11370 SW COTTONWOOD LANE-1 i
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11370 SW COTTONWOOD LANE
ADDRESS //3/0 �f� Gu'7�r,�!LPERMIT NO.� I _.
PER MTT CHARGE none
QlJNER7'� CONNECTION FEE
PAID BY .� .�✓c7� f
TYPE OF BUILDING _ �t'p S _ DATE CONNECTFD
SERVICE RATE _ �s/�, INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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City of Tigard Mechanical Permit N; 993 Pern.,t
Fos
Ne,,. installation Replace Re,ocdi"or, IJ Addition 0 Alteration 0 TOTAL
CONTRACTOR OWNER
ADDRESS WORK ADDRESS 7c)
PHONE _ ___ _ ___ ____ APPLICANT
Heat Input Rating (BTU Per H,3ur)_ ___ :-nt Size Flue Size
FUEL OIL Ll GAS FJ ELECT ❑ OTHE I
ITEM NO. FEE ITEM NO. FEE—
For !ssuance of Permit 3.00 Boilers Over 50 HP 25.00
New - Under 100.000 BTU 4.00 Air Ham;flng 10,000 CFM 3.00
New - Over 100.000 5.00 Air Handling Over 10,000 CFh',_ 5.00
Floor Furnace 4.00 _CIyapcirgive Cooler 3.00
Well Floor - Suspended 1C.00 Ven* Fan 2.00
Install Vents 2.00 Vent Systerr___ 3.00
Repair - Heat & Cooling---- 4.00 Hood 3.00
Boilers Under 3 HP 4.OfjDome;tic Incineraxor 5.00
Boilers 3 to 15 HP 7.50 Camr.1, Incinerator 20.00
Boilers 15 to 30 HP 10.00 Oth,r Not !.istekl 3.00
Boilers 30 to 50 HP
INSPECTOR'S COMMENTS-=
CITY BUSINESS LICENSE FEQUI 9ED FOR ALL CONTRACTORS OR SUB-CON I iliACTORF
APPROVED BY DATE ------- I SSUF D BY DATE
RECEIPT NO.
774 Signature of Applicanf
SEWER PERMIT �
4 � w 13493 f
Unified Sewerage Agency
of Washington County CITY OF Tigard DATE B-10-77
OWNER : Trademark HnmpG PHONE :-643-8491
OWNER 'S ADDRESS:
TYPE OF INSTALLATION%
[ZO<UII_DING SEWER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
'[aNEW X�XSINGLE FAMILY ❑ CGMMERCIAL
❑EXIST . (PRIOR TO 7- 1-70 ) ❑ MULI . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH AL-t- RULES
AND REGULATIONS OF THE UN'FIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER 0 THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMGUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEES:
PERMIT FEE S 25.
CONNECTION CHARGE 600.
SIDE SEWER, I NSTAI_LAT I ON
ISSUED BY
OTHER
TAL / $ 625.
C- ;///-5�/-7
APPLICANT DATE
v
SEWER PERMIT M' 13493
ADDRESS OF STRUCTUOE 11370 SW Cottonwood Lane
TAX MAr_ TAX LOT SYSTEM fanno creek '
LOT 232 BLOCK OF
APPROVED BY DATE ISSSSUL D BY DATE
REMARKS Bldg. #1631
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'2-3 BUILDING PERMIT APPLICATION 1 OF
TIGARD DATE_ 3-►10-�77 ,:�
slaw—balsa.
THE UNDERSI(jNED HEREBY APPLIES FOR APCRIAIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPRU'.'FF) IN THE ACCOMPANYING PLAN'S AND SPECIFICATIONS. OWNERPHONE_._�
113705W Lotiturtwood Lellc3 LOT NO.
OW;JER t08 AD:)RESS —� HOME ADDRESS
i;,fn ARCHITECT
BUILDER ENGINEER
--_ ADDRESS DESIGNER__ _
STRUCTURE xQ*JEW ❑REMODEL. ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑UEMOLItION
C3 RESIDENCE ❑COMM ❑EUUCATIONAI�❑G, —❑RELIGIOUS❑PATIO ❑CAR (TORT_ ❑GARAGE ❑STORAGE❑SLAB ❑FENCE_
❑BOND_ El MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
GCCUPANCY LAND USE ZONE_ BLDG. TYPE--FIRE ZONE_ PLAN CHECK BY HEAT
`iF�: per plumy ,, un u� /, . w A : ec rad geraye —5dr(jum 2 b .15 — — - —�
rl. . irss3uc� ut Loi. '192
OCC. LOAD___-__FWPR-LQAD ,O HC!fiHti`1 NO.STORIES 1 AREA 1741_... _ND. DRO I�
BE �—VALUE a t 80'
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 37 LEF i ouE 1.10 RIGHT SIDE
—
Permit -
-� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check 4EGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGRCEO THAT THE
— WORK Y''LL BE DONE IN ACCORDANCE WITH THE r'LANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb•total ALL AP. !CABLE CODES AND ORDINANCES. Til.. ISSUANCE OF ThIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURREN CITY BUSINESS
Stat.Tax t'" LICEN'
—_ irfi 6fP/1RATE PEgMI171*41f9UIREArfOA SEWERIPLYMBING AND HFATING.
Total 176,80
By
Anp"SANT OR AGENT
Approved ---- �etw R..c...l�l N.. (`
An�€ss– --
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
q-2.7- ' 13 ' ontractor
9_Z pc e< .. �– _,�.p P�,,. e•. Permit No. Z Z 3l /U -7-77
/0!Z
Rou h-in
Fixture _
7 J-D / rJl �� .5� Final —
�. HEATING
Contractor '7�d
- Permit No.'#�3O
OK _ i Gas or Oil
Rou h in
_ Final_
` SEWER
Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
_ Curb&Street Final
Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Fcnal
Landscaping
Zoning F inal
1