Permit CITY TIGARD SEWER CONNECTION PERMIT
° i DEVELOPMENT SERVICES PERMIT #: SWR1999 -00138
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/3/99
SITE ADDRESS; 16135 SW 74TH AVE PARCEL: 2S113AB -00800
SUBDIVISION: FANNO CREEK ACRE TRACTS GIN ��URISDI TIG
•
BLOCK: LOT:
TENANT NAME: JOHN DUNCAN
USA NO: FIXTURE UNITS: 40
CLASS OF WORK: NEW DWELLING UNITS: 3
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Fixtures for a new basic commercial bldg.
Owner: FEES
JOHN DUNCAN Type By Date Amount Receipt
7060 SW PALMER WAY
BEAVERTON, OR 97007 PRMT DEB 12/3/99 $6,900.00 99- 320170
INSP DEB 12/3/99 $45.00 99- 320170
Phone: Total $6,945.00
Contractor: •
Phone:
Reg #:
Required Inspections
Sewer Inspection
•
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the egon i Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain copie of these rules or direct questions to OUNC by calling (503 6 -1987.
-
Iss d by: i:1 I _ Permittee Signature. 2' l-Oj ' - (- 3
Call (503) 639 4175 by 7:00 P.M. for an inspection needed th / next business day
� cilR Accumulative Sewer Tally
Tenant Name: ,off Py 1C,J'(1 I This SWR # /96 g ` 60 /35
' Address: / tW 35 SW -q/'" Qkio This PLM #: 9 - Oc�l°1y
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial .4
- Domestic 2
Drinking Fountain 1 •
Eye Wash 1
Floor Drain/sink - 2 inch 2
- 3 inch 5
-flinch 6
- Car Wash Dm 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
Ice Machine/Refrigerator Drains 1 •
•
Oil Sep (Gas Station) 6 •
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar/Lavatory 2 S / 0 (
- Bradley 5
- Commercial 3
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 30 7 70
Urinal 6 •
TOTALS /0
Total fixture values: R1 divided by 16 = p�, 5 ' EDU = 3 E l7 /l =
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
i:\dstslswrtaly.doc
I
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested �t� // �� AM PM
BLD
Location / Y 1 3 c I 1" ` Suite MEC
Contact Person r It,?I,1 1/1 Ph 6n'1 PLM iiD IIemis
Contractor Ph SWR / q'' O/ 3
BUILDING Tenant/Owner- ELC
Retaining Wall ELR •
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT q I - fabOC7 (10
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation.
Drywall Nailing •
Firewall
Fire Sprinkler v - _ / �.� /
Fire Alarm
Susp'd Ceiling � Ir - , i n I -f
Roof
Misc:
Final
PASS PART FAIL 4f
AM" /41(..e.el
Post & Beam - L'
U
-
nder Slab IF
Top Out
Water Service j Alf %J -e L f�
am Drains
Final
_ PART
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
St B a rading
Sanitary Sewer
or Dr- [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk / ,
Other Date / 7 / Inspector , e • Ext✓��
Final i
PASS kV FAIL DO NOT REMOVE this inspection record from the job site.