13235 SW HILL COURT 13235 SW EITLL COURT
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BUILDING PERMIT APPLICATION TiGARD DATE ----.-----_ �s --THE UNDE;{SIGNED HEREBY APPLIES FOR A PERMIT FON THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIf ISA TION OWNER PHONE
I OT NO. -
OWNER lferbaiihnlz JOB ADDRESS il: 'i i1,i
ARCHITECT
ENGINEER
BUILDER tilana, 1totau8an ADDRESS DESIGNER
STRUCTURE 0 NEW Cl REMODEL Q ADDITIUN ❑ REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE El DEMOLITION
O RESIDENCE U'COMM D EDUCATIONAL n GOVT ❑ RELIGIOU8 CJ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE L SLAB❑ FENCE
OCCUPANCY _{ ;_ LAND USE ZONE BLDG.TYPE _ FIRE ZONE. PLAN CHECK BY _2',ibi -HEAT
— Construct Flaw Family Room 14 ;' 23 _--
+� _ All Per Plana ;test by Owner 'Jaod Burning Stove Per-i" P�
-- (Pikrbing fleritt will F)c r!iqutied,)
SEWER PERMIT#
OCL.LOAD_ FLOOR LOAD /, HEIGF,T I!'.+--- NO.STORIES I AREA 122 NO.BEDROOMS VALUE
Bl11LDING DEPARTMENT SET BACKS FRONT REAR 2 LEFT SIDE RIGHT SIDE
Permit . THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDIUANCES, AND IT IS HEREBY AGREEn THAT THE
PlanCha,;k 6 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-'otal I`' RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
tt.te Tax
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWI?F,PLUMBING AND HEATING.
�'
— SDC—
Tow _ 15(x. s
PDC# APPLICANT OR AQENT f
Ry _ Cf.
Receipt No.
Approved E"1': ADDRESS _ PHONE
r
DATE INSP. TYPE INSPECTION REMARKS
— PLUMBING _ DATE
CIQContractor
--rr-- - _� Permit No. --- - -
Rough-in _��--
- Fixture
- -- - -- -
Final _
----�---
_ --- �� ---- - `- HEATING -
-------- — - ---,.. - ----- - — - Contractor
Permit No.
Gas or Oil
-- --— - ------ Rough-in
Final -
-_ SEWER
Final
DRIVEWAY — .--- —
Final
Storm Drainage
(Rain Drain)Final --
-_._ Sidewalk
--- -- Curb&Street Final
61.DC3. DEPT.!"YApproach
At. TCMPORARY ��CERTIF'ICATa OCCUPANCY
CERTIIICATC OCCupANCY l Final
� Lend9r--aping
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City of Tigard
INSPECTION REOUEST
for
INSPI -ION TIME :. &L PERMIT NO.'
DATE: Za_L1` r DATE ISSUED:__L_L
OWNERS NAME :
::DRESS :'- `^ ./� � ,
CONTRACTOR : -----------
TEST: Air O, Water p , Visuals, Laboratory 0
RESULT: Approved i/, Disapproved 0 , Pending Ll
SKETCH: /��C'�"Pt-V
'ak � 7`%o/E✓ r JID
INSSPECTOR DATE
EOTE : Attach supplemental feet data hereto
ADDRESS PERMIT NO. 'I9 7 5—
PERMIT CHARGE
OWNER _ CONNECTION FEEo 0
PAID BY actirAi X1 a __
TYPE OF BUILDING . cam. DATE CONNECTED
SERVICE RATE 4 :1td INSPECTION FEE 4Y
. CONTRACTOR , a,cl PAID BY , Xox&, DATE
SIZE OF CONNECTION ��� ASSESSMENT PAID
City of Tigard
INSPECTION REO U E ST
for-
INSPECTION
or-INSPECTION TIME : PERMIT NO. : _
DATE: - 2//L .7y_ DATE ISSUED:_- t_
OWNERS NAME : 7Owj).�s1�^
ADDRESS :
CONTRACTOR : ___
TEST: Air ❑, Water ❑ , Visual [] , Laboratory p
RESULT.* Approved � , Disapproved ❑ , Pending ❑ 1
SKETCH: �_�---- e_
(' l^ ' SNL `
FFF
IN PECTOR DATE
NOTE : Attach supplemental test dote hereto
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Wit SPACES WTSm;Dl':'��DORSED PRTOR TO �
ISSUANCE OF BUILDING PERMIT
PLANNING DEPT. __ to
y PUBLIC WORKS DEPT- 444
By �.
BUILDING DEPT. mate
By
'PUAT,ATIN RURALFIRE DEPT. By D tie
APPROVED FOR CC_.a. '. .�� .•W
CITY Ob' T1,Gt^_i:cD
TITLE
DATE
3Y __. .....r..._,. ......
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Ciij of Tigard
INSPECTION REQUEST
for
.4
10PECTIGN TIME: `- PERMIT NO. :_____.�.
