10205 SW STUART COURT 1
ADDRESS:
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INS ?CCTIQN ?LC CE
city of Tigard Bul.ldinq Department
j
13125 811 Ball Blvd. Tigard, r1regon 97223 �
Inspection Line (Rec-O-Phones 639-4175 Busipess Phone: 46 -41V71
d Inspection:------ --
>s a Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plby. ^.p Out One Line FINAL:
Poet/Ream Struct. San. Sewer Framing -Bldg•
Post/Ream Hoch. Rain rem ir, Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Me:h.
Date Requesteds is - •� C7 C� _T f AN PMI
/US/ �� )�
Add,eas: � C.l rr_..t Pe7rmit/ i��1.s�_
RuLlder: MaA 3`// r,
THE FOLLOWING OORRRCTIOMS ARE REQUIRED:
,y
- i
Inspector: _ —_ _�-, Date•
APPROVED DISAPPROVED APPROVED SUBJE- IU ABOVE
Call For Reinap.
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RISEN
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C`IT'Y OF TIGARD
COMMUINiTY DEVELOPMENT DEPARTMENT
13125 SW Hail Blvd.Tigard,Or*90n 972239W (F)3)619-4171 PLUMBING PERMIT
PERMIT #. . . . . . . : PLM94-0123 �
639—fl l 71 D1AYE ISSUED- 06/2-9/94
PARCEL: 2S114BB-17100
SITE ;ADDRESS. . - : 10c05 SW STUART CT ZONING: R-7 PD
SUBD I V 1: I ON. . . . : R i VERV I EW ESTATES
BLOCK. LOT. . . . . . . . . . . . . : 17 ---- ---
CLASS OF WCRK. . :ADD -- GARBAGE DISPOSALS. . : - MOBILE: HOME SPPCES. :
TYPE OF USE. . . . :SF WAE,:iNG MACH. . . . . . . : BACKFLOW PREVNTRS. . : i
:.:
OCCUPANCY GRF'. . :R3 F' -)OR DRAINS. . . . . . . : TRAPS. . . . . . . . .. . . . . • :
STORIES. . . . . . . . t Wf "ER HEATERS. . . . . . : PATCH BASINS. . . . , . . :
FIXTUPES- __..-._ LAUNDRY TRAYS. . . . . . : 5F RAIN DRAINS. . . . . :
SiNI-13. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATOPIES. . . . , : OTHER FIXTURES. . . . . :
TUB/SHOWERS. . . . SEWER LINE (ftJ . . . . :
WPTER CLOSETFi, . : WATER LINE (ft ) . . . .
DISHWASH,.RS. . . . : RAIN DRAIN (ft) . - :
Remlarka : 6ACK FLOW DEVICE
Owner-: -------------------------------------------------
wner-: _ _ -- ---_._____-------•---------------•-.--- FEES -----------------
ROB LARSON type amount by date t�ecpt
10205 SW STUIRT CRT PRMT E 15. 00 SW 06/29/94 -
5PCT $ 0. 75 SW 06/29/94 -
T I GARD OR 972;:4
Phone #: 620-4659
Contractor -- --------- ---_ -__------ --_._.
DIAL ONE. WESCO PLUMBING
M&F CONTRACTORS, INC
PO BOX 2'.30594
TIGARD OR 97281 •--__________-------.-----------------___..
