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City of T Bard
INSPECTION REQUEST
for ,
I
IMPECTION TIME: ry' PERMIT NO. :
DATE: ��r DATE ISSUED :—
OWNERS
SSUED :_OWNERS NAME :
ADDRESS: ? /yP1y 1*✓dft LP.JAt �._
CONTRACTOR : ___ ,✓Lr_______.__�_��_
TEST : Air ❑, Water[] , Visual ❑ , Lnharatcry ❑
RESULT: Approved , Disappr,wed ❑ , Pending []
3kLETCH:
i
i
NSPECTOR DATE
EOTE: Attach supplemental test data beret]
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II� n
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�', V./�,6Y �+"'+ r�wr� •Cr1.r , `may' �r vl "� t•� !$/.Y "./ 77
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G�
CSTIGA RD C CITY �F Y
47OREGON
Owner:.... ........ ......--...Permit No...74.......-91............... � • -� ,}-y{��\,
Building AddressIM.Q..a1W.....HIL.HLAND...JR..,..._...._....-----
? ` . Certificate is hereby given this......4th _day 119........... ... 19.-'74 .. I, •, , ,*,�,.
that said building may be occupied and
j that it complies Nvith all requirements of
the Building Code for the City of Tigard, N
.E TO BASEMENT WITH SELF CLOSER
Via.: �<: ...... .. •
`2 `F P RMINENT Ff' 1AbRA1jt((T1RTEQ. ABOVE ,
STEPS LEADING TO BASEMENT_ _ _ -
- -..r_-`=*::,�Z'TT.��reS�e-s�iva•''o-.���•:�z:32�irti�r.�L'cri- .bgFS�r�•a�rx'�f3'v-rardF.l:ci§:;�k.�F' � � .�.
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52'76 EXHIBIT "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 restriction of occupancy was, on _ ) ` , 19 j1/,
recorded in Hook ) , Page (r,�/t/ , Deed Record of Washington
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY: r,to('1) _ L uT .?
L CCA L)b 0 1 A� 13106 A CTC 5 PL,4 7'
I�C�C'r%205 �F We9Sl�4�nrC�•(Gti C�.r�T7-, Cji2� CK•Gi1/
OWNER: V- 7 V G . AMt,AJ lJ
BUILDING PEPUdiT NUMBER:
BUILDING ADDRESS:
This is to certify the said structure meet^, with the require-
ments of the Building Code of the City of Tigard and the above
referenced restriction is hereby released and. terminated.
IN WITNESS WNEREOF, the undersigned authu, lzed officer of the
City of Tigard has caused this certi.fica.e and release of restriction
to be executed this __L day of r- y_l«_, 19'v .
Title:
STATE OF OREGON ---
County of Washington )ss
On this J day of _1 c 7�a , 197< , personally
appeared before me the above named �,,, ,� x'9101 , , , whose
signature appears hereon and who acknowledged to melt} t. he executed
the same in his offical capacity on behalf of the City of Tigard.
otary, ubl{c gon
MY isi .i expires:
II'DrXCD e3
996Mod is Mord 1� ���
flne[A THOW"M dMIS"I«lbopdp.k Rl"M"
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11909
+
CITY OF TIGARD �
Residential Structare Occupancy ReGtriction
KNOW ALL IC-X BY TIC;;L• P;1P.SEMM, ThAt occupancy of reai9ontial
structure (a) an tlo folluving described lands prior to the recording
of an occupancy pernit releaGing tha restriction in t:10 Dcec Recorda
of WaGhington County, Oragon, is prohibited by the ordirznce of the
City of IA- Card, Oregon.
DESCRIP'PION 0:_PROPERTY: Sumnerfield - Lot .rte
An recorded in aoo;c Plat records of l,ashing'on,
County, Oregon.
ADUMMS OF
' c _ ,Id/tEfl On. OWN.:R:`T�s L-ta-k
ADD_RcSS OF OWNM:
IN WITNESS IMEREOi, the anderGigncd has cauGcd this reatriction
Ccv0 1to bo etwcuted thio � ` Aay of 9
*, 4 OWNER:
1 ...1 1,
Tu,a1x+311 elo�T romrin•• Trr„
G7 rcoi �z 1�. I
d a
APPROVED:
1� ;+f 1 itla-
Filth ng MCI cinl PIP
�
— �/
i F'f��Im nccrA.,.�...::"Lw_..10:7.j..e1ZC.AM III'
i^ City of Tirard POW-riloMR96N, of no Me++o"s
"- STA'L'E. OP OREGON
" County of }lanllingt or j
r+,1 ',rGonally a cared bnfare we the above named
�. _ � .
nnd acknolflydbed tho fareQoina inGtrumc it o be
wollmt.ary net and deed.
