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C��� CITY OF TIGARD 'VC),
OREGON
Owner: .....Ar.t..Lu.tz---&...Co., . -_ .. ..Permit No._.._1.462....._.
` 11035 SW Cottonwood Lane
BuildingAddress.............................................. . . .................... ........ .. ... .... ......
Certificate is hereby given this. 14th November 77
....... ........clay of. .............. ............._, 19..........
y that said building may be occupied and
that it complies with all recluirementE of .�
the Building Code for the City of Tigard,
as approved by �' Tigard City Council.
I �y
Building Inspector
A d d r r,r, A S—
Permit No.
Psrinit cl-largf..,
Paid by
i,Y;-j u n r ,,u i i ui i n g
-Itu conflucted
5arvir,o roto
Inspuct.j(3n
Dalr;
paid
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Cit of •, �
City Tigard
INSPECTION REQUEST �
for
SPECTION TIME: _ - PERMIT NO. : I
DATE : /: DATE ISSUED :_--LL_ I
MINERS NAME
ADDRESS: .>�,•, ---(--- ----i I
--
'JN TRACTOR --
c ST .' Air tj, Woter(p , Visual p , Laboratory 1:3
!ESULT : Approve Disapproved C Pending 0
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SPECTOR DATE
[OTE: Attach supplemental test doto beret -1 1
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CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DAT!' : 5-1.7-77 ESTIMATED :'1'ES PRICE S.ng,nnn.
APPL)CAMT NAME Art Lutz & Co. TELEPHONE ,-. 287_4521
JOB ADDRESS 11035 SW Cottonwood Lane BLDG. PERMIT _ (��
AMOUNT OF FEE FOR S. D. C. $300,,00
DESCRIPTION OF IMPROVEMENT single family dwelling
EXEMPTIONS -PER ORDINANCE --77-26
FEE HATES:
A. Single family dwelling unit under $60, 000. --------- $300. 00
B. Single family dwelling unit over $60, 000. --------- $400. 00
C. Mobile Horr ! Court Space (New Development)---------- $150. 00
D. Multi-Family Dewllings--per unit-------------------- $249.00
E. Commercial , Industrial & Institutional (Park. Space) $ 50. 00 each
F. Single family unit under $40, 000. ----------------- $250. 00
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SEWER PERMIT
Uf
M12171
Unified Sewerage Agency Tigard of Washington County C I TY OF g DATE 5-17-77
OWNER : Art Lutz R ('n_ PHONE : 297-4521
OWNER 'S ADDRESS:
TYPE OF INSTALLATION :
X❑BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
X❑NEW Q SINGLE FAMILY [] 'COMMERCIAL
[:)EXIST . (PRIOR TO 7-- . --70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS CWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF T'Ac UNIFIED SEWERAGE AGENCY. WHEN CALLING FCR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITF_D SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE 25.
CONNECTION CHARGE 575.
SIDE SEWER I NSTALLA'r I ON >"7'✓ < ^C < t-i�--�-•--
/ ISSUED 6Y
OTHER
TOTAL_ $ 600.
AP LICANT DATE
SEWER PERMIT NV 12171
ADDRESS OF STRUCTURE 11035 SW Cottonwood Lane
TAX MAP _ TAX LOT SYSTEM Fanno Creek
LOT __1_9 5 BLOCK OF
APPROVED BY DATE ISSUED BY DATE
REMARKS_ Bldg, =1462
TIIGAIDBUILDING PERMIT APPLICATION I'oF DATE 5-17'• 7 1462
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOM IHE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE---
LOT NO.—
OWNF_R nrt Lutz & Coe J SADDRESS 11035 5U Luttonuguti 1.400EtADDREss
ARCHI''ECT
ENGIriEER
BUILDER 89171E
ADDRESS DESI(;NER
STRUCTURE __QkEW0-REMODEL– OADDITION ❑REPAIR []RENEWAL ❑FIRE DAMP_,E _❑DEMO_LIT_ION
RESIDENCE DCOMM []EDUCATIONAL DGOV'T DRELIGIOUSDPATIO DCARPORT DGARAGE DSTORAGEJSLAB DFENCE
DBOND
DMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW COUNCIL APPROVED ❑SIGNS
OCCUPANC'e LAND USE ZONE BLDG.TYPF FIRE ZONE_--. PLAN CHECK BY etw HEAT �Y8
r,onst* aingk family dwelling w/etta;,hud gereya $bedroom 2 beth s
Lot 195
OCC,LOAD E QQR LOAD 4(1 HEIGHT 20_ N .STORIES a —AREA NO.BELIRQDM"_ VALUE30a 500,
BUILDING DEPARTMENT SET BACKS FRONT REAR :13 LEFT SIDE 14 RIGHT SIDE jj
Permit 130.00
— -----_- __ _.�.. .._ ._ __-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUILDING CODE, ZONING
Plan Check 6500 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE POITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WIAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tay 5e85 LICENSE. SEPARATE PERMITS RE�UIRED FOiR :iEY11ER PLUMBINSi AND HFATING,
Total 200•:)5
BY _
— APPI ICANT OR A(.ENT i _
Approved :u Rvcf 1lpt No
ADDRESS Pl IoNF`
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-2 -N,2, Contractor
Permit No. _
n Rough-in
Fixture
Final _
HEATING
_ Contractor _
Permit No.
Gas or Oil
Final
SEWER
Final
DRIVEWAY
Final
jAr)oroach
orm Drainage
ain Drain) Final
dewalk
urb&Street Final
_BLDG DEPT. FINAL. TEMPORARY CERTIFICATE OCCUPANCERTIFICATE OCCUPANCY inal
andscaping
oning Final
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