Permit CITY TIGARD SEWER CONNECTION PERMIT
y DEVELOPMENT SERVICES PERMIT #: SWR2001 -00151
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/3/01
SITE ADDRESS; 12177 SW QUAIL CREEK LN PARCEL: 2S103C6 -11000
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 068 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 new single family detached residence.
Owner:
FEES
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 GALEWOOD ST STE 100
LAKE OSWEGO, OR 97035 PRMT CTR 5/3/01 $2,300.00 27200100000
INSP CTR 5/3/01 $35.00 27200100000
Phone: 503 - 387 -7538 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
•
This Applicant agrees tocomply 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 o• - copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issue • by: k , ; i ; A ar „,�� Permittee Signature: v' ( aAnik..,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
•
.'C,ITY'OF TIGARD BUILDING INSPECTION DIVISION • '
•` • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 li/ CO . 0/ - .2
BUP •
Date Requested 5 '" 7 AM P BLD
Location /2 / 7 7 S w (PG/ 4 1 / Ci--' e /C Suite MEC
Contact Person Ph .9- U4 3 7 PLM
Contractor Ph SWR p 'ZD� 1 -00 / S ^ /
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
OW Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear ,
Ina Sheath /Shear
Framing
Insulation
Drywall Nailing C- 5
Firewall
Fire Sprinkler .- krL■k_
Fire Alarm 3 1.1-4 �- ^ "" /) c ) \
Susp'd Ceiling
Roof J 1 _
Final 76 c-\",_
PASS PART FAI
i
Os
Top Out
Water Service
A/Sanitary Sewer
04 Rain Drains
F i
P S PART FAIL
CHANICAL
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 / -
Other oach /Sidewalk Date 5/ « ) / 6� Inspector `� v` Ex t3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.