11015 SW COTTONWOOD LANE-1 1
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11015 SW COTTONKM)D LANE;
oDRE:i5 PERMIT NO.
PERMIT CHARGE none
OWNER �'L_...5:�..�.�,..r_.}:�:�._..._._ CONNECTION FEE
PAID BY
TYPF OF H�.ILOI`1, �; DATE CONNECTED
:� iry rE RATF INSPECTION FEE _ ,�2S
JTRACT0R PAID BY DATE
:-) JZ! OF CONNF C T I ON ASSESSMENT PAID
n'
BIJILDIwG DEPARYMENT, TICARD
PLUMBING PERMIT lr • �
hold:T of a val;d plumbing contractors license is hereby 7
J authorized to cau-,e plumbing work as herein nosed to be installed in accordance with the plumhing code of
Tigiird. Such inst31lat.ions require inspection by the City Inspector who shall be notified not less than four
} (4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
j fo all contractors anp sub-contractors.
Owner= 7
— ---- Add;ess �Q/Jr�.Sr.LCA KGs�llata l�-//' 7
—�-- -- -----_._ NUh1P.Eri OF TUTAi PERrafl NO.'S
TYPE OF P" h111 ITEMS FEE ON EACH AMOUNI (Offlur Use Orly)
17 E5iDEA TJA L_____ — - --- -- - — - -- --� - -- — --
S n le �arnil 1 bath oarh 25.00 �' O
Uunlex Each t bath unit 25 00
i Ad' t oral hathrooms ia,-h 1000 .
Mohue Home Space—each_ — .1500
INt1IVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 building-each v - 100
51 to 100 Fixtures in 1 building_e.trh --_ 2.50
101 to 200 Fixtures in 1 building each 2.00
° 701 ur tore Fixtures in 1 bu lding eer..h 1.50
1 M i s r:E L L A N E O U S
9u;4ti+ut Sewer--1st 50 ft. 10.00
f S,e:aer-each additional 100 1t, t0A0
Wxmr service to building — ------ -- 5.70
Private Water Systems-cart, 100 ft. 1000_ 0 0 For Plumb ;9 1�'lrts cr.cion Phone 639-4 17 t
T' �
PERMI7 . —
t,State �, f3G Plumbing Contractor By —
TorAL crrfrl NO, Is,ued By ---_-- ---__ —
R
-�� SEWER PERMIT -'
��' 13831
Uf W
Unified Sewerage Agency Tigard DAT( ].0-17-77
of Washington County CITY OF
OWNER : Art .Lutz & Co. PHONE : _
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
Q (WILDING SEWER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XTq'NEW >eXSINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-- 1--70 ) ❑ MULl . RES. ❑ INDUSTRIA.L
FIXTURE UNITS DWELLING UNITS 1 '
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $ 625•
I APPLICANT DATE
..,, ' -fir' - • � .
-r-L ME SEWER PERMIT
c. a,ir,E 1�I11. .QE6IE1 u� r.1us N 1 1-3831
ADDRESS OF STRUCTURE 11015 SW Cottonwood Lane
TAX MAP TAX LOT SYSTEM Fenno creek
LOT _ _ BLOCK _OF
APPROVED BY DATE ISSUE BY DATE
REMARKS bldg. #1769 _
� A
r�.-.��rw'rr•..,M- +^�-*nhe- .�., .,;, y.R�g, arn^i�t *,
It wpm"w woulill moo 1 14
BUILDING PERMIT APPLICATION 11T TIGARD DATEOF
THE UNDERSIGNED HEREBY APPLIES F09 APERMIT FOR THE WORK HEREIN INDICATED BUII_DEF'PHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE.
n LOT NO.
