Permit CITY TIGARD SEWER CONNECTION PERMIT
� DEVELOPMENT SERVICES PERMIT #: SWR2000 -00014
� N pL ISSUED: 02/14/2000
13125 SW Hall Blvd., Tigard, OR 97223 (5 T
SITE ADDRESS; 12125 SW SWEENEY PL PARCEL: 2S103AB -05600
SUBDIVISION: WALNUT GLEN ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: TIG
TENANT NAME: RIVERSIDE HOMES INC
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
STE 140 PRMT GEO 02/14/200C $2,300.00 00- 321698
BEAVERTON, OR 97006 INSP GEO 02/14/200C $35.00 00- 321698
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 the e rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: / Permittee Signature: 7
Call (503) • 9-4175 by 7:00 P.M. for an inspection needed the next bus ness day
CITY OF TIGARD BUILDING INSPECTION DIVISION Azono_enc,
t 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested 3/l 0 AM PM BLD
Location 12 ! 2 S � pi• Suite MEC
Contact Person i Ph '/ 1 4 3 3 et ' PLM
Contractor Ph SWR a /
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg D
'.�Q� Inspection Notes: SGN
S a. SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fin
PART FAIL
MBIN
Post & Beam
Under Slab
Top Out
er Sew'
Fi
ASS 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 irs�
Inspector 1 77 2 % � Ext
Final
PASS PART FAIL O NOT REMOVE this inspection record from the job site.