Permit r �, CITY OF TIGARD SEWER CONNECTION PERMIT
!;' . COM MUNITY DEVELOPMENT Permit #: SWR2011 -00106
T1GA D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2011
. Parcel: 2S113AC00102
Jurisdiction: TIGARD
Site address: 7250 SW DURHAM RD, BLDG# J
Project: Stash Tea Subdivision: Lot:
Project Description:
Contractor: Owner: PACIFIC REALTY ASSOCIATES
ATTN: N PIVEN
15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: PHONE:
FAX:
FEES
•
Description Date Amount
Specifics: Sewer Connection Fee 07/19/2011 $900.00
Type of Use:
Class of Work:
Install Type:
Fixture Units:
Number of Dwelling Units:
Total $900.00 -
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 su — for- pore the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. hose 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 y calling 503.232.1987 or . 0. .2344.
Issued k - ��� �e +
Permittee Signature:
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.