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11345 SW CO`I'11-)NWCX)D LANE
City of Tigard Building Department
13125 Bw Ball Bled. Tigard, Oregon 97223
�Inspect:ion Line (Rae-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Fcotinq Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out -as Line
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
i
Poet/Beam Hoch. Rain Drain lnaalation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. Mach. LL
Date Requested: .•� ^ — _ __
Am
Addreses_.%,'>> i :5G✓ v r ''' ,.s ✓ �,i?Permit f:--� ---
Builder:
T11E FOLLOWING CORRECTIONS ARE REQUIRED:
C
Inspector:_ _ _ trate:_
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_--Call For Reinsp.
wAAr
I
g city of Tigard Building Dft-xtmwnt
C 13125 BA Ball Blvd. _Aard, Oregon 97223
Inspection Line (Rec-•O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _ --
rooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
i
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb'
Pl.bg. Underfloor Water Line Gyp. Bd. -Mach.
hate Requested:_ =� G��- ' Timet/i���_AM PM
Address:
Builder:_.^_
THF FOLLOWING CORRFCTIONS ARE REQUIRED:
i
i�
I �
-t,� /'
Inspector:� Dates ��•� i
APDROVtD
018APPNCPBO APPROVED BOBJtCr TO ABONB
Call Ior 1Minap.
I
City of Tigard RvAildiog Department Z„_
13125 ON Rall Blvd Tigard, Oregon 97223
Inspection Line (Rec-D-Phone): 639-4175 Business Pho.:e: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beim Mach. Rain Drain Innulation -Plumb.
i
Plbg. Underfloor Mater Lina Q!M- Bd. -Mec'.:.
Date Requested: [ — Time: AM _X__1 PH
Address:^,��J _�( )//��///IZ1G�- ' Permit
Builder:---
THE
uilderTHE FOLLOWING CORRRCTIONS ARE REQUIRED:
Inspector: __:t:�„ ,. Date s
--APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Cell For Relrsp.
i
i
1N9rMION NOT_ 1
City of Tigard Building Department
13125 ON Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
I
Inspection:
Footing Plbg. Underslab Koch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam st•:uct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain C btu alloff—> -Plumb.
Plbg. Underfloor Water Line Oyl,. Rd. -Koch.
Date Requested: d� ��� Time: Z�AN PK
Address:_11��yJ � D7J�JZTIPermit I: ��L� �. �
Builder:
THE FOLLOWJNr CORRECTIONS ARE REQUIRED:
/Tj� ���r�Lc'3T�
--
_ f
Inspector: a _-- ---+L--- Date:
APPR(MD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
City of Tigard Buildi-q Department
13125 SN Hall Blvd. Tigard, Oregon 97223 i
Inupection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 j
i
I ■pection: — --
I
F,jot ing P1k>g. Underslab Mech. Rough-in Appr/Sdwlk i
_----_-�- i
Found. Plbq. Top Ort) Gas Line FINAL:
?ramin -Bldg.
cost/Beam Struct. San. Sewer g
Post/Beam Mach.
Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line GYp• ad.
-Me:c h.
Time: —�PM
Date Requeste
d:
Addre6s:_1�; — "'��Gr!�G Permix i
/Builder: -- -
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
inspector:_
�PPROVED T_ DTSAPPROVED -_ APPROVED SUBJECT TO ABOVE
Cal] For Reinap.
i
INBPEt.TIMI NOTIg
0/1—jrnspection
City of Tigard building Depart>teut13125 SitHall Bled. Tigard• oregoo 97223
Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections --
footing Plbg. Undarslab Mech. Rough-in Appr/Sdwlk
✓' Plbg. Top Out Gas Line FINALS
Post/Beam Strnct. Sen. Sower Framing -Bldg.
Post/Beam Herh. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Water Lin. Gyp. Bd. -Mach.
�+
Ov-
Date Requested:_ %7�CU / Timet AH _PH
Address:.
Bu i lder:
THE FOLLOWING coRRECTIONS ARE REQUIRED:
Inspectors_
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainsp.
