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Permit SFWFR CONNECTION PERMIT �C�TY OF TIGARD D�TE 02/01/9���_� 3�. COMMUNITY DEVELOPMENT DEPARTMENT PARCEL.: , 51 3DA- 05600 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 ,_ (503) 639 -4171 SITE ADDRESS...: 13465 SW 107TH AVE SUBDIVISION....: ZONING: R-3.5 BLOCK........... LO"i ............. . TENANT NAME......: KROMER USA NO........... != I XTURE UNITS.... 0 CLASS OF WORK...: NEW DWELLING UNITS..: 1 TYPE OF USE.....: SF NO. OF BUILDINGS: 0 INSTALL TYPE.... :LTP IMPERV SURFACE: 0 sf Remarks: Must pump, fill, and inspect septic tank. Owner: ._ _ KRAIG KROMER & JEANETTE type amount by date recpt 13465 SW 107TH AVE PRr *1T $ 2200.00 JSD 02/01/96 96-275560 5560 INSP $ 35.00 JSD 02/01/96 96-275560 TIGARD OR 97223 Phone ft: Contractor: —• CONTRACTOR NOT ON FILE Phone it: $ 2235.00 TOTAL Reg #. REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations Sewe Inspect ion of the Unified Sewage Agency. The per ©it expires 186 days from the date issued. The total aeeunt 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. _ Permittee T'rl at w- e° . .`� , �•__ __ _ ___ Issued By Call for inspection -- 639-4175 -\ Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639 -4171 Jobsite Address: ,)0 7 U e- ':'Off ce Use Ont :: :: :::> >` >: :: ::;' _::: :::':' < ::::i::1:::::::::::::::::::::::::::::::::::::; ' : Subdivision: Lot # .'Contact• Date /. / Initials: Valuation: Result:;: --: . • - New Construction Only: (Square Footage) stru S a � 4 Y 9 :::: Pe : 5 ( ;..: (7:G - >cm>13:5 . ,: ; : House: Garage: Corner Lot? Y (N Flag Lot? Y N Map: i:8 - .. . • ( ` L ct /' : : ; : : Plat #; . : : :. ,: .:: Owner: ,;:;: a � Address: 1 � id i f"t .. .. Plannn g•S etbacks - :::.^ Solar.: : '•' '. : Engi �.< :::<::: > : >> <�; : � s:. = . :: Phone: o e. - dN' J :: ::::::Items :;Re a uired` :: s : ::<:: >:::: >:i: :: . <s <:a ? cto . Contra r: Address: : :: S be .... tra to s ..;;Tsk:Detail «<< «> >. > ; :: : > : :: > <* > > >:::: : :0 . russ..... a s :... . : :: Phone: ( ) Contractor's License # li (attach copy of current Oregon cense ( PY ) - Contact Name: ;... Contact Phone: ( ) Subcontractors: Architect/Engineer: Plumbing: Address: Mechanical: (attach copy of current OR Contractors License) Phone: ( ) JOB DESCRIPTION: a n Y 1 S_e I Nod k (mot (1 ., * ( ) D - .--V3, Applicant Signature - Applicant Phone number Recei by: / Date Received: vow va,,, o • Permit * Account Description Amount Amt. Pd. Bal. Due J. Bldg. Permit (BUILD) , • Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) Bldg: Plumb: Mech: Plan Check (PLANCK) Bldg: Plumb: Mech: G 2v4�/7o -6r Sewer Connection (SWUSA) C� Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF (TIF -R) Mass Transit T1F (T1F -MT) Commercial TIF (T1F -C) industrial TIF (TIF -4) Institutional T IF (TIF -4S) Office T1F (TIF -0) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrt Permit (ERPR.MT) Erosion Ptanck{USA (ERPLAN) Erosion Planck/COT (EROSN) ° v TOTALS: CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: D F f b - L r1 / 14,1 Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post /Beam Struct. Plbg. Top Out r Elec. Rough -in FINAL: Post /Beam Mech.. Se e Gas Line Plbg. Underfloor Rain Drain Framing - Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul. Shear Wall Gyp. Bd. - Elect. Date Requested: 2_,( d I Time: AM PM ' Address: t 3 k (p ,S l d , Builder: Permit #<5/4)g�6 0 0 35 THE FOLLOWING CORRECTIONS ARE REQUIRED: /RTAIIMIlr _ ,.... - _.,,,..... • O— 4 0 . /i _ .t.� /� d ,� _ ice _� _� d _ ' / (1 - ;, r _-_, • ,f.," Arffr' ....1 ....--- • s Inspecto Date: 1// APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE For Reinsp. 2/24/00 Activities for Case #: SWR96 -00035 8:22:56 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes SWRA007 Application received 2/1/96 JSD PASS JD 2/1/96 SWRA705 Sewer Inspection 2/13/06 MS PART MRS 2/13/96 septic needs to be pumped need to replace concrete pipe . to bldg drain SWRA080 (F) Issue permit 2/1/96 JSD PASS JD 2/1/96 SWRA080 (F) Issue permit 2/1/96 JSD PASS JD 2/1/96 SWRA710 Septic Tank Filled 2/21/96 MS PASS MRS 2/21/96 pumped and filled ok SWRA705 Sewer Inspection 2/21/96 MS FAIL MRS 2/21/96 SWRA705 Sewer Inspection 2/21/96 2/20/96 MS FAIL MRS 2/21/96 ground water is being pumped to sewer SWRA720 Case Fineled 2/23/00 JMT DONE No Hold JMT 2/23/00 • Page 1 of 1