Permit A ;
CITY OF TIGARD
/.4 DEVELOPMENT SERVICES SEWER CONNECTION
ll( PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171
PERMIT # • SWR97 -0307
DATE ISSUED: 10/22/97
PARCEL: 25109AB -06300
SITE ADDRESS...: 13063 SW STARVIEW DR
SUBDIVISION -FORAN ZONING: R -7
BLOCK.......... LOT -005 JURISDICTION: TIG
TENANT NAME -CLIFF WAIBEL
USA NO FIXTURE UNITS...: 0
CLASS OF WORK... : NEW DWELLING UNITS..: 1
TYPE OF USE.....: SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: SF — Path 1
Owner : - FEES - --
CLIFF WAIBEL type amount by date recpt
879 NW 10TH QUL $ 210.00 DRA 10/22/97 97- 300294
HILLSBORO OR 97124 QUN $ 290.00 DRA 10/22/97 97- 300294
PRMT $ 2200.00 DMA 10/22/97 97- 300294
Phone #: INSP $ 35.00 DRA 10/22/97 97- 300294
EROS $ 64.00 DRA 10/22/97 97- 300294
Contractor; - - - - -- — - -- ERPU $ 20.80 DRA 10/22/97 97- 300294
OWNER ERPC $ 20.80 DRA 10/22/97 97- 300294
Phone #: $ 2840.60 TOTAL
Reg #.. .
REQUIRED INSPECTIONS ---
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
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- m1 -0080. You may obtain copies of
these rules or - •stions to OUNC by calling (503)246 -1987.
•
Issued Y : Permittee Signature, , /�;t'�
+++++++++++++++++++++++- F++- F+++++++++++++- I-- I-+++++++ ++ + + ++ ++ ++t+ + ++++ + ++ ++ ++ +++ ++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + +-r- + + ++ + ++
5
1 j o3
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: J 0 A. ) P.M. MST: 7 :3 -- --�-'
Location: !_ - 5C , (, 3 &J _Stz. AicriL'_.t) 1-' BUP:
Tenant: Suite: Bldg: MEC:
Contractor: C Ji .Lal Phone: VC — 3 / / C PLM:
6 I-'
Owner: Phone: ELC:
ELR:
S r-r: S& / - if,' -L: .„(_
BUILDING BLDG (con't) — .-.PLUMBING) MECHANICAL ELECTRICAL SITE j.� c .) 7
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm •
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved qp Approved Approved Approved
Appr /Sdwlk Not Approved o pproved Not Approved Not Approved Not Approved
FINAL — /FI ; FINAL FINAL FINAL
0 Call for reins 6• to 0 Reinspection fee of $ requir before xt inspection 0 Unable to inspect
Inspector: Date: P age of