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11325 SW CO'T'TONWOOD LANE
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CITY OF TIGARD VeY
OREGON P�
K & W Homes
_ Owrner:. - .. 1537
....... .... . ..... ..... . �ermitNo..
11325
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5W Cottonwood Lane
Building Address............:.......... .... ... ........................ ._.. ....
Certificate is hereby given this-....... .... . clay of............... . ..._.. l9
14th November ?7 i
that said building rr-, =y be occupied and
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that it complies ,vith all rertuirements of....� �
? the Building Code for the City of Tigard,
' as approved by the Tigard City Council.
•.•• � ..........
Building Inspector
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Ownor
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CantracAor Paid, by dntE3.
9j--.0 of cannoction Asspstamprpt paid
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N. 13423
SEWER PERMIT � 6
WU
Unified Sewerage Agency
of Washington County CITY OF_-. Tigarrj* DATE
OWNER : KhW homes PHONE : 649-816n
OWNER ' S ADDRESS: —
TYPE OF INSTALLATION:
[XI BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
lfPE OF OCCUPANCY:
Q N E W O SINGLE FAMILY ❑ COMMERCIAL.
E-JEXIST . (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 (_ALLING FOR
INSPECTION, PI-EASE 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 E 25.
CONNECTION CHARGE 575,
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL 600.
APPLICANT DATE
SEWER PERMIT N`► 13423
ADDRESS OF STRUCT 'RE 11325 -SW Cottonwood Lane
TAX MAP 'TAX LOT SYSTEM fannn rrgr k__
LOT _ BLOCK _ OF
APPROVED BY DATE ISSYED BY DATE
RE MARKS �_ bldin. ;� l 517
BUILDING PERMIT APPLICATION COF TIGARD DATE_
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILDERPHONE ��g'MF3�fiG
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF
LOT NO..
OWNER JOB ADDRESS H25 OME
HOME ADDRESS
ARCHITECT
BUILDER ENGINEER
ADDRESS DESIGNER _
STRUCTIJRF_ ❑NEW DREMODEL- _❑AD_DIIT:ON_ ❑REPAIR LIRENEWAL ❑FIRE DAMAGE ❑DEMOLI0
`, 0N
❑ RESIDENCE—❑COMM ❑EDUCATIONAL ❑GOV'T RELIGIOUS❑PATIO-❑CAR PORT ❑GARAGE ❑STORAG ❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE - ❑DESIGN REVIEW ❑COUNCIL APPRO%LF) ❑SIGNS
OCCUPANCY LAND UFE ZONE______BLDG.TYPE FIRE ZONE---:- PLAN CHECK BY HEAT _
r.c�n�t= t VSA f y1x dwel gW—Inttcir�)� ��arrrlC�iy. tl(re�rllCuc 3 hath _—
bestymanC i Ufa
OCC LOAD_ -FL_04R_L.QAQ_ . -----�1GHT_ _ - ---�N9��T.4.Eil��_*' _._.A._REA_��� NO•g,F.1?EQ(?M$___.`a_._ Yi_���J.�1Z1J.
BUILDING DEPARTMENT SET BACKS FRONT 2b REAR — .3C LEFT SIDE 20 RIGHT SIDE
Permit ja+ X00 - --- — - --
THIS PERM17 19
Plan Check 77.00 REGULATIONSISSUED
ANDALL PPL CAB E COp CODES ORDINANCES, AND ICONTAINED TISHEREBY THE DACGEED THAT
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS A.NDIN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV@
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax tip:* 9„5 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 237.,97 stem ObvolGPmwnt Lharge S300,()Q
By
Am ICA TOR AGFNt ' ----- —
Approved �± 1, Receipt No
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
Permit No. / V � ! b ��
T9 �
Fixture —
=� Final — -- —
HEATING
I Contractor
--- ------- — _—�--_ Permit No.
Gas or Oil
-- Rough in -
Final
— SEWER
Final —
_ — ------------______— DRIVEWAY
_ Final
Storm Drainage
— (Rain Drain) Final .-
- Lnal
— — eet Final
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCYCERTIFICATE OCLUPANCY ng
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