Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2022-00056
T I CI;All 17 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/7/2022
Parcel: 2S112CA16100
Jurisdiction: Tigard
Site address: 7803 SW LAYTON AVE
Project: Brookside,Lot 21 Subdivision: BROOKSIDE SUBDIVISION
Lot: 21
Project Description: Sewer connection for new detached dwelling.
Contractor: Owner: BLACKWOOD HOMES INC
PO BOX 4188
TUALATIN, OR 97062
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/07/2022 $6,085.00
Sewer Inspection-Residential 07/07/2022 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $6,120.00
Required Items and Reports(Conditions)
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 yo 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. Y, obtain a copy of the rules
iiii
Issued By: �ti,n n (-{ ".(11.. Permittee Signature:
Call 503.639. 175 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.