15675 SW OLD ORCHARD PLACE 15675 SW OLD ORCHARD PLACE
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BUILDING PERMIT APPLICATION 11TY TIGARD04TE 4/111/
()F 0 2 T'
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE—r..:-._
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE-----
LOTNO
is675 (Ad rIrcharf,) HO.jEADDRE55
JOB ADDRESS ARCHITECT.T
gel* ENG INEER
BUILDER E,jck Lendwr 'k DESIGNER
-mnDEL EIADDITION OREPAIR [3RENEWAL CIFIRE DAMAGE CIDEMOLITION
STRUCTURE QNEW-- Ow
[I RESIDENCE OCOMRI []EDUCATIONAL OGOV'T 0 RELIGIOUS CIPATIO OCARPCIRT OGARAGE CJSTORAGEOSLAB OFENCE
OCONDITII 'I.LUSE CIDESIGN REVIEW OCOUNCIL APPROVED OSIGNS
HEAT_
7 PLAN CHECK BY
OCCUPANCY__ -LAND USE .ONE—. --BLDG.TYPE —FIRE ZONE---
I;,-,an aktruit swrj!,n(4 f.)x,i*tjrjLj p6ti s I
pgr pitimi All"d
000.
VALUE
BUILDING DEPARTMENT SET BACKS FRONT±iLl� REAR LEFT SIDE RIGHT SIDE I .: t:. r fl
Permitki , ZONING
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C,)DF
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. ANL' 11 IS HEREBY AGRFED THAT THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
._—..- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINF.1;F,
State Tax LICENSE, SEPARATE PEFMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Tot.i 40
tNT
By AqPLICANT 04 Ar
Apwovec Receipt No.
e
CITY TIG�ARD OATC A64 is 191-L_ N°2"4-
BUILDING PERMIT APPLICATION OF Gr�3_-0273
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHGrJ _ ��
OR AS SHOWN AND APPROVED IN THS: ACCOMPANYING PLANS AND SPECIFICATIONS OWNE'-PHONE'
LO NO....__
OWNER _ `%+�'M�A/►'� o v-_ JOO ADORES' 1 T� `�T_
AFCHITECT
f�/� � 'I�py � ENGINEER
AOnF.CS^y � (`� V ._ -- IL S�_._L-� DESIGNER
STRUCTURE ❑NEW FIEkingEL ADOITI;)N QREPAIn _Opr-^IFV'A! ❑FIRE DAMACE CIDEMOL!TION
� RESIDENCE 000MM ❑EOUCATIONAL CIGOV-T ❑RELIGIOUSLJPATIO L,..ICAR PORT GARAGE ❑STORAGE❑SEAS El ENCE
E-I nESI
` CCUPANCY_.k-a LAND USE ZONE BLDG.TYPE-4:/L/--FIRE ZONE n: PLAN CHECK BY NUIY,EAT
I �As 11
SEWEP PERMIT --
S?���I.cAD FLOG2 aQ HEI H ' Zr s NO•S.TOR1Es ARES NO.SEDROOM1S VALUE
p'IILOIIVG OEPARTNIENT _ SE r BACKS FRONT REAR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE OUILDING CODE, ZONING
Plan Check REGULATIONS AND AI.L APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
YVORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANG IN CWAPLIANCE YiITh
Sub-total w� Od ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
AIA RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Sate Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tota! �,, SDC
V PDC#
APPLICANT OR AGENT
Approved Receipt No.
Ar1hgE45 - HONE _
SDC - $
PDC -
SEWER CONNECTI +
SEWER INSUC'TION S
SEWER SURCHARGE $
Comments :
++if
t y r ul
for
IP S�CCTepN TIME :-- VERN;!'-T
-�Am -k DATE
OWNERS NAME
ADDRF-S%-*O * L:ib7 -%
5
C-
LNO'*'!: :
N PJFW as as W qw 9W for
i
Citgo o` Tigard
INS40ECTION REQUEST
I
for I
IN,tPFCTION TIME: PERMIT h�� :----
DATE: �E /3� DATE i5SUE.D :___1-.1_--
OWN ERS NAME : _7L 'n° G..- -- ------------ I
ADDRESS:
C0NT'RAC?TOR :
TEST : Air ❑, Woter D , visual IJ , Laijoratory ❑ I
RESULT: Approved ❑ , Disappr red ❑ , Pending G
SKETCH.
