Permit ►, CITY OF TIGARD SEWER CONNECTION PERMIT
A-v,,r DEVELOPMENT SERVICES PERMIT #: SWR2000 -00182
- F` �� � I DATE ISSUED: 8/22/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 12436 SW QUAIL CREEK LN PARCEL: 2S103CB -09100
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 049 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: S/F PATH I
Owner: FEES
DON MORISSETTE HOMES
4230 GALEWOOD STREET Type By Date Amount Receipt
SUITE 100 PRMT DEB 8/22/00 $2,300.00 0004671
LAKE OSWEGO, OR 97035 INSP DEB 8/22/00 $35.00 0004671
Phone: 274 -5223 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 Sew ' Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by th = • regon Ut tit( Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
1
� 1
Issue. . 4'1 `� ' ' Permittee Signature: �-1 L .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION aL ,-`6o ZZ7
24- Hour'lnspection,Line: 639 -4175 Business Line: 639 -4171 V
Date Requested / d 0 — / 0 AM PM BL'D ,
Location / 6 'Gs/ Q04 C Suite MEC l+
Contact Person Ph 5 07 7 7 PLM
Contractor Ph SWR DSO - DU/ ed-
BU 6 Tenant/Owner
ELC 4 Peg
Retaining Wall ELR FAO() C
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: i 3 (� Zo 0 0 - 33 33 3
Slab _ "`� SIT
/ hea• ty - eO Z L ,
Int Sheath /Shear b ^ �p 5"Te) � / � �� ramie 1 ` L ,W) b LtA5 S,t 6L3- v`-' `• " / 1 X t \ •
Drywall Nailing v (� `� �.( k . �J r�'� - c\ --e-CY .
Firewall
Fire Sprinkler 2.) `� `l''Q - 0 d r �v %-•\..A �/ �i S `► - k_ ` ^-S l 0 S/ (/)es)
Fire Alarm � , er /
Susp'd Ceiling � � � S t --s/�n �' •
Roof l.i I • \/ZQ\n tllPl f ' `c-
Misc: 0- �1
Final
PASS PART �frr,rvt •
• L M: - G l) l/lj w, r
-ost & Bea
P .; A ' ‘.."/N ajZ V e... G
,-...., ..
der Service i h>\---i l _^■_ 01-- - "A....
Sanitary Sewer i
Rain Drai • s 1f P /l/ �1/LSZC�
F � OP /
e. • RT FAIL 1 r b at )
/
- L 4
LenT , C_Aln 2%_e_<0 ! ..,_;,-,., _e ( , r4-0--‘f•
Gas Line
Smoke Damp 4-kit:Li r L o �- * � 1 f ,
Final � � Q__p `
PASS PART FAIL I &C
f —f .-e_S
ELECTRICAL
, ✓ Service \• ■
Rough In 1 Ilk
UG /Slab v �� &� A A A_�
Low Voltage 1 1 p ,� ,� 0 L v� 0( c Q4CJ3
Fire Alarm lJ \J`'
Final ' i
PASS PART FAIL 1 11111/AA-A ` > ►AI. u - L ` - . UP
SITE i_r- i I t ,
Backfill /Grading 13) �.- N- S '
i z s `1"es'f •
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
A roach /Sidewalk / �f ,` .�i
Other D J 0 ! 1 d/ O 6 Inspector \ ,k Ex V
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the jolt site.
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