Permit CITY TIGARD SEWER CONNECTION PERMIT
y, l DEVELOPMENT SERVICES PERMIT #: SWR2001 -00090
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/10/01
SITE ADDRESS; 13123 SW RAPTOR PL PARCEL: 2S104DA -08600
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SUBDIVISION: QUAIL HOLLOW - WEST
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ZONING: R -4.5
BLOCK: LOT: 072 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.
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Owner: FEES
BROWNSTONE HOMES Type By Date Amount Receipt
12670 SW 68TH PKWY #200
PORTLAND, OR 97223 PRMT BLD 4/10/01 $2,300.00 2001 -1479
INSP BLD 4/10/01 $35.00 2001 -1479
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 A. ency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measureme gi en, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall • urc ase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you o foil. les adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 $ 10 throu“ OAR 9. 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503 . ' 987.
Issued by: ,`L Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b iness day
• CITY OF TIGARD BUILDING INSPECTION DIVISION • i T _ a e, .60./ e•
74-Hour inspection• Line: 639 -4175 Business Line: 639 -4171
BUP -
Date Requested AM PM BLD
Location /3/ Z) $ - Ali G� { - / Suite MEC
Contact Person Ph '7'3-5 72 7 PLM
Contractor Ph SWR 2v / -44)(-)Y. v
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 •
Insulation � _ \
Drywall Nailing �� `�J `.j ` �J
Fire Sp ��
Fire Sprinkler �
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
rif
Post & Beam
Under Slab
Top Out
Water S ice
anit rSewer
Rain Drains
Fin
it 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
Approach /Sidewalk Date <154 5 ` Inspector C..�c Ex
ns p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
dl
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CITY`OF T1GARD BUILDING INSPECTION DIVISION ' ° G - /,z))"
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24- 1iour..IASpectlon Line: 639 -4175 Business Line: 639741 1
• BUP •
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Date Requested 4-- Z AM PM BLD
Location / 3/ Z 3 - RGA�►. P-? Suite MEC
Contact Person Ph 6‘,7 / 7H PLM ss11
Contractor Ph ; old � d '
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
Ina Sheath /Shear o _ '
Framing 7
Insulation
Drywall Nailing 2- Le
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof I - f
Misc: G.6 Vl ^- e-s�'^ � k
Final ( `� v
PASS PART FAIL , r
!/-1'_ w � k
ost & Beam ''(��`
der S !�
Top Out (jlZw•0
Water Service ‘
Sanitary Sewer
Rain Drains
Final
PASS PART F
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
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Inspector
Other Date 4114/ U t Y C� Ext�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.