Phone #: 639-4700
S 15. 7:i TOTAL_
17og #. . : 73626
-------- REQUIRED INSPECTIONS —___..__
?;
This permit is issued subject to the regulatio,is contained in the RP/Backf 1 ow Prev
Tigard Municipal Code, State of Ore. Spec.ilty Codes and all other F i n a l inspection
applicable laws. All work will be done in accordance with - --
approyed plans, This permit will expire if work is not started
within IN days of issuance, at- if work is suspended for more
than 188 days. ---
Permittee Signati-lr^e :
I s s,Aed By :
Call for- inspection 639-A175
�:
f
City of Tigard PLUMBING PERMIT P lanck/ho,�. #
13125 SW Fla►l Blvd. APPLICATION Permit # P.111ffi�qraw
Tigard, OR 97223 w
(503) 639-4171
�R �
rr__ \\ ORS 014.21-610 or. PRICE AMrMUNN
�
Job U2 O5 �lY CJTJ.t RT C� FIXTURES
Address ap 7.50 —
or I ub15h5w_a_r_l75iW •
Shower Only
a er
Owner :1 ti I ora
e
iWashing ne __
I7.50
S Oti) �O Water eater —
"T'Stf
4-wlF_ Uriral
------ — er RiUris
7.50
Gontractor �� MISCELLANEOUS
zs —
30.00
tryWA ea.Addit- 100'
Iiew
19 'Pf r arve st T r y x °w - a1Ti TTFave mad fisappl�caT�FiaT�ieWateService ea.Addit. 200' 15.00
ct —�
information given is correct,that I am the owner or authorized agent of
the owner.that pinna submitted are in comprianc;e with State laws,that I —Storm&Rain Drain 1,• 100' 30.00
am registered with the Construction Contractor t Board,that the number Storm b Rain Drain Addit. 100' 15.00
given is correct. (If exempt;rom Stare registra on,please give reason
below.) Mobile Hoiae Space 25.00
�� w revenuon
�+ /G /c r�! Device or Anti-Pollution Device7.50 ^, 17)
y rap or Waste Not
Connected to a Fixture 7,50
sat i—W—WTT a xt alteration repak
to he reridential Q non residential Q40.00
— -
- _ Insp.of Exist Plumbing Icer hr
40.00
Existing use of Specialty Requested Inspections per hr ---
building or property- � ' ,> n Drain.singli ramolF--
dwelling 15.00
Re ntv w prevention
--
Proposed use of � � devices
15.00
building or property . a
(Except residenlFal backflow '—
___ _ prevention devices)
NOTICE 'Minimum Fes*25.00 SUBTOTAL r
PERMITS BECOME VOID IF N;ORK OR CONSTRUCTION 6%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF _
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD JF 180 DAYS AT ANY TIME AFTER W')RK IS PUN REVIEW 25%OF SUBTOTAL
i
COMMENCED.
Special CaKitions _ TOTAL
-- --- _ ----- Date issued by
4AIiAli
�+UtswJw
T
INHICTION Mme«
Citi ,2! Tigard Building Depart-ant
13125 Be Ball Blvd.. Tigard, Oregon 97223
Inspection Lina (Roc-O-Phone): 639-4175 Buaineee Phonal 639-4171
Inspections , '
Footing Plbg. Underslab Mach. Rough-in ,¢App!'/aftik
Found. Plbq. Top Out Gas Line
Poet/Boom 7truct. San. Sewer Framing0; 6woo
11dq. J
Port/Ream Koch. Rain Drain Insulatian �llutlb.
Plbq. Underfloor Nater Line Gyp. Ed. A 1
Date Requeetedt �' I ') Y' ___Ti-
Address s
Ti-Addresst /L,.21' 1 S/� )TlI Ztt 'r L'� Permit h�1�'
Builders
-Ms�*.-?-L,t
/ TAE FOLA)RIMG 00%MCTIONS ARE Ra402RSDt
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.�•si;,._._�f ''_� 11� ,.�� S �1,�t �� � <�, � W
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.._---moi �� `r�., ,. �, v� _ �._ c� � c" - 'w' ✓ f c� ._._• ,'� _.,
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Inapector t C. �- Date t
11PPROYED DISAPPROVEC APPROVED SUBJECT TO ABOVE
V Call For Reinap. f
.;� a �+w., *.y.y.q�. ...-. ,r.«-w«,.. «rte--��aw•M M' a.. ,..s. «. unn . .R"�!,l�W '0•�n' nr�y�«r•-r. riw
401
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City or Tigard Buildleq Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:______
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
round. Plbg. Topp Out Gas Line FINAL:
Pont/Beam Scrur--t. ian/saerl Framing -Bldg.
i
Post/Beam Mach. Raio DR! Insulation -Plumb. t
Plbg. Underfloor �a �� r- Gyp. Rd. -Mach.
