Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00012
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/18/2012
TIGARD 9 Parcel: 2S102CB00700
Jurisdiction: Tigard
Site address: 13040 SW GRANT AVE
Project: My Financial Workout LLC Subdivision: NORTH TIGARDVILLE ADDITION Lot:
Project Description: Repair 30' of sanitary sewer line.
Contractor: SIERRA CONSTRUCTION & EXCAVATION LLC Owner: MY FINANCIAL WORKOUT LLC
PO BOX 30642 4636 SW KELLY AVE
PORTLAND, OR 97294 PORTLAND, OR 97239
PHONE: 503 - 492 -9242 PHONE.
FAX: 503 - 252 -9808
FEES
Quantity Description Date Amount
30 If Sewer Service 01/18/2012 $62.54
Specifics: 1 12% State Surcharge - 01/18/2012 $8.70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment - 01/18/2012 $9.96
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signatur I ,o
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.
FROM :SIERRA EXCRVATION FAX NO. :503 252 9808 Jan. 16 2012 09:35AM P2
REcElvED ,
!I .„
JAN 17 2012
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