Permit •
7 y - CITY OF TIGARD SEWER CONNECTION PERMIT
1 - $ ' COMMUNITY DEVELOPMENT Permit #: SWR2013 00052
T IGAD` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
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Parcel: 1 S135CA11500
Jurisdiction: TIGARD
Site address: 11481 SW 96TH AVE
Project: Everett Terrace, Lot 14 Subdivision: EVERETT TERRACE Lot: 14
Project Description: Sewer connection for new SF
Contractor: Owner: SAGE BUILT HOMES LLC
16280 NW BETHANY CT •
BEAVERTON, OR 97006
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PHONE: PHONE: 503 - 502 -6623
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/18/2013 $4,665.00
Sewer Inspection - Residential 03/18/2013 $35.00
Type of Use:
Class of Work:
Install Type:
Fixture Units: •
Number of Dwelling Units:
Total $4,700.00
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 a c..y of the r - . or direct questions
to OUNC by mg 503.' 2.1987 or 1.800.332.2344.
Issued y: ∎ —ae„,,t.t _ / Permittee Signature: At); 4 0�.
• Call 503.639.4175 by 7:00 a.m. for the next available inspection d. =.
This permit card shall be kept in a conspicuous place on the job site until com • etion •f the projec
Approved plans are required on the job site at the time of each in -. _ • on.
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