Date Requsatudt_ A 1'�� Tis / AM _ PM
Addraau i /U D.5 �CLGlt'i Permit #8 _3 -,1912_0
Builder:
THE FOLLOMING CORRECTIONS ARE REQUIRED:
Inspectors 13atotL-'4K,
_
APPROVED DISAPPROVED - APPROVED SUBJECT TO ABOVE
-___Call For Relnep.
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IHi"IST1_R I vJfl1.1 T /
CITYOFTIFARD I E_Rlyl i T it. . . . . . . : hIS T93-0120 �
CCMMUN" DEVELOPMENT DEPARTMENT onerac�e,
13126 SW Hall SMI. P.U.Bac 23307,Tip d,Oregon W 15 01 43041?S \"_ / U A 1 L-_ 1 S f i U F.D: 0 J/O8/9 6
SITE ODDRE'S:;. . . a 10205 SW STU►4HT C1 PARCEL: 25114E+8-•-17i0l)
SUBDIVISION. . . . a RtVERVIEW ESTATES ZONING: R-7 FID
BLOCK. . . . . . . . . . : LOI.. . . . . . . . . . . . . .. 17
---------------------------------- BUILDING -__-_-___
REISSUE.: DWELLING UN I T a a 1 BASEMENT. . . . . . . . :0 S f
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE•. . . . . . . . . . 946U 5f
TYPE OF USE. . . :SF FLOOR AREAS-_.______.__ REUUI REU
TYPE OF CONST. s 5N FIRST. . . . : 1009 s f LEFT. . :5 ft RIGHT. :8 ft
OCLUPANCY GRP. aR3 SECOND. . . 11219 sf FRONT. :20 ft REAR. . :25 f
STORIES. . . . . . . :c-'_ THIRD. . . . :O sf REQUIRED-- ---____.__.__________.._.
HEIGHT. . . . . . . . ..E5 ft TOTAL-------s2228 S f SMOKE DETEC-I ORS. :Y
FLOOR LOAD. . . . :40 la s f VALUE=. . . . . >f: 110604 PARK T NG SPNCES. . a 1
Remarks a PA'EH I
_.__.__,_------------------- PLUMBING
SINI{S. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTR S. . :0
LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
TUB/SHOWERS. . . . 13 LAUNDRY TRAYS. . . SO CATCH BASINS. . . . . . . :0
WATER C1_USETS. . 13 SEWER LINE (ft) . :0 GREASE TRAY S. . . . . . . :N
DISHWASHERS. . . . .. I WATER LINE (ft) . : 100 OTHER FIXTURES. . . . . :0
UARBAGF:: DISP. . . : I P(41N DRAIN (ft) . SO
WASHING MACH. . . : 1 SF" Rn I N DNA I N5. . : 1
----- ----------- MECHAIVICRL FEES
FUEL TYKES-----•-------- UNIT HTRS. . :0 type amount by date recpt
/GAG/ / / VENTS . . . . . .0 TIF $ 1460. 00 JF 03/08/93 -
MAX INPUT:O BTU VENT FANS. . a4 BPRT $ 460. 50 JF 03/08/93 -
I=UF2N ( 1 OOK . . so HOOPS. . . . . . : 1 HPLC; $ 299. 33 JLH 02/26/93 93-237182
FURN ) =100K . . a 1 WOODSTOVE S. :O 85PC $ 23. 03 JF 03i 08/93 --
FLOOR FURN. . . . :0 CLO DRYERS. s 1 SSDC $ 280. 00 JF 03/08/93 -
BOIL/CMP ( 3HP:O OTHER UNITS: 1 PARK $ 500. 00 JF 03/08/93 -
GAS OUTLETS: 1 MPRT 4 45. 00 JF 03/08/9:3 -
Owner: - - -----._____.____.__.._._._..___.___.__._.___._____--MPLC $ 11. 25 JF 03/0/93 -
KELLY SPEER HOMES INC M5PC E L. 25 JF 03/08/93 -
`J41A $E 119TH PPRT $ 147. 50 JF 03/08/93 -
P5PC $ 7. 38 JF 013/08/9:; -
Phone #s OR 9721c_.._____.__-•_- _
Phone #s r52-3966 �� ,
Contractor: „i
KELLEY SPEER HOMES, INC q✓
540 SE 119TH
PORTLAND OR 9 7216
Plicine #: 252-3966
Reg #. . ,. 58192
3E36. 24 TOTAL
This oersit Is issued subject to the regulations contained in the - - -- REG?UIRED INSPECTIONS -------
