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ALOHA SANITARY SERVICE
+ P.O. BOX 309 BANKS OREGON 97106
644-2797 / 648-6254 / 324-4343 / 639-5188
4
° NAME
ADDRESS
I HOME WORK
PHONE v
CHARGE- �- PAID BY CHECK �" CASH VISA - -M
❑ 1- A r ❑ ❑
DATE -- DRIVER AMOUNT
- - REMARKS
TYPE OF TANK: STEEL I CONCRETE / PLASTIC I OTHER
HORIZONTAL / VERTICAL I RECTANGLE I OTHEP
/v SIZE OF TANK: 350 I 500 / 750 / 1000 / 1250 / 1500
LID 1-01;ATiON: INLET I CUTLET / MIDDLE / OTHER ,
CONDI'ION OF TANK: GOOD / FAIR I POOR
FITTINGS: BAFFELS / CONCRETE I CAST IRON I PLASTICJi
NEEDS NEW LID ❑ SIZE
GROUND COVER OVER TANK
COMMENT ON CONDITION OF DRAINFIELD ET
RECEIVE��Y
��' TOTAL xv
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�NSPBCT10 NOTICE
City of Tigard Building Departnsent
3.312S SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (pec-O-Phune)r 639-4175 Business Phone: 639-4171
In&pect ion:__—
Footing Plbg. tlnderslab leech. Rough-in ApucSdwlk
/
Found.
P1 . Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Insulation -Plumb.
Post/Ream. Moch. Rain nrain i
4i
y -Mach.
;.( J Plb,,. Underfloor Water Gyp. Bd.
r Li. tb -moi y - a
im• PN
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Date Ragusa
teds T
Permit 1
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
f
Inspec4 or Date:
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I
APPEOVED DISAPPROVED APPR(IV61) SUBJECT TO /ABOVE
Ca11 For Reinnp.
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INSPECTION NOTICE
City of Tigard Building Depart,oent
13 12 5 SN Hall Blvd. Tigard, Oregon 97223
Inspection amine (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
inspection:---
Footing
nspection•Footing plbg, Underslab Mech. Rough-in Appr/Sdwlk
1'
Found. Plbg. Top Out Gas Line FINAL: 1
Post/Deam Struct. San. Sewer Yraminq -Bldg.
i
Poet/Beam Mech. Rain Drain Insulation -Plumb.
A
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PIL)g. Underfloor Nater Line Gyp. Bd. -Hoch. ,
Q
{ Date Requested$ Time:
Ij ( /
( + Permit It r
Addr6es: -_ - —
Builder:
i
THE FOLLOWING CORRECTIONS ARE REQUIRED: - -
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Inspector � �-- _- ^�- Date:
-APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Relnep.
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PE Rlyl IT
CITE' OF TIGA
PERMIT #. . . . . . . : SWR94-006-.,
RD DFaTL: ISSUED: 0i7-'/ 10/94
COMMUNITY DEVELOPMENT DEPARTMENT 2 s 112. G g 0D 20 0
13128 SvV Hall Blvd.Tigard, rogon 97223.0190 (503)639-4171 PARCEL:
S1TL ADDRESS. . . -fe4 +—SW I1i1LL I-)LVI)
SUBDIVISION. . . . . EDGEWPP,1) ZONING: R--7
BLOCK. . . . . . . . . . . LOT. . . . . . . . + y . ' . : 4
'TENANT NAME. . . . . :
USA NO. . . . . . . . . . : F I X T•URE ON I TS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . ..SF NO. OF BUILDINGS: 1
INSTALL TYPR'. . . . :BUSWR IMPEPV SURF=ACE.. . :
M
Remarks: CONNECTING TO SEWER
Owner: -- ---_._.__.______________.__.___________....._____.___._._.____..-_—__. FEES —
FINELY type amount by date re,cpt •
1390121 SW HALL bl_VD PRMT $ 2200. 00 BLT 02/iO/94 v
INSP $ .;35). 00 BLT 02/ 10/914
TIGARI" OR 97224
''hone #:
Contractor:
TOM MILLER
12454 SW EDGEWATER a
TIGARD OR 97: 23 ��
1='h on e #: C-,20-0767 /, $ 2235. 00 TOTAL
Rey #. . . 37385 v\
REQUI KED I NSPECT I ONS
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 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 oux located at the measarement
giver, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer sh ll purchase
a "Tap and Side Sewer" Permit and the A cy will SL 1 a lateral.
f;er,mittve Signature:
Issk_Aed By :
Call for inspection — 639--4175
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Residential Building Permit ApRiication �
City of Tigard
13125 5W Hall Blvd.
Tigard, OR 97223 •
(593) 639-4171
Jobslte Address:
Office Use Only
ubdivislon:_��u r� l•ot#
PlancklRec #
Valuation: - 4r : •
Permit# �+' ��� j ' —•
Owner: i ✓1 - Reissue of.
} Address: _ Map & TI_ #
Approvals Required
Phone: _ -
Planning _
a
Contractor: Engineering
Address: �.C- W aA Other _
r S / ' ]terns Rer�ulred
Phone: 1 -
Subcontractors _
Contractor's License #_
(attach wpy of current Oregon license) Truss Details
Subcontractors: Other —
Plumbing: ---- --
Mechanical:
(attach copy of current OR Contractor's License)
ArchitecUEnglneer:.
Address:
Phone:
COMMENTS:
Of
Applicant Signature R ne number
Received by:_ Date Received: �' ��
Permit # Account Description Amount A-mt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
3 Sewer Connection (SWUSA)
Y• Sewer Inspection (SWINSP)
�s
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-IAT) _
Commercial TIF (Tl--C)
Industrial TIF (TIF-1)
Institut-nal TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WOUAL)
Water(quantity (WOUANT)
Fire District (FIRE) _
TOTALS:
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