Permit . CITY OF T I GA ' 1 ' SEWER CONNECTION PERMIT
ar DEVELOPMENT SERVIC ' GIN A !
PERMIT #: SWR1999 -00268
II 13125 SW Hall Blvd., T i gard, OR 97223 (503) 639-41 DATE ISSUED: 12/27/99
SITE ADDRESS; 15211 SW REGENT TERR PARCEL: 2S111 DA -10400
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 097 JURISDICTION: TIG
TENANT NAME: LEGEND HOMES
USA NO: FIXTURE UNITS: 1
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 single family dwelling.
Owner: FEES
LEGEND HOMES
12600 SW 72ND AVE • Type By Date Amount Receipt
TIGARD, OR 97223 PRMT DEB 12/27/99 $2,300.00 99- 320684
INSP DEB 12/27/99 $35.00 99- 320684
Phone: 620 -8080 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 t Oregon Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
Y may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
•
by: ' / ��;;, , Permittee Signature:
Iss ed bi
Call (503) 6 ' -4175 by 7:00 P.M. for an inspection needed the next busines day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST <9gq �/O
24 -Hour Inspection Line: 639 1 75 Business Line: 639 -4171
BUP
Date Requested
�/ /S ('0 AM PM �C BLD
Location IS2( tl.�,(/1/1 TPXY Suite MEC
Contact Person (V'IA Ph q (q' Z (a ( PLM
Contractor Ph ( gOL/S SWR i QqQ- vv2(aq
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation i / / • FPS
Ftg Drain SGN
(Ciawl Drat - _) Inspectio otes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
_ " PART FAIL
� t MBIN
Post & Beam
Under Slab
Top Out
er Seruis
nia } 4Ptu�
Rat rams
Fi
� • 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 6
p
Approach /Sidewalk
Other D Inspector Ext
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.