Permit •
CITY TIGARD SEWER CONNECTION PERMIT
�" DEVELOPMENT SERVICES PERMIT #: SWR2000 -00109
°- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/06/2000
SITE ADDRESS; 12159 SW QUAIL CREEK LN PARCEL: 2S103CB -10800
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 066 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: SF PATH I
Owner: FEES
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 GALEWOOD STREET
SUITE 100 PRMT GEO 06/06/200C $2,300.00 0002751
LAKE OSWEGO, OR 97035 INSP GEO 06/06/2000 $35.00 0002751
Phone: 274 -5223 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
ORIGINAL
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 oft - e - -s or d -questions to OUNC by calling (503 246 -1987.
Issued by: Ar /` /j /// Permittee Signature: \ ,j / � .111.J1, 14
Call (503) 63• , 175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 19w-co 3'7 d
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ViVOC) AM X PM BLD
Location 12lSq Q (4JJJt L C' - K Suite MEC
Contact Person 151 I I Ph PLM o�
Contractor Ph SWR ' IXxYO0I 0
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
rawl D -ii.. Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm A
Susp'd Ceiling /
Roof %if � /
Misc: /
Fi. .
lam''' PART FAIL
I' UMBI G
Pos &Pied
Under Slab
Top Out
va Zi
- - n Drains
S PART FAIL
ECHANICAL
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 / / d Inspector /) Ext 3 /
Other
Final O
PASS PART FAIL DO NOT • EMOVE this inspection record from the job site.