Permit CITY OF TIGARD
�,„ DEVELOPMENT SERVICES SEWER CONNECTION -
h�i�dfip�" I PERMIT
I+I - __.: 13125 SW Hall Blvd., Tigard, OR 97223 (503 639 -4171 PERMIT # • SW R97 0416
DATE ISSUED: 12/09/97
PARCEL: 2S114AB -01201
SITE ADDRESS...:16283 SW 92ND AVE
SUBDIVISION....: ZONING: R -4.5
BLOCK LOT • JURISDICTION: TIG
TENANT NAME - MILLS, ALLAN
USA NO..........: FIXTURE UNITS...: 0
CLASS OF WORK...:NEW DWELLING UNITS..: 1
TYPE OF USE •SF NO. OF BUILDINGS: 1
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Single family new residential - Path 1
Owner: FEES
ALLAN MILLS type amount by date recpt
2772 SW 84TH PL PRMT $ 2200.00 JDA 12/09/97 97- 301548
PORTLAND OR 97225 INSP $ 35.00 JDA 12/09/97 97- 301548
Phone #:
Contractor:
OWNER
Phone #: $ 2235.00 TOTAL
Reg #..
REM IRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
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 r -0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued by: „� .. ,, L.� Permittee Signature: At 1 , 1 /
,:� __ //
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: ( C ` g / A .M. 1 , P.M. MST:
Location: ( -2.7 W 2 "p & /, BUP:
Tenant: Suite: Bldg: MEC: /�
Contractor: 1 -, Q 3 Phone: PLM: �7
Owner: Phone: ELC:
ELR:
S: A lr- ci l -D (i/
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing To • Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Hood/Duct Reconnect Vault
Bsmt Damp Drywall • Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr /Sdwlk Not Approved Ied Not Approved Not Approved Not Approved
FINAL r`IyH FINAL FINAL FINAL
Cl / 21-C1-Ze----141-44.7-"t— A554-17.N. '
Call for reins do Cl Reinspection fee of $ required before n xt inspection Cl Unable to inspect
Inspector: /� Date: 0 9 Page 1 of `/
6/6/00 Activities for Case #: SWR97 -00416
1:27:52 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRA003 Application received 11/26/97 DRA RECD DRA 11/26/97
SWRA008 Permit Created 11/26/97 DRA PASS • DRA 11/26/97
SWRA032 DST Post - Review Completed 11/26/97 11/26/97 DRA 11/26/97
SWRA705 Sewer Inspection 11/26/97 12/9/97 MS PASS J *H 3/15/98 This inspection for pipe
• placement or lateral line only,
see MS for verification. Note:
• Cleanout not on this.lot.
Cleanout must be a yard box as
it is located in the neighbors
roadway (not paved at this
time).
SWRA080 (F) Issue permit 12/9/97 JDA PASS JDA 12/9/97
SWRA705 Sewer Inspection 4/23/98 HOLD J*H 5/22/98 Needs yard box or protection
for cleanout in roadway. See
Hap regarding requirements (2
options). Letter written, see file.
SWRA705 Sewer Inspection 5/28/98 MS PASS J"H 6/4/98 Cleanout compacted with rock.
SWRA720 Case Fineled 5/28/98 MS PASS J "H 6/4/98
•
Page 1 of 1