Permit • CITY OF TIGARD SEWER CONNECTION PERMIT
;�� DEVELOPMENT SERVICES PERMIT #: SWR2001 -00084
r �� i � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/10/01
SITE ADDRESS; 13079 SW RAPTOR PL PARCEL: 2S104DA -08100
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 067 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
1NSP 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 given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall : urchase a "Tap and
Side Sewer Permit and the Agency will install a lateral. ATTENTION: Oregon law r- • uires you • follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 10 0 throug • • R 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) '46- • 87.
Issued by: Permittee Signature: A
all (503) 639 -4175 by 7:00 P.M. for an inspection needed the next • siness day
•
"Cfl Y OF TIGARD BUILDING INSPECTION DIVISION •
24 `Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ST
BUP
Date Requested AM PM BLD _
Location / 30 7 9 5 Suite MEC
Contact Person Ph 7f3- 77 7 PLM
Contractor Ph SWR 200/ 0Gocf
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 � l� 6" 4 � �_ `.J ' .
Insulation l� ( 1 - _
Drywall Nailing `' �1J ,-�+ c/�. "Lk
MN 9
Fire wall • � �� o p
Fire Sprinkler �
T '-�/�
Fire Alarm
Susp'd Ceiling S � •
Roof
Misc:
Final
PASS PART FAIL
CRIECING
Post & Beam
Under Slab
Top Out
Water Service
ary Sewn
Rain Drains
Fin
AS 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 6/
Other Date O Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.