Permit I
SEWER CONNECTION /
CI1Y OF TIGARD PERMIT V
PERMIT #.......: 'SWR95 -l306
COMMUNITY DEVELOPMENT DEP ?AR1MENT DATE ISSUED: 07/31/95
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S 12I3DD- X122+@
SITE ADDRESS...: 13970 SW PACIFIC HWY
Or
SUBDIVISION....: . ZONING: C -G
BLOCK . LOT......
TENANT NAME.....:CHEVRON
USA NO..........: FIXTURE UNITS...: 1@
CLASS OF WORK...:ALT DWELLING UNITS.. :1
TYPE OF USE °COM NO. OF BUILDINGS:
INSTALL TYPE....:BUSWR IMPERV SURFACE..: :sf
Remarks: Sewer for fixtures found in PLM95 -1153
Owner: ----------------
CAIN - - --
CAIN PETROLEUM type amount by date recpt
2624 PACIFIC AVENUE PRMT $ 2200.00 B !117/31/95 95•- 2626491
FOREST GROVE OR 97116
Phone 4 #e 357 -9711
Contractor: °-
CONTRACTOR NOT ON FILE
'Phone #: $ 2200. 00 TOTAL
Reg #..
--- - - - - -- REQUIRED INSPECTIONS ---
This Applicant agrees to cooply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The peroit expires 180 days free
the date issued. The total anount paid will be forfeited if the
perait expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the oeasureoent _
given, the installer shall prospect 3 feet in all directions fron
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: .",1;11 61111 __ — — --
Issued Byo
Call for inspection - 639 -4175
03/30/2000 Activities for Case #: SWR95 -00306
10:12:39 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA007 Application received CTR 07/31/1995
SWRA010 Plan check by 07/31/1995 CTR 07/31/1995
SWRA705 Sewer Inspection JMT NOTE JT 09/28/1998 9/28/98 inspection request
(research) sent to Hap
SWRA070 Ready to issue 07/31/1995 JSD CTR 07/31/1995
SWRA080 (F) Issue permit 07/31/1995 BON B 07/31/1995
SWRC108 Expired by limitation 02/29/2000 HAP EXPI No Hold HAP 02/29/2000
SWRC109 Return permit to issued status 03/28/2000 HAP PASS No Hold HAP 03/28/2000 Fee paid for reinstatement and
t final inspection (BUP95- 00247)
SWRC705 Sewer Inspection 03/28/2000 TLP PASS No Hold AKJ 03/28/2000 -
SWRC720 Case Finaled 03/28/2000 AKJ DONE No Hold AKJ 03/28/2000
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION M
•
244Iour Inspection Line: 639 -4175 Business Line: 639 -4171 f ST
`n /UP q S — R 77
Date Requested �� ti AM A _ v PM yBP 9 &t2 /
Location r4/ iP 4Gv G „ Suite MEC Z d0�/3 -
l
Contact Person bra /A41 Ph 7 $ y PLM
Contr, - or Ph SWR K-00 3D fee
tig1= Tenant/Owner d/4/7 ELC
Retaining Wall ELR
Footing Access:
Foundation V6e < Lr✓ FPS
Ftg Drain ) SGN
Slab
Crawl Drain Inspection Notesn„ n' ( 1_ , � / a ,l g �'1? SIT ! _c – MOIn
�LGIUI .G1N�- Y � �j
Post & Beam L &U PI 4 ! k
Ext Sheath /Shear TU ff��
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roo
Mi
tia PART FAIL
P BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
114;4':M?I[•fas
os b eam
Rough In
Gas Line
So.. -. a Dampers
4.■1
�� •AS�,� PART FAIL
E TRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
�S PART FAIL
ding
�C:i• [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �1 / /
Approach /Sidewalk U7Vv Inspector /
o , _ Date 3 �. (/ pector Ext
X01 PART FAIL DO NOT REMOVE this inspection record from the job site.