Permit (4) 14 CITY OF TIGARD SEWER CONNECTION PERMIT
I. ' COMMUNITY DEVELOPMENT Permit#: SWR2023-00158
Date Issued: 7/20/2023
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DC16300
Jurisdiction: Tigard
Site address: 15144 SW DEEPBROOK LN
Project: River Terrace Crossing, Lot 28 Subdivision: RIVER TERRACE CROSSING Lot: 28
Project Description: Sewer connection for detached dwelling.
Contractor: Owner: PACIFIC LIFESTYLE HOMES INC
11815 NE 99TH ST#1200
VANCOUVER,WA 98686
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/20/2023 $6,625.00
Sewer Inspection-Residential 07/20/2023 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $6.660.00
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 you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR -001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature: L�=�
Call 5 .6 9.4175 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.