DATE: V DATE ISSUED : 1 / -
OWNERS NAME : , _
ADDRESS: 3 ( 7
CONTRACTOR :
'TEST : Air p, Water[] , Visual p , laboratory ❑
RESULT: Approved O , D;sapproved ❑ , Pending I
SKETCH:
IN PECTOR DATE
COLE: Attach supplemental test data beret]
ew e>F 4. a wa n aw s
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City of Tigard
INSPECTION REOUEST
for
INSPECTION �iME :_,_._ PERMIT N0. ' � .--_
DATE' 2 122121 DATE ISSUED:.�..L-1
OWNERS NAME :ADDRESS :--'-32, -3--Z
CONTRACTOR
CONTRACTOR :---- -- __ -----
TEST'. Air CI, Water ❑ , Visual 0 , Laboratory L7
RESULT. Approved ❑ Disapproved ❑ , Pending []
SKETCH:
0
I _.�
INSPECTOR DATE
f CNOTE : Attach supplemental te.• dato here,-
I
City of Tigard
INSPECTION REQUEST
T
or
'x-�(
INSPECTION TIME : PCRti11T NO. :
DATE; `l 4/ 2 y DATE ISSUED:__/_._.
OWNERS NAME : —'r 6 rc
ADDRESS :
CONTRACTOR
TEST. Air D, Water ❑ , Visual Q , Laboratory []
RESULT: Approved , Disapproved ❑ Pending ❑
SKETCH.'
i
—IJQSPECTOR DATE
CN OTE : Attach supplemental tett data heret]
City of Tigard
INSPECTION REQUEST
for
IINSPECTION TIME :_—____ PERMIT NO. : -----
DATE: —
O. : __DATE: — /L' DATE ISSUED:._._1_.1.
OWNERS NAME : ' + `"l
I
ADDRESS : '"I r' � Ar►
ICONTRACTOR '------. ---- - —
1 TEST'. Air 0, Water ❑ , Visual O , Laboratory []
RESULT. Approved C] Disapproved 0 Pending []
I SKETCH:
I i
I
I INSPECTOR DATE
ICOTE Attach supplsmental fast data hsrslJ
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: .���yV �° PERMIT 0. :_
DATE: ��2W DATE IjSUED :_._1—Z—
OWNERS NAME _
ACr)RESS:
CONTRACTOR : ---
TEST *
ONTRACT0R : _ _TEST ' Air ❑, Water[] , Visual ❑ , Laboratory ❑
RESULT: Approved ❑ Disapproved ❑ Pending CJ
SKETCH '
To
INSPECTOR DATE
COTF. Attach supplemental test data beret a]
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f City of Tigard
I
INSPECTION REOUEST
for
IINSPECTION TIME : I 'L, PERMIT N
I DATE: L ;/ V DATE ISSUED:—Z---,'-
OWNERS
SSUED:._.L�OWNERS NAME: A 2 _
ADDRESS: _LL3 �
CONTRACTOR : _..___ ___.
TEST:Air❑, Water p , Visual ❑ , Laboratory ❑
RESULT: Approved ❑ , Disapproved ❑ Pending p
SKETCH:
E
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INSPECTOR DATE
CNOTE: Attach supplsmenta! test data hereto
J
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. "ype of Fixture Fee Per , t No.
Perm!t fee
1 Water Closets Toilets)- Permit Issued -Jtf
Bath Tubs pliproved by
Lavatoi WashB-—Ba-s-1-n-) Building Perm_�
Shower Receipt No. /e)fi y
Sinks, Dishwas ng
Sinks.
_
Sinks, Ordinary Location of Bui ding
Sinksar L��3,Z.a�_ (r;:' ` �-----------
Sinks Slo
_ _Au omatic � sFiwasTier __ ______---_.�.�----•--------- -_—_..
_
Disposal
Laundry Trays __. e & Address of Owner
.
_Drains Floor _ �� —--
DraainsArea __ ---_—-
Drains, of rigirator
Rain Drains
Automatic as er N me & Address of Plumber
VC un'[ i r n n --
Fountains :)da
Hot Vater 7a-Ek ---
Water Service Size
Urinals — Building Old or New) (Alter. Repair or--
Catch-Ras ns - Yard-- Install)
Lawn Sprinkler System -�-�-
Swimming_-Pnol
1-rinkler7-Ystem
� _ _ _---_�_-
This permit becomes null and void if work or construction 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
r--
I hereby certify that I have read and examined this application and know the sam
to be true and correct. All provisions of laws and ordinances governing this ty
of work will be complied with whethei, 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 regulating construction or the performance of
construction.
