Permit . - q CITY OF TIGARD SEWER CONNECTION PERMIT
., ; " - 2 COMMUNITY DEVELOPMENT Permit #: SWR2012 00194
' TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/23/2012
Parcel: 1 S135CA11100
Jurisdiction: TIGARD
Site address: 11443 SW 96TH AVE
Project: Everett Terrace, Lot 10 Subdivision: :HERS ADDITION TO GREENBURG HE Lot: 3
-' Project Description: Sewer connection for new SF. 10/22/12 Demo credits from BUP2011 -00149 applied to this permit
• Contractor: Owner: SAGE BUILT HOMES LLC
16280 NW BETHANY CT
BEAVERTON, OR 97006
PHONE: PHONE: 503 - 502 -6623
FAX:
FEES
Description Date Amount
Specifics: Sewer Inspection - Residential 10/23/2012 $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 $35.00 .
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 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 : •py of th• les or direct questions
to OUNC by callin . . 987 or 800.332.2344.
Issued By: Permittee Signature: _1 / / / G4 .vAi /// l
Call 503.639.4175 by 7:00 a.m. for the next available inspec '•n date.
This permit card shall be kept in a conspicuous place on the job site u c • mpletion of the • roject.
Approved plans are required on the job site at the time o - • inspection.