Permit CITY OF TIGARD SEWER CONNECTION PERMIT
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2 ,:- COMMUNITY DEVELOPMENT Permit #: SWR2010 -00040
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2010
Parcel: 2S109AB13100
Jurisdiction: Tigard
Site address: 14258 SW STELLER'S JAY LN
Project: Alpine View, Lot 12 Subdivision: Lot: 0
Project Description: Sewer connection for new SF. 12/10/10, Reprint to correct street name spelling.
Contractor: Owner: WEST HILLS DEVELOPMENT
735 SW 158TH AVE
BEAVERTON, OR 97006
PHONE: PHONE: 503 - 641 -7342
FAX:
FEES
Description Date Amount
Specifics:, Sewer Connection Fee 04/29/2010 $3,600.00
Sewer Inspection - Residential 04/29/2010 $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 $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. Thos 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 b calling 503.23 • e or 1.800.332.2344.
Issue By: / 6,0 Jai • Permittee Signature: i11
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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.
CITY OF TIGARD SEWER CONNECTION PERMIT
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COMMUNITY DEVELOPMENT Permit #: SWR2010 -00040
ruf: Date Issued: 04/29/2010
T i Gmt:b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S109AB13100
Jurisdiction: Tigard
Site address: 14258 SW STELLARS JAY TER
Subdivision: Lot: 0
Project: Alpine View, Lot 12
Project Description: Sewer connection for new SF.
FEES
Owner:
WEST HILLS DEVELOPMENT Description Date Amount
735 SW 158TH AVE Sewer Connection Fee 04/29/2010 $3,600.00
BEAVERTON, OR 97006 Sewer Inspection - Residential 04/29/2010 $35.00
PHONE: 503 - 641 -7342
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: NEW
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 • . C by calling 503.246.6699 or 1.800.332.2344.
Issued By / , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.