Tigard Municipal Cade, State of Ore. Specialty Codi, and all other Fr.ot/fol_md Insp Firep:ace Insp
applicable laws. All Mork will be done In accordance wit,) approved Post/Beam StrUct Gals Line Insp
plans. This permit will expire if Mork is not started Mitnln 180 Post/beam Mechan InsUlatinn Insp
days of issuance, or if work is suspended for sore than 180 day,. Ellm/Undslab Insp Gyp Board Insp
P�_hl/Underfloor Rain drain Insp
Pav,mittee 5iynatl_trv :,/ ?�� — - Mer-nanical Insp Water 1_.ine Insp
Plumb Top OUt AF.)pr/Sdw.TFc Insp
Esssr_:ed By : Framing Insp hlec_hanicaI F"i.na 1
[.1.1. 1 •for, in<. pection - 639-4175
I - PLUMBING PL-RM I T
CITYOFTIFA PERMIT #. . . . . . . : 11ST93-�012(d t
COMMUNITY DEVELOPMENT DEPARTMENT � UATE ISSUEDe 03/00/93
13126 8W Hoh SW&P.O.Bon 23307,TOW.Oreo^9=(603)630.41-6 � - �
SUBDIVISION. . . . a RIVERVIEW EbTATES _ ZONING: R-7 RL!
BLOCK. . . . . . . . . . a LOI.. . . . . . . . . . . . . .. 17
— — ------ —
CLASS OFWORK. . aNEW GARBAGEDISPOSALS. . e1
TYPE OF USE. . . . eSF WASHING MACH. . . . . . . 11 BACKFLOW PREVNTRS. . 10
U=URANCY ORP. . :R3 FLOOP. DRAINS. . . . . . . 90 TRAPS. . . . . . . . . . . . . . 10
STORIES. . . . . . . . s2 WATER HEATERS. . . . . . 0. 1 CATCH BASINS. . . . , . . 0.0
FIXTURES-------------- LAUNDRY "fRmG. . . . . . 0.0 SF RAIN DRAINS. . . . . 11 •
SINKS. . . . . . . . . . 11 GREASE TRAPS. . . . . . . 10
LAVATORIES. . . . . e4 OTHER FIXfURES. . . . . 10
TUB/SHOWERS. . . . a SEWER LINE (ft) . . . . 10
WATER CLOSETS. . :3 WATER LIME
DISHWASHERS. . . . 11 RAIN DRWIN (ft) . . . . :0 r-
1
Opm,11+s : PATH I
OWIVk::Fi:
KELLY SPEER HOME'S INC TIF $ 1460. 00 JF 03/08/93 —
540 SE 119TH BPRT t 460. U0 JF 03/08/93 —
DPLC $ 299. 33 JLH 02/26/93 93—►2-37182
PORTLAND OR 97 :16 B5PC E 23. 03 JF 03/08/93 —
Phone #: 252-3966 SSDC $ 280. 00 JF 03/08/93 -
PARK $ 500. 00 JF 03/08/93 -
Plumbing Contractor:--__.._.__..._.______.-._..J MPRT $ 45. 00 JF 03/08/93 4"A
MPLC $ 11. 25 JF 03/08/93Name : u��-C•GYc-�� -GZc�j'►l/ t 1v15PC $ 2. 25 JF 03/08/93 Address :
F'F'RT t 147. 50 JF 03/08/93 —
1
City, IP- I- _ . _. Estate : ���� P5F_,C $ '7. 38 JF 03 08/93 —
Z i�,: _ . ?"L 2y� F'h 0 n F+#1:_ t�. ,5 t7.
REUUI RED I Iq'.3V,LCT IONS
'This permit is issued subject to the reg—
ulations contained in the Tigard Municipal Foot/found Insp Bain drain Insp
Code, State of Ore. Specialty Codes and all Rost/Beam Stn t Water L.ine Insp
1 other applicable laws. All work will be done Rost/Ream Mechan l.'appr/Sdwik Insp
1 in acrordanr_e with approved plans. chis Plm/undslab Insp Mechanical Final
permit will expire if work is not started Pl.M9/Underfloor Plumb Final
within I80 days of .iasr"iance, or if work is Mechanical Insp Building Final
suspended for more than 1816 days. Plumb Top Out Erosion Control 5
Framing Insp Crawl Drain.
