Permit /\,. CITY OF TIGARD SEWER CONNECTION PERMIT
�,>l& DEVELOPMENT SERVICES PERMIT #: SWR1999 -00210
�� fl� 13 125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/14/1999
SITE ADDRESS; 11999 SW TREEVIEW CT PARCEL: 2S11066 -06500
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 007 JURISDICTION: TIG
TENANT NAME: JT ROTH CONSTRUCTION INC
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: New SF - Path 1
Owner: FEES
JT ROTH CONSTRUCTION INC Type By Date Amount Receipt
12600 SW 72ND AVE
TIGARD, OR 97223 PRMT GEO 10/14/199E $2,300.00 99- 319093
INSP GEO 10/14/199E $35.00 99- 319093
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
ORIGINAL
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 these r les or , ect questions to OUNC by calling (503) 246 -1987.
Issued by: lX� Permittee Signature E -
- Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b - mess day
CITY OF TIGARD BUILDING INSPECTION DIVISION • , •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST O �-
l / BUP
11� i on1Date Requested / 0/a,� AM PM BLD MEV
Location //q y'? - 771 0.-(2.- `t Suite MEC
Contact Person Tr Rio I- Ph S1 -3 87 PLM V
Contractor Ph j l WeC a`16
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 PART FAIL
PLUMBING
Post & Beam
Under Slab • ..+61)14.11
Top op Out c�
Water Service
-nit- • -.
- ain Drain
T "r
ART FAIL
ME ANICAL
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
Other oach /Sidewalk Date 7/1,/ Z31 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.