11070 SW COTTONWOOD LANE-1 MWAa�
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11070 SW COTTONWOOD LANE
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C-111"Y OF TIGARD Ivc '.
OREGON
_.. Permit No... .. . _............. ".
0�ner: Monogram Home�� 12��9
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Building Address... . 1.1.0.7.0 SW Cottonwood Lane Lot 215 '
Certificate is hereby given this.....b. daof.. .. ugar.......... ., 19.77.}
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_!� that said building may be occupied and � � �� '
that it complies with all requirements of
�►ythe Building Code for the City of Tigard, .i
as approved by the Tigard City Council.
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rr...a...:.:...Building Inspector
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City of Tigard
I NSPECTiON REQUEST
for
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INSPECTION TIME: '' �_ PERMIT NO. :i
DATE: G/z / 73 DATE ISSULID :_I
OWNERS NAME :
ADORES$: "7 0 (y
CONTRACTOR : L ►-� �� c I
TEST . Air p, Wate►Q , Visual', Laboratory p
RESULT: Approved , Disapproved O , Pend-'mo 0
SKETCH:
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INSPECTOR DATE I
NOTE: Attach 9uPplsmenta) test data beret] I
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City of Tigard I
INSPECTION REQUEST
I
for
INSPECTION TIME: _ PERMIT NO. : I
DATE: / %.__ DATE ISSUED '.--L-/-
OWNERS
SSUED :___L._.L_OWNERS NAME : -.
ADDRESS:
CONTRACTOR : _- -_.--- -TEST : Air 0, Water[] , Visual [7 , Laboratory []
RESULT: Approved 0 , Disapproved C Pending p
SKETCH:
I �
IiNOECTOR DATE
COTE Attach supplemental teff Aato beret]
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UNIFIED SEWERAGE AGENCY NO. ___1.1.696__-___ _
WASHINGTON COUNTY DATE
CITY OF___ Tigard.-- -- ---
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _--- Monooram Homr_�s
OWNER'S ADDRESS: -__-__...._..-___-___._.. ____-____
STREET
CITY STATE Til'
BUILDING SITE: LOT.--. .---— BLOCK __ _ __ ____._ ADDITION -_--_____
TAX LOT NO. — TYPE OF OCCUPANCY residgn>r8___.
ADDRESS _ 1107D- W -Cottonwood Lane
DWELLING UNITS 1 -- --- - ----- - . - FIXTURE UNITS _
SURCHARGE IF APPLICABLE
PERMIT -EE - 575'-_ INSPECTION FEE 25.'___ TOTAL DEPOSITED _.600.
FennoCieek
(NEVI) (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE
RECEIVED
(AGENCY�QK ITS AGENT)
p
COMMENTS: _ Bldg,#1349
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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7
2� BUILDING PERMIT APPLICATION C17Y
of TIGARD CIA -- 3�-l ''-7 I ___ 19
tR�
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE —
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE Y
LOT NO. _
OWNER a,r1L��jC," --I,i, _JOB ADDRESS-,11(17(7 :?W cottorriw000 HbM!'ADDRESS
ARCHITECT
ENGINEER
BUILDER � _ ADDRESS
—.- DESIGNER
STRUCTURE QN'EW ❑REMODEL_ ❑ADDITION ❑REPAIR ❑RENEWAL. ❑FIRE DAMAGE_ ❑DEMOLITION
13AESIDENCE_000MM ❑EDUCATIONAL ❑GOV'T ORE LIGIOUS❑PATIO ❑CARPORT ❑GARAGE —❑STORA�,E❑SLAR ❑FENCE
❑BOND _❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW Y 13COUNCIL APPROVED ❑SIGNS `—
OCCUPANCY--L—LAND USE ZONE 1'-7 BLDG.TYPE �)ti FIRE ZONE-! PLAN CHECK BY tw HEAT
e:ans single family dwolling sw,,'* t tsbhe cl ._,aragef iend natud an plans.
bs_♦.cnram —2 bath watsigD--��#r aSY• Pt. —
o .�.Q�`p--- . -e �_I.s��C?.-_�a—r�1s►�L__ _�vI T�Hi - -AAEaIEiI:; BEunDA 3 y .1 .400.
BUILDING DEPARTMENT 2O
— SET RACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit l:il�00 -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 7a.Z10 REGULATIONS ANn ALL APPLICA8I.E CODES AND ORDINANCES, AND 17 IS HEREBY AGREED THAT 1HF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLAriS ANDSPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APr'LICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTO1`1 AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6,79 LICENSE. SEPARATE PERMITS nEQUIREL) FOR SFWER, PLUMBING AND HEATING.
Total 233*"(Ili
By
APPL'1'AN7 OR AGENT
Approved ( ;W Receipt No.
ADr)RE55 �
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
_ i Contractor J
1 ,,� Permit No. `� -7VW-72 Q9 I
�'Q,,,.�; _ ��,: ' Rough-in
�j ZT (�y��� Fixture
Final
HEATING
Contractor ,3,
Permit No. ;7, -2,.)l
Gas or Oil
Rou h-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage__ _
(Rain Drain) Final
Sidewalk
Curb&Street Final
_ A roach _
BLDG- DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
(/ Zoning Final
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Address //o)p Ca` 'o- !' Permit No.
Permit charge
Owner Connection fee
0
P a i d b y
Type of building ,�� Date connected
Ser ce rate Inspection feed Q
Contractor _ Paid by Date
Size of connection Assessment paid
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