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` w CITY OF TIGARD BUILDING INSPECTION NOTICE
;i Inspection Lin (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: r_AL
Footing Susp. Ceiling S rink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elea Rough-in FINAL:
Post/Beam Mech. cSon. Wer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp, Bd. -Elect.
Date Requested:_ ` ' Time:_2&AM PM
Address:�� ]� _ � Z�
Builder: _ Permit #:�G�,/K, �+ o021 t
THE FOLLOWING CORRECTION'S ARE REQUIRED:
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Inspector: Date
APPROVED _DISAPPROVED _APPROVED SUF3JEC TO ABOVE i
_Call For Reinsp.
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�r P CITY OF TIGARD BUILDING INSPECTION NOTICE
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Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4171 r t
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Inspection:
Footing Susp. Ceiline Spiink. Rough-in Appr/Sdwlk
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j Foundation Plbg, Underslab Mech. Rough-in Fireplace , e
a- Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. an.Sew Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
UndedIr. Insul. Shear Wall Gyp. Bd. -Elect.
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Date Requested: �, l`'� Time: AM PM
Address: ,_ ��G' `� _ _. C t .,
Builder: Permit #:
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: -'_ Data: V
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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1 , Call For Reinsp.
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ALOHA SANITARY SERVICE fi
'P.O. Box 309, BANKS, OREGON 97106
644-2797 648-8254 639-5188
NAME: lYLFC —
ADDRESS:
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STAT E:6 TJP: q—7 ��
PHONE: HOME: WORK: rr
Joe SrTE: 1 I ADY-7 C 1L _ P.O* CAEUc_,t_____
PAID NY CHARGE riCHECK< ❑ CREDIT CARD Ov`
Din -���1�— DRIVER �n, �� !y� / _ AMOUNT �
M,` PUMP SEPTIC TANK
❑ MATERIAL
C] INSPECTION FEE
--
1:1 CALL
❑ LABOR, LOCATING DIOt31NG BACKFILL_
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--THIS Is NOT A SJPT)C SYSTEM INSPEC77ON REPORT--- —TL OTAL _ _ $ �
- - REMARKS - -
TYPE OF TANK: STEEL I7 CONCRETE ❑ PLALT:C (I OTHER
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HORIZONTAL ❑ VERTICAL ❑ RECTANGLE (-I OT4ER
SIZE OF TANK: iso n 500 O 7 OA) 000 1230 ❑ 150OF1 2000 Cj 3000 q
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LID LOCATION: INLET ❑ OUT _T MI D C7 OTHER _-
TANK CONDITION: GOOD ❑ [7
FITTINGS BAFFLES n ON RETE _ CAST IRON F; PLASTIC Cl
a NEEDS NEW LID? ❑ YES SIZE
GROUND COVER OVER TANK
COMMENC ON CONDITION OF DRAINFIELD ETC.
SIGNED BY I DATE
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OF TIGARD PERMITCI1Y
PERMIT #. . . . . . . : 5:�R96-0k721
DATE 1'3fiUED: 01/22/96
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hell Blvd.Tlpsrd,Oregon 97223"6109 (503)639.4171 i 'F 1F1GF L: 'moi 1 0299-0 1 000
SITE ADDRE5']). . . : 1:3705 SW HALL_ BL.VO
SUBDIVISION. . . . ; EDGEWOOD �ON I NG: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :7 »e•
TENANT NAME. . . . . :HUDSON
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0
CLASS OF WORT;. . . :NEW DWELL_I NG Ulu I T . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 0
INSTALL TYPE. . . . :L.TP IMPERV SURFACE: 0 sf
Remarks : Saanitary Sewer sraok-up
Owner: -.__------__,. -----------.---------------------------- FEES
KATHLEEN HUDSON type aM01-1nt by date recpt �
13705 SW HALL FLVD PRMT $ 22:00. 00 JSD 01/::2/96 96-275176
IN5P $ 35. 00 JSD 01/22/96 2/96 96-275176
TIGARD OR 97223
0-ione #: 603--0176
Contracts*-:
CONTRACTOR NOT ON FILE
PFi on e #: $ 2 235. Q''0 TOTAL
Reg #. . .
------- REQUIRED INSPECTIONS
--__._.......
This Applicapr agrees to comply with all the rules and regula ions Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from �._
the date issued. The total amount paid will be 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 sn located, tho installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will installAD lateral,
Permittee ''LiiRnatur^ i
Issued By�---
Call for inspection - 63r-4175
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Residential Buildi_engPermit Ap_ Ip.ication.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
I (503) 639-4171
Jobsite Address: pig P) /Y"/
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Subdivision: Lot 0 ONice Use Only
Pianck/Rec#,,.
a Valuation: - •
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Corne; Lot? Y N Permit# �
Reissue of
Flag Lot? Y N
Map & TL #
Owner:
// / n AA Provals Required
Address: ,ZLZ '�_ �.�-� ✓1_ l.� I� �V'�' Planning
Engineering _
Phone: — / -7 Other
Contractor: _ —� Items Required..
.Address: — Subcontractors
--- Truss Details
Phone: Other
Contractor's Licanse #_ _ _
(attacn cop} of current Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Engineer.
Plumbing: _ _ Address:
Mechanical
(attach copy of current OR Contractors License) -
Phone:
JOB DESCRIPTION:
Applicant Signature & Phone number
Received by: _ Date Received:
N woRDkcoMnwRESAPP
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Permit# Account Description Amount Amt. Pd. Bal. Due
_ Bldg. Permit (BUILD)
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Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) _ •
s
Bldg:
Plumb: {
Mech: tl
I ,JZ`' Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PK.SDC) _
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIFF (TIF-MT)
Commercial TIF (TIF-C) _
!ndustrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntil Permit (ERPP.MT)
Erosion PlancVJUSA (ERPLAN)
Erosion Planck/COT (EROSN)
TO ALS:
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