:./ +
-E��eLe:Ltd -A ature of Applicant
err +� ;+r . ■. �' .■
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: _ "bp PERMIT NO. :--
DATE:
O. :DATE. i/ DATE ISSUED :—,LZ—
OWNERS
SSUED :._,L1—
OWNERS NAME :
ADDRESS:
CONTRACTOR :
TEST : Air p, Water[] Visual O Labor I
story p I
RESULT: Approved ❑ , Disapproved O , Pending ❑
SKETCH: r
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INSPECTOR 1 TE
NOTE: Attach supplemental teat data bereto] I
UNIFIED SEWERAGE AGENCY NO, 4975 _
WASH N'GTON COUNTY DATE
CITY OF --- ---_
APPLICATION FOR SEVIER CONNECTION PERMIT
OWN E R: __ -�J� '�' -- --------- -----
OWNER'S ADDRESS: ----
STREET
i
STATE_--- - 21P
BUILDING SITE: LOT_—tQ_._.._ BLOCK-__ ------ ADDITION
TAX LOT NO. —___ TYPE OF /OCCUPANCY
ADDRESS - _L3.?3S_4) _ c ---- ---
DWELLING UNITS. /-_-- -------- FIXTURE UNITS-------
SURCHARGE
NITS--SURCHARGE IF APPLICABLE
PERMIT FEE - INSPECTION FEE PS"7 TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEM
Tha Applicant agrees to comply with all rules and re ions of the Unified Sewerage Agency.
APPLICANT
SEWER PFFiMIT
TH;S PERMIT AUTHORIZES CONNECTION TO "HE SEWER SYSTEM.
LINE SIZE _—._.__.-_ - ---- INSTALLER
RECEIVED BY_ _ - __ - -- -- -- ----- ____ _- ----
NCV OR ITT)
COMMENTS:
This Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.
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A
1090'7
EXHIBIT "All
CITY OF TIGARD
Residential Structure Occupancy Restriction
KNOW ALL HIEN BY THESE PRESENT, that occupancy of residential
structure (s) on the following described lands prior to the record-
ing of an occupancy permit releasing the restriction in the Deed
Records of Washington County, Oregon, is prohibited by the ordinance
mf the City of Tigard, nregont (The City will issue a release as
soon as a final inspection determinei that the construction is
satisfactorily completed)
ULSCRIPTION OF' PROPERTYs
Tax Map 251 2DQ, lot 61 Burnham park Subdivision
ADDRESS OF PROPERTY., 175235 •S.W. HillCouilr.� �
NAME OFOWNER: iu!
ADDRESS OF OWNER: I1n1.1 Blvd,, par .1_and
IN WITNESS WHEREOF, the undo signed has caused this restriction
to be executed thieoday of �,
OWNER, /
L
Name
e
APPROVED3J /
B y s 111.— /1':
r/r:..a--t�� ...
ung Official
City of Tigard
STATE OF OREGON
County of Washington 3 as /.-_ .-) "X e 19
Personally appeared before me the above named
and acknowledged the foregoing instrument
to be /r, voluntary act and deed.
1
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STATE OF OREGON
Courtly of Washington
e'I►a XI;U Notary Public for Oregon
My Commies' an Expiresi _
I, Roger Thormsen Dlntsetpr of Records
and Elections and Ex-OlFiclo Roca
of Con-
veyances forsaid county, do hereby certify �-�•
that the within Instrument of wti"na was (]$r1 32
received and recorded In book of ticorde 900K J
No. _ ...._..... _._.......
._.....
of sold County
Witness my hand and seal affixed.
ROGER THOMSSEN, Director of
Retards 6 Elections
t�
Deputy
JUN 17 II 25 aN'1�
CITY OF TIGARD
12420 S. W. Main SIreet
TIGARD, OREGON 97223
APPLICA'T'ION FOR BUILDING PERMIT
New Construction Demolish L�J Addition ❑ Remodel ] Move
ZONING — DATE ISSUED` (p-/a-7!� _T BUILDING PERMIT
DATE RECEIVED
AUTLDTNG E $ No.
._.
13Y __ FE ��PLAN CHECK $ ��s/� - r� ---
--- _ OTHER/r'
I"1-.---j $ k/. VALUATION Sr �D-D
TOTAL $_ � RECEIPT NO./z5*; -
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT N �-i MAP M CENSUS 'TRACT JOB tp
Architect or Engineer
Address
Owner 77-/1yo- S(�V
Address 7� LU. �L /,Sfl - --Phonlot1QI;,-.C1 /
Builder
Address- v S '� �r � Cy��zFS S_ C. � -------Phone��E�,
BUILDING USE Single Res. Multi Res. ❑ Comm. 1A industrial
OCCUPANCY GROUP_ Nn. of Stories--- Total Height_ Area of Lot
Type of Cons tri-,-ioj. I II III IV � Floor Area B 1A 4r 2— _
Set Backs: Front_ T3ack _ L.Side_ �, R.Side_
Private sewer Pipe Size----- _ Sewer_`---__ Septic Tank ❑
Water Service Pipe size_ 54 � Storm Sewer ❑ Ditch ❑ Drywell❑
Street and Curb Requirements
Driveway Width -- -_ -� No. of Parking Spaces Z
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED_ 7;- e i
FIELD CHECK B' —_ DATE
PERMIT APPROVED -
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building wil
not be occupied until a Certificate of Occup has been/is ued by the City of
Tigard Building Inspector. ;
S g-i nature6f App cant