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11399 SW COTTONWOOD LIME.
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CITY OF TIGARD
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Ortmer:......�.rt. .Lutz.........._........ .. ............. ..... _.. .. Permit No...13.19 J°
Building Address.....11.34.4...S.W ..Ca.t.tanwp.od. .Lane............................ ...... '
.......
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Certificate is hereby given this._.17...._....da� of August V 9 . . 19.....7.7
that said building may be occupied and
`:. that it complies with all requirements of
' the Building U-de for the City of Tigard,
as approved by the Tigard City Council.
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tr Building Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: . PERMIT NO. : I
DATE: DATE ISSUED :
OWNERS NAME : �z
ADDRESS:
CONTRACTOR
TEST . Air p, Watery , Visual I] , Laborwory ❑
RESULT: Approved V, Disapproved C Pp.-,ding p
SKETCH: •�_ I
1
INSPECTOR DATE
COTE Attach supplemental tett dota beret 01
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IF11'D SEWt_ '11-Ac ; �� AGENCY NO. - - 11ss��
V'�f 1� I1'�C� 1 ON C.V� � I Y DATE ---2-24-?? ----
CITY (�F _-- -_ Tigard
C
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Art Luta_
OWNER'S ADDRESS: -,-- ---- ---_ --- —� _ ._ -_.._.—
STREET
CrT'Y SI ATE - ZIP
BUILDING SITE: LOT__229___- BLOCK .___.___._ ADDITION
TAX LOT N0. ___.__ TYPE OF OCCUPANCY -.______ ___ _ resit,dence
ADDRESS 11344 SW Cottonwood Lane
DWELLING UNITS------I FIXTURE UNITS --
SURCHARGE
NITS _SURCHARGE IF APPLICABLE------- ----
PERMIT FEE -._ 5"_5- _---_.-- INSPECTION FEE _25' TOTAL DEPOSITED 600.
LN ) (EXISTING) BUILDING SEWER SYSTEM _______ Fenno Creek
EW
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE cr7F ... . -- -- INSTALLER
RECEIVED BY.--:..".--:
(AGENCY OR ITS AGENT( T--
COMMENTS- Bldg. #1319
This Application and permit expires in one hundred and twenty (120) days.
The amount pard will be forfeited should expiration occur.
' '�•9rT �:;:-.age,�.Aw.,;•'+,�.St�;rt,�r.--_^_�?'�'ilPs_w�u.,«.. »w w;v.w."V�+r71F`aaV-rv...a.. «.
BUILDING PERMIT APPLICATION coy TIGA,RD DATE 2. 24-7719 ;
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE„.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
t �OT NO.__
OWNER '.0 t, Lutz x.1344 5W Cottronwoo.�
JOA�\DDRESS � HC;tiViti gpDRES5
ARCHITECT
BUILDER s01910 ENGINEER
t�--ii _ADLRESS DESIGNER
STRUCTURE CdNEIY ❑REMODEI.�_-❑ADDIi-ION _ ❑REPAIR__ ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
FREESIDENCE ❑COMM ❑EDUCATIONAL— ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAiE❑SLAB ❑FENCE
LIBOND ❑MOVING ❑CONDITIONAL USE — ❑D'cSIGN RE✓IEW UCOUNCIL APPROVED EIS IGNS
OCCUPANCY-1__LAND USE ZONE/ SLUG TYPE_- _FIRE ZONE PLAN:HECK BY Otw HEAT L___
c Ot1L`t• birtyle family dwelling w/attscIvidd garage 3 bvidroom 2 beth -
-- Lot #22r', ger&gs 462 sq,W. -----
OCG.LOAD F�QOR LOAD_ 4Q HE G1 !�O NO.cTnwlEr t'
BUILDING DEPARTMENT 2n 37 !Z k1
— SETBACK FRONT REAP LEFT SIDE RIGHT SIDE
Permit 142,UO ---------------- —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check _ 71100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANC IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLANCE WITH
I
SUb total - At_1 APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
—^ RESTRICTIVE COVENANTS, CONTRACTOR AND SUR CONTRACTORS TO HAVE C'IRRENT CITY BUSINESS
State Tax Us 39 I ICENSF. SFPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 219.39
By
APl�ICANt OR AGENT --- --_-- ------- -- -----
Approved Mt6� Rereiht No
AMRI<S5
..,.,,...rt...._.u.-....r..i...,,......»...«.._..w....w.,.u� �-.........w..a.w..+.rn«.w....a.,....wi.w'.WPrYiw�l.rinrJua.rwiarw..vw.ww.wa..ru...M.a.,a....n.aWr,r
_ _--- L.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�r+_ ':L3-o- fti�c_,,�cx{ Contrwtor
Permit No. - r -3-9--77
Rough-in
.5-/ +� A i% 'U`""` Fixture
Final
HEATING
-- Contractor
/ Permit No. y-�/-
'���` re� •"� Gas or Oil
JI-_) /`/�t/ Rough-in _ —
_ Final
SEWER
_ Final
DRIVEWAY
I ina!
St.-rm Drainage
(Rain Drain) Final
Sidewalk
Corb&Street Final
_ A roach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
C. Zoning Final
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ADDRESS �! 3 ��� (�' PERMIT NO.__�ii(i
PERMIT CHARGC _ none
OWNER J �if��-� _ CONNECTION FEE
PAID BY u..
TYPE OE" BUILDING _,u DATE CONNECTED
SERVICE RATE INSPECTION FEE �S
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESEMENT PAID _
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