Permit j i h, CITY OF TIGARD SEWER CONNECTION PERMIT
r; DEVELOPMENT SERVICES PERMIT #: SWR2001 -00085
` - r � I - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -417 DATE ISSUED: 4/10/01
SITE ADDRESS; 13081 SW RAPTOR PL PARCEL: 2S104DA -08200
SUBDIVISION: QUAIL HOLLOW - WEST 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 SF detached rowhouse.
Owner:
FEES
BROWNSTONE HOMES Type By Date Amount Receipt
12670 SW 68TH PKWY #200
PORTLAND, OR 97223 PRMT CTR 4/10/01 $2,300.00 27200100000
INSP CTR 4/10/01 $35.00 27200100000
Phone: 503 - 598 -7565 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 . - • , the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall ,, urc - • e a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon la - • uires you o foil rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-t11-00 ■ throu• OA' • '2-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (513) 24 , -1 • :7.
Issued by: P ermittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
-el. ( OF'TIGARD BUILDING INSPECTION DIVISION' -
. 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ST
BUP
Date Requeste jj '- - f 4 AM PM BLD
Location / 3 0 8/ 5 - U /r vim- Suite MEC
Contact Person Ph 7f) -.- 77 7 PLM
Contractor Ph SWR — riOcdolvJ
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ��
Framing ) (r —/ ��/�
Insulation -�
Drywall Nailing ��1�� �
Firewall
Fire Sprinkler r v -‘,■.-+) k �
Fire Alarm
Susp'd Ceiling �
Roof
Misc:
Final
PASS PART FAIL
111
Post & Beam
Under Slab
Top Out
Water Service
CgaililaeoSo
Rain Drains
Final
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
Approach /Sidewalk ( 9
Other Date �7 1 Insp EX
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.