CITYOF TIGARD
MAND
..noon ON07
COMMUNITY DEVELOPMENT DEPARTMENT #. . . . . . . :
13126 SW HWI Blvd. P.O.am 23397.TOW,orspn 97M(SM)8394176
17 17 1 1
51 TE ADDRESS 5 SW CC TTONWOOD L.-N PARCEL: 1S1*24AC
ZONING: R-4. 5
�I.JBDI VISION. EN13LEWOOD NO. 3
LOCK. . . , . . . . . . 1_0'r. . . . . . . . . . . . . . 164
BUILDING
RE I 5SUE.: DWELL INU UNITS: 1 BA5EIyIEN'r. . . . . . . . :0 r
OP WORK. -.ADD BEDRMS:0 BATHS:0 GARAGE. . . . . . . . . . .*0 s
Ty'PE OF USE. . . .SF FLOOP icEQUIRED GEiSACK13____-_
TYPE OF CONST. :5N F'IRST. . - - ! 16ib Sf LEFT. . :O ft RIGHT- :0 ft
0CruPr4NCY GRP., IR3 SECOND. . . ",O 1;f FROM. :0 ft REA R. . :0
STORIES. . . . . . . : I THIRD. . . . 19' S f REQU I RED_.__._..__,_.__. _-._._.__-___
;EI iFIT. . . . . . . . 15 ft TOT AL -----"-"-'*0 f SMOKE DETECTORS, 'Y
LOOK LUAD. . . . :40 PSf VALUE. . . . . $t 7360 PARKING SPACES- 4-0
emar-k5 : acidic i ti,n tt7 bed ?-GUMINF PLUMBING
S. . . . . . . . . . 10 FI.-C)OR DRAINS. . -0 BCICKFLOW PREVNTR5. 0
TRAPS. . . . . . . . . . . . . . :0
AVPTORIES. . . . . . I WATER HEATERS. . . :0
'UB/13I I.-PUNDRY TRAYS- - - -0 CATCH BASINS. . . . . . . .0
JATEi'-R CL.usE'rs. : i SEWER L1NE (ft) - :0 GREASE TRAPS. . . . . . . .V1
P�01WOSHERci. . . :0 WPIER LINE (It ) , -0 OTHER F IX I'U PF 5i-
'f4HLAf4UL-. DISP. . . :0 RAIN DRAIN (ft ; . :0
I(K.11i i Hu) MACH. . 71 Gr RAIN DRAING. -
L
-------- MELHONICAL FEES
UEL TYPES ------ UNIT 1-17P . 141 type am o I_(nt by da :e
GAS/ VENTS . . . . . :0 BFIRT 6Ei. 50 JLH 07/11 /91
VENT FANS. OPI-17 4 4. iLI 1 0 7
-
URN < 100K . . !0 HOODS. . . . . . B5P(', 42 JLH 07/11 /91
URN . . :0 wO0T)'_-;1OvES. 11' IVI P Q 00 JLH 0 11 t
LOOR F-URN. . . . -0 CLO DRYERS. 0 M5PC $ 0. 65 JLH 07 1 .1 1
07HER UNITS:0 PPF.T $ 5. 00 J1_11 11+7/1. 1 1
GPS OUTLETS*0 P5PC, $ 1, 25 JLH 07/11/91
JPMES' LROOK
;. 13,(45 SW COTTONW011D LKI
1.13VIRD OR 97223
�'lhorie 0 : 6,-;9-6049
BEARS!JN
s MILL.
6 4
1 5 6, 716 T 0 TO
s issued sub)ICt to the regulations cintairled i� the RECSU IRET) TLN';PECTIONS
al
Purkipal Lode, State Of Ore, SM181ty Codes and all other 111rchat)1r. t
8vP!'_zvjP laws. W1 "o'"N "M be (Ion? Ir accoroance WITM apir-ew v,v-t f-am S t r,1.t c't r,,
ed within 181 FILM/lindet'f I POr' Foilr:linq F: irial
plans, This persit will exPi"i ' word it not started MP&1E;niCa1 Itisv) r.o A- I o T, C n ri t
issuance, or if mo,'( is sl�sl)PndtO f cre tha ave
".cUlAtiotl Irtsp
Gvo Boavrj Insp
II f or i'lspec't ion
C;ITY OF TIGARD - RE.rElPT OF PAYMENT RECEIPT
NO. --P I 1 1.15277
C K AMOUNT 81*3
CASH AMOUNT a 0. 130
NAME a GRUOK, LJAMES PAYMENT DATE' a 07,111/91
ADDRESS 11345 SW COTTONWOOD LANE SUSD I V I S IDN
TIGARD, OR 97223-
pUNI--,USE OF PAYMENT AMOUNT PA I D PURPOSE OF pAYMCINT pmouhvr Ppir)
25. 00
4 PERM
50 I.IMp.I NC -
BUIL-DI, Bull-D PER
-W4 E 13. 00 sT.
