Permit CITY OF TIGARD
A
DEVELOPMENT SERVICES SEWER
F'CO CONNECTION
, .h. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PERMIT #
- SW R98 -0358
DATE ISSUED: 01 /11/99
PARCEL: 1S135AD -05400
SITE ADDRESS...:1O78O SW SITKA GT
SUBDIVISION -TRENT TERRACE ZONING: R -12
BLOCK LOT -004 JURISDICTION:
TENANT NAME -KIMCO PROPERTIES, LTD
USA NO FIXTURE UNITS...: 0
CLASS OF WORK...: NEW DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1
INSTALL TYPE - LTPSWR IMPERV SURFACE: 0 sf
Remarks: Sewer connection for a new single family dwelling.
Owner : • - -- - -• -- -- FEES
KIMCO PROPERTIES, LTD type amount by date recpt
22060 SE 442ND AVE PRMT $ 2300.00 DLH 01/11/99 99- 312071
SANDY OR 97055 INSP $ 35.00 DLH 01/11/99 99- 312071
Phone #:
Contractor:
OWNER
Phone #: $ 2335.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS -------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
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 frog
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 -'0'1 -0010 through OAR 952-0001 -0080. You nay obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
-//
Issued by: Permittee Signature: /Z
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD BUILDING INSPECTION DIVISION MST q oScfl
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• Q q \/ BUP
Date Requested �� ' -` ( AM Jt PM BLD
Location 1 ern b 0 S1 "r lCi&_ G v Suite MEC
Contact Person r ` Q,� 1 Ph 297?c03 PLM
Contractor Ph bI I -- (U00 '7 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:p,Ld fi1� „ e
Slab �CJC SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ��! % /� /�i�_ # / /_
Roof ��
Misc: //„ - --
Final
P, PART FAIL
,
L
Post & Beam
Under Slab
Top Out
Water Service
acaymm.
Rai Drains
tr.
• ' PART di"
M 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 4
Sanitary Sewer
Storm Drain [ ] Reinspection fee of required before next ins ection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: v [ ] Unable to inspect - no access
ADA
Approach/Sidewalk ( 7( 7 Oth Date Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•