T+otn y Publ.io for y9 n
I
I
City of Tigard
INSPECTION REQUEST i
for
INSPECTION TIME: -- PERMIT NO. :
DATE: La 13/la DATE ISSUED :
OWNERS NAME : - Q , C-'
ADDRESS: 1u� -A-/b
CONTRACTOR :
TEST : Air p, Water[) , Visual 0 , Laboratury p
RESULT: Approved , 'DO4410rovsd 0 , Pending p
SKETCH: ACrlj'I ra""/P
i AJ t:r ' 0"� ii r,015 7-0 Jpi�9 St3.afr s,r�'
W J; 4• ,. ,r✓' ! !kn t)A,101 Jt Pro I L
y
IINKCTOR DATE
50TE: Attach supplemental felt data hereto]
1
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME:/o PERMIT NO. :
DATE: _L`E1ZY' DATE ISSUED :
OWNERS NAME ./ . ' C-
ADDRESS: CADDRESS.
CONTRACTOR —
TEST : Air ❑, Water[) , Vieucl?(""Laboratory p
RESULT: Approved , Dieopproved O , Pending []
SKETCH.
I
INSPECTOR DATE
5016: Attach supplemental tett data beret]
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. ,(�
Permit fee e.�.��<,. ,��p(_
1
Water Closets Toilets i" Permit Issue -IP_7
Bath Tubs �— _ _ Approved by _
Lavato�VJash 1 nBuilding PermiH
_ Shower_
Receipt No.
_ inTts, Dishwashi.ng�__
_7 Sinks- Kitchen
Sinks,_Ordinar� Location of Building
Si-nksi Bar------- - — �!/ = �i� _
_
Sinkst Slop_
Automatic Dis was er , k -L-" -s�4
-P iso s a 1 — ._._. ,._.. _ .
L Fiun�9r�Tr ays .___ J;ar��+ �4 r���cj1•es8 0: C,.T� r %-.<�r
Drains,--Flocir— _— — r 1r
brains Area _ _ _ 1' �y '�'=�
Drains"
rain Rei*
z.-.R_
s Rain Drains
Au_t.oma,ic Washer Name Ac�d2�ess of Flambe
iFCitlilL��11-5�NSio�dl_tauntain�
Ii_o_tWater Tank ` 0.<_
•� S�'
-----
,
_ Water Service_�Size. � _ ��%� _
BIunisl-e.-d-rA-S-fl- (Old
- ,o
r- = w-�---c--.AC_.l_dt.-�-e_-
r.__
Repair
i-r__or
Urinals
_-lradTra'cfi=Basis -5--- -�_ -SF stem
_i_n —
_
-•-------------
}
This permit becomes null and void if work or constr•,'etion authorized is not
commenced within 60 days, or if construction or work .is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond
I hereby certify that I have r-ad and examined this application and know the sam
to be true and correct. All provisions of laws and ordinances governing this t
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 cancel the provisions
of any other state or Local law regi-ilating construction or the performance of
construction.
i
f Signa;-ire o Applicant
i
... .. .r ,.. ■. ess
I
I
!
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: DATE ISSUED:__L_Z
OWNERS NAME : __.L-0Q .
IADDRESS : Ikk --- /oo9c?
CONTRACTOR :
ITEST: Air ❑, Water ❑ , Visual ❑ , Laboratory L
RESULT: Approved ❑ , Disapproved ❑ , Pending
I
I SKETCH:
I
4G,
I �'7
I INSPECTOR DATE
I
NOTE Attach supplemental toot dote hereto
V I '
I
I
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. : ---
DATE: DATE ISSUED :-- I Z- I
OWNERS NAME :-Y-L C el
ADDRESS: 2a' `j I
CONTRACTOR : .----
TE
ONTRACTOR : . —TE ST : Air ❑, Water❑ , Visual ❑ , La boratory ❑
RESULT: Approved ❑ , Disapproved ❑ Pending p
STRETCH:
/ ) ._t
INSPECTOR DATE
1
C07H: Attach •uPPI*mantal test data beret!j
9869 EXHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL IfwN BY TIESE PRESENTS, That occupancy of residential
structure (s) on the following described lands prior to the recording
o, an occupancy permit releas.ng the restriction in the DCeL. Re,:.)rds
of WachinL;ton County, Oic6on, is prohibited by the ordinance of the
City of Ti ard, Orcgor,:
D,SCRIPTION OF PROPERTY: Summerfield - Lot j�(Q
As recorded in Book 3Page , Plat records of WRshington
County, Oregon.
A
ADDRESS OF PROPERTY: C)(7" C? r, ,e r-
MVE OF OWNER: L
�'• V_�_�---_mss.-,..,r 5�-�,�
ADDRnSS OF OWNER: 1_3 ?c-)C) ut1 1
IN WITNFSB WHEREOF, the undersigned has caused this restriction
t h
to be executed this _ day of r 19."�q.
OWNER:
APPROVED:
-'Pstle
7
By=
Building Official
City of Tigard
STATE OF OREGON
County of Washington ) �� , 19'
.rsonally appeared before me the above rm*.:d
/ and acknowledged the fore� ,ing ins�ru4rlt be
,aJ voluntary act and deed.
14x+
�d. •Ma:.... �_ uw r ., oto y Public r regon
"uaeA tHOMesen;�I,�e1.i M. M..40e. My omm!scion Expires:
t !
