11350 SW COTTONWOOD LANE-1 1
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11350 SW COTTONWOOD LANE
Andrus, ._� .�,[� rra� Permit No.
P n r m i t charge ._..._._;�2.e'i2 tz ._ ._.
Ounr:r ZA Connection fee
_�._... Paid by
Type of Luildinn Date connected
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Contrsc:tur _ Paid Icy _ _ Date
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N° 13470
' Ur i7i,;d Sf-werage Agt•ncy Tigard 7-7-'77
of W shingtcn County CITY OF DATE
n N F R r _ -- .7 d .t�rk �r s� _ . PHONE
6 ..
P'v,.'NLRS ADDRESS:
FYPE OF INSTALLATIONr
XL,-IBUILDING SEWER ❑BUILDING SEWER AND `,IDE SEWER
TYPE OF OCCUPANCYi
xONo QXSINGLE FAMILY [] COMMERCIAL
❑EXIS'r . (PRIOR TO 7-1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL.
1 '
FIXTURE UNITS DWELLING UNITS —�
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 .
FEESs
PERMIT FEE $__ 25.
CONNECTION CHARGE —••-fin• _�
SIDE SEWER INSTALLATION
r --`-�-------
ISSUED BY
OTHER
JUTAL
APPLICANT DAT
SEWER PERMIT NV 13470
ADDRESS OF STRUCTURF .____— 1.1350 SW Cuttonwood Lane
TAX — TAX LOT —,.--,.-- SYSTEM
„_..—_.._ -- SYSTEM_farino creek
L OT 2�L_ __ B L OC K OFr
-�At'PF20VFD Bl DATE ISSUED BY r DATE'_--
REMARKS_�_ bldc6 92 ___ ------
BUILDING PERMIT APPLICATION coF TIGARD DATE
1HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDE:RPHONF'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE
LOT NO.
T rmdc4mark Ho ar.,r,. 1131A °,'I Cc ttunwoorl.nmc
OWNER _ JOB ADDRESS HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER��--yI � DESIGNER
STRUCTURE ' ONEW — QREMODEL ❑ADDITION _❑REPAIR _ ❑RENEWAL ❑FIRE DAMAGE_ ❑DEMOLITION
❑RESIDENCE ❑COMM ❑EDUCATIONAL_ ❑GOV•T ❑RELIGIOUS❑PA;10 ❑CAR PORT'❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED v ❑SIGNS °—
OCCUPANCY I LAND USE ZONE BLDG.T'YPE__'jN FIRE ZONE.._5 PLAN CHECK BY "' HEAT.—� _
__ _
SRR p�Jr plana an lot #230 'w/attached ym.aga --- --
--- _-._- � tsr�df•oo>� 2 �=�rth r�L•-int _.
OCf;_J.QAD FLO.QR LOAD 40 --HEIGHT—_''_U NO.STORIES 1 AREA_ I7_544Q.BEDROQMs 3 VALUE___r __
BUILDING DEPARTMENT SET BACKS FRONT 10 REAR 2Y FFT SIDE lt' RIGHT SIDE
Permit 151000 -- >_- - _ -- —_�_-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 13UILDING CODE, i7NING
Plan Check 10000 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL. APPLICABLE. CODES AND ORDINANCES. THE ISSUANCE Of THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax f7*lalL LICENSE. SEP TE PFEiMl1sREQUIFAD FOR SEWER, PLUM9ING AND HEATING.
Total 167,44
Hv
-- - ---- APPLICANT OR AOENI
--
Approved t Receipt No
A Di�1(ESS �
DATE INSP. TYPE INS'•ECTION REMARKS PLUMBINU DATE
4 �n s ' �[ sf Gc:» Contractor
Permit No. Uy 3L.�=� �" 1/-
/� — - .
b- L LD ) Hough-in
/() - Fixture
/0-26-lq fuel Final
l0_2Y _ -- p �p0•j��tr� D Q -v rte_- HEATING
.L-- _�- 2 Contractor
Permit No. ply x F_P-77
eu Y-,1 Ga- or Oil
f229h in_ -
>C�/ ti5, Final
---SEWER
Final
DRIVEWA/
--- ---- ----- — Final ----
-_ Storm Drainage
(Rain Drain) Final
-- - -__ ---_— Sidewalk --
_ _ _ __ _._�_ __ — Curb & Street Final
�L_ _ _ Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY —
CERTIFICATE'OCCUPANCY Final
Landscaping
�r \. Zoning Final
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City of 1 iQard M�,chanieu► Permit M Permit S3•QQ_____
Fee_.._ �'0"�New Installat;on Replace ❑ Relocation ❑ Adeition ❑ Alteration J `VA State _
T0TAL�.
CONTRACTOR , OWNER_ ,.dR •1 —Iel=t.r- _
ADnRESS___ i di_•�d��.- /�N,S!w 'L� Lw�_ WORK ADDRESS 00//3d"O (,�J, ate_
,.r,,-,_� PHONE �71�- �.�4°I APPLICANT wx
Heat input Rating (BTU Per Hour)_ Vent Size _ Flue Size
FUEL ' ❑ GAS ELECT ] OTHER
y-. ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit -1 .00 Air Condition Compressor 15 to 30 HP 10.00
` New- Under 100,000 BTU 4.00 Air Handling 10,000 CFM _ _ 3.00
New- 100,000 BTU&over 5.00 - Air Handling Over 10,000 CFM _ 5.00
C Floor Furnace _ 4.00 Evaporative Cooler 3.O1.1
Wall - Floor • Suspended 4.00 Range Vent Fen _ _ 2.
Install Vents Only 2.00 Vent System 3.0C
Repair - Heat & Cooling _ _ 4.00 Hood Commercial 3.0_
Air Condition Compressor Under 3 HP 4.0_0 Commercial Duct System 10.0
Air Condition Compressor 3 to 15 HP _7.50 ~�
k;r: INSPECTOR'S COMMENTS.____
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPIOVED BY BATE ISSUED BY DATE _A _
x ; RECEI - -
r�ati-nature of Applicant
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