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Permit
SEWER CONNECTION CITY OF TIGARD PERMIT #k PERMI : SWR94 -0173 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/08/94 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171 PARCEL: 28104CA -08100 SITE ADDRESS...: 13266 SW 136TH PL SUBDIVISION....: HILLSHIRE ZONING: R-7 PD BLOCK..........: LOT ° ° ° ° ° ° ° °. ° °° °°081 TENANT NAME.....: USA NO FIXTURE UNITS. ° °: CLASS OF WORK °° °:NEW DWELLING UNITS. :1 TYPE OF USE .SF NO. OF BUILDINGS:1 INSTALL TYPE. ° ° °:BUSWR IMPERV SURFACE..: :sf Remarks: PATH I Owner: _. FEES •— RICHARD WHITEMAN type amount by date recpt 5615 SUMMIT PRMT $ 2200.00 SW 06/08/94 — INSP $ 35.00 SW 06/08/94 — WEST LINN OR 97068 Phone #: 655 -8156 Contractor: CONTRACTOR NOT ON FILE Phone #: $ 2235.00 TOTAL Reg #° ° ° REQUIRED INSPECTIONS -- This Applicant agrees to co ®ply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The perait expires W days fra© the date issued. The total mount paid will be forfeited if the pernit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the neasureaent given, the installer shall prospect 3 feet in all directions frog ______ the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer° Pernit and the Agency will install a lateral. Permittee Signature:I"- _ — U l'.`�' Issued By: ---- ___ Call for inspection — 639 -4175 / � i e. • INSPECTION NOTICE C:::")/l City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out 41100 FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation - Plumb. Plbg. Underfloor Water L Li / inee / C'/ � / Gyp. Bd. -Mech. Date Requested: [ / 1 ' Time: AM PM Address: / 3 - (4 /3< ^- lj' a.C_Q__. Permit #: 51-4i - 9 d / �3 Builder: /C)- di -13 THE FOLLOWING CORRECTIONS ARE REQUIRED: /� - T.: f - i A: 2 Qtiu, i of / = . - /al /3 357 Inepecto Al Date: 7-7- APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep.