Permit CITY OF TIGARD SEWER CONNECTION PERMIT
1111 C OMMUNITY DEVELOPMENT Permit #: SWR2008-00022
13125 SW Hall Blvd. Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011
TIGARD Parcel: 2S102DCO5600
Jurisdiction: TIG
Site address: 13874 SW HALCYON TER
Project: GERTZ HOMES AT EDGEWOOD Subdivision: Lot:
Project Description: New SF.
Contractor: Owner: GERTZ CONSTRUCTION COMPANY, INC.
19200 SW 46TH AVE
TUALATIN, OR 97062
PHONE:
PHONE: 503 - 692 -3390
FAX:
FEES
Description Date Amount
Specifics: [SWUSA] Sewer Connection Fee 12/10/2010 $2,800.00
[SWINSP] Sewer Inspection Fee 12/10/2010 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: LTPSWR
Fixture Units:
Number of Dwelling Units: 1.0
Total $2,835.00
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 -0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503.2 1987 or 1.800.332.2344.
Issued By: 1 Permittee Signature:
Call 5030 by 7:00 a.m. for the next available inspection ate.
This permit card shall be kep 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.