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11020 SW Errol Street
n CITY OF
TIGAR D _SF WER CONNECTION PERMIT —
II / DEVELOPMENT SERVICES PERMIT#: SWR2003-00047
G 13125 SW Hall Blvd., Tigard. OR 97223 (503) 63t,-4117; DATE ISSUED: 2/3/03
PAPr'F L: 2S 10:IAD-00505
SITE ADDRESS; '1020 SW ERROL ST
SUBDIVISION: FCHO HEIGHTS ZONING: It-4.5
BOCK: _ LOT: _W I _ JURISDICTION: '1-1(j _
7ENAN1 NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS:
TYPE OF USE: SF IJO. OF BUILDINGS:
INSTALL TYPE: LTPSWR iMPERV SURFACE:
Remarks: Com+ c�ia►L
Owner �-- -- — FEES
GEORGE, F WAYNE + Description Date Amount
NESTER N' — ------
1 i920 SW ERROL S1 [SW USA] ,\�r Connect 2/3/03 $2,300.00
TIGARD, OR 07223 1SWUSAJ Swr Connect 2/3/03 $0.00
Phone: ISWINSP]Swr Inspect 2/3/0,A $35.00
1SWINSP]Swr Inspect 2/3/03 $0.00
Contractor: Total $2,335.00
Phone:
Reg#-
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180
days from the date issued. The total amount paid will be forfeited If the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions trom the distance given. If not so located,the installer shall purchase a "Tap and Side Sewer" Perm
i
Issued by �� _ Permittee Signature: 4�N /L'9✓7?^,
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the r-.xt business day
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 BUP
--
Received Date Requested �;2 —_[_I_ — AM_—_ _ PM BUP --
Location L � _ _ —_—Suite _ MEC _-
Contact PersonPh( ) � � PLM
Contractor_-- _—^ - Ph( j _ -_
sWR3 "a�`f7
BUILDING Tenant/Owner __—_ --___— _ ELC _
Footing ELC -_
Foundation Access: N r,� �� T ° f 5
Ftg Drain ���, ELF!
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam __-
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - -- -- --
Insulation
Drywall Nailing ----
Firewall �J -� L U�•yl
Fire Sprinkler - ---`
Fire Alirni
gl;sp'd failing --- - —
Roof
Other: -- -- ----
Final
PASS PART FAIL _
PLUMBING --- - —> _->4-)-
Post&Beam
Under Slab --.-- -- -------
Rough-In
Water Service -- - ---- - - ------- - - --
`8an1tery Sewer
AAin Dtatn'§ -- _ - - -------
Catch
------Catch Basin/Mannole
Storm Drain - -- -------- -- —'- -
Shower Pan
Other-.
------ ----- ---� - - ----
F F --- - -
FAIL -----._.-- - ---.
MOR
ICAL _------- ----
Post&Beant
Rough-In ----
Gas Line
Smoke Dampers -------------- --- --
Final
PASS PART FAIL -------- -- - -
ELECTRICAL
Service ------- ------- ---- ----------- _
Rough-In - --- - - --- ---
UG/Slab
Low Voltage --
Fire Alarm
Final Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ F] Please call for reinspection RE:--- —
U Unable to inspect-no ac ass
Fire Supply Line ''
ADA Dote ! _._�� n -- . inspector _ 2J Ext
Approach/Sidewalk -tom . - -- --
Other:
Final — — — DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL