Permit •
CITY TI GARD SEWER CONNECTION PERMIT
W DEVELOPMENT SERVICES PERMIT #: SWR2000 - 00349
_ , 1 67'il 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/21/00
SITE ADDRESS; 13345 SW 129TH AVE PARCEL: 2S104DA -04300
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 029 JURISDICTION: TIG
TENANT NAME:
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: Sewer connection for new SF detached.
Owner:
FEES
DEBISSCHOP & COMTOR Type By Date Amount Receipt
13590 SW 31ST ST
BEAVERTON, OR 97008 PRMT CTR 12/21/00 $2,300.00 27200000000
INSP CTR 12/21/00 $35.00 27200000000
Phone: 503 - 641 4541 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 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: ' Permittee Signature:
- -
Call (5 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
s-r —.CITY OF,VTI ARD BUILDING INSPECTION DIVISION ' :- • i
• • 24 - Hour Inspection Line: 639 -4175 Business Line: 639 -4171 T " �� — � �s S � 3
- BUP
Date Requested AM /5PM - BLD
Location r, ' L , s 3 /2,1 poi Suite MEC
Contact Person Ph 9 iv 1- 5 ! / PLM
Contractor Ph 437) Xdd 0
BUILDING Tenant/Owner '7 C ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
pity Crawl Drain • Inspection Notes: SGN
Slab SIT
Post & Beam -
Ext Sheath /Shear 1
Int S heath /Shear Framing /i ./ ■ , / = f ✓' l 6
Insulation
Drywall Nailing 1 l l
Firewall
Fire Sprinkler
Fire Alarm ;L ' ,(
Susp'd Ceiling 4 G 0-91/1/1 4- , v \
Roof 1 1 I ( - I
Misc: ! ��ii Iii `
Final
PASS PART FAIL
PLUMB •
(f — P o ` st &`Beam
Ult.. Water Se vice
V Sanitary Sewer
<Rain Dr i Q' �'
I-1 - :.i
PART FAIL
' ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL 1 >_ ,
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 k , � '�
Other
Date 31 l/" �� Inspector " ` Ext /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site