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8600 SW Hillsboro Hwy , iiillsborol 0 ThiQgTIGAF?D (WOKE NO.
tftl DIVISION 20 3 eq
503-644-2797 * 503-648-6254 * 503-846-1951 (FAx) • -
www.alohasanitary.c,-m • Email: info@alohasa itary.rom
NAME: ,43!..///7//-
ADDRESS: CITY:
ZIP: HOME: WORK: I CELL:
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Jos SITE: 44:5,6 ,..1t, 61/ . fi.1,,:e.,e„,4 fr-ht„I / ., P.0.#: e
PAID BY CHARGI(Ii) CHECK El TSH U. CREDIT.CARD 0
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DATE 3-Z,o-... 2.0/-7 DRIVER \ --4*-r* I ity. ..e, , 74.4 ,isou' AMOUNT
1URIA
_ig PUMP bEPTIC TANK
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LI SER CE CALL I
LI LABOR,LOCATING,DIGGING,BACKFILL
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TOTAL
Afar A SEPTIC SYSTEM AiSPECTION REIWRT—
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TYPE OF TANK: STEEL U . CONCRETE /PLASTIC-0 HOMEMADE U
HORIZONTAL 0, VERTICAL RECTANGLE 0 C:1 OTHER
SIZE OF TANK: 350 13 500 tl 750 LI 1000/C1 1250 13 1500 U 2000 U 3000 0
LID LOCATION: INLET LI OstITLET 13 /MIDDLE CI ENTIRE Top 0
TANK CONDITION: GOOD L',I FAIR. ! POOR U
FITTINGS: BAFFLES EI CONCR- E EI CAST IRON 0 PLASTIC LI
GROUND COVER OVER TANK
COMMENTS
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Customer Signature DATe 7....)' ,,...,?<- 6/1
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SITE COPY
CITY OF TIGAR 1111
• BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016 00048
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/11/2016
T f C�'4 k.11 g •,�,i7 Parcel: 251070001300
Ivy Jurisdiction: Tigard
Site address: 16830 SW BULL MOUNTAIN RD
Project: Polygon at South River Terrace Subdivision: None Lot: None
Project Description: Demolition of(2)existing structures and asphalt removal:(1)3,023 sq.ft.house and(1)1,335 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 7600 E DOUBLETREE RANCH RD STE 130
VANCOUVER, WA 98660 SCOTTSDALE,AZ 85258
PHONE: 360-695-7700 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM T Permit Fee-Additions,Alterations, 07/11/2016 $542.11
ype of Const: 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: $32,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $651.71
•
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: (�A ' Permittee Signature: cSee_ (C �
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.
•
Inspections Required for ' rmit No.: � c.� t 49—CCC e
IVR Code Type Permit Description IVR Code Type Permit Description
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 J Req'd Code , Inspection Description
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 final
265 Masonry 199 Electrical fmal
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
295 Misc.inspection 625 Duct work
Cr-9
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 fmal
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 fmal 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
Erosion Control Inspections 585 Misc. inspection
' Initial erosion control 599 Final inspection
752 LIDA on-site facility inspection
755 Regular erosion control Manufactured Structure Inspections
797_, Final LIDA inspection 810 MFG-Structure set-up
8 Final erosion control 899 MFG-Structure fmal
I:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard_All 031816.docx