Permit .71 CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2022-00072
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/16/2022
Parcel: 2S103DD00850
Jurisdiction: Tigard
Site address: 13815 SW PACIFIC HWY 50
Project: Avalon Massage Tenant Improvement Subdivision: None Lot: None
Project Description: Adding:(1)clothes washer,(1)sink and(1)water heater. .50 additional edus.
Contractor: Owner: D W SIVERS CO
4730 S MACADAM AVE#101
PORTLAND, OR 97239
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/16/2022 $3,042.50
Type of Use: COM
Class of Work: ALT
Install Type:
Fixture Units:
Number of Dwelling Units: .50
Total $3,042.50
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 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
Issued B 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.