Permit CITY OF TIGARD
P �t►ER CONNECTION PERMIT
�� A . DEVELOPMENT SERVICES �� ATE ISSUED: MIIT# SWR 000 00107
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 �/
SITE ADDRESS; 12197 SW QUAIL CREEK LN PARCEL: 2S103CB -11200
SUBDIVISION: QUAIL HOLLOW - EAST R -4.5
BLOCK: LOT: 070 O 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 SW GALEWOOD
LAKE OSWEGO, OR 97035 PRMT DEB 6/6/00 $2,300.00 HAND RECPT
INSP DEB 6/6/00 $35.00 HAND RECPT
Phone: Total $2,335.00
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' Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by th regon U't' 'ty Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain co i es of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: ok _ OLI4A4 Permittee Signature: 2 ,, ikAog ,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2 OD - DDI3 7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested �v /q / . , AM PM BLD
Location r / Q) Ql/tet�t 1 r r!i / — Suite MEC
Contact Person 61 I Ph PLM
Contractor Ph SWR 'Zex O - o cy' C 7
BUILDING Tenant/Owner ELC
•
Retaining Wall ELR
Footing Access:
Foundation FPS
Ft Drain
Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
�or PART FAIL
MBI►Ie►
Post & Beam
Under Slab
Top Out
eater Se IN7
•
Ina
C PART FAIL
HANICAL
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 6 DC Inspector Or j Ext 3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.