11050 SW COTTONWOOD LANE 1
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11050 SW COTTONWOOD LANE
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address QC's ,- .� � ',, ,_�r_,''r.:1� Permit No.
Permit charge �jd72
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Paid by
...........
Type of building Datr co;inected
Service rate Inspection fe13
Contractor Paid by date
iz, -i' ,,innaction Assessment Paid
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CITY OF rT IG,ARD Ney
OREGON
Monogram Hames .Permit No._.�.h.e.4.... ...
. ..
Owner:..-............................................ ....................".......-.
Building Address.... ._......�Stl SW Cottonwood Lane
Certificate is hereby given this....27.......-day of .@n.�ia.r.y............. 19...7.8... �' r
r that said buildiny; may be occupied and
that it complies with all requirements of
the Building Codo for the City of Tigard. I'
as approved by the Tigard City Coun%.il
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SEWER PERMIT13o 376
N. 66
of
Unified Sewerege Agency Tigard c-�s rd 9-12-77
of Washington County CITY OF DATE
OWNER : __ I►'Innng,ram HnmPq
PHONE : 646-0186
OWNER ' S ADDRESS: —
TYPE OF INSTALLATION:
QO UILDING SEWER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
JEW X0 SINGLE FAMILY ❑ COMMERCIAL
❑EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
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:
PEgMIT FEE $ 25.
CONNECTION CHARGE b00
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
T TAL s A25 —
APPLICANT DAiE
NOTICE : IVC days of "le above
date, sewer service charges
will r egin.
SEWER PERMIT M
ADDRESS OF STRUCTURE 11050 SW Cottonwood Lane
TAX MAP TAX LOT SYSTEM fanno eek
LOT BLOCK OF _
APPROVED BY DATE ISSUED BY DATE
REMARKS bldg. #1684 _
�:�\�,,�.,...r,-,.-....r--.,........,....,..,.�,,..,..._.�..,.,,,_...., ..,�,..�....•....._._...., _-....-•..,.._..r,.....,.._.,.......�.
BUILDING PERMIT APPLICATION of CITY TIGARD DATE �•i:>-�j Oji �
THE UNDERSIGNED HEREBY /APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE .XCOMPAN'�'ING PLANS AND SPEC'FICATIONS. OWNER PHONE
LOT NO. _
OWNER +Jno6ram nomwo JOBADDRESS 110t�U 1,0tt0fi, IdU Lna IOME ADDRESS _
ARCHITECT
ENGINEER
BUILDER
ADDRESS �— DESIGNER __
STRUCTURE ❑NEW C1 REMODEL ❑ADDITION ❑REPAIR ❑R_ENEWAL_ L11FIREDAMAGE []DEMOLITION
❑FIESIDENCE ❑COMM ❑EDUCATIONAL ❑GOVT ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GAR:GE ❑STORAGE❑SLAB [:]FENCE
_❑BOND OMOVING_ ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _
OCCUPANCY LAND USE ZONEh-' r BLDG. TYPE J11 FIRE ZONE PLAN CHECK BV ®VAI HEAT.----
const. -sing .0
EAT.__ _const. _singly P'arnily dWoli.Lm, w1attactictd g3r.agiu raisoue Ptlrmit, #1097
3 bedroom 2 tiath
QCC
LOAD F144P19A�_-;r4��----N�L ITr _ NQ•1TQRIES 1 AREA 1 4 NQ
BUILDING DEPARTMENT SET BACKS FRONT 2D_ REAR 1L LEFT SIDE , RIGHT SIDE
�1-
Pcrmr 1b3*0L ---
THIS
—THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10,0C REGULATIONS AND ALI_ APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THA 1HE
WORK Wit 1, BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 173.('C ALL APPLICARLE CODES AND ORDINANCES. THE ISSUANCE OF TKIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURnENT CITY BUSINESS
State Tax L. UCENSf. SEPARATE PERMITS REOUIBEU FOR' SEWEN PLUMBING ANn 14EATING.
.),s O(Q L1t."jo ,.;pmwri_. L.'lciI'161I4 4J(JLI*
Total 179,9i hark Jolvaivpmont . F)arm�•
By
APPI-ICANT OR A .ESV -- -- --�-- ---._..-----
Approved atu Receipt No.
ADDRESS —.. ------ PNONE •----"
.—. r.+.Y�..e+WM_�wJ1�YYW+.u.wa"----••.. t..w....�.�rM.�tiuYe'uJr.++4wurMlYUYWc.MYW.Y.Y.+Ili1�.Y-.aei.._ J'`.�'..s-�..""wawe�'iw5.�:iIMI�/M�W.wS.uAYY'YLY..iMfLA�iY1Re.a..... ..
DATE INSP. TYPE ONSPECTIO14 REMARKS PLUMBING DATE
-0-- T(3 Contractor _
- 5-11 Topt-- Permit No.
Rough-in —
�T—
/0.2i 77 .�a� Fixture
/ •Z(i 7 / —_-tom. G_¢e -Gt-/" -��/rttse Final-_ -- ---
. .u c-ls�C4- HEATING
Contractor q
/U •7/'�. ;/A��' R-<-•'� '- .Q�� �e.ct Permit No.
Gas or Oil.—--- - - --
- r/• S�/.�C�r. �.? r_�
Rough-in
- Final
-- - --- SEWER
4-`'1 ---
'Onl �3: Final —
'�'"T"--�u DRIVEWAY
Final
Storm Drainage
�¢Zn�s (Rain Orain) Final
�I(nocMa " Side•ya:k
-23- 47 - OIC Curb&Street Final
A roach _
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATF OCCUPANCY F.nal
Landscaping
Zoning Final
1
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iL,ard Mechanical Permit N70 Permit _S3.00_ _
Fee CA-0 _
Nm Installation Replace ❑ Relocation ;� Addition ❑ Altcrat�nn 'D State____.r_._��_
CO .TRACTOR �_L �t.1�'l� 5�.---- --.— tTA L
OWNER / /1� -
ADnRFSS--L- �"!_� r� ✓l. 9 �� y WORK ADDRESS D`SD S�C,✓�
PHnNE _ � G U� _• — APPLICANT (1-E,✓tc,�,r}�� „:�- _ L '�
Heat Input Rating (BTU Per Hour) /1/j Vent Size '"�� Flue Size—
FUEL OIL ❑ GAS ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _ _ 3.00 Air Condition Compressor 15 to 30 HP 10.00
New• Under 100,000 BTU —_ �/ 4.00_ Air Handling 10,000_ CFM _ — _ 3.0_0_
New- 100,000 BTU&over 5.00 Air Handling Over 10,0_00 CFM 5.00
Floor Furnace _ — 4.00 Evaporative Cooler _ 3.00
Wall• Floor •Suspend_ed _ 4.00 Range Vent 2.00
Install Vents Only 2.00 Vent System _ 300
Repair - Heat & Cooling 4.00 _ Hood Commercial
Air Condition Compressor Under 3 HP 4.00 Commercial Duct System 10.00
Air Condition Compressor 3 to 15 HP i 7.50
INSPECTOR'S COMMENTS
y, CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
D BY--.---- DATE ISSUED BY DATE
774 Signature of Applicant
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