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Permit • CITY OF TIGARD SEWER CONNECTION PERMIT ;�� DEVELOPMENT SERVICES PERMIT #: SWR2001 -00084 r �� i � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/10/01 SITE ADDRESS; 13079 SW RAPTOR PL PARCEL: 2S104DA -08100 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 067 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 detached rowhouse. Owner: FEES BROWNSTONE HOMES Type By Date Amount Receipt 12670 SW 68TH PKWY #200 PORTLAND, OR 97223 PRMT CTR 4/10/01 $2,300.00 27200100000 1NSP CTR 4/10/01 $35.00 27200100000 Phone: 503 - 598 -7565 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections 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 : urchase a "Tap and Side Sewer Permit and the Agency will install a lateral. ATTENTION: Oregon law r- • uires you • follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 10 0 throug • • R 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) '46- • 87. Issued by: Permittee Signature: A all (503) 639 -4175 by 7:00 P.M. for an inspection needed the next • siness day • "Cfl Y OF TIGARD BUILDING INSPECTION DIVISION • 24 `Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ST BUP Date Requested AM PM BLD _ Location / 30 7 9 5 Suite MEC Contact Person Ph 7f3- 77 7 PLM Contractor Ph SWR 200/ 0Gocf BUILDING 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 }� Framing � l� 6" 4 � �_ `.J ' . Insulation l� ( 1 - _ Drywall Nailing `' �1J ,-�+ c/�. "Lk MN 9 Fire wall • � �� o p Fire Sprinkler � T '-�/� Fire Alarm Susp'd Ceiling S � • Roof Misc: Final PASS PART FAIL CRIECING Post & Beam Under Slab Top Out Water Service ary Sewn Rain Drains Fin AS 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 Approach /Sidewalk 6/ Other Date O Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.