Fireplace Insp
Gas Line Insp
Insulation Insp
x �..,___.__.....__ •�---ter Gyp Board Insp
Authorized umbing Vontractor Si gnat Ure
Call for inspection -- 639••4175
Contractor Notes e
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u.:. •"
i
�(j (lj� T ]� 11175 SW Hal BWd PLNCK/RECT 1 —
CIT .l �..Jl' TIGARDPERMIT A �v
COMMUNITY DEVE[APMENT DEPARTMENT T'�Q _.._._..
(sW) "�'4171"" DATE ISSUED �
s � ` TAX 'LOT MAP
JOB ADDRESS: /C� � c> �� �7� ' � --
SUB: / �/IEZy �Si�' LOT: _/ 7 LAND USE: -VALUATION: q, ` r
OWNER SPECIAL FOTE
NAME: /�E�/Ey 5� .�fr�i��c �ryr REISSUE OF:
ADDRESS: �zfu s 7 /�y�-r` LAST REISSUE: y
FLOOD PLAIN/
PHONE: .257` 3�11a� SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: _^ _ Sf'�NF PLANNING: _.
ADDRESS:Y ENGINEERING:
— FIRE DEPT:
PHONE: OTHER:
1
CONTR. BOARD 0: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: ,��E�'�5!'r�+� � iivi4cyt 6 LAST/SUBCONTRACTORS:
MECH: C'C�SS Wt e,477AAC=, BUS TAX:
RC ENGINEER CALCULATIONS:
NAME: C°,�aeec c:-7 ye-enl��r� _ TRUSS DETAILS:
ADDRESS: �d3 �'/� /a��r�s.�4�c= OTHER:
PHONE:
PROPOSED Bi-DG. USE:
COMMENTS:
•3r-� gb �
APPLICANT SIGNATURE '—
Received By: <« — ,_ Date Received: _ 12(e_ ='
F—
PERMIT
A' ACCT # DESCRIPTION AMOUNT AMOUNT Pu. UAL. OUE` k
10-432 00 Building Permit Fees p3 v lPt1'.
10-431 00 Plumbing Permit Fees
10-131 01 Mechanical Permit Fees
10-230 01 State Building Tax (5X)
Biiilding al3.uj_
Plumbing 7,3 •�
Mechanical : Z� �. •
10-433 00 Plans Check Fee / 2�Z G'U
Building
Plumbing
Mechanical
1.0-230 05 Fire
.Sw %001 30-202 00 Sewer Connection
30-444 00 Sewer Inspection 3 _
25-448-02 Commercial TIF Fees
2.5. 448-04 Industrial TIF Fecs
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
i'
25-448-01 Residential Traffic Fees S�� ' /-7 v
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) 5-0 d ✓�U —
31-450 00 Storm Drainage Syst Dev Chrg
(SSOC) 9 —
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
nm/3a87P.WPF
Page No. 1 CAGB HISTORY FOR CASH NO.: MS3'93-0120
KELLY SPEER HOMF3 INC
10205 :;i7 3'Pl1AF7' CC
04/30/91
Reg/ 3chd/ Elul/ Action Noten Diop BY Update Upd
Action Description Date BY
Code -
Bent Does Done
ti ------------------------------
02/26/93
K9TA007 Application received
PASS JI�11 09/04/93 TLD fp
02
/ / /26/93 PASS JLH 03/04/93 BLT �.. t
K4TA010 Plan check deposit paid / / PASS RT 07/04/93 BLT
M_9TAo20 Plan -heck by 03/04/93 03/04/93
/ /
restrict. / / 07/04/97 07/04/93 PASS RT 07/04/93 BLT
MSTA030 Check for prcl. x PASS JLH 03/08/93 JH
KSTA092 IPI Issue coabinatim permit / / / / 03/00/93 03/00/93 JH
K9TA097 Ieeus plumbing signature fox" / / / / 03/08/93 -',
MSTA705 Foot/found Inap / / / /
07/08/03 PASS TLP 03/09/93 TLP
PASS TLB O3(16/93 TLP
