Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2011 -00143
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2012
TIGARD Parcel: 2S112BD09500
Jurisdiction: Tigard
Site address: 14670 SW 78TH AVE
Project: Brittany Meadows, Lot 31 Subdivision: BRITTANY MEADOWS Lot: 31
Project Description: Sewer connection for new SF.
Contractor: Owner: FISH CONSTRUCTION NW INC
1834 SW 58TH AVE #102
PORTLAND, OR 97221
PHONE:
PHONE: 503 - 292 -9891
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/05/2012 $4,500.00
Sewer Inspection - Residential 01/05/2012 $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 $4,535.00
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 as.pted by the Oregon Utility Notification
Center. ose rules re set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtai copy of the rules or direct questions
to OUN by calling 503. 2.1987 or 1.800.332.2344.
Issue y: ( Permittee Signature: thr c
111 �
Call 503.639.4175 by 7:00 a.m. for the next available inspecti.n .a -.
This permit card shall be kept in a conspicuous place on the job site until co ple ion of the project.
Approved plans are required on the job site at the time of each i sp= ction.