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Permit n e CITY OF TIGARD CONNECTION PERMIT Spi COMMUNITY DEVELOPMENT Permit #:, SWR2009 -00109 810.A.RI)) 13125'SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued:. 10/08/2009 b Parcel: 2S1 02 DD00812 Jurisdiction: Tigard Site address: 13905 SW`87TH CT Subdivision: FILBERT PARK Lot: 5 Project: Curtis Project Description: Connect existing SF to sewer. FEES Owner: CURTIS FAMILY TRUST Description Date Amount 15285 SW ALDERBROOK CT Sewer Connection Fee ' 10/08/2009 $3,600.00 TIGARD, OR 97224 Sewer Inspection - Residential 10/08/2009 $35.00 PHONE: Contractor: SAMMY LEE MUNSEY PLUMBING 11771 LONGSTANDING CT OREGON CITY, OR 97045 PHONE: 503 - 333 -5499 FAX: 503 - 723 -4753 Type of Use: SF Class of Work: ALT Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $3,635.00 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 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: C gj\ Q I i t Q Permittee Signature: S n "\ PP Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit, card shall be kept ima conspicuous placeion the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. •