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Permit CITY TIGARD SEWER CONNECTION PERMIT y DEVELOPMENT SERVICES PERMIT #: SWR2001 -00151 II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/3/01 SITE ADDRESS; 12177 SW QUAIL CREEK LN PARCEL: 2S103C6 -11000 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT: 068 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 single family detached residence. Owner: FEES DON MORISSETTE HOMES Type By Date Amount Receipt 4230 GALEWOOD ST STE 100 LAKE OSWEGO, OR 97035 PRMT CTR 5/3/01 $2,300.00 27200100000 INSP CTR 5/3/01 $35.00 27200100000 Phone: 503 - 387 -7538 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections • This Applicant agrees tocomply 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: k , ; i ; A ar „,�� Permittee Signature: v' ( aAnik.., Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day • .'C,ITY'OF TIGARD BUILDING INSPECTION DIVISION • ' •` • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 li/ CO . 0/ - .2 BUP • Date Requested 5 '" 7 AM P BLD Location /2 / 7 7 S w (PG/ 4 1 / Ci--' e /C Suite MEC Contact Person Ph .9- U4 3 7 PLM Contractor Ph SWR p 'ZD� 1 -00 / S ^ / BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN OW Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear , Ina Sheath /Shear Framing Insulation Drywall Nailing C- 5 Firewall Fire Sprinkler .- krL■k_ Fire Alarm 3 1.1-4 �- ^ "" /) c ) \ Susp'd Ceiling Roof J 1 _ Final 76 c-\",_ PASS PART FAI i Os Top Out Water Service A/Sanitary Sewer 04 Rain Drains F i P S PART FAIL CHANICAL 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 / - Other oach /Sidewalk Date 5/ « ) / 6� Inspector `� v` Ex t3 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.