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Permit • - CITY OF TIGARD' SEWER CONNECTION PERMIT r '� DEVELOPMENT SERVICES ' PERMIT #: SWR1999 -00219 .,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/19/1999 SITE ADDRESS; 08955 SW PIPPEN'LN PARCEL: 2S111DA -12000 • SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7 BLOCK: LOT: 113 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 a new single family dwelling. • Owner: LEGEND HOMES FEES 6900 SW HAINES Type By Date Amount Receipt • TIGARD, OR 97223 PRMT GEO 10/19/199E $2,300.00 99- 319176 INSP GEO 10/19/199E $35.00 99- 319176 Phone: 620 -8080 Total $2,335.00 Contractor: • • Phone: OR1.GNAL 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 o hese ules or direct questions to OUNC by calling (503) 246 -1987. • Issued by: i/ �. Permittee Signature: jj /- • Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the •. • ness day • • 3/28/00 ? Activities for Case #: SWR1999 -00219 2:50:19 PM . Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SWRA003 Application received 10/5/99 GEO RECD No Hold KJP 10/11/99 SWRA008 Permit Created 10/11/99 KJP DONE No Hold KJP 10/11/99 SWRA705 Sewer Inspection 10/26/99 TLP PASS No Hold JMT 11/9/99 SWRA070 Ready to issue 10/15/99 GEO DONE No Hold GEO 10/15/99 SWRA080 (F) Issue permit 10/19/99 GEO DONE No Hold GEO 10/19/99 SWRA720 Case Finaled 11/9/99 JMT DONE No Hold JMT 11/9/99 • • • Page 1 of 1 • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST ( Gj_ O7) 3c f� 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / �y BUP Date Requested U �? / AM PM BLD Location g9 sS tL L - Suite MEC Contact Person Il L LC1 /Lt.v Ainc --d Ph 031 "EO` PLM Contractor Ph (.09 at g'' SWR /cfif I ' UILDING Tenant/Owner ELC Re wing Wall ELR Footing Access: Foundation FPS Ftg Drain SGN :Crawl Drau Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall,Nailing Firewall Fire Spiinkler Fire Alarm Susp'd Ceiling - Roof Misc: Final .4'ART FAIL Pos :earn Under Slab Top Out , t ; l (Ass) 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 � CJ // ? �J Other Date ��p 7? / I nspector / Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.