Permit CITY TIGARD SEWER CONNECTION PERMIT
11 DEVELOPMENT SERVICES D I PI n'
PERMIT #: SWR2000 -00019
c1�3� I V �{
� 13125 SW Hall Blvd., Tigard, OR 97223 1 H DATE ISSUED: 4/5/00
SITE ADDRESS; 12211 SW SWEENEY PL PARCEL: 2S103AB -05700
SUBDIVISION: WALNUT GLEN . ZONING: R -4.5
BLOCK: LOT: 015 JURISDICTION: TIG
TENANT NAME: RIVERSIDE HOMES
USA NO: FIXTURE UNITS: 0
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 detached single family dwelling.
Owner:
FEES
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140
BEAVERTON, OR 97006 PRMT DEB 4/5/00 $2,300.00 0001178
INSP DEB 4/5/00 $35.00 0001178
Phone: 645 -0986 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 m. • • ' of the rules or direct questions to OUNC by calling (503) 246 -1987.
Is - tied b y: L �, � i , � Permittee Signature: 1/ ��� ,
, ,� � /� /� _ i .
Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2600
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested IV / '7/ AM PM BLD
Location 1 221 1 ,SweVA-9 Suite MEC
Contact Person • (w 1V/1 Ph y y 3 - 39 31 PLM
Contractor Ph SWR 9
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS P�RT FAIL
PCCJMBIN /f
Post & Beam
Under Slab
Top • ut
a S- • -
pfr 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 Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date • Inspector C/ Ext
Final
PASS PART FAIL ' 0 NOT REMOVE this inspection record from the job site.