Permit 4 411‘ 1,1014' CITY OF TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR1999 -00128
DEVELOPMENT SERVICES DATE ISSUED: 6/17/99
i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 15373 SW REGENT TERR PARCEL: 2S111 DA -11300
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 106 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: Sewer connection for a new single family dwelling.
Owner:
FEES
LEGEND HOMES • Type - By Date Amount Receipt •
6900 SW HAINES STREET
PLAZA 2, SUITE 200 • PRMT BON 6/17/99 $2,300.00 99- 316211
TIGARD, OR 97223 INSP BON 6/17/99 . $35.00 99- 316211
Phone: 620 -80810 Total $2,335.00
Contractor:
•
•
•
Phone: • • •
Reg #:
Required Inspections
. Sewer Inspection
OR1 GJNA L
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: F), a/(T — Permittee Signature / j� /` %�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed th : e t us' e s y
CITY OF TIGARD BUILDING INSPECTION DIVISION MST f?'? , 3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP
Date Requested (to-L3-- I AM PM (4 4€) BLD
Location (s ji e,vk Suite MEC
Contact Person rn rz Ph 2' / V - - J S PLM
Contractor Ph i�`7 ? SWR — 06 y i p
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation ACCe p� ,� ('f� FPS
Ftg Drain s'�� SGN
Inspecti Notes:
Slab SIT
Post & Beam 3 1( e2-_5
Ext Sheath /Shear I Q ''
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
AS PART FAIL
Post & Beam
Under Slab
Top Out
AZG
ani a . -`
Rain Drams
F r -1
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 [ I 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
Other oach /Sidewalk Date ' Inspector /2�� EX _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.