ke,o,fl t1
ow 'r �.s ;,� 70
Z)G°7'
Y,0 a �'! 6 t
wcr
U h ds"7l oa ,7' 7)4-m7' T m
T IMCTOR DATE
1:Nptg: 4ttoeh SUPPIOmentol iw dote Eeretil
WNW W
I
City of Tigard I
INSPECTION REQUEST
forte
INSPECTION TIME: �� '�� PERMIT NO- :- --
DAT E: :Y �L�, DATE I S SUED :--.-L-L-. I
OWNERS NAME *. _ -- ---C---- - I
ADDRESS:
CONTRACTOR : --� C ' - ___
TEST : Air 0, WnterO r Visual Laboratory C
RESULT: Approved , Disapproved 17 , Pending Q
SKETCH-
I
� max.
�1 L
INSPECTOR DATE
[olE : Attach auppl#k"ental test data beret
1
i,
FILE COPY
iity of Tigard
I N S FEcTI O N REQUEST
for &wc�)
INSPECTION TIME: PERMIT NO. : —
DATE: y DATE ISSUED :.__L_L_ (E
OWNERS NAME :
ADDRESS: 51
N T R A C T O R :
CO I4
TEST '. Air ❑, Nater [7 , Visual K, Laboratory 0 II
Di so Pending [)
RESULT: Approved L7 _ = W I
SKETCH:
P-1, P
INSPECTOR DATE
C01g : Attach supplemental test dots hereto]
CITY OP
BUILDING PERMIT APPLICATION TIGARU DATE 18No 0025
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANC AND SPECIFICATIONS. OWNER PHONE _
Tualatin oevelopmont j`❑ 1 ld Or�cho ((� �r� ` J /y�f�
OWNER 7BbRESS `�` '4 ILDIf A6NE _
owner ENGINEER
BUILDER DESIGNER _
ffU
STRUCTURE ANEW ❑REMODEL OADDIIION ❑REPAIR -1 ❑RENEWAL ❑FIRE DAMAGE 1 ❑DEMOLITION
RESIDENCE ❑COMM ❑EDL; O
ATIONAL OGGV'T ❑RELIGIOUS OPATIO CAS PtJRT ❑GARAGE O STORAGE OSLAB []FENCERE
BOND 0MOVING OCONDITIONAL USE DDESIGN REVIEW OCOUNCIL APPROVED OSIGNS
OCCUPANCY—LAND- USE ZONE_ BLDG.TYPF FIRE ZONE r5 PLAN CHECE BY — HEAT..
This is a duplicAte ror our recordo — -
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
- BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 112.00 – – -- -----------__
THIS PERMIT IS ISSUED SUBJECT TO THE RF.GUI.ATIONS CONTAINED IN THE BUILD.NG CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AN13 ORDINANCES, AND IT IS HEREBY AGREED THAT TH:-
WORK WILL. BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND Ik COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOSS N'IT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CON TRACTORS TO HAVE. CURRFN f CITY bJSINESS
'I%State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
TotalBy
' APPLICANT OR AGENT - - -- --
Approved Receipt No
IBM—FI --
DATE INSP. TYPE INSPECTiuN NEMARKS PLUMBING DATE
—
7Q3-
Contractor-4 _
Per-nit No. 7(/-/5*1 c ju f- �(c•-
s„x.' _ _ `i Rough n
Fixture
LOS _ �� - Final � _.—
HEATING
--- �—
Contractor
--- — Permit No.
�. Gas or Oil
-- Rough-in
Final _
SEWER
Final _
DRIVEWAY
-- _ -- _ Final
Storm Drainage
(Rain Drain) Final ^1
-- _ Sidewalk —
Curb&Street Final
Approach
BLDG.DEPT, FINAL T TEMPORARY CERTIFICATE OCCUPANCY —
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
CITI OF TIGARD
12410 S %. ma;m $fro vt
YIGARD, OREGON f77.1
APPLICATION FOR PlAo"111,
N— Construct fop. Demo It s h Add t t i on Remo do-I Movc-
71
+`i:,.. DATE 1S.S11H) P j•, I
111J _7
ILDINt*, FEE $ -p
No.
