Permit CITY OF TIGARD SEWER CONNECTION PERMIT
111111 s COMMUNITY DEVELOPMENT Permit#: SWR2014-00057
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/22/2014
Parcel: 2S 110BD01500
Jurisdiction: TIGARD
Site address: 14680 SW 117TH PL
Project: ANNENBERG Subdivision: SHADOW HILLS Lot: 6
Project Description: Sewer connection for new SF. 9/4/14,Demo credits from BUP2014-00095 applied to this permit.
Contractor: Owner: ANNENBERG, ROBERT F
11430 SW PINTAIL LOOP
BEAVERTON, OR 97007
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Inspection-Residential 09/22/2014 $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 ides and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not st. ed with 180 days of issuance, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules =d•.ted b the Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may o• ain - co. +f •- rules or .ire, questions
to OUNC by calling 503 32.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ,
Call 503.639.4175 by 7:00 a.m.for the next available inspectio •a e. /
This permit card shall be kept in a conspicuous place on the job site until cgrfipletion of the project.
Approved plans are required on the job site at the time of each inspection.