Permit CITY TIGARD SEWER CONNECTION PERMIT
A "111 \ DEVELOPMENT SERVICES PERMIT #: SWR2000 -00113
" ' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/26/00
SITE ADDRESS; 13520 SW 122ND AVE PARCEL: 2S103CB -10200
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 060 JURISDICTION: TIG
TENANT NAME: DON MORISSETTE HOMES
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 for a new single family dwelling.
Owner:
FEES
DON MORISSETTE HOMES Type By Date Amount Receipt
4230 SW GALEWOOD ST
SUITE 100 PRMT DEB 6/26/00 $2,300.00 0003272
LAKE OSWEGO, OR 97035 INSP DEB 6/26/00 $35.00 0003272
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
•
I AL
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 o • - . copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issue • by: / 0_, 10.0_4 Permittee Signature: LA--/ —i dd 4 A
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION —rJ
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
'/
`� 3 3 1 Date Requested / AM PM /3 e BLD
Location 3 s o (2Z /4 4' Suite MEC
Contact Person Ph 579 b"7a7 PLM
Contractor 4 Ph SWR P600 — 00 U 3
11‘0 tie Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Ext Sheath /Shear
Int Sheath /Shear ) _ i / u L v V c A A
Framing (�>(J
Insulation � n
Drywall Nailing M , � "V " � C /`� & / � CT �C / f .
Firewall !
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof �/ / 6 0 ( ‘ — S Somas
Misc:
Fin.,
(� PART FAIL e-XA
`•! BING
b-Post & Beam
Under Slab
Top Out
— Water Service
• Sanitary Sewer
06 Rain Drains
Final
PASS PART FAIL
MECHANICAL
4ost & 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 `7 / 1' c' U V ∎ �tt
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.