Permit CITY OF TIGARD SEWER CONNECTION PERMIT
a COMMUNITY DEVELOPMENT Permit #: SWR2012 00077
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/17/2013
Parcel: 2S 1 o4AD05200
Jurisdiction: Tigard
Site address: 12880 SW 129TH PL
Project: Fleskes Partition Subdivision: 2004 -003 PARTITION PLAT Lot: 3
Project Description: Sewer connection for new SF
Contractor: Owner: PARK PLACE INVESTMENTS LLC
PO BOX 91069
PORTLAND, OR 97291
PHONE PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 06/17/2013 $4,500.00
Sewer Inspection - Residential 06/17/2013 $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 adopted by the Oregon Utility Notification
Center. T. - ru - "re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OUN .y calling 503.2 . 1.800.332.2344.
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Iss , - d By: I � /I Permittee Signature: /27, ,2 "j.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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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.