11095 SW COTTONWOOD LANE N
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11095 SW COMNWOOD LANE
BUILDING PERMIT APPLICATION "c Y TIGARD DATE—.—,
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPF'ONF
OR AS SHOWN AND APPROVED IN THE AC,OMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER t L I`I T I.U„ l.:J i Uf1 W s}f l: LOT NO.
- JOB ADDRESS_ hbME ADDRF_SS
Q111f ARCHITECT
HUILDER Y__ ADURESS ENGINEER
UESIGIIIJI _
STRUCTURF ❑NEW LJ REMODEL ❑ADDITION _ ❑REPAIR ❑PENI:WAL_ _ ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑G(W'T ❑RELIGIOUS❑PATIO OCAR PORT_ ❑GARAGE ❑StORAGE LJSLAB nFENCE
❑BOND ❑MOVING _ ❑CONDITIONAL USE �QDESIGN REVIEW ❑COUNCIL APPROVED 0iGNS
uccurANCY_I LAND USE ZONE f �� BLDG.TYPE ' FIRE_ZONE,__ PLAN CHECK BY _
HEAT_ _
0060• Eini,jc:t faMily 01,1111i.rllj Wo�fattaL.had garvUe ;a ,�udruufn r arat:n
FL9DR LOAD._,AQ_ EICHHT NO.STQRIES l 4
-.BP�J�EFT I NO.BEDROOMS,d
BUILDING DEPARtIv:EN7 SET BACKS FRONT
REAR LEFT SIDE RIGHT SIDE
Permit --'�—
1u0.gfl - _ :— _
THIS PERMIT IS 'ISSUED SUBJECT TO THF. REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check (300 00 REGULATIONS AND ALL APPLICABLE 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
Sub-total 240eUU ALL ,APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRIC71VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax (I,40 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
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Total 246.40 +�.i,�.>r. ; 1 s1f7Q.
BY
A RLICANT OR AGENT -
Approved Receipt No
ADORESi
DAIS INSP. TYPE INSPECTION REMARKS PLUMBING DATE
t — .: ontractor
2
L Permit No. 2" 3—7�l
1-20-91 p
Fixture
0 '#"v0' " re Pe f r Final
HEATING
Contractor
Permit No.
'{ 1 Gas or Oil
Rou _'n _
T �r� Final
SEWER
- --- '-' Final
~ DRIVEWAY
�— final
_ Storm Drainage
Rain Drain) Final
_ Sidewalk
Curb III Street Final
oath
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
C Landscaping
Zoning Final
r, Re:riace Reln,ation AdI tion 1 r.lr4:rallrw ._l , ",t,+te. •1/_ _+
CCiRACTOR�XCC� t'�,(• grfN R�t'�+
AEORESS �DOZ_.[.wL��'a/--'� QRK DRES C� o lu�r�LH�i
PHONE -��___L_l� PLICANY. w
Heat input Hating IBTU Per Hourly v '7Gr�st.4aar« Is ,.Vent'Size '/ —�F;-- Flue"$iae * —
FUEL OIL L GAS' t ELECT. OTHER `
ITEM NO. Ftp 'ITEM' NO. FEE
For Issuance of Permii O0 'AY.46rhfillon Compressor 15 to 30 HP
�_.
New Under 100.000 BTU _ - 4. Ari Han lino:?O,p00 phi_.' 3 0,'
New• 10D+0(10 BTU&over V00 ff .0_0 y AirNandlinWver 10, 0 CFM
Floor Furneee �!_.____. _ r q,b0 _fYvq�StrtatilrllCookrf ��__� _� -D�'t
_ a ��—� - --- Ra
_ 7.00l4all Fgor•Suspnded 4�' — iMeht.
Install Vents OnlyVent" ieMY
3.04•
Rcp3ir • ti_eat 8 Cooling 77 -'H CoYntrterC�a(�
Air Condition CcmPrpssor Under 3 HP-- _ ,p0 _ Ob piN, u�Sy t en• _ � _ 10 OG
.r rCondition C7rnpressor 3 to 15 HP
�ararz � --- as:z.-rs-�c-.ar_-��. -s.l--e�rsr-•e_ ssR�_ t4e..�pfMtlraeaf_•-�ta.= s:7+.-_a._ ..syr
1N',PEC f OP'ii (XIMMI N1$. .. .-. -.; . ..e.s .S . �► +
CITY BUSINVSS LICENSE.REQUIRED FOR ALL CONTMtVIWl OR�Uh-CONTHACIONS
APPROVED By _ DATE _ � _-- ISSUEb*Y W"TE
t RECEIPT
•- _ ._...«---�......�_�'-ra• A-.�.....Y.�..r-tfT+C1�•••* r. a--+�-�'f 1. � .1�iOn�l1,1�R QIlL�I1L_ � �...
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BUILDING DEPARTMLNT, TIGARD N1.)
