Permit CITY TIGARD SEWER CONNECTION PERMIT
a� I DEVELOPMENT SERVICES 4 R7I1� I No
R ) 13125 SW Hall Bd., Tard, OR 97223 (503 SSUED: 0 2/29/2000
SITE ADDRESS; 15331 SW REGENT TERR ARCEL: 2S111 DA -11000
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 103 JURISDICTION: TIG
TENANT NAME: LEGEND HOMES
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: New SF - Path 1
Owner: FEES
LEGEND HOMES Type By Date Amount Receipt
12755 SW 69TH AVE
TIGARD, OR 97223 PRMT GEO 02/29/200C $2,300.00 00- 321888
INSP GEO 02/29/200C $35.00 00- 321888
Phone: 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 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: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2.00U
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/, BUP
Date Requested 3// t 0 PM BLD
Location I S3 3 1 k.elei l Suite NJ s MEC
Contact Person .( �e Ph 6S/ p 0-` PLM
Contractor Ph 90-11,41 SWR 240 O00
BtitCD Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
C �J?J 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:
F' a
S PART FAIL
u
Post & Beam
Under Slab
Top Out
.1 co:
am Dra' .
F'
PAS 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
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
)
Approach /Sidewalk
Other Date Ins Ext
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.