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Permit 4 411‘ 1,1014' CITY OF TIGARD SEWER CONNECTION PERMIT PERMIT #: SWR1999 -00128 DEVELOPMENT SERVICES DATE ISSUED: 6/17/99 i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS; 15373 SW REGENT TERR PARCEL: 2S111 DA -11300 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7 BLOCK: LOT: 106 JURISDICTION: TIG TENANT NAME: LEGEND HOMES 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 a new single family dwelling. Owner: FEES LEGEND HOMES • Type - By Date Amount Receipt • 6900 SW HAINES STREET PLAZA 2, SUITE 200 • PRMT BON 6/17/99 $2,300.00 99- 316211 TIGARD, OR 97223 INSP BON 6/17/99 . $35.00 99- 316211 Phone: 620 -80810 Total $2,335.00 Contractor: • • • Phone: • • • Reg #: Required Inspections . Sewer Inspection OR1 GJNA L 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 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 obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued by: F), a/(T — Permittee Signature / j� /` %� Call (503) 639 -4175 by 7:00 P.M. for an inspection needed th : e t us' e s y CITY OF TIGARD BUILDING INSPECTION DIVISION MST f?'? , 3 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested (to-L3-- I AM PM (4 4€) BLD Location (s ji e,vk Suite MEC Contact Person rn rz Ph 2' / V - - J S PLM Contractor Ph i�`7 ? SWR — 06 y i p BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Foundation ACCe p� ,� ('f� FPS Ftg Drain s'�� SGN Inspecti Notes: Slab SIT Post & Beam 3 1( e2-_5 Ext Sheath /Shear I Q '' Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Fi AS PART FAIL Post & Beam Under Slab Top Out AZG ani a . -` Rain Drams F r -1 PART FAIL HANICAL 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 Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Other oach /Sidewalk Date ' Inspector /2�� EX _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.