Permit CITY TIGARD SEWER CONNECTION PERMIT
lA DEVELOPMENT SERVICES PERMIT #: SWR2000 -00058
c �' I 13125 SW Hall Blvd., Tigard, OR 97223 (( 639 -4171 DATE ISSUED: 06/01/2000
SITE ADDRESS; 12247 SW ERt ' / / -1 T/ PARCEL: 2S103AB -05900
SUBDIVISION: WALNUT GLEN ZONING: R -4.5
BLOCK: LOT: 017 JURISDICTION: TIG
TENANT NAME: RIVERSIDE HOMES
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: New SF - Path 1
Owner: FEES
RIVERSIDE HOMES INC Type By Date Amount Receipt
15455 NE GREENBRIER PKWY
SUITE 140 PRMT GEO 06/01/200C $2,300.00 0002630
BEAVERTON, OR 97006 INSP GEO 06/01/200C $35.00 0002630
Phone: 503 - 645 -0986 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
ORIGINAL
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 (50 246 -1987.
Issued by: ' � /�` / _._ Permittee Signatu :
all (503) 63' -4175 by 7:00 P.M. for an inspection ne, ed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ;° n72
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested (0/1 AM _ PM BLD
Location 22� //Suite �z& MEC
Contact Person gOIC2eAk Ph tit43 '' 3' PLM
Contractor Ph SWR V)D0 Si
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS P�A FAIL
rUMBIMG_)
Post & Beam
Under Slab
Top Out , /a/1
anitary S-
i .
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
Othe�ach /Sidewalk Date ,67016O Inspector / 2 / / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.