Permit • CITY OF TIGARD SEWER CONNECTION PERMIT
� DEVELOPMENT SERVICES PERMIT #: SWR2000 -00025
A ��'ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 06/21/2000
SITE ADDRESS; 12120 SW SWEENEY PL PARCEL: 2S103A6 -05400
SUBDIVISION: WALNUT GLEN ZONING: R -4.5
BLOCK: LOT: 012 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 single family dwelling.
•
Owner:
FEES •
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140
BEAVERTON, OR 97006 PRMT KJP 06/21/200C $2,300.00 0003172
INSP KJP 06/21/200C $35.00 0003172
Phone: 645 -0986 Total $2,335.00
Contractor: •
Phone:
Reg #:
Required Inspections
Sewer Inspection `
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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 obtain co,. ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issue # .4 s' Permittee Signature.
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busin - ss day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 7 —000Y Y
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171
BUP
Date Requested g'— / Z AM PM BLD
Location / Zf Z' 5't/ J Cv eL- Suite MEC
Contact Person Ph ll 1 - 3y PLM
Contractor Ph SWR 0 - 0110�s
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 ( WW J S
Insulation , /n� ,A, 44 c�,� `— � , U
Drywall Nailing ' `X `-S t O e-e9\ •
Fire wall V v� 2 J LJ �R UL.-51 ,0Q (v'vs).
Fire Sprinkler .�/r
Fire Alarm ..� ,/Z 2 � n 7 o — 6 O 2S)
Susp'd Ceiling `J' 1� !
Roof
Misc: 1 -- •
Final
PASS
��� FAILV" �+ \� i te-- 0 ge/e
P os l rder9fe49- N 0 s ,-;1A r'
o. Crib. l , `� '' _ ` '` " / ��
I +ater Service VA I ; (AA) ( ► (���W1
AS
Sanitary Sewer e
Rain Drains ,Q 0-r ti .e-f0
PASS PART /60
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 D Inspector " (J� Ext l
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.