Permit CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2001 -00230
.40- DATE ISSUED: 8114/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 11700 SW 98TH AVE PARCEL: 1S135CD 01900
SUBDIVISION: GREENBURG ZONING: R -4.5
BLOCK: LOT: 004 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Connect existing house to sewer. Septic tank is to be pumped and filled.
Owner:
FEES
VISTA NORTHWEST Type By Date Amount Receipt
P.O. BOX 91459
PORTLAND, OR 97291 PRMT CTR 8/14/01 $2,300.00 27200100000
INSP CTR 8/14/01 $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" 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 (503) 246-1•87.
Issued by: (:, ,Z/A Permittee Signature:
(503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
Date Requested ✓ $ ( AM PM BLD
Location l 17 D q 9 8�r`� 1:147-e--- Suite MEC
Contact Person Ph - 7 0 – 7/ qo PLM – DO3 7 7
Contractor Ph SWR ,.fir; / — 00 - 2 - 36
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access
Foundation P �' FPS
Ftg Drain r " t'`„ SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm -Q,
Susp'd Ceiling �' r �l`R G[� � 'ref ��
Roof L.Or ), f�, y l� �'P 2l4 c� Ag�y rA-(
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
ary ewer ;
Rain Drains
A PART FAIL i
HANICAL
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 a - ;l! O /
Other Date Inspector � / /% Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 � � ,_ — / AM PM BLD
Location 17C? 0 c ' �" Suite MEC
Contact Person 0. ! g Ph / 7L' — 7/ 9e) PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes:
' SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm Of Pt( / /,� R✓
Susp'd Ceiling
Roof 'e4el .
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out 0/1-
L
Sanitary Sewe
ins
SS PART FAIL
MECHANICAL
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 [ I Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date P - � � / Inspector T i / I I `e ci (►�'e- E x t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BU P - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils
Welding Lab Final Mechanical rough -in
Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Structural observation Mechanical final
Fireproofing Lab Final
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Description Date Passed By
Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final t'_/6 , o r
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils Al Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \ forms \InspRecordBUP.doc 04 /17/01
•
CITY TIGARD SEWER CONNECTION PERMIT
�1 DEVELOPMENT SERVICES PERMIT #: SWR2001 -00230
. .� � i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/14/01
SITE ADDRESS; 11700 SW 98TH AVE PARCEL: 1S135CD -01900
SUBDIVISION: GREENBURG ZONING: R-4.5
BLOCK: LOT: 004 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Connect existing house to sewer. Septic tank is to be pumped and filled.
Owner: FEES
VISTA NORTHWEST Type By Date Amount Receipt
P.O. BOX 91459
PORTLAND, OR 97291 PRMT CTR 8/14/01 $2,300.00 27200100000
INSP CTR 8/14/01 $35.00 27200100000
Phone: 503 - 531 -0505 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
Septic Tank Filled
11
gir
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 adopte
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain cop' -s of these rules or direct questions to OUNC by calling (503) 246 -1 ;;, .
Issued by: � L Permittee Signature: / 7-J
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
O