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CITY OF TIGARD
DEVELOPME NT SERVICES
., SEWER CONNECTION
13125 SW Hall Blvd., Tigard.OR 97225 (503)639-4171 F'E RM I T
PERMIT #. . . . . . . : StJR97-0333
DAZE ISSUED: 08/20/97
F'ARCEL: 2S 101 AB-02 100
SITE ADDRESS. . . :07155 SW BEVELAND ST
SUBDIVISION. . . . :BEVELAND ZONING: MUE
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : : JURISDICTION: Tili
TEN!INT NAME. . . . . :ANDRUS
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS OF WORD,. . . :ALT DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :LTPSWR IMF'ERV SURFACE: 0 5f
Remarks : MiIst pl..lmp, fill, and cap septic system.
Owner-: _____ --- --__.._..__.... -------_ ------ -- ...__ ..._----- -- FEES --
MICHAEL ANDRUS type amount. t)y clate recpt
7155 SW BEVELAND PRMT $ 2200. 00 JSD 08/2111/97 97-298478
TIGARD OR 97223 INSF' f 35. 00 JSD 08/2.0/97 97•-2'98478
Phone #: 624-1756
Contractor,:
OWNER
---------------------------
Phone #: $ 22.35. 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 188 days from Septic Tank Fill
the date ise:ed. 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 th \easurement
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 Sidt 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
952-8A1-019 through SWR 952-4141 A(:HB, lou say obtain copies of
these rules or direct questions to OUNC by calling 05831246-1987.
Iss,_ted bv : ._T_ _ Permittee Signature : 77-777
*+++++++++++++++4•t++++++++++++++++++++++++++++.4-++++++++++++++.I-++++++++++++++++++
Call 639-4175 by 6:00 p. m. for an inspection needed the next bl-Isiness day
+++4+++++++++++++4.++++++++*+++++++4.++++++++++++++++++4+++++++++++++++++4++*+++++
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 PE RhI I T #. . . . . . . : F'LM97-0 ;43
DATE ISSUED: 08/20/97
SITE ADbRESS. . . 07155 SW BEVELANb Sl PARCEL : 2S1O1AB-Oc,1O0
SUBDIVISION. . . . : BEVEL.ANDZONING: MUE
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :J JURISDICTION: TIG
CLASS OF WORK. . :AL1 GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
F I X TURES---------------- LAUNDRY TRAYS. . . . . : 0 SF' RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . : 0
I.._AVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0
fUB/SHOWERS. . . : 0 SEWER LINE (ft ) ., . . : 100
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 4,
( Remarks : Andrus
I+
Owner,: _..-------_.--------- ------------ FEES
MICHAEL ANDRUS type amoi..rnt by date -recpt- _
7155 SW BEVELAND PRMT t 30. 00 JSD 08/20/97 97-29847'
T IGARD OR 97223 SPCT f 1. 50 JSD 08/20/97 97-1298479
Phone #: 624-1756
l;ont Tact or'•__.____._-------------------_--____--
OWNER
Phone #: --._$_.---31. 50 TOTAL
Reg #. . 1x99999
---- --- REOUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Sewer- Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for morethan 190 days. ATTENTION: Oregon law requires you to follow rules _
adopted by the Oregon Utility Notification Center. Those rules are _
set forth in MR 952-MI-N019 through OAR 952-0001-A080. You may
obtain copies cf these rules or direct questions to OW by calling -
(503)246-1997. -
"AI s s i_r e d By :_ � --�-� `
Permittee Signatr_1r^e : --�
++++++++++++++++++++++++ •+++f•+++*+++++++4•+++++i-++++++++++++++++++++++a•+++++++-1
Call 639-4175 by 6:00 p. m. for an inspection needed the next bUsine,s day
++++++++++++++++++++++++++++++++++++++++•••++ ++++++++.t +++++++++++++i++.+,-�4-+++4
�ITY OF TIGARD Plumbing Application Ftocd By
R
Date ec d�
13125 SW HALL BLVD. Commercial and Residential Da .
T-IGARD, OR 97223 Date to P.E.
(503) 63§-4171 Date to DST yN,`�_5 y�j
Permit t
Print or I ype Related SWR 0
Incorap;me or illegible applications Will not be accepted Called_ -I i
�— Name of Development/Pfofect
•Job 7/!Ss Si Q U e )y-t,,17 FIXTURES (Individual) QTY PRICE AM7
Address Street Address Suite S;nk 9.00
/[55' Sue' _ Lavatory - -- 900
9ldg 0 City/State Zip _ Tub or Tuti/Shower Comb 9,00
Name —� / 3 Shower Only 900
Q YJf Water Closet 9.00
Owner Mailing AddressSuite Dishwasher
7)5:
P EA5E COMPLETE AS APPRQP[ TATE TO PROJF_CT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only _
Water Closet _
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3„
_Water Heater
Laundry Room Tray
Urinal
Other. Fixtures (Specify) T
COMMENTS REGARDING ABOVE:
.s„r•am x.. .�'
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