A
I PLAN CHECK
VALUATION
OT1,111t I _:- j-
TOTAL I RECLT I'll, NO. lC
-
TWO Sf,V1, Of' PLANS AND PLOT 111.AN.11, mun iij, k, io
I,/,/ MAP 1 CENSUS TRACT Joll
Architect or U r I,'
C, --1 -
--Phone-
i I d e r
USE Single PCs. Malt i Comm. U Industrial
OCCUPANCY GRnUP ,A
_. No. or stuticn- Total He1qht_ Arq!a of Lot_
lyps., of Construction 1 11 11 1 IV 1FJ Floor Area B I I Ir j7 2
t liack s i Profit.- Hick_4.G . 1,.ride_ R.c;Jdv.
1111vato Sower Pipe Size'. I/ Sewer—k,,./ (, Sel tic Tank
Pipc i r v- Yq Storm Sew c i f K I Ditch Lr Drywe 11
I t and Curl• Noquirertiontn_a rc?j
I,r ,v way wi(ltl,- IS") Nu. of Poiki.iq Sjjv-�,:
SIA'AIPAIT PEWITTS RV.)UIRED FOR sf:wf:n Ami
SPECIAL INVORMATIOtt
I it !.0 CHI. hy DATI,
I
Pf rtvv AlIPPoVi f, ItY_
I' i" thilt 0II WOL-k Will confor-ii With appd lc I,ln ctrl(,:, and ordin,ii
1,1 tl- St-0- of Orejon and the City of Tiqard, Oregon, and that. tho buildinj will
a of cw,iiipinr-y hnr beer, Jr.,-,tj(-1 t r'll .;
A e
Siqii iture of A14 ,c;11,
15933
CITY OF TlGAHD
Residential Stricture Occujx►ncy Jbmtriction
KNOW ALL KZI? BY 1=1' PJIZi14=j, That occupancy or ru:.identiul
t:tructure (r.) oa LLu fulifwing described lands prior to the recordtng
of an occupancy purailt r;:Icasing tho restriction in the Dees. ituee rlP
of WarMnAton County, Oration, iu prohibited by the oidituu;co of thu
City of TiCard, OreOon:
DESCRDVIOY 0? PRUYk:RTY: Summerfield - Lot 1
to recorded in Boot � , I'nge �, Plat of Waahington
County, Oregon.
AUD�6 OF PROPLTM "1,2_
KAM-.' 0? OWNER: T�� , ,r� 1��+ /t I[it�. ,�� t-Y•) .�.S�S�
ADD.LvSS OF OWNE2: tr. 3C,"
Ili WITtG;S ti.i0:RSO:, t1':a ttn:vruldned hue cawed thio restriction
W be exe;:ute1 this I,L day or 197 .
owlsit 7
1 � y
AMMMt
Nate
f
Building official
City of Tigard
ST"ia OF ORIEZOS
County of Wanhington ) ` / X97y�1,
6 v
'Perconally.appeared before me the above tutored _
and acknowledged the forcLoing instrurr_n
voliu,tary act a„d d,ed.
tc,' ty Public for Origon
a-tom
1 r •L01 T1/OMffi1[N.An,�.w d Mme.d� A Llr.-�w� '
.. a7�a�f • �\W
9 �
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3
$ x
"kill
c
CITY OF 'T ICARD
lRe,idential Structure Occu,xincy Rettrictioa
K\OY1 ALL h'20 BY 7l=& 1'i`(Y.:aF.Wj, That occupancy of residential
s:tructuro (c) on th,i following described land-s prior to tho rccordI sg
of an Gecupancy permit releasing the reatrictivn it the Dcoc. Rocords
of Vasliiu6•tun Coussty, Oration, is prohibited by thu ordinunce of the
City of 'Tigard, Orafor.i
I1)OCi2UTIOY O: PROMITYs Lummerficid - Lo. 1—ILL
/,a recorded in '3ovX ! , Page 15� , Plat recorna of Viwhir.;;ton
County, Oregon.
