11150 SW COTTONWOOD LANE 1
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11150 SW CO'T'TONWOOD LANE
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CITY OF T IGARDOREGON
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Owner:.. � Ho es
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C ............ ..............Permit No.....1.3H31� ,
" BuildingAddress...
Add �.J, .�A...S.I�..Got.tonWoo.d.,
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Certificate is hereby given this......1?......day of..A4.9U9.t119 19..73....
that said building may be occupied and
that it complies with all requirements of 'Frf:
the Building, Code for the City of Tigai-(!,
as approved by the Tigard City ('council.
...........
a Building Inspector
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City of Tigard
I N S PECTI ON REQUEST I
for
i '�PECTION TIME' . �; �_. PERMIT NO. : I
DATE: __ fyiZ '._ DATE: ISSUED __ LL_
WNERS NAME :— ---
ADDRESS:
-)N r R A G T O R : __ U • cJ .-m� Ooh c7 r� / a;�' I
EST .. Air (_j, Water r� , isual 0 , Laboratory
ESULT: Approved M Disa roved E Pending
P P f D CJ I
'SKETCH.
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IN PECTOR DATE
(_NOTE ANvrh -tuppiemerinl felt data hGreta,
;J SEWER PERMIT �� �7
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V? 12117
Unified Seweraoe Agency
of Washington County CI1Y OF Tigard DATE 4_7_77
OWNER : ___. K&W Homes _ PHONE :
OWNER 'S ADDRESS:
TY.'E OF INSTALLATION:
BUILDING SEWER ❑BUIL_DING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
[^ANEW K3 SINGLE FAMILY [j COMMERCIAL
❑EXIST. (PRIOR 10 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-HUNCRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
PE FORFEITED S'1OULD EXPIRATION OCCUR .
FEES:
PERMIT FEE y 215.
CONNECTION CHARGE 575 .
SIDE SEWER INSTALLATION J/-
ISSUED B
OTF,ER
TO a 600.
APPLICANT DATE -�
SERVER PERMIT N 12117
ADDRESS OF STRUCTURE ___ 11150 SW Cottonwood Lane
TAX MAP TAX LOT SYSTEM Fanno Creek
LOT _ 218 BLOCK. OF
APPROVED BY DATE ISS D BY DATE_
REMARKS Bldg. #1383
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BUILDING PERMIT APPLICATION C0F TIGARD DATE a_p��t ,s.__ ' �". 3
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONC _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
LOT NO.--
19 'tulnr.� . i l .�.:;!! ' �` It i!islr-,,;�,ac� � .�r:c3 -
OWNER JOB ADDRESS _ _ HOME ADDRESj
ARCHITECT —�
ENGINEER
BUILDER ADDRESS
—,.��qtt DESIGNER
STRUCTURE "OhEW T_0 REMODEL ❑ADDITION f❑�REPAIR ❑RENEWAL. []FIRE DAMAGE ❑DEMrO,LITION
V rREESIDENCE OCOMM DEDUCATIONAL ❑GOV'T DRELIGIOUS OPATIr ❑CAR PORT ❑GARAGE ❑STORAGE OSLAB []FENCE
OBOND DMOV!NG UCONDITIONAL USE ❑DESIGN REVIEW _ ❑COUNCIL APPROVED ❑SIGNS_
OCCUPANCY I LAND USE ZONE '_1 _BLDG.TYPE ir' FIRE ZOPJO_ PLAN CHECK BY_ (3tU _ HEA1.
cLJrist. single f amilY dtJP111►,1.; w/attr:r..hud yarage 3 bsurt) Jm 3 bath
Lat ,4216 :sasbamwit b rjaraWfj1-1-16 ae.
4�S LOAD ____f1e90R L9.E1L) _. STORIES..__/_�REAI42b N_Q.D.EDa4S!A5_3.---V9LUFJ.L,0�wlt�
BUILDING DEPARTMENT — SET BACKS FRONT
— REAR LEFT SIDE RIGHT SIDE �
Permit 1:,1.0q --- —_ —^Y_ -- --
THIS PERMIT IS ISSUED SUBJECT TO THE REG.iLATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 15,5U REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— -- WORK WILL HE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTPACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6,80 LICENSE. SEPARATE PERMITS RErIUIP.ED FOR SEWER, PLUMBING AND HEATING.
Total 233`30APPLICANT OR r4i
By
--
ApprovedidtW Receipt No
ADD f_
p Ar—
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——w�+M4f0111f111r1.,.W.1Y. -- - - -'Lr.L.:WF.•+dlw.uW.— —_ .��. .
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PLUMBING DATE
GATE INSP. TYPE INSPECTION REMARKS
"ontractor
JPerrnit No. C�
n,: u7h•in —
Fixture _
Final —.
I AA 4c -c� ► F-., �ycaa. -- HEATING
r �2 0�`- entractor
--- Cwx� Permit No.
Gals or Oil
Y�
Final
-- a SEWER
--- _.—.— Final
-- --- �— ---- -- �—
DRIVEWAY
----- --i— Final
_ Storm
Drainage
(Rain Drain;Kinal
--- Sidewalk
----- -- Curb&Street Final _
BLDG DEPT. FINAL TEMPORARY CERTIf ICAIE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping /
[oningFinal
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AddressPermit No.
Permit chargettz—
Owner4�,� Connection fee
Paid by
Type of building 4'LL1 J Date connected
Service rateIn
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spection fee S -
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Contractor Paid by date
Size of connection Assessment Paid