11375 SW COTTONWOOD LANE WALOWAM ONE�
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11375 sw cariONwa)I) LANE
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Permit
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Connoct ion
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SEWER PERMIT �/�
� • 13949
Unified Sewer>Ags Agency
of Washington County CITY OF T.i ja rr' DATE 3-7-78
OWNER : Art Lutz PHONE :
OWNER 'S ADDRESS:
TYPE OF INSTALLATI.iN:
jl*UILDING SEWER ❑BUII,_DING SEWER AND SIDE SEWF'
TYPE OF OCCUPANCY:
xr x
' NEW SINGLE FAMILY ❑ COMMERCIAL.
❑EX I ST . (PR I OR TO 7-- 1- 70 ) ❑ MUL-1 . RF5. ❑ INDUSTRIAL
FIXTUgE UNITS DWEL_L. ING UNITS
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 UNE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 2"1.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION _
ISSUED BY
OTHER
TOTAL. $ 62.5. _
APPLICANT DATE
SEWER PERNIff NI? I ;94.4
ADDRFSS OF STRUCTURE--- 11375 561 Cottonwood La.le
TAX MAP _ — TAX LOT SYSTEM fanno creek
LOT 1"1 BLOCK OF
APPROVED BY DOTE ISSUED BY DATE
NEMARKS bd�. ,, 1935
..+. ......,.+rw►.,gw.•�,.,,_.......—...._ ......rr.ew•w.o,t ....+.ww..w�r Iw.r .....,,,. .rrw.��w......-+,....,+w..�o•... +.�
S
BUILDING PERM"T APPLICATION OF
Y TIGARD DATE ''..7-7�1
fHF UNDERSIGNS HI=REBY AFPLIES FOR M.PERMIT F09 'HE WORK HEREIN INDICATED BUILDER PHONF646T5,74
ll; AS S4�OWN ANG ,4PPRO�ED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. owNERPHgIVIL}
11375 SW CUtt0('IU00d HUMS
LOT NO,
— —
OWNER_ � - JOB ADDRESS S ADDRESS _--
^?: ins u ARCHITECT
ENGINEER
BUILDE7. ADDRESS _ DESIGNER
STRUCTURE _ NEW^ ❑REMODEL ❑ADDITION ❑REPAIR ❑_R_ENEWAL _❑FIREDAMAr'E ❑DEMOLITION
`RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOWT ❑RELIGIOUS❑PATIO ❑CARPOFF ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL_USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY L-A••�N_D USE ZONE___ BLDG.TYPE__ FIFE ZONE_-__ PLAN CHECK BN HEAT
... .�il,:i • �31f11,�,1.$: i Flml1y rtlue II W� Chfir �:.1nraije, =�f:C.l1'��)U{11 3 ba r, - -•-
------ - -- r•IaTr;,a
- - -- _-_ _- A 9 -
OCC, LO.<_Q FLQQH._19A1) -_._____KEIGHT__ —. 2Hfi-NQ_fi Q_9_1f$_—t:� AHEA.--___N_Q+DR00MS VALUE --------
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 00
---
-- THIS PERMIT IS ISSUED SUB.JFCT T(•) TFiE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ' REGULATIONS AND ALL APPLICABI E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAI THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WIT14
Sub-total ALL. APPLICABLF CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State TAX LICEN94. SkPARAtE PERMITS REQUIRED FOR SEWER, PLUM LING AND HEATING
Total . Z IULI
CANT (1R A13ENI -------------
Approved l� Receipt No
ADDRESS P14ONE — -- -
...W1Wr.A.. ..r..A.1v.:'--.- —"Wil/Nl:b➢ii4...,.......•.
LATE INSP. TYPE INSPECTION REMARKS PLUMBING —' DATE
_ Contractor
C _
8 6 8
lRough-in -- - -- —
�'zr6-7g VIE N Fixture _--lit ' -
��`-p1 /LR- Final
��,�� I 7 HEATIN.IG
---�-=f-� ---
51-7f Contractor
//- j� %) rrG'L'�' //�'S✓��r/i0.-vl- Permit No. / / 22.
li (s� /.J- Gas or Oil - -
-_ W—jol __ e"f- f147",S U/v Roubin - -- —
�y>> c _ -/,�"-�.o• �'f'� ���'� �.�L•:/��i� :�;<._(.�`�'-' Fin 11 ---
j SEWER
final -- —
�_�� s DRIVEWAY
Final - - -- - - — - --
Storm Drainag,
(Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG DEPT FINAL vTEMPORARY CERTIFICATF OCCUPANCY —T
CERTIFICATE OCCUPANCY Final _—
Land,caplio
Zoning Final
i
01 �2 J I U uV
roc Ia;nl atian r' -1 Fee.
:)!are Pl.)ration Addition ILD Ahi:'raliun J
tTAL
C'-'.'. C,T 0 R
WORK
PHONE 19
APPLICANT
Hea; Input Rating (BTU Per Hour) eAc Vent Size
Flue Size
FULL OIL F-I GAS V__*"'ELFCT L-1 OTHER
ITEM No. FEE ITEM
NO. F
7 For Issuance of Permit 3.00' Air Condition Compressor 15 to 30 HP
10
New - Under 100,000 BTU 4.0r) Air Handling 110,000 CFM
New. 10U,0'3 BTU&over -AT, 'Handling -Over 10,005 FN.
5
Floor Furnace 4.00 Evaporative Cooler
Wall - Floor -Suspended 4.00 FlangeVenlTil_n
2
Install Vents Only 2.00 Vt,nt System
Repair - Heat_& Cooling 40 )mnivrrial
��7,�� oni4;tion Crimpressw UndL-r
-Air Condition Cumpt essor 3 to IS HP Y.bo
INSPEC10R'S Cor.!%rLNTS
x-7
cire BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUI;-CONTRACTORS
APPROVED BY DATE ISSUED BY
DATE
RECEIPT NO.
774
Signature of Applicant
Now