MECIIANICAl-
AMOUNT PPID 11. 1. 83
u1is SW iieu
CITY GF TIGARD {'O Blvd. PLNCK/RECT # _
Box 73397 PERMIT # V1,36 —
COMMUNITY DEVELOPMENT DEPARTMENT '(lprd,Oregon 97Z'3
(503)639-4171 DATE ISSUED
JOB ADDRESS: - U-3i521L Oo- 1PY'WOPd L'A TAX MAP/LOT
Still: LOT: LAND USE: ��- �A ------
VALUATION:
,I C SPEC AL NOTES
_
NAME: j3jll S.-�.ZREISSUE OF: -- —.--
ADDRESS: +3_ _S CLAST REISSUE:
`►c�aNd �_ R G17�a FLOOD PLAIN/
PHONE: r—�o��' �d�q� _ SENSITIVE LAND:
fQNTRACT(iR APPROVALS REOUIREQ
NAME: Dave Reiwson 6kJ rwi PLANNING: Lok 1Ci- —
ADDRESS: Ip 3131 SC Mill ENGINEERING: — —_
PoY1R- 7 "II'-� _ FIRE DEPT: -
PHONE: u 3-- ('04a2 OTHER: 4d —
CONTR. BOARD #; a EXP DATE:
ITEMS REQUIP.ED
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRAL-TORS:
BUS TAX:
MECH: ------ -
ARCH ENGINEER CALCULATIONS:
NAME: _ TRUSS DETAILS: —_
ADDRESS: —_--._ ---_-- OTHER:
PHONE: _--
PROPOSED BLDG. VE: -
COMMENTS:
APP MANT SIGNATURE i
Received By: — Date Received: ,
�w
PERMIT # NC,uT # DESCRII-BION
AMOUNT AMOUNT PD. BAL. DUE
h� 310 10-432 00 Building Permit Fees
✓ �,SZ _ G .5 u
10-431 00 Plumbing Permit Fees 13
10-431 01 Mechanical Permit Fees 1 `a
10-230 01 State Building Tax (5%)
Building 11 ✓
Plumbing l Z,
Mechanical � � =
L l ✓�
10-433 00 Plans Check Fee —
Building -4 S j
Plumbing —
Mechanical _
10-230 06 Fire --- —
30-202 00 Sewer Connection
30-444 00 Sewer Inspection — ----
25-448-02 Commercial TIF Fees — — — —
25-448-04 Industrial TIF Fees �-
25-448-06 Institutional TIF Fees _ --
25-448-03 office TIF Fees — -- — ---
25-448-01 Residential Traffic Fees — —
25-44£-05 Mass Transit TIF Fees - —
52-449 00 Parks System Dev Change (rnr) —
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) —
24-445-01 Water Quality (Fee in lieu of) — —
24-445-02 Water Quantity (Fee in lieu of) —.— --
TOTAL - 1 _--..( 11 J 1
nm/3587P.WPF
CITY OF TIGARD RECEIPT OF PAYMENT RFC FIPT NO. 01-215155
:,HECK AMOUNT s 44. 53
MANE c CROOK, JAMES i.-ASH AMOUNT 1 0. 00
ADDRESS s 11345 OW COTTONWOOD LANE PAYMENT DATE s 07/09/91
SUBDIVISION
TIGARD, OR 97823--
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PA I !i
P—L'—AN "-CH-FC-K FE 44. 53
l%.
TOTAL AMOUNT PAID 44. 53
n A^ /� Y
+♦,fir
nom•
OF O
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.�L P P44
r ° r ARD PVC
��ITY �F T I ;
L OR>h:GON 1360
Bob Smith {b
1 permit No. :.
.......... .......... ,
... 11345...5W,.Co.tt.onWood _Lane ,
r: C Building Address June. .... . ....
30 day' of._..
•, give this ............ s �
Certificate is hereby g in be occu.,ied and
,r that paid building Y '�.
