13770 SW FERN STREET ADDRESS:
5 EON
i 1,eccrdslmicrcilmltargetslbuilding.doc
r— CITY OF TIGARD BUILDING INSPECTION NOTICE _ �I
Inspection Line: 639.4175 Business Phone: 639.417'
Footing Rain Drain Cover/Service FINAL:
Foundation Water Urs Ceiling -Plumb.
Post!Beam Mech. Shear/Sheath Framing -Mech
P'bg.Und/Flr/Slab F. g. Top Out Insulation -Elect
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
oewe Gas Line Appr/Sdwlk Reins.
Other: _
Dater A.M. P.M. Entry: - --
Address: _�_�� 7Z) 11n�
--------- ------
Tenant -_ Ste: ._ _- MST
Con/Own:_ - BLIP - --- -- -
-- -- -- MEC:
PLM: —THE FOLLOWING CORRECTIONS ARE HEQUIRED: ELR: —
Inspector. _ D0e
APPROVED ___DISAPPROVED/CALL FOR REINSP. CF CO
L
ALOHA SANITARY SERVICE
P.O. BOX 30^, BANKS, OREGON 97106
644-2797 646-6254 639-5186
NAME: �.
ADDRESS: -
CITY: � - - - STATE: ,. ZIP: --
PHONE: �"� � HOME: �- WORK:
,JOB SITE: ����,. 7 tZ P.O.#: ---
PAID CHARGE Cl CHECK CASH Cl CREDIT CARD L7
DATE DRIVER �. 'N� �iiat,r� _ AMOUNT
PUMP SEPTIC TANK __ y
Cl MATERIAL
_ ❑ ^ INSPECTION FEE
❑ SERVICE 30ALL
Cl LABOR LOCATING DIGGING & BACKFILL
--T 4ts IS NOT A SEPTIC .HYSTEM INSPECTION REPORT--- TOTAL _
eHHORIZONTAL
- REMARKS - -
TYPE OF TANKTEEL ❑ CONCRETE ❑ PLASTIC ❑ OTHER❑ VERTICAL n1 RECTANGLE ❑ OTHER
SIZE OF TANK: 350 71 500 ❑ 7.50 ❑ 1000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: INLET ❑ OUTY�T ❑ MIDDLE ❑ OTHER
TANK CONDITION: GOOD ❑ OAIR ❑ POOR ❑
FITTINGS: BAFFLES ❑ C3�RETE ❑ CAST IRON Fl PLASTIC ❑
NEEDS NEW LID? ❑ VES SIZE j
GROUND COVER OVER TANK/'
COMMENT ON CONDITION rSI F!!;LD ETC.
SIGNED BY DATE
SEWER CONNECTION
CITY CSF TIGARD . .
F'ERMTT #. . . . . . . : SWR96-1156
(COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/08/96
13126 8W Hall Blvd.Tigard,Oregon 07223.6140 (503)639.4171
f='ARCEL: 2S 104BD-0 i 900
SITE ADDRESS. . . : 15770 SW FERN fel`
SUBDIVISION. . . . . HANDY ACRES ZONING: 6�,., 1
,BLOCK. . . . : LOT . . . . . . . :2 7
...-----_—.—___.---------------- ---------------
TENANT NAME. . . . . .LAMB
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0
CLASS L:= WORT;. . . :NEW DWELLING UNITS. . .-
TYPE
NITS. . :TYFE OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL TYPE. . . . :LTG IMPERV SURFACE: 0 sf
Remarks: Connect residence to sanitary sewer system,
Owner: ------------------------------- FEES
P LAMP type amol_cr.t by date recpt
13770 SW FERN ST PRMT s ,-x:00. 00 JaD 04/08/96 1)6-27'7923
INSSP $ :35. 00 JSU 04/08/96 96-277923
TIGARD OR 97223
Phone #. 503-524-8748
Contractor: ----
CONTRACTOR NOT ON FILE
---------------------------
Phone #: t 22.::5. 00 TOTAL
-------- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date i!sued. The total amount paid will bc, 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 from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Setter" permit and the Agency will ins (ll a latera .
F'ermittee Si.gnat1.cre:
Issl.led 13y ' Z
Call for inspection — 639-4175
Residential Building Permit Application
City of Tigard
13125 SIM Hall Blvd.
Tigard, OR 97223
(503) 639-4171
-77
- Jobsite Address:
1 —-----
Subdivision: —_ Lot # — Office Use Only
Contact Date / / _Initials
Valuation: Result
New Construction Only: (Square Footage) PlanckiRec #
?ermit #
Nouse: Garage: --.- Reissue of
Corner Lot? Y N Fla Lot? Y N Map & TL# —
9 Zona
111 Plat
�
Owner: lc 2—_
Address:
3 Z7c _ 4 _ Ap rovais Required
-�
Planning Setbacks— Solar.-
Engineering
olar._Engineering .
Phone: (_S? 3 ) Other
Items Required
Contractor:
Subcontractors
Address: _ Truss Details
Other
Phone: L ) _ Notes —
Contractor's License #
(attach copy of current Oregon license)
Contact Name: —
Contact Phone:
Subcontractors: Architect/Engineer:
Plumbing: _ Address: _—___-- _---- -- —___
Mechanical: _^-
(attach copy cf current OR Contractor's License)
Phone
JOB DESCRIPTION: U _ �l ` T- — --
Applicant Signature Applicant Phone numb
Received b+,: nate Received: -7
r1 apn.Ah4nwa
Penult ;$ Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mach. Permit ('MIECM)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: _
Plumb:
Mach:
Sewer Connection (SWUSA) U C
Sewer Inspection (SWiNSP)
Parks Dev Charge (PKSOC)
Residential rIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRlf T)
Erosion Planck/LISA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: U L 55,
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MIA f-011(lili'll P$III
DEPARTMENT OF LAND USE &TRANSPORTATION
WASHINGTON ` LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLS®ORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-441'
armit # : 05075866 Project # . P0055566-__Status APPF,)VED Page 1 of I
pplied 12/28/95 Issued .- 12/28/95 Expires 06/25/96 04/03/96 05 : 15
RESPLMB
ermit Title SFR - SAN . SWR . LINE NOP CONNECT OTH
ascription CONNECT 1_-1 FUTURE Begun : 12/28/95
ob Addrass 13770 SW FERN
'aner Name LAH3 , CHARLES B AND 2ADA M Region D
pplicant Name LAMB . B . C
hone number 524-9748 Valuation . 0 Approved_
Appr.oval4 . APPR
nst;�ctcr Comments. RzjEcte.i
_ IVR-REnULTE
- f=�d/r L 1./%i m'•�' �'� ' Com/ t ';'�'_I �_ _ ___ _
REQUEST ERROR !
lumbing
echanical :_—
lectrical :
tructrual .
eneral 1
nspecta3 by Date -
9i
r -
Inspection Reque:+£ud
k :unitary Sewer/Sewer Line 0202 P AP DN iVR
04/03/96 RI SQ