Permit •
•� CITY OF TIGARD SEWER CONNECTION PERMIT
1111 f COMMUNITY DEVELOPMENT Permit #: SWR2011 -00073
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503718.2439 Date Issued: 05/17/2011
• Parcel: 25111 BD00305
Jurisdiction: Tigard
Site address: 9840 SW INEZ ST
Project: SULLIVAN & WINTERBOTTOM Subdivision: PEMBROOK HEIGHTS Lot: 5
Project Description: Connect existing house to sewer service.
Contractor: Owner: WINTERBOTTOM, LISA & SULLIVAN, JOHN
9840 SW INEZ ST
TIGARD, OR 97224
PHONE: PHONE: 401 - 823 -1638
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/17/2011 $4,100.00
Sewer Inspection - Residential 05/17/2011 $35.00
Type of Use: SF
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $4,135.00
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 s .-7•••-d for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Cente . Those rule are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obt. n , - copy of the rules or direct questions
to 0 NC by calling 503.2' •r 1.800.332.2344.
Is ued By: ■ , Permittee Signature:
111r
Call 503.639.4175 by 7:00 a.m. for the next available inspection .ate.
This permit card shall be kept in a conspicuous place on the job site until comp etion of the project.
Approved plans are required on the job site at the time of each inspection.