11218 SW COTTONWOOD LANE 0
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1.1218 SW COTTONWOOD LANE
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Address `L,a,� �e1„�sis Permit No.
Permit charge 220 e-
Owner ����� ��� Connection fee 12 p°
Paid by � ".
Type of buildingDate connected
Service rate �S Inspection fee 2S
Contractcr Paid by date
Size of connection Assessment Paid
City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME :/ PERMIT NO.:
DATE: / / DATE ISSUED:--/
OWNERS NAME :
ADDRESS
CONTRACTOR
TEST:Air❑, Water ❑ , Visual Laboratory ❑
RESULT: Approved .EI Disapproved ❑ pending G
SKETCH:
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INSPECTOR DATE
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INSPECTION REQUEST
for
I'''NSPECTION TIME . �. PERMIT NO. :—
DAT E:
O. :DATE: _s 1�1 DATC ISSUED :- I
wN E RS NAME .' --
ADDRESS'
AME : _ADDRESS: ',_ ��,� I
JN rRACTOR : - 21
" ST . Air j), Water❑ , Visual ❑ ,
F-RULT' Approved fk"*." Disapproved C Pending
SKETCH:
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WEN SEWER PERMIT -z ''7 ,-, ,
N" 12104
Unified Sewerage Agency
of Washington County CITY OF T,Lgard DATE March 25,__1177
OWNER: Trndnmark Homes _ PHONE : 643-8491
OWNER 'S ADDRESS: _
TYPE OF INSTALLATION:
E BgWILDING SEWER [:]BUIL_DING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
M NEW M 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 $
CONNECTION Ci RGE 575. 00
SIDE SEWER INSTALLATION
QY'
OTHER Inspection fee 25.00 ISSUED
TOTAL s 600.00
(APPLICANT DATE
SEWER PERMIT NY 19010
ADDRESS 0= STRUCTURE 11218 5.- L Cottonwood Lane
TAX MAP- -----.- TAX LOT SYSTEM_Fanny, Creek
L.O T _�. - -_,_______ B t_OC K _ _OF-
APPROVED
FAPPROVED BY DATE ISSUED BY DATE
REMARKS Petmit #1361
H MF^+`T+�o..'...,...,.•"n'R'"MI'y..+n�++a..`wr.-rvw�..�.:..wrv.^r.r.o.ryw.n.�.�.ny...,....
BUILDING PERMIT APPLICATION 11T TIGARD DATE z`.�. - 19 r7 A �y13C1
OF
1HE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED 8 111:;«:PFIr.NF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. uWNILHPF'ONF —
LOT NO.– _
OWNER f 'J@It111(tiT�t I•�i�msd _JOB ADDRESS 11tt18 CUttafZWCJOd L,R HOME ADDRESS _
ARCHITECT —
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW+ ❑REMODEL ❑ADDITION ❑REPAIR QaENEWAL. ❑FIRE DAMAGE - ❑DEMO:=ITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL. ❑GOV'T ❑RELIGIOUS❑PATIO []CAR PORT ❑GARAGE 0 STORAGE[:]SLAB []FENCE
❑BONG ❑MOVING ❑CONDITIONAL_USS EI DESIGN REVIEW ❑COUNCIL APPROVED USIGNS
OCCUPANCY.._-LAND USE ZONE rt`! _BLDG.TYPE __FIRE ZONE. PLAN CHECK BY_ j HEAT ,+
€.ut 219 LLanot aing1v fam.z jy owrailing with attar, tad
Q bedroom 3 bre° h _...__._ � ----------
- -- 470 garage
O-QC4j,0AQ 8 FLOOR LOAD21n- HFIGHT 181 .STORIES 1 AREA �1 _L�1_Q,_@EDL1pQM;z—_-YALUE
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 32#
LEFT SIDE 12 RIGHT SIDE k
Permit 159,0 — - — ---- --.—___
84,50 - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WIL L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINAVCES. THE. ISSUANCE OT THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTPIACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 70139 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLLIN-GING AND HEATING.
Total a'
By
-- - APPLICAN? OP AGENT --
Approved - Rect, pf Nti
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AIDATETYPE INSPECTION REMARKS PLUMBING DATE
_ _ _ I v
Contractor
Permit No.Rou h•in
Fixture
Final
1,13' -.e_^ HEATING
Contractor
6 Permit No. �• 77
Gas or Oil
Rough-in
Final _
SEVER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
f
rb&Street Final
proach
BLDG DEPT. FINAL TEMPORARY CEHTIFICATE OCCUPANC
CERTIFICATE OCCUPANCY al
ndscaping
ning Final
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