Permit CITY TIGARD SEWER CONNECTION PERMIT
�y� i DEVELOPMENT SERVICES
PERMIT #: SWR2001 -00111
'�� I! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/30/01
SITE ADDRESS; 13054 SW RAPTOR PL PARCEL: 2S104DA -07100
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 •
BLOCK: LOT: 057 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 10/30/01 $2,300.00 27200100000
INSP CTR 10/30/01 $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 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 obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: Alb , , `- Permittee Signature: ! ��
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BU" DING INSPECTION DIVISION • MST ZOO f 00/61 ?
24 -Hour Inspection Line: 63a ,175 Business Line: 639-4._
BUP
Date Requested I — S 'AM PM BLD
Location / 3 U S �-( (� /k '.fi . Suite MEC
Contact Person Ph PLM
Contractor Ph SWR ZD O% b C I/
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl 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:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Wate - ice
Rain Drains
Final
PART FAIL
MECHANICAL
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
BackfilUGrading
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 DateJ � O i Inspector ie earl7'c. Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.