12950 SW 135TH AVENUE ;may
ADDRESS:
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50 SW 1351h'AYA)vm�
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CASCADE PHILLIPS CO.
SAKI-POT
P.O. Box 47
OREGON CITY, OREGON 97045
656.9415 345-9009
1 800-4528379
NAME
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CITY. V DESCRIPTION PRICE AMOUNT
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70 .............
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TAX
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TOTAL I
All claims and returnedoods
1072 MUST be accomporiled by Als blit, 'Aank Wou
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INSPECTION NOTICE ✓
City of Tigard Building Department
13125 SH Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)= 639-4175 Business Phone: 639-4171
Inspection: — _
Footing Plbg. Underslab Mech. Rough-in APpr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sew-r'� Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water
^Line Gyp. Bd. -Mech.
Date Requested:, � i Time.- AN ____PM
rr l�f-
Addrese: JPermit 1:
Bull or: ^
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors_ — Date: �_�_�'r
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rsinsp.
aTYOFTIGrARD SEWER CONNECTION
�WYOFTWARD PERP111
COMMUNFTY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. P.O.Box 23397,TlqmM,Oregon 97223 (503)&W-4175 PERMIT #. . . . . . . . SWR92-0168
639--4171 L)(-ir'E ISSUED: 0C-,/11.,4/')1`
,ITE ADDRESS. . 12:'950 SW 135TH AV PARCEL: 2SI04AD-03000
-U1:DIVISION. . . .
UBDIVISION. . . . HANDY A'—'RE r:) ZOt,,iING: R—E,
. . . . . . . LOT. . . . . . . . . . . . . ..31
ENAN1 NAME. . . . .
USA NO. . . . . . . . . . . FIXTURE UNITS. . . -
'LASS OF WORK. . . -ADD DWEt.L I NG UNITS. . u 1
1 YPIE OF USE. . . . . :SF NO. OF' BUILDINGS- I
INSTALL TYPE. . . . - SUSWR I1v1PEPV G)URFACE. . : - 5f
�emat-ks : Connect existing SFr) to selYpt,. Hol.ise existed pt,ior, to 7-1----70. Sep-tic,
. wank IRLISt be pl.imped and filled wtih sand or, qt-avel.
Jwner,.- ------------------ FEES
:TARRY BAXTER type amoLtnt ny d i. to rel--st
2950 SW 135TH AVE PRMT f 3+71121. 00 JLH 06/04/92
INSP t. 35. 00 J L 11 1716/04/1)2
FIGARD OR 9'722-'.','
,f)one 0:
,onty,actor:
IWNER
o 1-1 e 3,215. 00 TOTPL
000,016
---- REQUTRED I NSPEC;I I ONS
m4s Applicant agrees to comp,y with all the rules and regulations Sewer- Inspection
f the Unified Sewage Ayercy, The Dervit expires 180 days fror Septic, Tank Fill
the date issued. The total avount paid will be forfeited if the
perait expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the seasuresent
given, the installer shall prospect 3 feet
in all directions frov
the distance given, If not to located, the installer shall aurchas:
a "Tap and Side Sewer" Pervit and the Agency will install a iaterai.
Gall fo- inspection 639-4175
V,
sEivu SEIYU INTERNAT'I J1VAL
T'EL: (503) 245-4090• (503) 245-4435 FAX(503)245-4351
d a t e LY'—f1_
To whom it may concern ;
of
has contributed to our satisfaction on the public sewer line that
we have installed on 135th Avenue , Tigard .
Project # 89340
Summit at Bull Mountain , Phase I
TIAs letter is to serve as a "Lettc., -+i' Participation" concerning
the above public sewer line project .
Sincerely ,
1
"' Kurt VanVolkenburgh
cc
�- Generz:l Manager
Un
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Lincoln Center • 10220 S.W. Greenburg Suite 450 Portland, Oregon 97223
CITY OF TIGARD 13175swHaualvd. PECT #
1,°[lox Z3Y, PERMIT
# '
COMMUNITY DEVELOPMENT DE:PARTME?NT 7sprd.Oregon97221
(50063"171 DATE ISSUED
,C,�7 r
JCB ADDRESS: /� �_'r "�`.�_� '~ _ TAX MAP/LOT 4D �� v
SUB: LOT: LAND USE:
VALUATION:
OWNER �., SPECIAL NOTES
NAME: r �r� _ REISSUE OF: __
ADDRESS: LAST REISSUE:
_ FLOOD PLAIN/
PHONE: SENSITIVE LAND: —
CONTRACTOR APPROVALS REQUIRED
NAME: PLANNING: _
ADDRESS: _ — ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTOI' PLUMB: _ LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
LL PHONE:
ti PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATURE
Received By: ____ Date Received:
PERMIT # ACCT # DE:SCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees �._.
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building _
Plumbing
Mechanical
10-433 00 Plans Check fee
Building
Plumbing _
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees
2.5-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Oft ce TIF Fees
25-448-01 Residential Traffic Fees
2.5-448-05 Mass Transit TIF tees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSOC) —_-- --
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quaiaity (Fee in lieu of)
V1
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1OTAL
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