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Permit CITY TIGARD SEWER CONNECTION PERMIT ���► DEVELOPMENT SERVICES PERMIT #: SWR2002 -00117 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/5/02 SITE ADDRESS; 11825 SW WALNUT ST PARCEL: 2S1036A -00700 SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: ALT DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection. Reimbursement district #18. Owner: FEES GAARDE, RICHARD J II AND JUDITH O Type By Date Amount Receipt 11825 SW WALNUT INSP CTR 3/5/02 $35.00 27200200000 TIGARD, OR 97223 PRMT CTR 3/5/02 $2,300.00 27200200000 Phone: Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection 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" Perm Issued by: . _ Permittee Signature: MIP - / !tom Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested AM PM BUP Location // U Q` C uv� Suite MEC / - Contact Person • Ph ( ) PLM O � —D�747 Contractor I �. • , i J � h ) SWR o� ©a /1°7 c BUILDING Tenant/Owner 1 . f (j � G- ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: ' SIT Post & Beam Z � J Shear Anchors c Ext Sheath/Shear �Q Int Sheath/Shear I _ Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm • Susp'd Ceiling Roof Other: Final PASS PART FAIL UMBIN Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Oth- • m lflo ALB' PART FAIL 77 ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE E Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL