11025 SW COTTONWOOD LANE A
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11025 SW CO'rl'D%IOOD LANE
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Addrns3 ��aS- -.SV Pr: rm.it No, 19
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SEINER PERMIT N° 13479
Unified Sewerage Agency
of Washington County CITY OF Tioard DATE July 19, 1977
OWNER : Art Lutz & Co. PHONE : 646-5174
OWNER ' S ADDRESS: 11025 S.W. Cottonwood Lane
TYPE OF INSTALLATION:
U BUILDING SEWER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑NEW Q SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
I
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 FEF 500
CONNECTION CHARGE 6nn_ nn
SIDE SE=WER i NSTALLAT I ON (�
ISSUED BY
OTHER
TOTAL $ 6?c;_ nn _
APPLICANT DATE.
SEWER PERMIT M 13479
ADDRESS OF STRUCTURE 11n75 c EnLtmnrrnnri I ansa - --
TAX MAP TAX LOT SYSTEM '
LOT _BLOCK OF --
APPROVED BY
DATE ISSUED BY DATE
REMARKS
.+1� •b....'�..'!Yr+wn •. rn_r-.._•.+r'rwM�VrW-✓.WrYaw.;. w.�.a.eyyrw. nYMM'N^n.+�.r r.n
w i•rr'nw�.nr +wnr•,,.,.,y,.n-.m-nM'v+w+w^1�wn...r-w�wnyrRwrr++�.
BUILDING "riERMIT APPLICATION of TIGARD DATE 3ul.y 19 '19 77 �� 1; 0
THE UNDr RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE f:�� "•=•� '�`•
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPIIONF
ULOT NO.
OWNER -rt { ub;- & Co,, JOBADDRF.SS 11025 SU C.a"UllWJi WOMEADDRESS _
ARCHITECT
BUILDER SA-:ns Ebr ,;d ADDRESS r ENGINEER
DESIGNER
STRUCTURE ONEW ❑REMODEL LJADDITION ❑REPAIR ❑RENEWAL ❑
FIRE DAMAGE O
DEMOLITION
❑ RESIDENCE ^COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS DPATIO UCAR
PORT ❑GARAGE ❑S-ORAGE LISLA13 ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_-_LAND USE ZONE_ __-BLDG.TYPE—F IRE ZONE_. PLAN CHECK BY HEAT
— To conutruct aaingis family dwaalling with attached g roue '-- —
3 bt1. rm. .' pith Lot 196
This In a P-iealae of Permit ;#13151 — --- --
--- ----------
9C0.LOAD.__._ F AWB-LQAD 4r, -------. HEIGHT 20N0--ST29.IES ` AREA �'59r-- Vl1LSlE1L� .,�; l
BUILDING DEPARTMENTp
-- .— SET BACKS FRONT 20 REAR 35 DE LEFT SIDE RIGHT SI6
Per rn t 142,00 -- — —... -------- ----
10.OC — THIS PERMIT IS ISSUED .'SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COCE, LONING
Plan CheckREGULATIONS 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. 7HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
��� RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax • LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total j;��•��
RY
- - " � AFV• i-nNt cR ar.Fr�I
Approved —� Receipt No
ADDRESS
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
TE/�?Cil ? �e�1 f �s,.cn� — Contractor
g _ I ��G Permit No
Rou h in
vG It Fixture _ __--
- Z)(. _ - Final ---- �-
-� -L_ �6C 7) jo U v2�IHEATING
x - -71 — j)I AP O��E C f fi '1 C0�„•actor _
�— �— Permit No_
_c-tA-M �to Gas or Oil ----- — --
�— = R uucjh I n _ --- ---
/,� Final12
_
SEWER
---
-- — -- n-s -�o `� -----DRIVEWAY----
-- _1J�f �3L�-'�` �- Final
D. Q- a Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach --
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CFRTIFICATEOCCUFANCV _----.- —
Landscaping
�. Zoning Final
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