Permit CITY TIGARD SEWER CONNECTION PERMIT
„. I +� DEVELOPMENT SERVICE / PERMIT #: SWR2000
A. c �' II 13125 SW Hall Blvd., Tigard, OR 97223 (50 6 1� I / DATE ISSUED: 4/5/00
SITE ADDRESS; 12254 SW 114TH TERR ! / ' l ` PARCEL: 2S103AB - 05100
SUBDIVISION: WALNUT GLEN ZONING: R - 4.5
BLOCK: LOT: 009 JURISDICTION: TIG
TENANT NAME: RIVERSIDE HOMES, INC
USA NO: FIXTURE UNITS: 0
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for a new detached single family dwelling.
Owner:
FEES
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140
BEAVERTON, OR 97006 PRMT DEB 4/5/00 $2,300.00 0001180
INSP DEB 4/5/00 $35.00 0001180
Phone: 645 - 0986 Total $2,335.00
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 Ore on Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You obtain co is of theses or • irect questions to OUNC by calling (503) 246 -1987.
Iss ed by: A �� � / /�,� Permittee Signature:
' � i ��
Call (503) 6 9 -4175 by 7:00 P.M. for an inspection needed the next busines day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST et - -zaoe /7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
b S .- / % Date Requested / Z 6 d AM PM BLD
Location. /2 51-4 ' u ) l r 7 Suite MEC
Contact Person ,19, ,piii" Ph VI" 'i PLM
Contractor Ph SWR
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PAS RT FAIL a Aro
Um-BI
Post & Beam
Under Slab
Top Out
Water Service r
Sanitary Sewer
Rain Drains
01E10 PART F L G
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 ` 1 (9i Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 'L-COI 7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
•
BUP
Date Requested / 1,4 i AM PM BLD
Location 1 2-2 (-� ) 1 "I /� ,,, TeXY Suite �i MEC
CCJ'� '�
Contact Person ``!I Ph l it/ ' PLM
Contractor Ph SWR
BALDING -) Tenant/Owner ELC
Retaining Wall ELR
.1011,.5.- Access: FPS
nd- .•
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing {6/ //l-/,77A - /. ��ac'n &A/7 Gsel ,')
Insulation
Drywall Nailing 7 ci�� --;r .ThS
Firewall
Fire Sprinkler iit, s - LC - 4 o.L - a1 - z 5, SO/<C ....e r-
Fire Alarm
Susp'd Ceiling /4-3 S. c4,.L/
Roof
Misc:
d Fin -
PART FAIL
' - 11 B ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS 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 �� �t Z In Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST VZO'CXDO l 7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested i_/ // 7 OD AM PM BLD
Location / Zi I J / ( 1 Suite MEC
Contact Person Ph y i-G - 393/ PLM
Contractor Ph SWR
(UILDINr Tenant/Owner ELC
Retaining Wall ELR
Access:
H aio FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing r , O
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Misc:
Final
PASS PART
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains -
Final
PASS 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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date G / ' — / 7- O Inspector d Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 06' - V6 7 6' /7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
'
7 4 ' /
� Date Requested 7 1 / - 0 d AM X PM BLD
Location / - - 2r //'' 721/L Suite MEC
Contact Person Ph 313/
PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
MIMMP Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm '
Susp'd Ceiling
Roof
Misc:
Fin-
" 2.41 -1 , PART FAIL
um:
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
rai
Fina
( ar 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 Hail Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk Date �G. l Inspector //7) Ext '
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST c 000
24 - Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (v t/o AM PM BLD
Location I 1 -I / 1 ` . ��e_4 J' Suite MEC
Contact Personn( Ph 1414 1 2i? PLM
Contractor Ph SWR
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
Firewall
Fire Sprinkler
Fire Alarm �`/
Susp'd Ceiling %� ! //
Roof
Misc: Q�
Final
PAS§ PART FAIL
Z LUMBII
Post & Beam
Un Slab /x),a2(
p.0
ater Service
Sanitary Sewer
Rain Drains
Final 3 dr
PASS 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
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 7/�
Other Date • / / Inspector /7 / /7 Ext
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION 32- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST �'��
/� BUP
Date Requested r/ /0V AM PM BLD
Location 122.9' ) P ) P./ Suite G MEC
Contact Person ,0I0ik Ph l �-I ?°" 1 7 PLM
Contractor Ph SWR
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 -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Lot
Post & Beam
Under Slab -''
T.. Out
Ina
PASS 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
Other Date 2r! Inspector Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION . MST 2000 - 000
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(' BUP
k
Date Requested ( q AM PM BLD
Location I< '2-2S(-1 J 1 e4"Y Suite • MEC
)
Contact Person Vbe' I Ph I / - I g -3 q 3 7 PLM
Contractor Ph SWR Z — O �1
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof MAW P a .
Misc:
Final
PASS PART FAIL
[UMBIN)
Post & Beam
Under Slab
Top Out
Water Service
S
ain Dr
Final
PASS 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
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 -
Otheiach /Sidewalk Date Inspector /�� �' Ext )/ �
Final
PASS PART FAIL ID 0 N ST REMOVE this inspection record from the job site.