Permit CITY TIGARD SEWER CONNECTION PERMIT
14 DEVELOPMENT SERVICES PERMIT #: SWR2000 -00207
• I DATE ISSUED: 7/25/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 10135 SW INEZ ST PARCEL: 2S111 BC 00700
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -3.5
BLOCK: . LOT: 019 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection. Paid $8,000.00 fee for reimbursement district #13 on 7/25/00. DLH
Owner:
FEES
HALL, JANET M Type By Date Amount Receipt
10135 SW INEZ
TIGARD, OR 97224 PRMT BLD 7/25/00 $2,300.00 0003961
INSP BLD 7/25/00 $35.00 0003961
Phone: 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 (50. 46 -1987.
Issued by: Z P ermittee Signatu // /
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed4- e next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/
Date Requested — ( AM PM BLD
Location f 0 F - C 5'v' (7 f? - Suite . ME
Contact Person • Ph t 9 3 - - _, • LM vv -c/o 93
Contractor Ph 4 , v4O — OCc'•d7
BUILDING> a Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
SGN
Crawl Drain Insvec motes: /
Slab /� 77 v C SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear . i
4
Framing 1_.. J ! _A
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
�LUMBING
`ors - tseam
Under Slab
Top Out
Water Service
ni ary Sews
Rain Drains
Fin-
0 PART FAIL
ANICAL
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
Approach /Sidewalk Date 11 fl ) Inspector Ex;
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.