RSTA710 Post/Beam Structural 03/25/93
' PASS TLP 03/26/93 TLP
MSTA711 Post/Beam Mechanical / 03/25/93
U7/25/93 PASS TLP 03/26/91 'TLP
K9Tn717 PLM/Underfloor / / / / ?ABS MB J5/07/93 MRS
MS-A720 Mechuical Inap / / / i 05/06/93
K9TA722 Plumb Top Out / 05/03/93 PASS TLP (5/04/97 TLP i
MRIA725 Framing Inap
/ US/17/93 PASS TLP 05/14/93 TLP
K9TA735 Gas Line Inap
/ 05/06/93 FA.93 MA 05/07/93 MS
M3TA740 Insulation Inep / / / / ns/17/93 APP G3 05/17/93 GES
MSTA'74S Gyp Board Inap
/ / 05/26/93 PASS TLP nS/27/93 TLP
+� MbTA-ISS Rain drain Inap / / / / 03/16/93 PARS TLP 03/17/93 TLP
/ / 03/16/93 PASS TLP 03/17/93 TLP
mn-TA760 (cater Line Inap
I
MSTA765 Appr/Sdwlk Lnep / / / / 06/16/93 1. Provide 3/4"-0 rock in sidewalk area PEtID [,T 06/20/93 11, 1
to north of approach. 2. Be prepared to
protect finish.
K9TA795 MechAllicAl Final 06/19/93 SRR REPORT PEND RB 00/19/33 RP
KSTA797 P1uR-h Fin;,l / / / / 10/19/93 PASS TLP 10/25/93 TLP
MSTA799 Buildino Final / / / / 08/19/93 SEE REPORT FWD RA 01/24/94 TLP
M3TA799 Building Final / / / / 10/19/93 handrail missing garage /hews steps. FAIL TLP 10/25/93 TLP
KITA960 IF1 Isnue Cert. Of Occspanc-v / / / / 08/19/93 .TF 09/14/93 JF
SEWER CONNECTION
PIE RN I T
CITYOFTHFARD 10 PER1117* #. . . . . . . . SWR93-010/
COMMUNITY DEVELOPMENT DEPARTMENT
mom
13125 SW Hall Blvd. P.O.B=2,1197.figarr.,aegon 97R23(OW)63"175 �77 D114TE ISSUED,- 03/08/93
S I TE qF)DRESS. 10205 SW 5 (JAR T' LT PORCEL: 2S114BB-17100
51113D I Y I S I 01\1. . . . .. RIVERVIEW E'5'TAII_� ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 17
-1 ENANT NAME. . . . . ..
USP NO. . . . . . . . . . : F 1 X-F U 14E U141 1'S.
CLASS OcWORK— :NEW DWELLING UN I TS. I
TYPL:.*1 OF USE. , . . . -SF 1\1 0. OF b U J L D.1 N(,.'j S I
I Ni'I*PLL. TYPE. . . . :DUGWR 1111PERV bURFOLE.
Hemiarks : PA-I H I
Owner: FEES -----------------
KELLY SPEER HOMES INC type ainal.int by date reapt
540 SE 119741 PRMT $ 2100. 00 JH 03/08/93 —
INbP $ 210 JVJ 0--i/08/93 --
PORTLAND
PORTLAND OR 97816
Fklane iii �-152-3966
Contractor. ---------------------------------
CON'TRACI*OR NOT' 01\1 FILE'
Phone #: $ 2135. 00 TOTAL
Rer4
RLOUIRLD INSPECTION:
This Applicant agrees to comply with all the rules and regulations Sewer Inst-.,ection
------------
of the Unified Sewage Ayency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited , the
permit expires, The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not locatee at tip Peasuremept
given, the installer shall prospect 3 feet in all is from
the distance given. If not so located, the insta purchase
a "Tap and Side Sewer" Permit and the Agency wil a lateral.
F--'Prmittee SiL
q n t 1-1 r e
lip By "
pct ion 6:39-41'79'
........... .............. -...........