Permit CITY TIGARD SEWER CONNECTION PERMIT
1 DEVELOPMENT SERVICES PERMIT #: SWR2000
cll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 -4171 DATE ISSUED: 12/4/00
SITE ADDRESS; 13308 SW 129TH AVE PARCEL: 2S104DA 02900
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 015 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
KORNERSTONE CONSTRUCTION Type By Date Amount Receipt
14247 NW SPRUCERIDGE LN
PORTLAND, OR 97229 PRMT CTR 12/4/00 $2,300.00 27200000000
INSP CTR 12/4/00 $35.00 27200000000
Phone: 260 - 8918 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: / ( d 4 1 , 1 , Permittee Signat e: r
1 Call 503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
3/ p
'CITY OF TIG BUILDING INSPECTION DIVISION
MZ,jed v Y 51 (
24=Hour Inspection Line: 639 -4175 Business Line: 639 -4171
'/ UP
Date Requested ['/ 2 7 AM PM BLD
Location / 33 G Y GYw /Z7 & -' Suite MEC
Contact Person Ph - 8 9 /Y PL '?e 00/ c2--
.Contractor Ph 4 12, O -06
BUILDING Tenant/Owner ELC Cc�
Retaining Wall ELR / 2/) Z`6 u ()1
Footing Access:
Foundation FPS
Ftg Drain SGN
(*.Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear / r
Ina Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final L H 7) Q \- Q 0 L
PASS PART FAIL •
CatElaffro. 6 Np 4(1 Cc- 6--e-T-C2_
Post & Beam
op Out e 4(27/0 1)
Water Service
Sanitary Sewer
/Rain Drains
PASS PART AIL1
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 [ ] 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 / 3
Otheoach /Sidewalk Date 4( - / � / O 1 Inspector li p J Ex t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
OF T P BUILDING INSPECTION DIVISION
a
VIIIIIIPkY
24 -Hour Inspection Line: 639 -4175 Business Line: 639 171
BUP
Date Requested ei — .2.....rr AM f' if PM BLD
Location / 3 3G 4 5 w J 24 / Suite MEC
Contact Person Ph 240 iry /o O 1 oo / S'
Contractor Ph sw e / g-00)-Cc
BUILDING Tenant/Owner ELC l 1i4a% 0/9
Retaining Wall ELR pAs -
Footing Access:
Foundation FPS
Ftg Drain
14/Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear C� (Ali 1 • Framing 1'�- C�/1 -°r'� ° J (A ► c- ke \& r
Insulation I Il A, 'lz ' . � �
Drywall Nailing � �:GL..'C./L� - c L^r� (--te\sE.9_,..)(--4_e_: .
Firewall
Fire Sprinkler _ �-�
Fire Alarm �� 1f
Susp'd Ceiling .
Roof T e a 1 , U S 1
Misc: A _-
Final /Z I ( a .. :'F�
PASS PART FAIL �_
- :III 014/ ( 'lz.e- C--e,.. -0 7"r - 0--r6 .
I 'r •ost & Beam
O Out �4 f '^ n � D 1, � c^ -
(I -- Water Service `�e, a ` _ ' V � `� 0 1 Y� c
0 14., Sanitary Sewer
64/Rain wins - f ILIA,
F PASS PART a I 1 _� IAA AL->\ \-J • , _ S. d ,
MECHANICAL ' cAl .„...„ ei....,„Jr_e__ Post & Beam IW
Rough In ! `
Gas Line -. VJ � ' - —.� - . �. . •
Smoke Dampers (0, 0.--e-AA - 6
Final
PASS PART FAIL
ELECTRICAL , , " 4 ,4
Service
Rough In
UG/Slab l b / 9 vv. (- _- 1
Low Voltage
Fire Alarm
Final \ r Al-- ae-vq-Di
PASS PART FAIL N U
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 Dat 4 I 24 \
b) Ins pector ' 1. A , 7 i f
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.