Permit • CITY OF TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2001 -00091
;���;� DEVELOPMENT SERVICES DATE ISSUED: 4/10/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 13135 SW RAPTOR PL PARCEL: 2S104DA -08700
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5
BLOCK: LOT: 073 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
12670 SW 68TH PKWY #200 Type By Date Amount Receipt
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 #:
• 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 measureme ,, iven, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall pu chase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to fdlow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -• • • 4 10 throug O • R 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (5 14) 246 9':7. .
Issued by:
.iktkz_________ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next ,, usiness day
• CITY OF'TIGARD BUILDING INSPECTION DIVISION -
• 24 -Hour Inspection Lihe: 6394175 Business Line: 639 -41
• �,/ • BUP
• Date Requested � ! AM PM BLD
Location /3( 35 Sw f PI Suite y9 MEC
Contact Person Ph �' I /7‘1 PLM
Contractor Ph �4 � Q k i'.
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 I
Ina Sheath /Shear
Framing XAQ t �, f �
Insulation /6
Drywall Nailing l'
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof '`. kact
Misc:
Final 0 902 C J 6 C� , O
PASS •ART FAIL / O �C�
10
Po m
6 v
Top Out
(4
Water Service
Sanitary Sewer
Rain Drains
Fi
AS 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 ,{
Other Date 2`f / Inspector Ext3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
L
° CITY'OF TIGARD BUILDING INSPECTION DIVISION -
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • U � r
BUP
Date Requested AM PM BLD
Location / 3 / 3 S 5 y.J �4 r /?-e Suite MEC
Contact Person Ph 7c 5-57 7 7 PLM
Contractor Ph SWR 21o7 - v
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
LUMBRRb
``Post & Beam
Under Slab
Top Out
Water Service
Kam rains
Fin
P 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 [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date 4 </" / c t Inspector Ext
Other
`
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.