Permit •
A CITY OF TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2000 -00196
4, 1. jl DEVELOPMENT Tigard, S SERVICES PERMIT
639 -4171 DATE ISSUED: 7/24/00
a 13125 SITE ADDRESS; 12252 SW QUAIL CREEK LN PARCEL: 2S103CB -10000
SUBDIVISION: QUAIL HOLLOW - EAST • ZONING: R-4.5
BLOCK: LOT: 058 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 residence. •
Owner: FEES
DON MORISSETTE HOMES INC Type By Date Amount Receipt
4230 GALEWOOD ST #100
LAKE OSWEGO, OR 97035 PRMT BLD 7/24/00 $2,300.00 0003937
INSP BLD 7/24/00 $35.00 0003937
Phone: 387 -7538 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 Sew ' ' and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by th regon Utility tification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
Yo may obtain copies o these rules or direct questions to OUNC by calling (503) 246 -1987.
Is ued by: 1 , � � /JIL _/ Permittee Signature:, ,Q&
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION �r/�� &O a 73 (0 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /b — I 0 AM PM BLD
Location / ZZSZ Sw Qu G( / C/1 -.e -f( Suite MEC
Contact Person Ph 2e 9 PLM
Contractor Ph SWR
0 /
°� I SS i
BUILD! Tenant/Owner ELC
retaining Wall ELR V27 U d ii/C)
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
P ART FAIL (14):77
• II BING ot
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHAN
eam
Rough In
Gas Line
S 1 • - P - • ers
Fin - -
PART FAIL
TRICAL Duc
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
P S PART FAIL
dfITOI
Backfill /Grading t t
Sanitary Sewer k
St Drain ,l [ 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 • spect - no access
ADA
A • • oach /Sidewalk
o • :. Date D Inspector Ext
P S PART FAIL DO NOT REMOVE this inspection record from the job site.