ind the City of Tigard, Oregon, and that the building will
not be occupied until a Certif4e7ate of Occupancy has been issu by the City of
Tigar9 Building Inspector.
S gnature applicant
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EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL MEN BY THESE PRESENTS, That occupancy of residential
;;tructure (s) on the following described lands prior to t; recording
of an occupancy permit releasing the restrict, in the Deet. Recordu
of Washington County, Oregon, in prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTY:
l r"A Am
^'`
ADDRESS OF PROPERTY: '\��L, =� �� • �n�`�- �'`r "t
NAME OF OWNER:
ADDRESS OF OWNER:
�aL•��E C>�ae, p�ti�e,
IN WITNESS WHEREOF, the ,..ndersigned has caused thiLl restriction
to be executed this; k." day of, •�� � r 19`x',
OWNER:
Name
APPROVED:
By: !�
Building Official 9 �+ t. .....•`1�'M PM
riled f•f fi d....... CtentlnM
City of Tigard poatit THoM"E" dr•�^'°�eiOOta•��`
STAT,. ' " OREGON ) se. pa... ._. ... _
ly 73•
Conn-: of Washington ) September 5 ,
Personally appeared before me the above named R.oy Brown,
Vice President and acknowledged the foregoing instrument to be
his volw.;.ary .ct and deed.
7
Notary Public for Oregon
'-, My Commission Expires: Januar 16, 1975
eoux 945 PAGE 773
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EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Pestrictio
KNOW ALL NEN BY THESE. PRESENTS, That occupant;,, of residential
structure (s) on the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Deet- Records
of Washington County, Oregon,, is prohibited by the ordinance of the
City of Turd, Oregon:
DESCRIPTION OF PROPERTY: �s
W e.SIT.
ADDRESS OF PROPERTY: 'k-
NAME OF OWNER: M< . �\ �c�.- r_
ADDRESS OF OWNER: E'
IN WITNESS WHEREOF, the undersigned has caused this restriction
to be executed thi: S"r� do of _ � 19-N;,
OWNE]i:
Name
APPROVED: �yr.:.- /? �y ,t
Title
By: VBuilding Official ��a�
City of Turd n:.d lo►namd.._Q:�U_..._to l.,?..:.e%... P M
ROCts THOMSU11.04w—W MoeM�a t.MA
STATE OF OREGON ) so. .. �.... .... .
County of Washington ) gllb��� 5 , 19 73.
Personally appeared b_fore me the above named Roy Brown,
Vice Prealdsni_ and acknow:edged the foregoing instrument to be
his voluntary act and deed.
Nota Public for Oregon
f4y Comm'.ssion Expires: January 16, 1979
Boor• 015 PALE763
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EXHIBIT "A"
CITY OF TIGARD
Residential structure Occupancy Restriction
KNOW ALI, MLN BY THESE PRESENTS, That occupancy of residential
structure (s) on the folloving described lands prior to the recording
of an occupancy permit releasing the restriction in the Deet. Records
of Washington Cuunty, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon: ,
DESCRIPTION OF PROPERTY: w
�a`e_-`e..�R.
ADDRESS OF PROPERTY: ASC-M N• .v 11L-
NAME
NAME OF OWNER• jt,, \ %L-,-- C-.o \
ADDTIia i:, OF OWNER: V, cv ��-A� lr�-
1I WITNESS WHMOF, the undersigned has caused this restriction
to be executed this vc day of 19.ZL-.j
OWNER:
�,lfr►it/ �r�.lo ,vr �o
Narae
APPROVED: /� w
By:
Building official
City of Turd
STATE OF OREGON ) se.
County of Washington ) _ f�t�Dat S 19��•
Personally appeared before we the above named Rpj Stawn,
Ma-. P:raldani and acknovledged the foregcire instr.ment to be
volw.:.ary act and deed.
Notah Public :for Oregon
toy Comm'ssi:)n Expires: J&8UaTT 16, 1975