ECok 978 PALE694
STATE OF OREGON
County of Washington f ss
W
I, Roger Thnnssen, Olrgtor of Re„rd
and Elections and Fr-Offlr.lo Recorder of Con'('1 veyonces for said counly, da henb
'Nptl�lhe NIMH instrunsent of yngerwlos
rlk i4 and recorded In Ic
book of records
No,
of said County _...
Witness my hand orad seal offlxed.
ROGER TNOMSSEN, Director of
Rem is S E4ctlom
D"
t 12 3i
.Ar-1
EXHIBIT "A"
CITY OF TIGA.RD
Residential Structure Occupancy Restaiction
KNU ALL 11214 BY TIMSE PRESENTS, That occupancy of residential
structure (s) un the following described lands prior to the recording
of an occupancy permit releasing the restriction in the Deec. Records
of Washington County, Oregon, is prohibited by the ordinance of the
City of TiZard, Oregon:
DESCRIPTION OF PROPERTY: Summerfield - Lot
As recorded in Kook Page S , Plat recorris of WAshinfrton
Cnunty, Orogon.
ADDRESS OF PROPER`1'Y: C--.f
NAME OF OWNER: L
ADDRESS OF OWN'r'R: _yt/.
IN WITNESS 14ff7REOF, the undersigned has caused this restriction
7h
to be executed this day of
OWIVR:
APPROVED:
� tle
By:
building Official
City of 'Pigard
STATE 0r OREGON ) ss.
County of Washington
firoonally appeared before me the above tu;mcd
and acknowledrred the foregoing instrume t o
voluntary act and deed, i
i
Not: ry PublicTO 17e gon
My Comm'siion Expiress
-,7.0 _._
CITY OF TIGARD
12420 S. W. Main Street
TIGARD, OREGON 97127
APPLICATION FOR BUILDING ^ERMIT
New Construction Demolish O Addition F I Remodel Move
'I,ONING DATE ISSUED � .�`I _`— BUILDING PERMIT
BUILDING FEE $ « No.
DATE RECEIVEDJ�_1 j �y pj_
-7� PLAN CHECK $moi-�(Lc.Trt•• ` - * /
BY 1 -e l --- n J �,, N $ 41 �1-J,�
OTHER •: :..� $ VALUATIO
y= -
TOTAL/%,•fl)- $�1 RECEIPT No. /o-2j
OZ
TWO SETS OF PLANS AND PIOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT N -_ MAP N _ CENSUS TRACT � -r JOB
Architect or Engineer � \�r_vr� �.�,c„ '
C-.U.
Address_L'i ISO S W lit"' ���T—r_-e_�C�-.t __Qcc�_Phone(,yCAk- J
Ow n e r±1t�
Acidress_i:3Lao 7 _ _ ��_���-- ------ --- ---Phone
Hui Ider-
Add ress -_ Phone--_
BUILDING USE Single Res. FX1 Multi Res, lr;^ Comm. D Industrial
OCCUPANCY GROUP -F _ No. of Stories_ _ Total Height____--- Area of Lot
Type of Construction I II III IV (?) Floor Area B_____ ljZC_ 2`
Set Hacks: Frontjo' _ Back- L.Side - R.Side /
Pt.i.vate Sever Pipe Size Sewer,. fA_, Septic Tank
Water Service Pipe Size .3
Storm Sewer Ditch l_j Drywell ❑
Street and Curb Requirements
Driveway Width,-- __ I _-- -----------__No. of Parking Spaces-____ '7,
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED &. _���•'
FIELD CHECK BY - ------ /----- ---._�--___.--DATE
PERMIT APPROVED BYL•... ,
It is understood that all work wi'l conform with applicable codes and ordinances
of the State of Oregon and the Cit , of Tia-A, Oregon, and that the building will
not be occupied until a CertificatE of ..cupancy hes be.n issued by the City of
Tigard Building Inspector. i � ��
iynature of Applicant
EX111BIT "B"
CITY OF TIGARD
cPIRTIFICATE 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 restriction of occupancy was, on , 191
recorded in Book , Pa®e , Deed Record of Wat,hiniton
County, Oregon, is hereby authorized and approved.
DESCRIPTION OF PROPERTY! C�2(7' ri _ LUT "tet
6 b I n) 13 06 k 3 y, P"-'61
I?n�c�2f�5 G� wr9Sl��nJC� (GN �vc./it1TY� C%2t.; L-���✓
OWNER: ,( . V• V• G . f�M�-n1<; l4J -_ _ ---
BUILDING PERMIT NUMBER:
BUILDING ADDRESS:-&090 �.(.y &,e A)D J-?r l Uff
This is to certify the sari structure meets with the require-
ments of the Building Code of the City of Turd and the above
referenced restriction is hereby released and terminated.
IN WITNESS 1411EREOF, the undersigned authorized officer of the
City of Tigard has caused this certificate and release of restriction
to be executed this day of , 19
Title:
STATE OF OREGON
County of Washington )ss.
On this dhy of _, 19 , personally
appeared before me the above named , whose
signature appears hereon and who acknowledged to me that he executed
the same in his offical capacity on behalf of the City of Tigard.
Notary Public of Oregon
My Commission expires: