Permit CITY TIGARD SEWER CONNECTION PERMIT
. ;r {, DEVELOPMENT SERVICES PERMIT #: SWR2001 -00186
� - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/20/2001
PARCEL: 2S 103CB -11600
SITE ADDRESS; 13434 SW 122ND AVE
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 074 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: Sewer connection permit for new single family residence.
Owner: FEES
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 GALEWOOD ST. 100
LAKE OSWEGO, OR 97035 PRMT CTR 06/20/2001 $2,300.00 27200100000
INSP CTR 06/20/2001 $35.00 27200100000
Phone: 503 - 387 -7538 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 cosies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued by: ' •- Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1
. CITY.OF TIGARD BUILnING INSPECTION DIVISION r • '
24 -Hour Inspection Line: 639-& 5 Business Line: 639 -417 _ i } ' °2 � �- oc 13,
BUP
Date Requested 7 — ,, AM PM BLD
Location / 2 i q 3 Zl l ZZ ,4i, -ems Suite MEC
Contact Person Ph 26 7 -4 4 837 PLM
Contractor Ph SWR o3-60/ .. 100p
BUILDING Tenant/Owner « tek - <5 , e-ek
Retaining Wall ( / L/61 L( L)
Footing Access:
Foundation FPS
Ftg Drain SGN
P/A/C Drain Inspection Notes:
Slab SIT
l/ti./ Post & Beam
ux Ext Sheath /Shear s D / . G / / ( 13�)
A Int Sheath /Shear / Lev/ 0 /� Gt.cN / j L -,�,�.� —i4 x.! / /d 0/ L')
ation
(J W 'Q',' ` (,Q
Drywall Nailing
Firewall 4 _ • }
Fire Sprinkler ' WI . , c iw - A__ _
Fire Alarm
Susp'd Ceiling A' - ' •
Roof •
�� i 1 f
Misc: �,� A A A ....../ I ‘-,_.r k c.- 1/4----. F PASS PART C.. - !' s � Te- A
PLUMBING 7 , 1 0\, 3 c /
f f Post & Beam 4 �� . /
Water Service ►" INIC2--I-31--v
Sanitary Sewer � ,.
Rain Drains D -C — d @ L�t/� c • ,
F'
A PART FAIL r �I - -- t - s �7
M ECHANICAL `
Post & Beam Rough In > 5‘-i-ke �QXD S r � —, - k /�' Q om - -
n -_ ( LC c r
0 .4/ Gas Line
Smoke Dampers �'! v' �/ Cam �eLp�
Ayl - . b a
Final J Z �/`.► c..,---.) L ��`i`"
PASS PART FAIL • Q � f" 4-- �, �� f Li jaS•
ELECTRICAL l � - �"' ` > _�
GA/ Service ' ALA Allf I . .m S
WU Rough In `l_/ 4 7 r -� ` L � _ p C S
UG/Slab Low Voltage (
Fire Alarm AI V
! O •
Final ;\ • ,
PASS PART FAIL i ' • • At V` `�' �`
SITE $ I f t. 4 5�k p W ✓�.�`"-,9
Sank y S e w e r ' 6 ` /14 J" �r Sanitary Sewer J .
Storm Drain [ ] Reinspection fee)f $ 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 Date 21 In ector �� Ext3
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• '!CIT OF TIGARD BUILnING INSPECTION DIVISION f? aia._..„. :—. •
• • 24 :14our Inspection Line: 639- 5 Business Line: 639-411
BUP 0/- 1) d33a
Late Requested �, Z AM/IS- I:::1 BLD
Location / 3 '134 5 ..L.> / Z Z ...,,f A - Suite MEC
Contact Person Ph 37 9 £ c( S v PLM
Contractor Ph SWR 9 l (- 00 1 E b
U1 Tenant/Owner ELC
fining Wall ELR
Footing Access:
Foundation FPS
Ft in SGN
Crawl Dra Inspection Notes:
tab- SIT
C. Es t &
Ex Sheath /Shear
Int Sheath /Shear (\ C _ r- � t
Framing 1 , Gam -/
Insulation _
Drywall Nailing -cY /A/V1 }-
�✓ — Z s i c\-Q S
Fire wall ?/ l \ - f `-./ t�i /,O S .
Fire Sprinkler p
Fire Alarm 1
Susp'd Ceiling - + A` AL ■ • AO ` •
Roof
/L .
misc: Final 47./l.�` n�1 -A 6.-- & - C� J \J � 1
PASS PART FAIL O
IP,1 :31.`1: 7 A .x L Lo �. .
n • er Slab • ?I �� l 0 — 4
Top Out - A J ) • ��S L f1 a
Water Service �, �t S
U s
Sanitary S- er
Cam_
Rain D - ns
C +
h4)-- ) ,�� lrJ� \r/ 6 S +), D c,e _ `c,cf- (�
PART FAIL 'Z -i7-� U2� C --- S 2lex--Q KS A- - .
Po & I
)ALr x / 2 1 3 (A Cs) V1 a �l t.—./\ ough In l 2 -v — C/ S b T e d c�
Gas Line "'�
Smoke Dampers ^ - c 4) l ( �� (�
ASS PART FAIL � _ �,�;^ ( S,
ELECTRICAL
Service V " �- OZ_ ` S ■A. S •i� •
Rough In • + Pk. �,� A , Q ` r
UG /Slab mil. 4' V U
Low Voltage
V� 5 n - -
Fire Alarm C � ' , v.;
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 Date �,(� / DI Inspector Ext l
Other ns p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
I_
• = f , . . t •
MST — Master Permit 200i 0035
J Inspection Description _ Date Passed By Notes
Grading
/v-Footing/Setback _ c' 1' - r�
Foundation walls '• - �'i -, -i /(fi,
Slab
___ Footing drain
Waterproof basement walls r■■oxr■immi
Plumbing underslab
✓ Crawl drain V eiro . --'�:
✓ Post/beam plumbing (.Q 7 1
✓ Post/beam mechanical ( p
Underfloor insulation emerrowli
V Post/beam structural -.2 7 -a/ 271
V Shear walls /anchors d o ► 7 -/' -or ""
v' Exterior sheathing 7 -12 -o/ 9
V Plumbing top -out 7/7--7/. / .
" Gas line & test 7 - 0/' /
✓ Mechanical rough -in 7 -25 -o, '24
7 Electrical rough -in - at,. -0 /
v Electrical service — —a6 -0 / 44,4
Low voltage _ 2 - -(- o j MP
Sprinkler rough -in
Backflow preventer ontostmessmaIMINS
Roof nailing
Firewall
v� Framing - 7 "L3161 ,701
MFG-Home set -up
v Insulation '7 - j OI �:1
Drywall nailing � c J
Masonry/Reinforcement emsgrompormis _
Ny Rain drain �q Cr Q� _
v Sanitary sewer 6/20/6/ eDt ('
v Water service
Pump /fill septic tank riliNINNIMINS
v Approach /sidewalk
Gradin e mposarmoiroll
v//Z/o / T/6
v' Plumbin final ...Aerr_.,.......017/..,.
L„ Electrical final v' Final ins ection � G / 77,
Special Reports /
- Sewer Permit X-C) Q < — O C) / F-6
-4 Inspection Description Date Passed By Notes
Sanitary sewer (o (.7 e ( P4..
Final inspection
INSPECTION RECORD - MST (MASTER) PERMITS