Permit CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2000 -00286
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/8/00
SITE ADDRESS; 14785 SW 104TH AVE PARCEL: 2S1 11 CB 01311
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 ZONING: R -3.5
BLOCK: LOT: 022 JURISDICTION: TIG
TENANT NAME: MARGESON
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Connect existing residence to newly installed sewer lateral. Septic tank is to be pumped, filled and
inspected or removed. Reimbursement district fee paid on this date.
Owner: FEES
MARGESON, ERIC C + DEBRA J Type By Date Amount Receipt
14785 SW 104TH
TIGARD, OR 97224 PRMT CTR 9/8/00 $2,300.00 27200000000
INSP CTR 9/8/00 $35.00 27200000000
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
Septic Tank Filled
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 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: k 1 Permittee Signature: VLI. �- tiw+..AA-._
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
i
T ABLE
_ II SEPTIC SERVICE
P.O.BOX 1130
WILSONVILLE, OR 97070
(503) 582.1929 FAX (503) 570.0779
CUSTOMER'S ORDER NO. PHONE DATE
109,3 � (0(0 in 9 - ),,' - rfi
NAME ../ `1 I
I if A la .Sr y) 1
ADDRESS /
/9- SP , RcookiA)cey rF;
i ••ra '- `�7
SOLD BY CASH C.O.D. CHARD ON ACCT. MDSE. T'D. PAID OUT
QTY, DESCRIPTION PRICE AMOUNT
) -■5.1 \. I ( 1 tiwk f I A f-30 0
I
1 715 . A) / t)d9' 1.
1
■
1
TAX
RECEIVED BY
TOTAL
All claims and returned goods MUST be accompanied by this bill.
', 1- ; � THANK Ye
CITY OF TIGARD BUILDING INSP€CTIbN DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested � AM PM BLD
Location / (1 7 5 C 5 /° 4 f Suite MEC
Contact Person Ph PLM
Contractor Ph SWR •e _G-J '24'6
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall 72/2("7"
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
FAIL
L U am
Under Slab Sk / G 1
Top Out
Water Servi
Sanitary Se r Qtyf9)
Rain Drains
Fin
PART FAIL
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
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date (3/ d Inspector G'
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
r
r 'r
r ,
f r
, ' el . -.. ,41,:. I 1 ' . •
.
7
2
. r
4. . * ... . i Z ),, , . . .
I I 0
X
ie
it
' .,;
•
I
d
R ug
et
l
CITY OF.TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• BUP
Date Requested 9 �/ Z AM PM - BLD
Location ( 7 V5 Suite MEC
Contact Person Ph 33 G Z z y PLM —e;e) 333
Contractor Ph SWR ZrJUr/
BUILDING Tenant/Owner ELC
Retaining Wall � �Gl S f G�r ,� ✓ ELR
Footing Access:
Foundation � FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm / /
Susp'd Ceiling X1 / ii ``
Roof
Misc:
Final
PA ' • RT FAIL
LUMB
Post & Beam
Under Slab
Top Out
Water Service
.= uur�•Y�^Ia.
Rain i rains
PART FAIL
CHANICAL
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
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk /
Other Date ( r� Inspector E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.