„-• Axl
that it complies with all reduiremencs of
the City of. Tigard,
C
I the Building ode for
approved by the Tigard City' Council
a_s
, .
........ Building inspector
-gyp
i' Z �4i'4w V0 •
47.3rrSS M r % 1 y ,
1
City of Tigor4
INSPECTION REOUES'T
for
.�, !
INSPECTION TIME . ' PERMIT NO.:
DATE: 6 113177 DATE ISSUED:_.L_L
OWNERS NAME : _
I
ADDRESS :
CONTRACTOR : 8�'�-� �--- - ----
TEST: Air O, Water [3 , Vivuali, Laboratory ❑
RESULT: Approved Disapproved ❑ , Pending Q
I
SKETCH'.
If
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INSPECTOR DATE
CNQTE . Attach supplemental test dato hertt:1D]
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City of Tigard
INSPECTION REQUEST
r �
!49PECTION TIME: PERMIT NO. : I
DATE. DATE ISSUED :- /
I
WNERS NAME : !
A.0DRESS: A _.5
i
'-ter: rRACTO R
_ S 0, Water[] , VV ual Cl , Lab �rotory ❑ I
"?ESULT: Approved I& Diaa roved C
PP , Pending []
SKETCH.
I ECTOR DATE
50TE: Attach supplemental teff doto hereto]
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Unified Sewerage Agency
of Washington County CITY OFTigard DATE __ 3-25-77
OWNER : Boo Smith —` PHONE :
OWNER ' S ADDRESS:
TYPE OF INSTALLATION:
BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
nNEW LJ SINGLE FAMILY COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) E MUl_T . 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 CAI-LING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE--HUNDRED Af'D TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHnUL_D EXPIRATION nCCUR .
FEES:
PERMIT FGF g 25.
CONNECTION CHARGE 575•
/ r
SIDE SEWER INSTALLATION �i�__ •-J�+ J'-�
ISSUED BY
OTHER
TOTAL
APPLICANT DATE
SEWER PERMIT M 12103
ADDRESS OF STRUCTURE 11345 SW Cottonwood Ct.
TAX MAP TAX LOT SYSTEM Fanno Creek
LOT X164 BLOCK _OF_
APPROVED BY DATE ISSUED BY DATE
REMARKS Bldg. #1360 ___ /F�� ��-�i S - A) 3/�0/
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a BUILDING PEPMIT APPLICATION "OF
TIGARD DATE —�J— r 19_—_
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF
LOT NO.
OWNER JU .fl,4 JOB ADDRESS 1134- ;ii,t i uttUnwujo H1Dklr,ADDRESS
ARCHITECT
$ii:1l1, ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE "13NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL- ❑FIRE DAMAGE ❑DEMOLITION
❑AESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE '~ BLDG.TYPE. 'Jr� FIRE ZONE_- PLAN CHECK BY ®�w _ HEAT_ J-' v_
conste single r-awiiy dwelling w/atrttechod garage 3 usdroom 2 both
_ Lot #164
OCC LQA_Q __- -Lg A LOAD �O _NE1C�bT z0 M.STORE_ 1 AREA1408 NO.BEDROOMS VALUE
BUILDING DEPARTMENT SETBACKS FRONT 20 REAR 30 LEFT SIDE G RIGHT SIDE
Permit 1:560 Go
— --- _—_ _—THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 104 00 REGULATIONS AND ALL APPL.ICADLE 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
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4*38 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 150.30
_ r
By
---- -- APPLICANT OR AGENT
Approved Rt,uf�ipf Ni)
Abr)RE55 Y�iQNE
v
i
PLUMBING DATE
DATE INSP. TYPE INSPECTION REMARKS
--
Contractor 71-7
Permit No.
- 'Ti"
Rou h•in
�� --
Fixture
Final
i HEATING
_ Contractor p F
� Fermit No.
Gas or Oil _
Rough in
Final —__— -
SEWER
---- Final ---
---`� DRIVEWAY
-- l Final
Drainage_--
--- �— (Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL TEMPORA CERTIFICATE OCCUPANCY Final —
CERTIFICATE OCCUPANCY
Landscaping /
r ( Zoning Final l
I
{
ADDRESS '�,�Tl n . , �(� �« PERMIT NO.
4
PERMIT CHARGE none
OWNER ' t�� CONNECTION FEE --f
. c_r. PAID BY t
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID