Permit CITY TIGARD SEWER CONNECTION PERMIT
i k*At DEVELOPMENT SERVICES PERMIT #: SWR2000 - 00289
• 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/25/00
SITE ADDRESS; 13332 SW 129TH AVE PARCEL: 2S104DA 03000
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 016 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 for new SF dwelling.
Owner:
FEES
EVERGREEN HOMES, INC. Type By Date Amount Receipt
15890 SW BULRUSH LN
TIGARD, OR 97223 PRMT CTR 9/25/00 $2,300.00 27200000000
INSP CTR 9/25/00 $35.00 27200000000
Phone: 307 - 7117 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
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 -1987.
Issued by: Permittee Signatur-
Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next busi ss day
•
•C,ITY OF TIGARD BUILDING INSPECTION DIVISION re , ,,, . a . ?'3 f �
,r24 -Hoar Inspection Line: 639 -4175 Business Line: 639 -417
BUP•
• Date Requested / ' �" 1 AM Q 9 /S PM BLD
Location / 3 3 3 Z- 54,/ 47-f Suite MEC
Contact Person Ph o3,7 7//7 PLM
Contractor Phi — ooh
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
I SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam - ...._
Ext Sheath /Shear
•
Int Sheath /Shear ` / � 1 �. n ow ,� ,� '
Framing • )C_.Q _ ! C Uw
Insulation L. = ^ s �
•
Drywall Nailing l^ oP
Firewall °
Fire Sprinkler C."l 1
Fire Alarm \ „ ` L3 1�
Susp'd Ceiling Vv� � Q=,, ,,
Roof 66 -✓l/2� ) 'e" --�
Misc:
Final . K�
PASS PART FAIL �'`��
aglAira-- i(V/ Iiik ...11 .. .
eam
MEI
Wider Stab
1Q; vice i�ln Y v \/15�j %!� ^y� T GC -vI
- I Sanitary Sewer
Rain Drains as A _ l�.* r �»�L 1 ,
Final i
PASS PART . Mk_ ' V V V II r ■
MECHANICAL, . 1 ''
Post & Beam _y =� I Ad WA S 1. ) .
Rough In
Gas Line -
Smoke Dampers 2• ✓ .A - V6--i" �� S - J • t 1 Final i J
PASS PART FAIL 0 i7V1. s , _ - Gam.. �(^• ,
ELECTRICAL
1� 1 - L " _ 1, 1
Service L�
Rough In v 1
UG /Slab
Low Voltage ./1 n �, LW"1
Fir e Alarm V �/U . ,Q S '
Final
PASS PART FAIL
SITE 4 'NI U — v
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 1 'WO 1 Inspector (� Ext3 R
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.-