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Permit CITY TIGARD SEWER CONNECTION PERMIT *i DEVELOPMENT SERVICES PERMIT #: SWR2001 -00247 .- 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 8/29/01 SITE ADDRESS; 11670 SW 98TH AVE PARCEL: 1S135CD-01800 SUBDIVISION: GREENBURG HEIGHTS ZONING: R -4.5 BLOCK: LOT: 001 JURISDICTION: TIG TENANT NAME: 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: Connect existing house to newly installed sewer. Septic system is to be properly abandoned by either pump, and fill or remove and inspect. Owner: FEES - VISTA NORTHWEST PO BOX 91459 Type By Date Amount Receipt PORTLAND, OR 97291 PRMT CTR 8/29/01 $2,300.00 27200100000 INSP CTR 8/29/01 $35.00 27200100000 Phone: 503 - 531 -0505 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection Septic Tank Filled 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" Perm Issu by: . '' 's ' Permittee Signature: f' Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day I T"'". - - ORVAU. T. CADE JOB INVOICE ., BYER'S SEPT .c 1./kNK SERVICE, INC. .OREGON �T S ORE ON 97045 (503) 656 -3326 CUSTOMERS ORDER NO DAB OF 2ED of OR ER TAKEN BY Dg y /4 ' PR ❑ A M 6(IaCC / 0 P.M. BILL TO ' _ PHO way►1L S :Q- Sk`;.t 6,1S - �T (-,�b -8Z 3 S ADDRESS / MECHANIC CITY HE�� JOB NAME AplpJ.pCPT1ON OD S . • _'. 92+11 ❑ DAY WORK DESCRIPTION OF WORK 'J W R\� A ` ❑CONTRACT i rC/�� � ❑ EXTRA QUANT. DESCRIPTION OF MATERIAL USED PRICE AMOUNT > i ZQ © fJ ivs eL ( s I .-- / f /`_ ..._ .-- - t / lank r � p,n, / . 74... 7 > HOURS LABOR - AMOUNT TOTAL MECHANICS @ MATERIALS HELPERS @ TOTAL LABOR I hereby acknowledge the satisfactory TOTAL LABOR TAX completion of the above described work. SIGNATURE DATE COMPLETED / / TOTAL e CITY OF TIGARD BUILDING INSFCTION DIVISION /a 24 -Hour Inspection Line: 639 -4175 ` usiness Line: 639 -4171 MST BUP (' /Mk Date Requested 9 H AM PM BLD Location 9 Suite MEC Contact Person %% Ph 750 PLM Contractor Ph SWR ado 1- d6 q 7 BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: G � FPS Foundation Ftg Drain N Crawl Drain Inspection Notes: / � ( � Slab v ` G 1 IT Post & Beam 4 `�-,� Ext Sheath /Shear / 7 /Z! 0 / Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler ` � Fire Alarm I Susp'd Ceiling Roof Misc: Final `mpti 1� - T FAIL t . :eam Unde - lab Top Out Water Service anitary Se -�: s PART FAIL 9 ) f °vcr ANICAL 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 Approach /Sidewalk , /" Other Date ( Inspector 7 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.