OWNER'STt. Lutz Co. JOB ADDRESS 11015 SW cottonwood H MEADDRESS
ARCHITECT
ENGINEER
BUILDEF, s:''aM(I ADDRESS DESIGNER _
STRUCTURE X'Q'hEW ❑REMODEL ❑ADDITION_ [I REPAIR A_❑RENEW_AL ❑FIRE DAMAGE_ QDEMOLITION
❑ R--ESIDENCE OCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB []FENCE` OBOND ❑MOVING ❑CONDI i IONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED USIGNS _
OCCUPANCY LAND USE ZONE__' BLDG.TYPE—_.T_—FIRE ZONE__ _PLAN CHECK BY- �It,(., HEAT
feibi 1,,' dwcd link, w/AttLich OU ;jare�p;f � buuruum -3 Uat;ll�
QCG LQAD-„—_-F,L-QQN LOAD O _b EIGHT_ Lk _ NO.STORIES_. AREA 199QN0.BEDROOMS 4 VALUE 47.JAjf%
BUILDING DEPARTMENT' `n SET BACKS FRONT REAR 7 LEFT SIDE RIGHT SIDE '
Permit -
'TF11S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN FHE BUILDING CODE, ZONING
Plan Check ti i0.an REGULATIONS AND ALL APPLICABLE COOFS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK Wit L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb•total 171.JO ALL APPLICABLE CODES AND ORDINANCES THF ISSUANCE OF THIS PERtAIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, GONIRACTOR AND SUB C.3NTRACTORS YO HAVE CURRENT CI'T'Y PUSINESS
State Tay 10.86 LICENSE,SEPARATE,PERMITS REQUIRED FOIL :SFWER, PLUMBING AND HEATING.
Total '282,,36
- -- ¢`1 °S100.
BY _
-- — - ,
- I
APPLICANT OR AGENT
Approved ` L� Receipt No r -
1
awl re .w ■
UATE INSP. TYPE INSPECTION — REMARKS_ - PLUMBING ;DATE'^
Contractor
_7
Permit No.
Contractor
h-in
L�o
Final -- -
iEATING
^�eOI< _ - _- --_w—� Contractor
.44N�ac� -Olc — -------- __ Permit No. 0`-- y� 2
• + ,.� Gas or Uil
0211 in
✓C d.af�( �Gz- Final
A2 -- - SEWER- - --
�- 0 � Final _
DRIVEWAY ^
Final -
- Storm Drainage
(Rain Drain) Final
Sidewalk
tA
Street Final
ch
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCERTIFICATE OCCUPANCY aping
Final
1
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...� .r. iti L 1 6 A.i A
Adc111't0a, ,;J A4r'l *n
C^.NTP
4CTOR�-X'!3�'*.
Ap7 ,
RESS T Cd.� /I W�d2 r►P_� !' t:`l�cr,,; 1'�)RK aots$��!
APPtI1AN,1 ,
Heat InPUT Rating (i'3TU per Hour)` ' ?SCI /�? �: Vim Jyizl ----_-��_ _ Flue Size- �-
FUEL OU ❑ CAS lT ELECT [6 OTHEFI'
ITEM 41IG1. F'!5 ► 17CI�A NO. FEE
For Iss:a wee o'?error, .tom
Air Condition Grmpre_%gor Jr.to 30 HI' 7;
New- Under 100.003-BTU - 4.tV_
IVew 10p,000 I3TI &o.'er— p <- _.QO Air Hisndling_Over+1%. D CFM 5 0
Floor Furnace 4100 Evapcirat e Coder ! ----- 3 U(
r------ - _�_ _. _.
Wall- Floor -Suspended -4.00 2.0(
Install Vents Only 2.00 _ Venf ystem __ ;t Vii(
liepair Heat& Cooling _ _ 4.00 ~_Hood Commercial s —3 0(
Air Condition CoR►press Un;ly! 3 HP 4.00 Corarndreial Duc;System
Air Condition Compressor 3 to 15 HP 7.50
j �
INSPECTOR'S CORRMFNTS
CITY WSWESS LICENSE REOUIRED FON ALL, CONTRACTORS OR SUB-CONTRf1CT'OTIS
APPROVED 8 DATr. ICS11E0 By � PATE
RE=CEIPT N0.
714 tipnature of-Applicant
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