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DEC 1 8 2018,
LAI—0: HA 'r:k":13,„. AN [ ARV S, 7,_[W[CE INVoicE No.
OF !TIGARD , , 4
8600 SW Hilisioro Hwy., Hilisbs ro9 OR 97. §.
i 10!NG ntviSIONE ,5 4 '1
503-6444797 * 503-648-6254 • 503-846- 1 ! (FAX)
wviAv.alohasanitary.com 30 Email: info@aiohasariltary.com
NAME: ilIZEZ
ADDRESS: Om
' ZIP: HOME: WORK: „"/ CELL: f
'-':? 17 12>.d /1' 12
Jos SITE: .-/&"7 70 A--fxii , If 'tsPa..4 4. i , / 4.-,:, ROA
i .
PAID BY CHARGE(6), CHECK 0 CASH 0 CREDIT CARD 0 ,
DATE DRIVERtrA1A.,1 ,-.7ont.,1,:ar 744 Ifra AMOUNT
I - i
PUMP SEPTIC"TANK #!-13
1. 6-6-6
i
0 INSPECTION FEE (I ' I
t U SERVICE CALL
I
0 LABOR,LOCATING,DIGGING,BACKFILL i
.
V /
TOTAL $ 11-5?::,
- - mis.Is Ar44 SEPTIC SYSTEM&SPECK/ON REPORT -
/ t /
TYPE OF TANK: STEEL 0 CONCRETE 0 PpiASTIC 0 /HOMEMADE 0
\ ,
HORIZONTAL 0 VERTICAL-0 RECTANGLE 0 OTHER
_
SIZE OF TANK: 350 D 500 D 750 U\ 1000 0 ;1250 D 1500 0 2000 D 3000 0
LID LOCATION: INLET 0 OUTLET LI \ MIDDLE'0 ENTIRE TOP 0
TANK CONDITION: GOOD 0 FAIR 0 \ r-in, 1-1 R La
FITTINGS: BAFFLES 0 CONCRETE 0 JAAST IRON 0 PLASTIC 0
GROUND COVER OVER TANK
COMMENTS
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??.1446-1,71/A- itt64
Customer Signature DATE-.7 ,.'2„)--..,76/I
•
sar P,
SITE COPY
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016 00049
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Ai�p 3 Date Issued: 25/0/2016
�1 Parcel: 2S1070001305
doz. Jurisdiction: Tigard
Site address: 16780 SW BULL MOUNTAIN RD
Project: Polygon at South River Terrace Subdivision: None Lot: None
Project Description: Demolition of(2)existing structures and concrete: (1)2,368 sq.ft. house and(1) 1,674 sq.ft.structure. Property
is not billed for sewer.UPON FINAL INSPECTION, DEMO CREDITS FOR SDC FEES WILL APPLY.
Contractor: WILLIAM LYON HOMES INC Owner: ADLV LAND HOLDINGS LLC
109 E 13TH STREET BY FORSUM, MICHAEL
VANCOUVER,WA 98660 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 360-695-7700 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 07/11/2016 $487.01
Demolition
Occupancy Grp: Occupancy Load: Erosion Control w/Development 07/11/2016 $107.60
Dwelling Units: 0 Info Process/Archiving-Sm$0.50(up to 07/11/2016 $2.00
Stories: 0 Height: 0 ft 11x17)
Bedrooms: 0 Bathrooms: 0
Value: $27,675
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $596.61
Required: Required Items and Reports(Conditions)
1 Ersn Cntrl 503-639-4175
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1,800.332.2344.
Issued By: Permittee Signature: ®—��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. „,1an
Inspections Required for P nit No.: 1 t) 1)00-6,162 - 1
IVR Code Type ' Permit Description IVR Code Type Permit Descriptio ' w
01 BUP Building—structural 07 SIT Site Work
02 ELC Electrical 08 SWR Sewer Connection
03 ELR Restricted Energy 09 FPS Fire Protection
04 MEC Mechanical 10 RER Re-Roof
05 MST Master—residential combination 11 CMS Commercial Manufact.Structure
06 PLM Plumbing 12 SFM Single-Family Manufact.Structure
J Req'd Code Inspection Description I Req'd Code Inspection Description 4:1'
Building(structural)Inspections Electrical Inspections
205 Footing 105 Underground/slab cover
210 Foundation walls 110 Temporary electrical service
215 Footing drain 115 Electrical service
220 Slab 120 Electrical rough-in
225 Post/beam structural 125 Wall cover
230 Underfloor insulation 130 Ceiling cover
240 Exterior shearwall 135 Low voltage rough-in
242 Interior shearwall 140 Sign installation
245 Firewall 145 A/C or heating unit circuit
250 Roof nailing 150 Hot tub/spa/pool
255 Wtr proofing basement walls 195 Misc.inspection
260 Tilt-up panel 198 Low voltage fmal
265 Masonry 199 Electrical final
270 Reinforcing steel(rebar)
275 Framing Mechanical Inspections
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough-in
289 Approach/sidewalk 620 Hydronic piping
2 Misc.inspection 625 Duct work
r..., 72994 Final inspection 630 Fire damper
635 Smoke detector shutdown
Fire Protection System Inspections 640 Exhaust hood
901 Sprinkler supply lines 645 Grease duct test
905 Sprinkler underfloor/slab 695 Misc.inspection
906 Flush test 699 Mechanical final
907 Sprinkler hydro test
910 Sprinkler rough-in/test Plumbing Inspections
915 Fire alarm rough-in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc.inspection 312 Backwater valve
998 Alarm final 315 Post/beam plumbing
999 Sprinkler final 320 Plumbing rough-in
322 Shower pan
Site Work Inspections 330 Water service
405 Excavation 335 Rain drain
410 Fill 340 Storm sewer
415 Grading 345 Culvert/catch basin
495 Misc Inspection 350 Septic tank
499 Final Inspection 395 Misc.inspection
399 Plumbing fmal
Sanitary Sewer Inspections
505 Sanitary sewer
Er 1..•.n Control Inspections 585 Misc.inspection
50 Initial erosion control 599 Final inspection
2 LIDA on-site facility inspection
755 Regular erosion control Manufactured Structure Inspections
:77,947,...„ Final LIDA inspection 810 MFG-Structure set-up
C8' Final erosion control 899 MFG-Structure fmal
I:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard—All_031816.docx