Permit A: CITY OF TIGARD SEWER CONNECTION PERMIT
'll DEVELOPMENT SERVICES i 4GI�1 , t PERMIT #: SWR1999 -00209
13125 SW Hall Blvd., Tigard, OR 97223
4\1
. DATE ISSUED: 10/7/99
SITE ADDRESS; 12001 SW TREEVIEW CT PARCEL: 2S11066 -06400
SUBDIVISION: REDWOOD VISTA ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
TENANT NAME: J T ROTH, JR
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
J T. ROTH, JR
12600 SW 72ND Type By Date Amount Receipt
SUITE 200 PRMT DEB 10/7/99 $2,300.00 99- 318906
TIGARD, OR 97223 INSP DEB 10/7/99 $35.00 99- 318906
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
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 Sew ' Pen ri end the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by th regon Utility No i Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
Yo may obtain copies oft ese - or direct questions to OUNC by calling (503) 246 -1987.
Iss ed by: � I _I I ga . Ail., Permittee Signature: \
Call (503) 639-4 5 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 1999_ cv 38'
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
G� BUP
/
Date Requested /D I I5 / AM PM BLD
Location 0 ( i -Q-() G?.( CY Suite MEC
Contact Person , Ph PLM
Contractor Z� � L Ph -7 9 - 38 7 17/ q I 7()& „207
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 4 _
Fire Alarm
Susp'd Ceiling / __' A><
Roof � ��
MSC: - -
Final //�i
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab • 5-� Srzut � •
T••
'r4.(:' =►"e
a rnta Sewer
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 3 2
Other Date Inspector 172 7. , " Ext v
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
Business l9 9 9� 3 2g
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417
/cc Date Requested I/ (p AM PM BLD
Location j ' ) We ) l CU) Suite 22 O MEC
Jr Contact Person & Ph Si / - 30 7S PLM
Contractor Ph - 114 1 k, Ci - 0020
UILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain — SGN
rave D Ins 'on Notes:
Sla SIT
Post & Beam
Ext Sheath /Shear "e `•
Ina Sheath /Shear C 1q�G - U 0 Z O `l (1 ' f � S
Framing 7 p V
Insulation \ 0 ?moo G
Drywall Nailing L_ _ — ■ 1
Firewall U /�
Fire Sprinkler --lJl_
Fire Alarm
Susp'd Ceiling 5Zi R oof / l Le �. V , . �, ' 1 o 0; . r � S'S - ••
Misc: '
Final _ / v a
PASS PART L r
MB ,�,, 1 /L- 6 L—•■ k l -oL_, S r.,( . SS -e_._,O, '"rl'‘ !' .._ - `'"di '
pUost & Beam 1, J v C' P 1 .(6\7\r , lS , ,`3 w•-.A T..• ( J
L-a, .
Sanitary Sewer S2/ ` 6 Qr U"\ Rain Drains �,�0
Final 4 r Q � l �
PASS PART lJ�, ,.
MECHANICAL 21`. S 9 V/• kr c `�., `/t,`
Post & Beam
Rough In C/•rth/v■3 L 5 e a___e..e.- -
Gas Line /
Smoke Dampers \JI.QM/\ -t___ 1444_ d}2-./ t S g vn.,.", U 0-4
Final
PASS PART FAIL S Qf Li- Cam-. 1 r.QN� c_ .
Service otot...k..1-- S \.&» -S 'v..-4
Rough In
UG/Slab \, J Q—..r 1..ki Zt---L1�a— Cam` S S .
Low Voltage — 1
Fire Alarm
Final O
PASS PART FAIL 5iJ 3 �1 1 �'� �� (�` AiY-- -
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 ` ® v Inspector Ext 3 6
Other
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.