ADDiLr'.'^G OF PROPERTYs��.�L.�_�
MW 0? OWNER:
Oflr'..°sS 0? OltliiTis
IN WITNESS klMil 0:, the undaraignocl has caused thio routriction
to be cxccutea thio 1'L•� Jay of
uilding Official
City of 'TiGard
count OF OWashi
EGON
County of Washington
perr.att'sl}y nppeared before me the above untied "
and nclu.awledged the foreioing inctrw. r to be
._..�s!,._._.. volus:;,;.y n;t rsr.d •'.'cr�?.
1 s y I`Lsblic :o r, go
._. C
EXHIBIT "B" 2m
CITY (W TIGAn
CERTIFICATE: OF OMMANCY AND HELFJI A OF R?;2TR1CTI0N
The City of Tigard twceby certirica that the occupancy of
the following described structure .,r precaisec with rec.Nect to which
a restriction of uccupancy waa, on B 1974,
recorded in Rook yAb , Page , Deed Record of Wa!thington
County, Oregon, is Lereby authorized and approved.
DESC}?liTION OF i'ROI N"i
gummelfieldY- lot 144
An recorded in Book 34, Paged 5, Plat racords or Washington
County, Oregon
OWii}:3ir....._Ju/.lt.L.in_.ii�>��ngm+�,^_�.-1-O•-r -lA�.—_--_._.__------ _ .___.,_.
BUIMINII FF MIT NUMMM: 0025
PUIIA]AMO_ADURE:;3: .1421_.S.M....L11t1..�Lc:l18Ld
This ie to certify the said structure wets with the require-
inerts of the Building CA.rie of' the City of Tig;%rd and the nbuve
referenced retatricticm I!% herosby relena;ed and terminated.
1N WIT!It:'I5 1.11F.REOT, the undersigned authorised officer of the
City of Tigard tan caused thin certificate and relcar.e of rentrietiun
to bt executed this ,� day of
Tit 1
e:
::i'fATE uF u*VON ) i t ds
r n• r y,�A.M,..P.r A r I ( 11 �S AI�D '�M ',AA
Cbunty of Washington ) ►x�x fi►wK,AecM.A.,,.w r a...,,,,.ti C«.,....
rta_ 7J G' b.,,4r
On this 10th _ d.y of March , lye
, per-muAlly
apye. ab
red before me the ove TART d _OorinµHart_ijL_..___-, vhu.se
sijrnml ..e apJ,ears hereon and ileo acknowledgeri tt; me that he executed
tint so-m in his offical capacity on behalf of the City of Tigard.
;k,tery Pub- c of Oregon
My Ccsmission expires: _
M illi 4 W350
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ord fbc� f KOrdor M Cm
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h'o' hMb� t�rM
rOtwdad fn bAl d�lro wog
1041 G"'"
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kJGiIAIT °a•
CITY 0! TIGARD
CERTIFICATE OP OCCUPANCY AND R1:LUSI OF MTRICTION
The City of Tigard hereby certifies that the occupancy of
the following described structure or premises with respect to which
a restriction of occupancy was, on 8-2 , 19 94,
recorded in Book _9Hb , Felp �ti. , Deed Record or Washington
County, Oregon, is hereby authorized and approved.
DISCHITION OF YROFERTY:
Summeffield�- lot 144
As recorded in Book 349 Page S, Plat records of Unihingtun
County, Oregon
SriLMR: _ .Jue1,Atin n&u&jQpmsnt.-Lo.r-�IAc.-
BMIDING VEKMIT MOWER: 0025
MIMING AUDRE,S:
This is to certify the Heid structure ixets with the require-
mer.ts of the Fluilding Cale of the City orf Turd and the above
referenced restriction is hereby released rand terminated.
IN WIT!OZS 64iM.01', the undersigned authorized officer of the
City of Tigard has cau:;ed this certifieste and release of restriction
to be executed this day of —^ 19w
STATE of u1 r,ON
County of Wal.hington
On this _10th _ _ day of March _, 19n, personally
appeared before c the above naued $Cris Herti _ , whose
signature appears hereon and who acknowledged to me that lie executed
the same in his offical capacity on behalf of the City of Tigard.
i
Notary Pub c of Oregon
My Cormission expires: