12660 SW 136TH COURT ADDRESS:
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'CITY OF TIGAR® SEWER PERMIT CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT FtERMiT #. . . . . . . : SWR95--0140
1312b SW Hall Blvd.Tigard,Oregon 97223*8199 (503)839.4171 DATE ISSUED: 04/07/95
PARCEL: �S104BD00700
,-)ITE ADDREj',. 12660 SW 13611i L-i
3USDIVISION. . . . : OBRS HEIGHTS ZONING. R-7
1�
ILOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :1
TENANT NAME. . . . . .SCHMIDT
USA No. . . . . . . . F I XTI IRE UN!TS.
CLAPS OF WORK. . . :ALT DWEJ.L 11'16 UPI I TS. I
TYP-: OF USE. . . . . :SF NO. OF bUILDINGS- 1
IN'.TALL 7Y[`E. . . . :SUSWR IMPERV SURFACE. . : : 5 f
Reioarks: HOOK UP SEWER TO CITY LATERAL - SEPTIC TANK TO DE: rumPED, F_- ILLEE) AND
INSPECTED.
)wner: FEES
I-'ETER SCHMIDT t y,P antol.(nt Lid date i-rapt
t2660 SW 136TH CT [DRMT $ 2200. 00 SW 04/,-'h-7/95 -
0 INSP $ 35. 00 SW 014/07/1:ytS -
TIGARD OR 9721'13
!-,hone *P.
�_untractoi-. --------------- -
'r'NTqACTOR NOT ON FILL
"'holle 2235. 00 TOTAL
Reg #.
REOUIRED IIISPECTIONS
T! is Applicant agrees to camp' with all the rules and regulations Sewet, Intpection
of the Unified Sewage Agency. Ine permit expires 180 days fro® Spjlitic- 'Tank Fill
`he date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer lateeals. If the sewer is not located at the measurement
;iven, the installer shall pri.,!pect 3 feet in all 1--ections ft�oq
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Ayr, 11 a later .
P I-M i t 17 'T'
s s U e d Ll j
f- -.01 for inspection 639-4175
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Pnone): 639-4175 Business Phone: 639-4171
Inspection: _
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
r,st/Beam Struct. Plbg. Top Out Elec. Rough-ire FINAL:
Post/Beam Mech. n. e F Gas Line -Bldg.
Plbg. Undertloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ t7 S/ Time:_4AM PM
Address: �,� (F'(c ( �� Y` Cr-f� _
Builder: Permit rr:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectoti�/� Date: /
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r APPROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE
//�� `Call For Reinsp.
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Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 / )
Jobsite Address:
Subdivision: Lot # - Office Use Only
Contact Date ,41. Initials
Valuation: _ Result
Planck/Rec # _
New Construction Only: (Square Footage) Permit #
House: Garage: _ Reissue of
Map & TL # 25 1 p/T�2-00 70�
Zone le
-
Corner
7
Corner Lot? Y N Flag/Lot? Y N - y
Owner: fie °✓ ��v� rD( Approvals Required
Address: �2 (c G D S cis ; Cn L _ Olarint g Setbacks _ Sola[ _
1`gin ring
Other
Phone: ) `t'- `F S' / Items Required
Contractor:
�� is r- Subcontractors
_ `� L
Truss Details
Address �(f ��« (�v , Other.
Notes
Phone
Contractor's License # _
(attach copy of current Oregon license)
Contact Name:
Contact Phone:
Subcontractors: Arch itect/Engineer: _
Plumbing: Address'
> Mechanical.
h (attach copy of current OR Contractor's License)
Phone:
JCB DESCRIPTION:
jome�- 4n.�-i'U,U `�� �U�{,l,'Q.(� � � ` �Q
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Appkant Signature T, Applicant Phone number
Received by: i Date Received:
M`Mpg'AMI MpC
Permit # Account Description AmOUrit Amt. Pd. Bal. Due- '
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) _
Mech. Permit (MECH)
State Tax (TAX) —
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: _
Plumb.
Mech:
�(1JVI-5_`)ASewer Connection (SWUSA)
Sewer Inspection (SWINSP) 1�•�.-y `�U
Parks Dev Charge (PKSDC) _
Residential TIF (TIF-R)
Mass Transit TIF (TIF-NIT) _
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0) __—
Water Quality (WQUAL)
Water Quantity (WQUANT) _ y
Fire Life Safety (FLS)
h
Erosion Cntrl Permit (ERPRMT)
L
Cj U.)
Erosion Planck/USA (ERPLAN) _
Erosion Planck/COT (EROSN)
j
TOTALS:
A'
a•
A - ACTIVE
WALTER LAWSON
11055 S.M. Clay . Sherwood, OR 97140
Phone 682-0233
I
Al ,)J Da
Service for /,i l 0_
Address
City
'—' - ode
For Cleaning Sep}tc Tank r,
�. `.
For/ilea lain Line
Fb C ea g Gre a Trap f
y For Extra Labor
i
tfO b
TOTAV
Amount Paid ialance Due
Due Date
Signature
Please make check out to present driver
7hr4 percent pnr month interest charged on bills if not pard m 30 day,
Ne' espons•We for septic lank drain held.curt,ng or driveway damage
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