Permit A . CITY OF TIGARD SEWER CONNECTION PERMIT
10IA DEVELOPMENT SERVICES PERMIT #: SWR1999 -00212
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/21/1999
SITE ADDRESS; 13225 SW ROCKINGHAM DR PARCEL: 2S104DB -02100
SUBDIVISION: AMESBURY HEIGHTS ZONING: R -4.5
BLOCK: LOT: 021 JURISDICTION: TIG
TENANT NAME: GEORGE WALL CONSTRUCTION
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: New SF - Path 1
Owner: FEES
Type By Date Amount Receipt
PRMT .KJP 10/21/1996 $2,300.00 99- 319250
INSP KJP 10/21/199& $35.00 99- 319250
Phone: Total $2,335.00
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Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection •
ORIGINAL
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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 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: e Permittee Signature: A / C
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the n � t usiness day
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST / a v 3 3 Z
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417
AM Y3? BUP
PM Date Requested BLD
Location / 3 2 3-1 S `✓ l7oc /<� h 4 - /�r Suite MEC
Contact Person G I. 6 Ph CY o 5'77 0 PLM
Contractor Ph l"L"I — 00 2■ ?�
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 9 , 6 . ` 1 i4 _ 0 2-I 2- ( Q .)
Framing w1 J W X1`1 _ Q "� U
Drywall on 1 C -�G�/ IJ∎ O
Drywall Nailing
Firewall
Fire Sprinkler /" G■
Fire Alarm
Susp'd Ceiling
Roof C L , f q-r‘e. s 5 5 5 Misc: 1 1/�
Final D
PASS PART FAIL
(PLUMBING -A ` 5
Q osTi-Eream
wme.Olab w ,.� ►�,.`�.
oteMater ice V vU 5— (•y■ i) 1
Sanitary Sewer
44,Rain Drains � `'�%✓\� "ILA
Final
PASS PART r - 56 , -
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage 1/110+ , ^ n ck \
Fire Alarm C/ Y V ` 1 �v
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer J �
Storm Drain einspection 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 �f
Other Date " Inspector V C� Ext
Final
PASS PART FAIL D NOT REMOVE this inspection record from the job site. •