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14785 SW 81ST AVENUE
INSPECTION NOTICF.
City of Tigard Building DePMn.r*et
1.3125 SU Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 business Phone: 639-4171
Inspection:___ _ �---
Foot ing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Innulati.on -Plumb.
Pltg. underfloor Water Line Gyp. Bd. -Koch.
Date Requests t G• 2 I _ Time: AM PH
euilder: If
THELLONINO OORRECTIONS ARE RiEQIIIREDt.._.•. --
Inspector: �� Datsi(
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
TTT"'���� Call For Reinsp.
TI � SEWER CONNECTION
CITYOFFARD PERMIT
WY0FTWARD PERMIT #. . . . . . . : SWR-;1-0195
COMMUNITY DEVELOPMENT DEPARTMENT oemooei
13125 SW HdI Blvd. P.O.Box 29397,Tig".Orpon 97M (6039)639-4175 DATE ISsur_D: 10/23/91
SITE ADDRESS. . . : 14785 SW 81ST AV PARCEL: 2S112BC-01000
SUBDIVISION. . . . : DURHAM ACRES ZONING: R--4.
LALOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .58
-------------------------------------------------------- ------
TENANT NAME. . . . . .
USA IVO. . . . . . . . . . . FIXTURE UNITS. . . .
CLASS OF' WORK. . . :ADD DWELT_I NU UN 14 S. . : 1
TYPE OF USE. . . . . :SF' NO. OF BU I LD I NGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remarks : Connect exisiting SFD to sewer. Hol.tse existed prior to 7-1-70. Septic
tank mi.tst be pl-tmped and filled with gr-avP1. inspection of filled tank r-egj- .red
Owner-. ___._.__ __-------------______ ____.__._ _____._. ________ FEES
,SIM RAZE: type amol.tnt by date r,ec-pt
16!25 SE PACIFIC PRMT $ 300. 00 PCR 10/23/91 -
INSP $ 35. 00 DCR 10/23/91 -
PORTLAND OR 9 7,:_30
Phone #:
Contr-actor: --- •-------------------------
CONTRACTOR NOT ON FILE_
Phone #: t 335. 00 TOTAL
Reg #. . .
----- - REQUIRED INSPECTIONS ---This Applicant agrees 0o comply with all the rules ani regulatiot.s Sewer, In:,pection _
of the Unified Sewage Agency. The Permit expires 1211 days from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the +� -
permit expires. The Rgency does not guarantee the accuracy of the
side sewer laterals. 14 the sewer is not located A the measurement
given, the installer shall prospect 3 feet in al'. directions from
the distance given. If not so located, the instaPer shall purchase
a "Tap and Side Sewer" Permit and the gency will install a lateral.
Wer,ulittee 5ignatlar,e • I'zj�,,
I s si.ted By:
Call for inspection - 639-4175
CITY OF TIGARD RECEIPT OF PAYMENT RE'CEIP'T NO. 91-218931
CHECK AMOUNT 1176. 68
NAME [RAZE, JAMES R. CASH AMOUNT 0. 00
PDDRLGS s DEVELOPMENT ()CCOUNT PAYMENT DATE s 10/23/91
167215 NE PACIFIC DRIVE SUBDIVISION
POR-a.PNO, OR 97230—,
PURPOSE OF PAYMENT AMOUNT PAID- PURPOSE OF PAYMENT AMOUNT PAID
PUBLIC IMPROV 841. 68 SEWER USA SWR91-193 300. 00
SEWER INSPECT 35. 00
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SEWER PERMIT IP 1478n SW 81ST 09UNUE
SUB. /RAZE MEADOWS #3
TOTAL AMOUNT �IAH) -- It 76. 66