Permit CITY TI GARD SEWER CONNECTION PERMIT
— 4 1 DEVELOPMENT SERVICES PERMIT #: SWR2000 -00111
Ai( S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/3/00
SITE ADDRESS; 13302 SW 129TH AVE PARCEL: 21 SO4DA QHWO
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: TIG
TENANT NAME: ROBERT & KRISTIN DEBISSCHOP
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
ROBERT DEBISSCHOP, KRISTIN Type By Date Amount Receipt
17175 NW BLACKTAIL DR
PORTLAND, OR 97229 PRMT DEB 7/3/00 $2,300.00 0003411
INSP DEB 7/3/00 $35.00 0003411
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
C3N
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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 regon-LI ility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
. You ryy obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issue. .y: 0 00 ■i �� ' Permittee Signature: _______ --
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION ®JD a6 5
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
k rti 5' Date Requested - 040 AM PM / BL
Location / 3 ' D2- 9 / 71/ 41/ Suite CD)/1E(
Contact Person it
Ph 7 b9 b 39d PLM 00//
Contractor . Ph _, 0 -- %%'=
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ! L �� • Al 6 6 � � ,
?� _
Drywa ailing I ei / b 0 c e) C w / ----
Firewall k.
Fire Sprinkler l‹
Fire Alarm
Susp'd Ceiling
Roof W f� L l OU-
Misc:
Final ( e* ( L.--v j
PASS PART
PLUMBING
Post & Beam A `A ,� �� �- --\--Th
Under Slab �/ 1 �,
Top Out ,(� _ r� �h
Water Service `� Q 4-1 L � -Cww ` e V -k ol,t,S 'i- ►'I Li5 r
Sanitary Sewer
Final Drains a
Final
PASS PART F • L i ' , A. Lam_ A." L -, ILI,...iZ -- "acj
MICAL - _—
Post & Beam W Al AS �► - A_ A I
n
Gas Line 1 6
Smoke Dampers C- V ,,,_.( f air ..A.--
F
•A - FAIL �
Service t t) e A /(./2 4'11--e v" ��.."-
Rough In
UG /Slab -
Low Voltage 4 k 5
Fire Alarm Ir 1 V ���
F PASS PART FAIL W1 4-city-v./I. .=.6--- ►/ _ � i7D w -
SITE
Backfill /Grading � q /�
Sanitary Sewer k "`' �f ..-
Storm Drain [ ] Reinspection fee of $ require efore 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 N(/)
Approach /Sidewalk t i
Other Date l ''l) �a Inspector E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.