13895 SW 121ST AVENUE lid
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A CITY OF TIGARD
-N DEVELOPMENT SERVICES SEWER CONNECTION
I--
13125 SW Hall Blvd,, Tigard,OR 97223(503)639-4171 PERMIT #PERMIT SWR9-8-0c--.'7/i
DATE ISSUED: 10/12/98
PARCEL: ?S103CC-00460
SITE ADDRES5. . . : 13895 SW 121ST AVE
SUBDIVISION. . . . : ZONING: R--4. 5
LALOCK. . . . . . . . . . LOT. . . . . . . . . . . . . .. JURISDICTION: TIG
TENANT NAME. . . . . :FRED PASSMORE
USA NO. . . . . . . . . . : FIXT'-JRE UNITS, 0
LLASS OF WORK. . . :ADD DWEL -I.NG UN I TS, . I
'TYPE OF USE. . . . . .SF NO. OF I3UILDIlq6S: 0
INSTALL TYPE. . . . :I-TP IMPERV SURFACE: 0 sf
Remarks : Installation of sewer line to connect existing house. Septic tank must
he removad or pumped, filled and inspected.
Owner: ---------------- --------------------------------------- ----- FEES
FRED PASSMORE type amount by date rec;pt
7501 SW 195TH PLACE. PRMT $ 2300. 00 1 F13 10/1;2/93 98-30991. 1.
ALOHA OR 97007 INSP $ 35. 00 DEB 10/12/98 98-30991. 1
Phone Q
Contractor: -------------------------------
OWNER
------ ---------------------------------------
Phunp 0: 2335. 00 -TOTAL
Reg & . :
RF01,.1TRFD INSPECTIONS
This Applicant agrees to V with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewe. laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "rap and Side Sewer" permit and the Agency will in,tall a lateral.
ATTENTION: Oregon law requires you to follow ruses adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
OAR 3`.e-409I-0W. Yot may obtain copies of
these ruleor direct q4stions to OUK by calliny (503)246-1987.
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Permittee Signature!, o-Ayj I
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...............4-++++4.........................4•........4-++++4......................
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
..............4...................++++++++++++++++++++++++++++++++++++++++++ ...
CITY OF TIGARD BUILDING INSPECTION DIVISION AIST
213-Hou*r Inspection Line: 639-4175 Business Line: 6 11-41
MUP
Date Requested �L I _ , MYO, PM _ BLD _
Location '?u - , �l t- Suite ��� MEC —
Contact Person Ph 7- - 76 PLM p
Contractor y '`1,vu - 5iuctL Ph
BUILDING Tenant/Owner /�,t L� 1��( n���k.--� ELC
Retaining Wall ELR —_
Footing Access:
Foundation FPS
Ftg Drain _ SGN
Crawl Drain Inspection Notes:
Slab ^_ _ SIT _
Post& Beam
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall ,
Fire Sprinkler
Fire alarm
Susp'd Ceiling ✓ - —_ --
Roof
Misc: �� 1! `-
Final L
PASS-- RT
PLUMB
IN n
Post& Beam
-
Under Slab (='
Top Out ��'/
WajwS NIC . ,V Al
anitary Sewed
Rarn rains _
,Fina!-_ - — - --
�A� PA FAIL —-_ --_ -- _--_ -
NI
POM& Beam -- - - -�
F ough In �.
Ge,Line --
Smoke Dampers
I heal - -_ - ---- -
PASS PART TAIL
--LECTP.iCAL — -
Service —_-- _--- ---
Rough In ---------_----
UG/Slab _-
c Low Voltage
v~i Fire Alarm
Final
PASS PART FAIL _—______ — ---------
SITE
Backfill/Grading ---
w Sanitary Sewer
-� Storm Drain [ ] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Lupply Line I ] Please call for reinspection BE ( ]Unable to inspect- no access
ADA C
Approach/Sidewalk Date 1 `1 Inspector � _ - Ext)
Other
Final
PASS PART FAIL DO NOT otEMOVE this inspection record from the job site.
CITY OF TIGARD
DEVELOPMENT SERVICES ENGINEf:RING PERMIT
PERMIT #. . . . . . . : FNG98-04 5E!
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PRIM. PE RIh 1 T #. . : ENr398--005,"
LATE IS4-LIED: 10/13/`8
SITZ i-1b0RES9. . . : 113139w SW 121ST AVE 6'ARLEt_.: 2SI03CC-00400
SL)BD I V I`3 I ON. . . . : Z ON I NO:R-4. 0
BLOCK. . . . . . . . .L : L.o,r. . . . . . . . . . . . . a JL]RI:SDICT'ION: TICS
PERMIT TYPE. . : SOP PLIB -IC IMPRV QUANT. iLIN FT) VAL..LIE
F413RIt1faMr'NT DATE: / / GRAD/EROS ROS $
A990 RAN:.-E L YPI RAT ION-_.-- STREET t
P'RFORMANC:E: I ! SAN SEW ------- $
MA'NTF_'NANCEE : STM SEW
PFal'FaWN1Y'S
AL.L. O THF R 2
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . I — $
Remarks : STREET OPENING; TO RELOCATEIRECM7RUCT A PUBLIC WiTARY SEWER LINE
CLLANOUT, TO INSTALL AN 8" K 6" "TEE" DOWNSTREAM THEREOF, TO ENABLE i:ONNECIION OF A
SIX 7JANITARY SEWER SERVICE LATERAL TO SAID "TEE".
Permittee: _._.___.___..._._.-.-- ----_.__._... FEES
FISHER PROPERTIES type aamn1.int by crate recpt
7501 5. W. 19511-1 F!UEIVUE OPEN $ .30. Q10 DLH 10/13/98 u8-.-:309962
BE:F1VF_RT'ON OR 97O07 BOND 'l; P50. 00 DI_11 10/13/9R 913•--3VJ'3`62
Phone #: 64EI--1591
Engineer,:
f 'I80. 00 '101AI
Ohnno #:
- ----- RIFOI J I RF_D I NSPE CT IONS --- --
[permittee/ngerlt, . ..nature : - -_.STOROI SEWER_.._
G' ,�-.._, M. H. & C. H. CRI# LINE B GRAD
--------- _..---.-..___._._..._...____...._._ N I F'F I.N d ORD St.180RADE'
T s s ued By: �- HCHFL L. & C 11PE T BASE ROCK
_ .__.t" �,-•.. ._...._.._._ . ___._ FAIR & -rV vF:S T l-EVE,L- LOIJRSF
('ity of Tiyar,d, wCh-egan WEARINN C:OURSF
> l::li?'moi S. W. Hall. Blvd. - -SON. i-TFWt R- - - TRAFf= & FIFD CONT
r
T'IC;HRU, Or•egan 97P;Ef+ M. H. & E.:. G. MONUME:N7PIT ICIN
J
�- Phone #: 639--41. 71 PtPF LN & GPD SFREEFTL IGHTINO
RCKF-I._L & CMF,C:T WPLK/APRON/RAI1P
w FAIR & ! V TEST
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i-OR I N -TON, CONTACT: _ - --(3RAD I NG-__._
PAA 1 I at.t. #6394 171 (c f fi re) - RE'E'R1 9,1AD T, S-_. U-ON1;)LJRS
DRAINAGE
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r�� ..CIAL CONDITIONS: