Permit I. ,
CITY TIGARD SEWER CONNECTION PERMIT
't + "�I' DEVELOPMENT SERVICES PERMIT #: SWR2001 -00020
`�'�" � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/24/01
SITE ADDRESS; 13585 SW WALNUT LN PARCEL: 2S1046D -09700
SUBDIVISION: SULLIVAN MLP2000 -00004 ZONING: R -7
BLOCK: LOT: 001 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: New connection for USA sewer system. Septic tank must be pumped, filled and inspected, or
removed and inspected.
Owner:
FEES
ED SULLIVAN
13585 SW WALNUT LN Type By Date Amount Receipt
TIGARD, OR 97223 PRMT CTR 1/24/01 $2,300.00 27200100000
INSP CTR 1/24/01 $35.00 27200100000
Phone: 503 - 699 -0238 Total $2,335.00
Contractor:
OWNER
Phone:
Reg #:
Required Inspections
Septic Tank Filled
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 %'I80
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 ' • 87. / i
Issued by: Permittee Signat e: / / _,_� /�4111
, ,,zCiffk2,_____
Call (503) 639 -4175 by 7:00 P.M. for an inspection ne • • ed the next busi - ss I
Jan 31 01 01:07p Ed Sullivan 503 579 6328 0 p.1
Invoi
•
A- AFFORDABLE SEPTIC SERVICE DATE INVOICE I4
P.O. BOX 1130 1130/2001 10472
WII SONVILLE„ OR 97070 ____ __ _ .. __ _-
BILL TO _ _ _ 1 JOB SITE ADDRESS — — — -
En SULLIVAN + 13585,S.W. *ALNUT LANE s . l�j l7 0 .
6 0 I . 00a). 0
4 TOUCHSTONE #74 i 141KARD; OR 9J223 . ' - ' � 1
LAKE OSWEGO, OR 97035 I
I to v
t P.O. NO. TERMS PROJECT
i
ITEM , QUANTITY I DESCRIPTION ' RATE I SERVICED AMOUNT
septic truck — — — 11 cleaned septic tank — - - 250 -00 1!29/2001 250 00
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IF ANY QUESTIONS, 'PLEAS (503) 682 -1929 THANK YOU! Total $250.00
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
2 iour'Inspection Line: 639 -4175 Business Line: 639 -4171
P
Date Requested /— 2 AM PM BLD
Location ( Sw Suite MEC
Contact Person C Ph f Z3 42rP c / — 000 / 7
Contractor Ph 247 c `i
BUILDING Tenant/Owner y /.!G£c Cc,/ ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab I 1
SIT
Post & Beam d
Ext Sheath /Shear
Ina Sheath %Shear PL-H ^ �, o l - Q 0 ` C
Framing \ (,�() l I
Drywall Nailing C + ` + 2-43 (-1Attl3 )
Dryw Jw U — O U l C, ,V\
Firewall
Fire Sprinkler
Fire Alarm C W A i
Susp'd Ceiling ` \
Roof
Misc:
Final
- -PASS ART. - FAIL
Post & Beam
Under Slab
Top Out
Water Service
Rain Drains -
Fi
9P PART FAIL
CHANICAL
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 Q S
Other Date I 7 - Inspector E
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.
1
Feb 07 01 11:25a Ed Sullivan 503 575 6328 p.l
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_ �' SERVICE ,( 2d
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. P.G.BGX 1134 TT 0 �
WILSONVILLE, OR 97070 � V
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CiySTOMER'S ORDER N0. /� e� � 3 ;
ADDRESS . / k°4142It _F
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C.O.A. CHARGE
SOLD BY AMOUNT
PRICE "
7. - DESGRIPT 1 —
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TOTAL t
RECEIVED BY this hill.
Dods MUST be accompanied by THANK YOU
1— All claims andf9 u�
Feb 07 01 11:25a Ed Sullivan 503 579 6328 p.2
Invoice
A- AFFORDABLE SEPTIC SERVICE
DATE INVOICE f!
P.O. BOX 1130
WILSONVILLE„ OR 97070 1/30/2001 10472
BILL TO 1 'JOB SITE ADDRESS
- ED SULLIVAN 13585 S.W. WALNUT LANE
4 TOUCHSTONE #74 I TIGARD, OR 97223
• LAKE OSWEGO, OR 97035 L 6 J —...
P.O. NO. TERMS PROJECT
ITEM QUANTITY DESCRIPTION 1 RATE
I SERVICED ' AMOUNT
s eptic truck 1 I cleaned septictank — ^ — 250.00 41(29/2001 - 250.00
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1
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IF ANY QUESTIONS, PLEASE CALL (503) 682 -1929 THANK YOU! — 1 —
Total 5250.00