Permit CITY TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2001 -00153
DEVELOPMENT SERVICES DATE ISSUED: 5/18/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 12740 SW WATKINS AVE PARCEL: 2S102BC -08400
SUBDIVISION: MLP2000 -00007 ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
TENANT NAME:
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: Sewer connection permit for new single family detached residence.
Owner:
FEES
RIVERSIDE HOMES Type By Date Amount Receipt
15455 NW GREENBRIER PKWY #140
BEAVERTON, OR 97006 PRMT CTR 5/18/01 $2,300.00 27200100000
INSP CTR 5/18/01 $35.00 27200100000
Phone: 645 -0986 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: Permittee Signature:
/
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busin s day
tne: 639 -4175 Business .
" BUP
.Date Requested_ 2 AM PM
BLD
Location / Z 2 all Su' wa ,1 hS Suite MEC
Contact Person Ph r PLM
Contractor SWR a 1 — 66
UILD Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Dr_., SGN
rawl Dr Inspection Notes:
as SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall A r� - _
�.o
Fire Sprinkler V �'^-�` 1J` �-
Fire Alarm
Susp'd Ceiling
Roof S
Misc:
Fina
PART FAIL
Post & Beam
Under Slab
Top Out
To c ■�—r � -
�_,.0 � � -• - mac v`P' ` '
F ( Ay PART FAIL �� — d `�--
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final ,-■
P ASS PART FAIL
ELECTRICAL • .W Q 5
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 (� 1
Other Date 7 / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.