11125 SW COTTONWOOD LANE i
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11125 SW COT'T'ONWOOD LANE
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UATE INSP. TYPE INSPECTION REMARKS PLUMBING CATE
jPermit
ntractor
No.
u h in
Fixture
Final
HEATING
q_16'7 .L a(3 Contractor /�v
Permit No. lZ-
- fl Gas or Oil
—._.— Final
_SEWER
Final ,-
7 '9 DRIVEWAY
Storm Drainage_
— _ (Rain Drain) Final
-- - � -_^-- -- Sidewalk
T Curd&Stre-lt Final _—
_
Approach _
FILOG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CFRTIFICATE OCCUPANCY ---- --
Landscaping
( Zoning Final
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BUILDING PERMIT APPLICATION 11 Y TIC ARD DATE_ r 1625
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE 63SUB"160
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPC-CIFICATIONS. OWNER PHONE..
LOT NO.._—
OWNER jeLe Light JOB ADDRESS 11125 sy cottonLiCII Ja. H611141'AO_DRESS
ARCHITECT
! ENGINEER
BUILDER _ ADDRESS r DESIGNER�7
Sl RUCTURE VIEW ^T LJ REMODEL_ ❑_ADDITION _LJREPAIR ❑RENEWAL ,❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENC,E ❑COMM OEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAP PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MUVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY I LAND USE ZONE 9-7 BLDG. TYPE jh FIRE ZONE 3 +PLAN CHECK BY it HEAT____
U. const. sinyle family dutill- ng W,/atta^hiud garagb 3 budroom 2 bath
of X16 re-iacluu same as 11H45 SU11wood Lt.
__F1S14R-UALZ.__ HEIGHT .Bml_u^ 1_6REAla38N._HURQQ5_ 3 VALUE_37JL 0fl"
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 313* LEFT SIDE R16HT SIDE
Permit 151,00THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY .AGREED THAT THE
W(JnK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total (I4iAA ALL APPLICA13LF CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF
RESTRICTIVE COVENANT'S. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRFNT CITY BUSINSSS
State Tax 6144 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 167.44 y"atom Dcitrelppment Chat., 300100
By
APP ANI` OR AGENT
Approved Receipt Nu.
Ari ss PHONE --
.......... ,u..,.,rr...,r, ".....,...�,v:_,. ...._ .....,,,.u„r. ..........,.....r-,._:..,..r.a..,.,..�..,..r...w....�,..raw.....r ..,.wr.,..«...m;:....r.a.m.,,.......rr....,..:,.
PERMIT R M I T N 0.
ADDRESS .---
PERMIT CHARGE nuns
OWNER CONNECTION FEE 4�ere
PAID BY -�2
TYPE OF BUILDING DATE CON�kCTED
SERVICE RATE / Ste_ INSPECTION FEE S
CONTRACTOR _ PAID BY OATS
SIZE OF CONNECTION ASSESSMENT PAID
BUILDING �r_rt:,r; i��;.w� , 1 IGAR,ta N�)
PLLlN'dING PLfy,"v1IT T
hold:+r of a valid pluml.)iny Contractors IIGPt1S0 is hereby
authorized to cause plumbing work ash in noted to be installed in accordance with the plumbing cocle. of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four I
(4) hours prior to the tirne the installations are ready for inspection, City of Tig..rd Business License required,
for all c tractors and sue antra tors.
Owner_
_ address _,K_ _--__--__.-_-- Al at. 7
NUN!,!rR OF Tal AL PrzwolI NO.'s `
j TYPE OF PERMIT ITEMS FEE ON EACH AMrIUN1 " rr i.r Ulo 010y) 1
-
5inyle Family--1 bath aar-h 25 00 �d
Duplex Each 1 bath unit 7500
Additional bathroorna each 10()()- 1 01
1Mobila Horne apece_sac'+ 15 rl, —
INDIVIDUAL FIXTURE FEES
1 to 50 Pixturesin 1 building each —_ — 3.00
51 to 100 Fixtures in 1 ouildin_y___each 2 SO
101 to 2r)0 Fixtures in uHdin each 2 00
' M
I S C E L L A N E O U Sn 1 buildinq__'arh 1.5�'
201 nr mure Fixtures
i 9uildinjSewer- lst 50 ft.
Sewer_each additional 100 ft
Water Service to building ——_ 5.00 l )
Private Watt+ S mems- each 100 ft__ 10 0O
_ UtrterS ecify - L--
PE R_MIT � o e) For Pll.mihvig losn,lr.rro.n Phone 6:19.4171
�°state r y�' Plumbiny Contractor B _e ll v I-C&
1 - Y � 271_ .�__'_ I
i T01AL � 0 -- RECEIPT NO. Issued By
f=- SEWER PERMIT W 13489
Uf v
Unfied Sewerage Agency
of Washington County CITY OF Tir prd _ SATE
OWNER : J.L. Light PHuNE : 639-6560
OWNER 'S ADDRESS: —
TYPE OF INSTALLATION:
BUILDING SEI-ER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCYt
XE]NEW SINGLE FAMILY ❑ COMMERCIAL `
❑EXIST . (PRIOR TO 7-1--0 ) ❑ 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, P -ASE REFER TO THE PERMIT NUMBER . THIS APPLICATION R
EXPIRES IN ONL-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
F E E 5 1
PERMIT FEE $ 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TO AL $
625.
�2
APPL CA DATE
. SEWER PERMIT N9 13489
ADDRESS OF STRUCTURE_ 11125 5W Cottonwood Lane
TAX MAP TAX LOT SYSTEM fen no creek
LOT 185 BLOCK OF r
APPROVED BY DATE �ISS`UEBY DATE
REMARKS bldg. #162.5