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SWR1989-0110
SEWER CONNECTION 144,, PERM C11YOF TIRD PERMIT # ^ SWR890110 C�Y��1�N�� PRIM. PERMIT #.: 881745 ~~^~^---^'' ~~~~^E-~'--'''- —' � DATE ISSUED: 03/09/90 1m1mamwmwe*dP� Box ^ ~,� SITE ADDRESS... WALNUT ST PARCEL: 2S1 4AD— 3400 SUBDIVISION ^ ZONING: BLOCK ^ LOT ---- — . -- --------- --- —_--- ----_ TENANT NAME ^ USA NO ^48601 FIXTURE UNITS...: CLASS OF WORK...:NEW DWELLING UNITS..: TYPE OF USE ^SF NO. OF BUILDINGS: INSTALL TYPE ^ IMPERV SURFACE..: :sf Remarks: need contractor number Owner: ------ -- -- FEES ---- BRIAN LEWIS type amount by date recpt 12902 SW WALNUT ST PRMT $ 35.00 MAN / / PRMT $ 1250.00 MAN / / TIGARD OR 97223-0000 PAYM $ 1285.00 JLH 04/18/90 Phone #: 503-684-6841 Contractor: ------- — CONTRACTOR NOT ON FILE Phone #: $ 1285.00 TOTAL Reg #..: REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 128 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. Permittee Signature: Issued By: _ Call for inspection — 639-4175 l X901/0 o F Permit No: 1/4360 o H Address: :P. s, • O t Issued by: Date: la STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. • Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1. 'OE I own, reside in, or will reside in the completed structure. 2. A. RYA My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must-be registered with the Construction Contractors Board. OR B. 1 I I will be my own general contractor. rf If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. S atuP• •fican{ 'Date 7,./77a • CONSTRUCTION CONTRACTORS BOARD • 0244J 10/24/89 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT - - • • • i : • - I • - • = = - -,. • -.... •••::-.. . -,- • ::- 0-- •: ..• ., ..:, :.t.... ' " - 'i ; • :!... -.. ..4- . '7. t : -7- M 7 '-'. .: - 4:11,... - ; '-i ••;: :•••:;.;;.V ••••;i - ,• • . 1 4 f ., . • • . . • . ' . . _ „ 6.--- , - . . . i . ...—... . . 5■A/R9o110 . (--- _ , . _ ., . . . . • 4 ( C 17-525 s 1/v kAic..1,,,_4- si . : --, , /L ,6 -- _ 0 _ _ .. ci . . : p. y „AAA .....p. fl • • . , . . . .. • . • f TA .J14: • . . ..- , . . Length...148:m . . -- • - ;:,--;-•:' ....'1.: 4 ..k 0 • - . . - . . Cletli-........... . -- • ' :.f... lip 1, • . Oist. 11.4H 212210 . 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