11135 SW COTTONWOOD LANE 1
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SEWER PERMIT N? 13478
of
Unified Sewerage Agency
of Washington Count; CITY OF Tioard DATE 6-15-77
OWNER: Bob Smith PHONE : 297-2715
OWNER ' S ADDRESS:
TIPE OF INSTALLATION:
BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
�3MEW gXSINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) ❑ MULT. RES. 0 INDUSTRIAL
FIXTURE UNIT; DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATION`_= OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PL.LASE 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 FEF_ S 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION _
ISSUED BY
OTHER
1 TOTAL S 625.
APPLICANT DAZE
- SEWER PERMIT
N`•' 1347`
ADDRESS OF STRUCTURE 11135 SW Cottonwood Lane
TAX MAP TAX LOT SYSTEM fanno : •eek r
LOT i 95 BLOCK OF
_-2
APPROVED BY DATE ISSUED WY DATE
REMARKS bldg.#1609
.... - ... .._ .................r.tiwrwyew•wuuwr., ..... ,. ,....w.....�,.yW+ir..o+w++�..+,..w...........nvn.�r+n.•r•.�..�r�a.+.�w+....•.....ww....w•r.�+w•.+.1+1�•*•r.vgwwn
CITY ATIGARD DATE
BUILDING PERMIT APPLICATION
OF
�C T � BUILDER PHONE— l���J? ��
�(
,/, THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR HE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANIS SPECIFICATIONS. OWNER PHONE---
LOT NO
OWNER ' L1 5tvlith JOB ADDRESS Lj j .:r1 F-,l,l cattanwood H610 °kbCRESS
—— ARCHITECT
ENGINEER
BUILDER ��--77�'��""'' _ ADDRESS rr--11 —_ DESIGNER
STRUCTURE i.NVtw— ❑REMODEL ❑ADDITION _ —DREPAIR ❑RENEWAL ❑FIRE DAMAGE_ ❑DEM^OLITION
D+R.EWDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T_DRELIGIOUS[]PATIO ❑CAR PORT CGARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND []MOVING ❑CONDITIONAL USE ❑DESIGN ITEVIEW� ❑COUNCIL APPROVED []SIGNS _
OCCUPANCY_ —LAND USE ZONE--M r —BLDG.TYPE_ _FIRE ZONE_— PLAN CHECK BY- _NEAT
,.-!3+ 3 i null ramiii dwouinsi wlettachad cla.raus G bedroom 3 batt --
Lot iib _ l,alaoment. 1.150 0ga -p._fgraGe Tri sq. 6 3
ARFA I�G_.N4...�IiQ@S�OMS VALS1� 7 580,
PUILDING DEPARTMENT SET,BACKS FRONT REAR 50_ LEFT SIDE— RIGHT SIDE
Permit +fie —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, "ZONING
Pl?n Check Ili,00 REGULATIONS AND AL! APPLICABLE COLES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WI1H THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal All- APPLICABLE CODES AND ORDIIM 1NCES. 1 HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
--- ---- RESTRICTIVE COVENANTS. CONTRACTt)R AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE.CEfftATE PEFIMIT$ PkQVIRCJ FOB SEWER,PLQMAING AND HEATING.
TotalBV ?.
- A" L(CANT OP AGENT
Approved ---- — Receipt No.
"—'--'-- ADDRESS
PHONE
DATE INSP. TYPE INSPECTION REMARKS 'LUiNSING DATE
�.�
7" ' I ) J-_ Contractor _
Permit No. 0 y6 9-z7 -9 7
7� Fixture
-2 2-77 Final
9— _ HEATING
e Contractor
-- L�,. r�Q.��as ,,.� ss• .s.e(r _ Permit No.
Gas or Oil
Rough-in
-2- 71 L13 Final
SEWER
r -
k t, Final _
DRIVEWAY
_ 1 Final
10-G-11 :Td Storm Drainage
/010. (Rain Drain) Final
e 04.«c Sidewalk _ - -
- D- Curb&Street Final___
Approach _
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANPY ii(� Final
�e-
� Landscaping
Zoning Final
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