Permit CITY OF TIGARD
A � a��,di DEVELOPMENT SERVICES SEWER CONNECTION r�
.. "341 - I � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT
PERMIT # SWR97 —O223
DATE ISSUED: 07/15/97
PARCEL: 251O4DB -03800
SITE ADDRESS...:13212 SW WELLINGTON PL
SUBDIVISION - AMESBURY HEIGHTS ZONING: R -4.5
BLOCK LOT -38 JURISDICTION: TIG
TENANT NAME :AMESBURY HEIGHTS
USA NO FIXTURE UNITS...: 0
CLASS OF WORK...: NEW DWELLING UNITS..: 1
TYPE OF USE -SF NO. OF BUILDINGS: 1
INSTALL TYPE °BUSWR IMPERV SURFACE: 0 sf
Remarks: SF — Path 1
Owner: FEES
DALTON CONSTRUCTION INC type amount by date recpt
8465A SW HEMLOCK ST PRMT $ 2200.00 DRA 07/15/97 97- 297123
TIGARD OR 97223 INSP $ 35.00 DRA 07/15/97 97- 297123
EROS $ 64.00 DRA 07/15/97 97- 297123
Phone #: ERPU $ 20.80 DRA 07/15/97 97- 297123
ERPC $ 20.80 DRA 07/15/97 97- 297123
Contractor: G!UL $ 210.00 DRA 07/15/97 97- 297123
OWNER G!UN $ 290.00 DRA 07/15/97 97- 297123
Phone #: $ 2840.60 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 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 GAR 952- 0001 -0080. You may obtain copies of
these rules or questions to WIC by calling (503)246 -1987.
Issued • : - l ��
Permittee Signature: —
++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +,
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
• CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: Gag/Jiff?
� / 5/W — , ' / A.M. .P.M. MST: q 7
1
Location: • /5 c/ i et (.z47 £ 0 p BUP:
Tenant: Suite: Bldg: MEC:
Contractor: g, 111 .I_ / _ L ■ o Phone: .=)-6 p cP -® 9- 0 , o PLM:
Owner: Phone: ELC:
ELR:
8ff: e9 &
BUILDING BLDG (con't) PLUMBING, MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer/Storm
Footing Roof UndFl/Slab Rough -In Ceiling • ____all•
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation - t :, Hood/Duct Reconnect Vault
Bsmt Damp Drywall toe,. Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved M Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL ' FINAL FINAL
•
O Call for re' lion 0 Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: � / /e7g7 Page / of J
C/
•