11020 SW COTTONWOOD LANE 1
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--�� CITY OF -11GA RISOREGON
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+Y►4 Art Lutz & Co. Permit No._132J
Curler:..
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,7 Building Building Address....................................................... :................... ....#..................
t 11020 SW Cottonwood Lint= Lot 210
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Certificate is hereby given this...... c•f....AuQust__........... ly ..1:?.. ✓j`
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tl,,W said building may be occupied and
that it. complies with all requirements of
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the WiHing Code for the City of Tigard,
as approved by the Tigard City Council. M �:
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BuildinR Inspector
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City of Tigard
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INSPECTION REQUEST
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for
INSFECTIONI TIME . 'PERMIT NO.:
DATE: -5-//`/j_ ,77 DATE ISSUED:
` OWNERS NAME " - 4'rte:
ADDRESS :
CONTRACTOR
TEST: Air ❑, Water p , Vieuisl*, Laboratory p
RESULT: A
pprawed , Dkiapp11-,,w++..L7 , Pending L;
SKETCH: 1')
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INSPECTOR _DATE
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t! CITE !trach supplem*ntal tett data keret]
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: j; 'r� _ PERMIT NO. :
DATE: —''`� `'
Ly�/:, DATE ISSUED:_.1__1__
OWNERS NAME : _ - Z`
ADDRESS :
CON-TRACTOR :—. Z-_lQ___—_ ___
ITEST- Air O, Water ❑i Visual ❑ , Laboratory ❑
- RESULT. Approved Disapproved ❑ Pending ❑
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INiECTOR GATE
�NC'7F Attach supplemental fast data herstp
UN I F= IED SEIJVERA(_i E AGENCY NO.
WASH I NGTON COUNTY DATE ---_2-24-77
CITY OF
APPLICATION FOR SEWER CONNECTION PERMIT f
OWNER: _._�_---------------- _ Art Lutz a
OWNER'S ADDRESS: -__.`_.
STREET
CITY - -
STATE - - --- - .._--------
ZIP --
BUILDING SITE: LOT 210 ADDITION
TAX LOT NO. ._ TYPE OF OCCUPANCY _____
ADDRESS - 11262XSZX _11020 SW Cottonwood Lane
DWELLING UNITS_ _- 1 _ FIXTURE UNI1S .
SURCHARGE IF APPLICABLE.
PERMIT FEE .- 75• INSPECTION FEE 25' TOTAL DEPOSITED _bpd•
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fanno Creek
The Applicant :agrees to COrriply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT__..-
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE_ 3iZC INSTALLER
RECEIVED BY-- - _ .,_ i
(AGENCY OR 4TS ASI_NT)
COMMENTS: .._.B1dq.__#- 1320
This Application .ind permit expires in one hundred and twenty (170) days.
The amount paid will be forfeited should expiration occur.
$0 NNW 1010
BUILDING PERMIT APPLICATION cOFY TIGARD DATE ,c= _
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK 14REIN INDICATED BUILDER PHONF'- 4,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFJCATIONS. OWNERPHONIF _
LOT n U. —
OWNER ALL Lw Li JOB ADDRESS I"" -U ' "LUftOd000 HONd ADDRESS
ARCHITECT __
�y
ENGINEER
BUILDER ADDRESS ^ DESIGNERST ❑ ❑
STRUCTURE ❑NEW ❑REMODEL
ADDITION REPAIR ❑RENEWAL ❑Fir,EDAIdAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPA110 ❑CARPORT ❑GARAGE ❑:,TORAGEC{SLAB ❑FENCE
CIBOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN PcVIEW _ GCOUNCIL APPROVED DSIGNS
bN
QCUPANCY_—_—LAND USE ZONE BLDG.TYPE FIr,c ZONE_ PLAN CHECK SY etw HEAT—_^�_
i. family ojelliwi w/atto hod 'garage 3 badyocr 2 t+:
a _MQ�IQBIFS_?_ AREA d. .:—_ NO.B_F aQDMS__LYALUE
B. iLDING DEPARTMENT SET BACKS FRONT '20 REAR ,j,5 LEFT SIDE RIGHT SIDE
Permit •JU _—�-------.�— ____ --
—'—'— THIS PERMIT IS ISSb D SUBJECT TO THE REGULATIONS CONTAINECI IN THE BUILDING CODE, ZONING
PlanCheck r.L�Clil REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTR!CTI1lF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax I ICE NSE, SEPARATE PERMITS REQUIRED FOR SEWER, PI_UMBING AND HEATING.
Total 19e 39
Bv
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APPL.ICANT OR AGENT
Approved t� Receipt No.
FIT AD51111ESS
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-p2nvoctor
C Sj tea_ ;` - �° 3-5-'7
_ Permit No, �� �-�
., �_,_' Rough-in
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CQ�u r__ �oc�- ,_�•.__!' rL� � L Firwrr,
F inal
HEATING
Contractor
Permit No.
`I Gas or Oil
Rou -in
Final
SEWER
Final
—_ DRIVEWAY
Final
Storm Drainage
---- (Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCJPANCY Ficial
( Laidscapmg
Luning Final
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ADDRESS PERMIT NO.
PERMIT CHARGE none
OWNER CONNECTION FEE _573 V
PAID BY
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE _ �`'/�� INSPECTION FEE
C014TRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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