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-71
rOF OC
1G A CU
CITY OF TtOARD C�
r� OREGON
Owner:..JuA1.e.tin Development Co........ ..........permit No,74- 113.........
Building Address...... X255 S.W. Highland Drive
Certificate is hereby given this..29th.....day of---?4Y...................... 19.7.5.....
' that said building may rQ 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
a e �
i
Building Inspector
Qf ao�•eeD ttwn ir.u 7�.
EXHIBIT "B" 9097
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 re6ptct to which
a restriction of occupancy was, on _5opt.embor 4 , -19211 ,
recorded in Rook _Uj, Page •;c-I , Deed Record of Washington
County, Oregon, is hereby Ruthorized and approved.
DE3CH-PPION OF PROPERTY:
Summerfield-lot 197
As recor 'ed in Hook 34, Page 5, Plat records of
Washington County, Oregon
OWNER: Tualatin Development Co.
BUIIDING PERMIT NUMBER: 0026
BUILDING ADDRESS: 1'1255 S.W. Highland Drive
This is to certify the ;aid structure meets with the require-
ments of the Building Code of the City of Tigard and tt,.: above
referenced restriction is hereby released and terminated.
IN WITNESS I411EREOF, the ,indersigned authorized officer of the
City of Tigard has caused this certificate and release of restriction
t,, be executed this .,'� '_ day of i)�,W (,;,�. , lye.
Title: CITY
STATE OF OREGON 5�
County of Washington )
on this 2'11.1) day of November , ly 7,4 personally
nl-peared before me the above named Doris ar ig , 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.
l
Notary ublic of Oregon
My Commission expires:
pp
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City of Tigard
INSPECTION REQUEST
for
r,. ,
INSPECTION TIME: PERMIT NO. :
DATE: DATE ISSUED : I Z
OWNERS NAME : I
ADDRESS:
CONTRACTOR : / 07 47
TEST : Air p, Water[3 Visual p , Laboratory p
RESULT: Approved , Disapproved O , Pending p
SKETCH:
IN kCTOR DATE
FNOTV Attach supplem@ntal test data bereta�
Lp r b _
BUILDER . � � VALUE a7 ,gsv FEE DATE&, tov-
LOCATI0N i�sf,ac.J ,�•rQ,4,,.�t��• OWNER .2,. ..�� � . & .
J ,;3 � f�1 A P� �r / 7—TY PE h�c.a,c.�t'1�,�.¢, _
PLU,i iEER � ,_ti 4. PERfIIT r t'�C��n 4 FEE
SEWER PER f .T ;f FEE — MECHANICAL PERf'1IT r 57 ;473—i�
DATE by DATE b
Excavation Fill Air conditioninq
T Footin s Foundation Ventilation
Forms _ Sprinkler system
Slabs Masonry/Flues
Reinforcing Steel Fire doors exits
Structural 5tee1 - -'� Garade_ Floor Ott..
Plumbinq R . I . 7c Drivewa G 2-
'?nof Flashing y� -?5 Sewer _
/ �► Fame _ G
_ Storm Drain
Lath 17 1br_ar Parkin
Heating_ Fence screen
_ L'atcr Heater Final
EXHIBIT "A" 1.1908
CITY OF TICARD
Residential Structure Occupancy Restriction
KNOW ALL M''N BY 711ESE PRESENTS, That occupancy of residential
structure (s) on the following described lands pr ar to the recording
of an occupancy permit releasing the restriction in the Deec. Racorde
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION OF PROPERTY: Summerfield - Lot L!
As recorded in Book `, PaSe , Plat records of Washington
County, Oregon.
ADDR.MG OF I'ROPi,ctTY: li?II`7. 15 J. LcJ.
NAM OF Omm: `LL"
ADDRESS OF OWNER• /5- ��I �L J �/G� 7Ji Qr Jc' ��(✓t�
IN WITNESS WIIL•'RLOF, the undersigned has caused this restriction
to be executed this 41 day of _ 19,2q.
OWNFRI
eU�I,fi.t111 1:rVD :'lit �.O'A"�1"' ^r.
( r NerJe
APPROVED: Byt\_ -`Z:
Title
Byt
le
uilding Official
�,� i21. ,
'..._SR'...�C......19.'... ........A M.TSTA
City of Turd ROOCR I1C)roSSf.N. thrl+cnor of R�Mrd�6 CIM,nne
STATE OF -)AEGON ) se. /
County of Waahinaton )
��ssrsonally appeared buf"ore me the nbove mxud
� o � and acknowled,ed the foreRo..ng in.. c ru to be
voluntary act and deed.
iot ry -Public f aG-bn
.. ,., .vue;nn
BUUK 981OLE351
LLI
STATE Or OREGON
e5
County of Washington Q
ERoger Thomssen,71*90cr of I ecords
and cflurn and ExOfficioRecorder c' Con.
veyances for said county, do hereby :etfify
that the wiffun Instrument of wriflnt was
received and recorded In book of rSt:o ds
No.
of said County
Witness my hand and seal affixed.
