Permit ° CITY OF TIGARD SEWER CONNECTION PERMIT
° COMMUNITY DEVELOPMENT Permit #: SWR2011 -00118
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/03/2011
Parcel: 1 S136DCO3900
Jurisdiction: Tigard
Site address: 7110 SW CLINTON ST
Project: Farza Subdivision: Lot:
Project Description: Connect existing house to sewer service.
Contractor: Owner: FARZA, JAVAD
7110 SW CLINTON ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
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FEES
Description Date Amount
Specifics: Sewer Connection Fee 08/03/2011 $4,500.00
Sewer Inspection - Residential 08/03/2011 $35.00
Type of Use: SF Reimbursement District Revenue 08/03/2011 $11,483.61
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $16,018.61
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 ules are : forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy rules or direct questions
to OUNC by !ling 503.232.198 or .:: o. . .2344.
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Issued By. i1 � _ / d j , , / Permittee Signature: `�`iir ■
Call 503.639.4175 by 7:00 a.m. for the next available inspection .
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.