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A446"'I'lPLUMBING PERMIT lr •�1 holder of a valid piumbiny contractors license is hereby
autllurir to cause plumbing wor�'as herein noted to be installed in accordance with the plumbing code of {
Tigard. Such installations require inspection by the City Inspector who shall be notified not less thdn four i
I (4) hours prior to the time the installations are ready for inspection. City of TigLrd Business regr.lired {
! for all contractors and sub-contractors, t
� p`''•`�''r �s�'_"�. __ ._ _ _ -. Address._.�,L� _ __.. _�V.� 2 ��tl�ate._a"_�� -�_
i NUMBER Or TO1AL PERN11r NO.'S
- TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Oftice Use Only)
R E.S I.D.E NJ AAA—
Single
IAA-Single Family _loth etch 25.00
t Dlnlex Each I bath unit 25.00 j
- �- --- --
Ad6tional ba ',r rnns each L_ 10.00
- M. hrle Hume SP.,cN each --- -- 15.00
I INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 buildng- a rcf, ---�. 0 00
51 to 100 Fixtures n 1-br,rildrny L+rh250
101 to ?Un v xturas in I buildinr each 2.00
1
?01 or rtr r•; rix a .sin 1 hu,lrling_ead-h 1.50
MIS�FLLANEO115 _ _>
—.1000
S•'-' each additional too ft —
n� " +;CR to buildin 5.00 +� ---
$�aterns-esc r 100 ft. IR 00
1 Urhrr 'SLL)-c V
t PERMIT For/'lambs,; n,:ne CrorrgPlrorta 639 4171
11'1 atate - Plumbing Contrartor By
Tpl AL -'— RECEIPT NC IssuP'! By
A
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SEWER PERMIT N? 13855
Unified Sewerage Agency
of Washington County CITY OF_ T i qa rri DATE 12-6- 77
OWNER: _ Art I :if.? R rn. PHONE :
OWNER 'S ADDRESS: _.._
TYPE OF INSTALLATION:
'ffIBUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
'UTNEW SINGLE FAMILY ❑ COMMERCIAL
❑EXIS1 . (PRIOR TO 7-1-- 10 ) ❑ MULI RE`, . ❑ INDUSTRIAL
1
FIXTURE UNITS DWELLING UNITS
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFFR 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 $ 25,
CONNECTION CHARGE
SIDE SEWER INSTALLATION _
ISSUED BY
OTHER
'TOTAL $ 625,
APPLICANT DATE
rllljTli'�o
rt
SEWER PERMIT
.iii N° 13855
ADDRESS OF STRUCTURE 11095 SW Cottonwood Lane
TAX MAP TAX LOT SYSTEM fanno creek
LOT 189 BLOCK OF
APPROVED by DATE ISSUED BY DATE
REMARKS bldg. #1813
P
UILC!NG PERMIT APPLICATION "'y TIGARQ DATE-�t^�__.__... 1921__ NQ 1 �f
UF
+[ ON[A Hc.I('NED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERFHONr__
F A I '-)WN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERP,io� r..
1 LOT NO.��
JOB ADDRESS //V��c1`� � kSQ�._1�----pDARCH TECTENGINEER
ADDRESS
R ADDRESS DESIGNER _
❑REMODEL ❑ADDITION—�OHLPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
--rte ---- —n ----- _ _ r�
Nl.E O _nMM l �EDUCATIONAL OGOV'T ORFLIGIOUSOPATIO ❑CARPORT OGARAGE 0STORAGEOSLAB ❑FENCE
n �- r--O --
]r'INO O
OMOVING ❑CONDITIONAL USE ODLSIGNREVIEW COUNC:LAPPROVED SIGNS
t';':.NCY L ANb L'SE ZONE--R-- . ___ BLDG TYPE 'Y FIRE ZONE—j—Pl AN CHECK BY HEAT—_CL �
r.. 4AL _ FL9.OfjL4AD_ /I'J N..E1�T_.,a►t.�--NQ_nQFIES__ AR�!�Jcc� 4�8Ei�H4lZ —YALU d�
HUILUING LEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULAT'ONS CONTAINED IN THE BUILDING CODE, ZONING
nlan Check REGULATIONS AND ALL APPLICABLE 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
Sulllntal ALI APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
` - - - — - --- RESTRICTIVF COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVF CURRENT CITY BUSINESS
`.Tate TaxU LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Tntal
Hv
APPI iCANT OR AW NT
aI Ir wed Receipt No
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CITY OF TIGARD
ORDINPigCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE
DATE : 12-5-71 ESTIMATED SALES PRICE $ 52,800.
APPLICANT NAME Srt Lutz & Co. TELEPHONE #
JOB ADDRESS 11095 SW rattnnunnrd__Lana BLDG. PERMIT # 1M13 I
AMOUNT OF FEE FOR P. D. C . 6100.
DESCRIPTION OF IMPROVEMENT S.F.0.. ------�-
EXEMPTIONS - PER ORDINANCE #77-71
FEE RATES:
A. Single family dwelling unit under $40,O09--------------$ 75.00
B. Single Family dwelling unit; over 640,000---------------$100.00
C. Mobile Home Court Space (New Development)--------------5 bL).UiJ-
D. Multi-Family dwellings--per unit-------------------- $ 60. 00
CONSTRUCTION IS LOCATED ON S.E . N.W. SIDE OF S.( PACIFIC
HIGHWAY . N.W . is Park District #I . S.E'. is Park District #II.
CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE :� 2_ ESTIMATED SALES PRICE $ 52, 800.
APPLICANT NAM7 , Art Lutz & Co. TELEPHONE ]
JOB ADDRESS 11095 SW Cotton wood Lane BLDG. PERMIT #
AMOUNT OF FEE FOR S. D. C. $300.
DESCRIPTION OF IMPROVEMENT S.F .D.
EXEMPTIQNS -PER ORDINANCE if77-26
FEE RATES:
A. Single family dwelling unit under $60,000.--------- c3., 00.00
H. Single fr mi..ly dw�!Ilinq .!nit over 100,000.--------- $400.00
C. Mobile Horne Cuurt Space (New Development)---------- $150.00
D. Multi-Family Dwellings--per unit___________________ $240.00
E. Commercial, Industrial & Institutional(Park. Space) $ 50.00 each
F. Single family unit under. 540,000. ----------------- $250.00