Permit CITY OF T SEWER CONNECTION
6nh„td, DEVELOPMENT SERVICES PERMIT
��n" PERMIT # SWR98 -0232
_= 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 09/11/98
(p PARCEL: 1 S 125CD-- +Zi4000
SITE ADDRESS...: 0 - && SW LANDAU ST
SUBDTVISION ° ° °° :BOULEVARD HEIGHTS ZONING: R -4.5
BLOCK LOT...... ° °.. °..: JURISDICTION: TIG
TENANT NAME.....:
USA NO ° FIXTURE UNITS...: 0
CLASS OF WORK...: NEW DWELLING UNITS..: ' 1
TYPE OF USE °.o.. :SF NO. OF BUILDINGS: 0
INSTALL TYPE... ° :LTPSWR IMPERV SURFACE: 0 sf
Remarks: Hook up of existing house to newly installed sewer line.
Owner: FEES
PETER KUSYK type amount by date recpt
BEACON HOMES PRMT $ 2300.00 DRA 09/08/98 98-- 308949
9500 SW 125TH AVE INSP $ 35.00 DRA 09/08/98 98- 308949
BEAVERTON OR 97008
Phone 4*:
Contractor:
OWNER
Phone #: $ 2335.00 TOTAL
,Reg #° .
• REQUIRED INSPECTIONS --
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from Septic Tank F i l l •
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 - 001-0 ro T.. IAR 952- 0001- A80. You may obtain copies of —
these r es or direct q': tions to OUNC by calling (503)246 -1987.
Issue by: Perm ittee Si gnatI_Are:
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+ ++++±+++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + ++ + + + + + + + + + + + ++ + + ++
Call. 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
' p n BUD
7 Date Requested ) O ! AM PM J p � BLD
Lo ation 9 ill ?G k Suite MEC
Contact Person 7 4 •ie - Ph ( 7-05243 PLM
)0±e.
Contractor � � � ,i. ./__A Ph SWR 7J ' c 3
BUILDING "; °°` r `i 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
PAST FAIL_
IUIVIBINGr;
Poems '&Beam
Under Slab
Top Out
Water Service
. nitary Sewe
R.•• Pra ns
inal
- AS PART FAIL
Post & Beam
Rough In
Gas Line
Smoke Dampers
- Final
PASS PART FAIL
ELECTRICAL °'ap.r r , - -
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
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
Other poach /Sidewalk Date /e.> " Inspector - Ext
Final.
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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