Report RECEIVE
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ALOHA AMTAFT ' 1 8iG2A01R8
D INVOICE NO.
8600 SW Hillsboro Hwy.„ Hillsboro, OR 911-234G DIVISIO!` ..to Q 4
503.444-2797 • 503-648-6254 • 503-846-1951 FAX}
www.alohasanithry.com * Email: info@akthasanitary.com
NAME: fiete.—/
ADDRESS: if.:(1). :..."?1;q1 /16() 7 CITY' .1/2 "4-1 a?AM 'I* 07/4
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ZIP:57/90 HOME: 4.-' -le-`,72 3 i WORK: CELL:
JOB SITE; i 7 0/2- !L.:,64.1 "Ck---,11:Aiel,/2..)1 Z.41 3 C nil.i i gli;41t:
PAID BY CHARGE*01 CHECK Li CASH (3 CREDIT CARD 0
DATE ..7.-I z. 24 4,9 DRIVER tli)ìçì 74e4fpal AMOUNT
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11) PUMP SEPTIC TANK
D INSPECTION FEE
_ 0 SERVICE CALL 1
LI LABOR,LOCATING,DIGGING,BACKFILL
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/t ififeC 7.tiVe,--4C ffi- if: 17/-5
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- MYS is Afar A SEPTIC SYSTEM INSPECTION REPORT-- TOTAL $ -.7,?.3- 615
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TYPE OF TANK: STEEL 0 opNCRETE D PLASTIC LI HOMEMADE D
HORIZONTAL Li VERTICAL 0 RECTANGLE 0 0 OTHER
SIZE OF TANK: 350 0 500 U 750 D -1000 0 1250 0 1.500 0 2000 U 3000 0
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LID LOCATION: INLET 0 OUTLBT (41" MIDDLE 0 ENTIRE Top El
TANK CONDITION: GOOD 0 FAIR d/ POOR 0
i‘. 13 .
FITTINGS: BAFFLES LI CONTE CAST IRON 0 PLASTIC U
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GROUND COVER OVER.TANK / •
COMMENTS /
Customer Signature DATE 9°--/''' -4? il 11
SITE COPY
CITY OF TIGARD BUILDING PERMIT
II: COMMUNITY DEVELOPMENT Permit#: BUP2016-00207
l I G,,Ug D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/13/2016
Parcel: 2S1060001101
Jurisdiction: Tigard
Site address: 17012 SW FRIENDLY LN
Project: River Terrace East Subdivision: None Lot: None
Project Description: Demo 2,182 sf house barn,on septic.UPON FINAL INSPECTION,DEMO CREDITS FOR SDC FEES MAY
APPLY.
Contractor: NORTHWEST EARTHMOVERS INC Owner: ADLV LAND HOLDINGS LLC
PO BOX 1609 BY FORSUM, MICHAEL
SHERWOOD, OR 97140 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 503-625-3100 PHONE:
FAX: 503-625-3108
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM T Permit Fee-Additions,Alterations, 07/13/2016 $225.80
ype of Const: Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 07/13/2016 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 07/13/2016 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $9,800
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $307.00
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
11
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR
952-001-0010 t r :'; 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: / '1 Permittee Signature:11111111b L0 �/f/!
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.4
Inspections Required for P nit No.: - �-'
IVR Code Type Permit Description IVR Code Type Permit Description
01 BUP Building—structural 07 SIT Site Work
02 ELC Electrical 08 SWR Sewer Connection
03 ELR Restricted Energy 09 FPS Fire Protection
04 MEC Mechanical 10 RER Re-Roof
05 MST Master—residential combination 11 CMS Commercial Manufact.Structure
06 PLM Plumbing 12 SFM Single-Family Manufact.Structure
J Req'd Code Inspection Description I Req'd Code Inspection Description
Building(structural)Inspections Electrical Inspections
205 Footing 105 Underground/slab cover
210 Foundation walls 110 Temporary electrical service
215 Footing drain 115 Electrical service
220 Slab 120 Electrical rough-in
225 Post/beam structural 125 Wall cover
230 Underfloor insulation 130 Ceiling cover
240 Exterior shearwall 135 Low voltage rough-in
242 Interior shearwall 140 Sign installation.
245 Firewall 145 A/C or heating unit circuit
250 Roof nailing 150 Hot tub/spa/pool
255 Wtr proofing basement walls 195 Misc. inspection
260 Tilt-up panel 198 Low voltage fmal
265 Masonry 199 Electrical fmal
270 Reinforcing steel(rebar)
275 Framing Mechanical Inspections
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough-in
289 Approach/sidewalk 620 Hydronic piping
295 Misc.inspection 625 Duct work
299 Final inspection 630 Fire damper
/ 635 Smoke detector shutdown
Fire Protection System Inspections 640 Exhaust hood
901 Sprinkler supply lines 645 Grease duct test
905 Sprinkler underfloor/slab 695 Misc.inspection
906 Flush test 699 Mechanical fmal
907 Sprinkler hydro test
910 Sprinkler rough-in/test Plumbing Inspections
915 Fire alarm rough-in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc.inspection 312 Backwater valve
998 Alarm fmal 315 Post/beam plumbing
999 Sprinkler fmal 320 Plumbing rough-in
322 Shower pan
Site Work Inspections 330 Water service
405 Excavation 335 Rain drain
410 Fill 340 Storm sewer
415 Grading 345 Culvert/catch basin
495 Misc Inspection 350 Septic tank
499 Final Inspection 395 Misc.inspection
399 Plumbing fmal
Sanitary Sewer Inspections
505 Sanitary sewer
ttn Control Inspections 585 Misc.inspection
50 - Initial erosion control 599 Final inspection
752 LIDA on-site facility inspection
755 Regular erosion control Manufactured Structure Inspections
797 Final LIDA inspection 810 MFG-Structure set-up
79 - Final erosion control 899 MFG-Structure fmal
__ �' I:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard_All_031816.docx