ROGER THOMSSFN, Olrocfor of
Records d Elect"-%
Duty
JuF,2� i.o 5a
AM'74
• �'1. .1 1.41fr
F;XHIBIT "A"
CITY Or TICARD
Residential Structure Occupancy Restriction
KNOW ALL IdLN BY TINGE 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 Deep Racords
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon;
DESCRIPTION 0: PROPERTY: Summerfield - Lot 107
As recorded in Hook �'�, Page , 19.at records of Washington.
County, Oregon.
ADDRESS OF I'RUL'ERTY; �7, G�
NAME OF OWNER: ,�,ti_ �r•1lw�O�rsrrT .
ADDRESS OF OWNER: /S, LY� S�✓ �//� fe- crt 20
IN WITNESS WIiL•'REOF, the undersigned has caused this restriction
to be executed this 1 q day of 19 7e
OV51 .R:
s
Tunlatin Devr ent CoAam-'. J'.c. �
APPROVED;
Nese
Title
By.
Building Official
City of Tigard
STATE OF OM;GON ) s s.
County of Washington ) ��. �97w
Personally appeared before me the above named
and ncknowledged the foregoing; instrumen to he
w. - volunt.t.ry act and deed.
IOta y Public f on
... �,,....oSiJ:.
CITY OFF TIGARD
12420 S. W. Mein Street
i IUARD, OREGON 47227
APPLICATION FOR 13UILDING PERMIT
New Construction Demolish Addition Remodel Move
ZONING _ DATE ISSUED__________ BUILDING PERMIT
—v BUILDING FEE No
$ � 'G' .
DATE RECEIVED �/%f7 y �L7Y"
� PLAN CHECK $ Ir �'�' ICiJS•• r —/3 r
BY %J,,� lU VALUATIO14
OTHER&,...I,•f $ `/� �✓ d—/L
TOTAL//rr $Irfr $ /'l RECEIPT No. 10
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT #- _� _ MAP # CENSUS TRACT JOB
Architect or Engineer-1-! ;'C !0,-
Address 1`����-
i ``
- -S. c,�� ---._&_,Lg— -�r,,s�c'& _.__..______.Phone �'� �14�L�
owner e
Add req Phone
Address __ _ _Phone
BUILDING USE Single Res. F-VI _ Multi Res. Comm. —Industrill C.
OCCUPANCY GROUP`y — No. of Stories_ Total Height+ — Area of
Type of Construction I II III IV (D Floor Area B-______
Set Backs: Front Back-I-)__--_ L.Side � R.Side 1
J - y - -y- g--
Private Sewer Pipe Size Sewer Septic Tank l J
Water Service Pipe Size_ Storm Sewer X Ditch brywcll
Street and Curb
Driveway width_knINo. of Parking S aces
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
r
ADDRESS ASSIGNED—f,[/�J� �J•%% �X �r <fi�, ✓+,. _—� -- --
—— f rx--�— —
FIELD CHECK BY ------ ----- _---..-- --._.__DATE ��1'_._ --
PERMIT APPROVED B
It is understood that all work will conform with applicable codes and ordinanc ,_
of the State of Oregon and the City of Tigard, Oregon, and that the huilding wii
not oe occupied until a Certificate of Occupancy has been issued by the City r,f
Tigard Building Inspector.
Sicca-ureter A p1�t
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: '1 31)/P, 01 .
ez/ _ PERMIT NO
DATE:_
DATE ISSUED :__L_�__
OWNERS NAME ;��U
ADDRESS:
CONTRACTOR :
TEST : kir p, WoterQ„ visual
RESULT: Approved ' �. Laboratory p
/ Disapproved Q , Pending
fj—
SKETCH.
L.
A
Ia
I ;
INSPECTOR
ATE }
IOtQ: Attach suDPle�enfai test date hereto f
i
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME * ��----'-- PERMIT NO.:
DATE: ' 7 ;
'11L�DATE ISSUED:(_,
I
OWNERS NAME : T�:-�'��
ADDRESS :
CONTRACTOR :- r� 'S ....
TEST. Ai► O, Water ❑ , Viewali, Laborator
RESULT: Approved , Dieupproved 0 , Pending
SKETCH: 0
I
I
� ,%c
INSPECTOR DATE
ENOTE . Attach supplements Bei+ as+a heret�
I