Permit CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2001 -00259
�,� �i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/6/01
SITE ADDRESS; 06855 SW BAYLOR ST PARCEL: 1S136DD-01300
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
TENANT NAME: BAYLOR COURT OFFICE BUILDING
USA NO: FIXTURE UNITS: 32
CLASS OF WORK: NEW DWELLING UNITS: 2
TYPE OF USE: COM NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new office building.
Owner: FEES
ESLINGER BUILDERS Type By Date Amount Receipt
11575 SW PACIFIC HWY
TIGARD, OR 97223 , INSP CTR 11/6/01 $45.00 27200100000
PRMT CTR 11/6/01 $4,600.00 27200100000
Phone: 503 - 620 -9515 Total $4,645.00
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" Perm
Issued by: / _ `/ ' Permittee Signature: I / I
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busine . ay
Accumulative Sewer Tally
Tenant Name: Zit -O/2 C-daK7 4f -f BLS' W
- This SR #o�OD / DOI S
Address: 6,9"5" S&J AR /LP 2 S7 - S/,' This PLM#:A?) 0 / -60 y33
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 ,
-3inch 5 .
- 4 inch 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 p .
Sink - Bar/Lavatory 2 $/ d
- Bradley 5 .
- Commercial 3
- Service 3
Swimming Pool Filter 1
-
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 y . 02
Urinal 6 p - 3
O 0Z
TOTALS
Total fixture values: �0 divided by 16 = - EDU 02,3 odfr4. -- c - ''y G oa • 00
HISTORY A/E AJ Se.//4.„4.747c---
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
ildstslswrtaly.doc /�
��-C /� / ///
CITY OF TIGARD BUILDING INSPECTION DIVISION
g
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested /1— AM PM BLD
Location o 6' 8 SS S 1,,, �3G �t. Suite MEC
Contact Person Ph 80 - tw-4/ PLM
Contractor Ph SWR .2e/ -GG -
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
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
4 Drains n VO . fP
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 4-7 � ,� Other Insp ���'/��r -� E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.