Permit A CITY OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2001 -00082
--44. " � � I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 39 -4171 DATE ISSUED: 4/10/01
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SITE ADDRESS; 13055 SW RAPTOR PL PARCEL: 2S104DA -07900
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5
BLOCK: LOT: 065 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
INSP CTR 4/10/01 $35.00 27200100000
Phone: 503 - 598 -7565 Total $2,335.00
Contractor:
Phone:
Reg #:
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Required Inspections
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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 shal • rchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law r- • ires yo • ■• •w rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 .1 01 1 hro 1 4► ' 952- 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503 246 -19 ;7.
Issued by: Permittee Signature: _
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the n` business day
CITY OF TIGARD BUILDING INSPECTION DIVISION .7‘,7 / d 3 7
24 -Hour Inspection Line: 63, 175 Business Lin • 39-4
BUP
Date Requested AM BLD
Location )3C . r5 ;J7 ,ter Suite MEC
Contact Person � Ph 3 .53 YS PLM
Contractor Ph aaf pW
BUILDING Tenant/Owner - % //
Retaining Wall {{ —
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing �! _ (P1/1 _ _
Drywall l Nailing �f, .1 v
Drywal �� • " G'�� """ ■Ary6
Fire wall
Fire Sprinkler C .6 c e uiLire.
`�� � V � S � �'
Fire Alarm �^ �, 1-J2_, •
Susp'd Ceiling p
Roof 3 1 5 p
Final
Final , -'
PASS PART FAIL — ..
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
in
PASS PART AIL -
MECHANICAL
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 n t
Other Date 9/W° Inspector 1 �. C Ex \ i
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
' C,ITY OF TIGARD RUILDING INSPECTION DIVIS' "N .
2$ Hr'I
ounspection Line. 39 -4175 Business Line: 6. _ 4171 MST 01.24 /— /)d/37
BUP
Date Requested S' AM PM BLD
Location ( 36).3 /Lf Suite MEC
Contact Person Ph /93 -5 777 PLM
Contractor Ph SWR 2i-
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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Rain Drains
PAS PART FAIL
MECHANICAL
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 J d I Inspector d Ex
Other /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.