Permit 1 11111 CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2013-00096
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/18/2013
Parcel: 25111 CB01735
Jurisdiction: Tigard
Site address: 10310 SW HOODVIEW DR
Project: Switzer Subdivision: HOOD VIEW NO.2 Lot: 34
Project Description: Connect existing house to sewer service
Contractor: Owner: SWITZER, KRISTEN C & CARL R
10310 SW HOODVIEW DR
TIGARD, OR 97224
PHONE: PHONE: 503 - 806 -6446
FAX:
FEES
Description Date Amount
Specifics: Deferred Reimbursement District Fee 04/18/2013 $4,000.00
Deferred Sewer Connection Fee 04/18/2013 $4,665.00
Type of Use: SF Deferred Sewer Inspection Fee 04/18/2013 $35.00
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $8,700.00
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. T , e rules a - 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 t calling 503.232. 987 . 00.332.2344.
Issue By: Permittee Signature: �l 1 ,
Niv
Call 503.639.4175 by 7:00 a.m. for the next available inspection cl% `
This permit card shall be kept in a conspicuous place on the job site until comple of the 'i oject.
Approved plans are required on the job site at the time of each inspection.
IN CITY OF TIGARD RECEIPT
a : 1312 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 191041 - 04/18/2013
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SWR2013 -00096 Deferred Reimbursement District Fee 500 - 0000 - 23300 $4,000.00
SWR2013 -00096 Deferred Sewer Inspection Fee 230- 0000 -23300 $35.00
SWR2013 -00096 Deferred Sewer Connection Fee 500 - 0000 - 23300 $4,665.00
Total: $8,700.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Journal Entry 312 -10 -2013 DADAMSKI 04/18/2013 $8,700.00
Payor: City of Tigard
Total Payments: $8,700.00
Balance Due: $0.00
Page 1 of 1
General Ledger
Journal Entry Proof List III
User Amyl. i w
Printed 4/18/2013 - 11:57 AM
Batch: 10019,04 2013
TIGARD
- ®
Account Number Account Description Debit Amount Credit Amount Line Description Project Management
Journal Entry: 312 -10 -2013 Journal Entry Date: 04/I8/2013
230- 0000 -121(13 Accts Receivable - Reimh. Dist 35.00 0.00 Book Inspection Fee - Switzer
23(1-0000-23300 Deferred Revenue 0.00 35.00 Book Inspection Fee - Switzer
500 -0000- 12102 Accounts Receivable - CWS 4,665.00 0.00 Book Connection Fee - Switzer
5(1(1-0000-12103 Accts Receivable - Reimh. Dist 4,000.00 0.00 Book Reimbursement Pee - Switzer
500- 0000- 23300 Deferred Revenue 0.00 8,665.00 Book Sewer Loan Fees - Switzer
Journal Entry Totals 8,700.00 8,700 00
Journal Entry Balance (1.(1(1
Report Totals: 8,700.00 8,700.00
0.00
GL Journal Entry Proof List (4/18/2013 - 11:57 AM) Page 1