11030 SW COTTONWOOD LANE 1
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11030 SW COTTONWOOD LANE
4
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� CITY NCk ' `OF TIGARD ► 4
OREGON �..
Ow-ner:..Art Lutz Co. 1 I •`
Permit No. 4 71 '
Building Address....11030...SW, Cottonwood. La_ne.......
Certificate is hereby given this......4th day of. November
•
that said building may be occupied and �.
i,hat it, complies with all requirements of
the Building Code for the City of Tigard,
3"
R5 Approved by the Tigard City Council.
$uildinr Inspector
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SEWER PERMIT N9
12176
Unified Sewerage Agency Tigard DATE `-r�'"3�`7?
of 4'a-hington County CITY OF
L'WNER: Art Lutz & Co. PHONE : 646-5174
OWNER 'S ADDRESS:
TYPE OF INSTALLATIONS
[j]BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
LnJNEW I.J 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:
PERMIT FEE E 25.
575.
CONNECTION CHARGE
SIDE SEWER INSTALLATION
ISSUO BY
OTHER
I TOTAL $ 600. _
APPLICANT DATE
SEWER PERMIT N? 12176
ADDRESS OF STRUCTURE 11030 SW Cottonwood Lane
TAX MAP.r TAX LOT SYSTEM Fanno Creek
LOT 211 BLOCK OF
APPROVED BY DATE 10I SSEtl) BY DATE
REMARKS Eldo. .14471 _
BUILDING PERMIT APPLICATSON " TIGARD DATE e,� —77 1s - '� '
THE UNDERSIGNED HEREBY APPLIFS FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE •,f�. � '��+
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
1 yycc LOT NO.
OWNER Nr?. LOtZ vQq JOB ADDRESS 11USW LgtL onijgud jEoMEADDRESS _
ARCHITECT
ENGINEER
BUILDER kli1Mt..v ADDRESS _ _ DESIGNER
STRUCTURE AQ9W ❑REMODEL ❑ADDITION _ 0REPRIR _❑_RENEWAL^❑FIRE DAP/AGE ❑DEMOLITION
❑-FIESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR F'r1RT ❑GARAGE ❑STORAGE❑SLAP ❑FENCE
❑BOND ❑MOV ING ❑G'?NDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVE' ❑SIGNS
OCCUPANCY a< ..LAND USE ZONE_ I!�� _BLDG. TYPE_ _FIRE ZONE_ PLAN CHECK BY JU ^ _ HEAT_ 4ria _
to conet. .aa 3 bedroom 2 bath ain�,ly family residence 2 w/attachrrd geers4'Ag -'
tat 211 anpinunnd 11f
-f&•-LQEQ-- —EL0QEi-1�D- -_ HEIQHT ,� NO.STORIES I- AREA 1a910 NO.BtDRr�oMS 3__VALUF� A2.�il�„
BUILDING DEPARTMENT SET BACKS FRONT - 20 REAR _ � LEFT SIDE If, RIGHT SIDE 1Q
Permit 163.00 —� ----_ --!
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE. BUILDING CODE, ZONING
Plan Check sl.50 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AEED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE W17It
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIc PERMIT DOES NOT WAIVE
RESTr%ICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO H..JE CURRENI CITY BUSINESS
State Tax 7.34 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 2511.84 yn'.•'.'m ;. LavL�u�►nlerl I l�rrlyti ��II<< , 1�)
By
-- APPL ANT OR AGENT
Approved receipt No.
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING GATE
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n / ontrs.:tor
Per
AF-(A,-LI nit No.
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R Mh-iin
q• _ Fixture _
—c— -I--L1 F incl
HEATING
Contractor
Permit No.
Gas or Oil
---
Rough-in
Final
SEWER
Final
_. DRIVEWAY
—_ Final
— _ Storm Draina
(Rain Grain) Final
Sidewalk
Curb&S*.eet Final
A roach _
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
``- l_onir Final
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