Permit CITY OF TIGARD y SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2015-00144
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/03/2015
Parcel: 2S1060001500
Jurisdiction: TIGARD
Site address: 13416 SW SABRINA AVE
Project: River Terrace Northwest,Lot 23 Subdivision: RIVER TERRACE NORTHWEST Lot: 18
Project Description: Sewer connection for new SF-Model Home 2/4/2016: REPRINT permit to correct address from 13415 to 13416.
Contractor: Owner: POLYGON WLH, LLC
109 E 13TH STREET
VANCOUVER,WA 98660
PHONE: PHONE: 360-695-7700
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 12/03/2015 $5,100.00
Sewer Inspection-Residential 12/03/2015 $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 $5,135.00
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 copy of the rules or direct questions
to OUNC by calling 503. 2.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Cali 503.639.4175 by 7:00 a.m.for the next available Inspection date.
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.
. CITY OF TIGARD SEWER CONNECTION PERMIT
111
COMMUNITY DEVELOPMENT Permit#: SWR2015-00144
I t:,
TI xARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/03/2015
# Parcel: 251060001500
Jurisdiction: TIGARD
Site address: 13415 SW SABRINA AVE
Project: River Terrace Northwest,Lot 23 Subdivision: RIVER TERRACE NORTHWEST Lot: 18
Project Description: Sewer connection for new SF-Model Home
Contractor: Owner: POLYGON WLH, LLC
109 E 13TH STREET
VANCOUVER, WA 98660
PHONE. PHONE: 360-695-7700
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 12/03/2015 $5,100.00
Sewer Inspection-Residential 12/03/2015 $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 $5,135.00
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 copy of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800 332.2344.
Issued By: •• ' .• Signature:
Call 5: by 7:00 a.m.for the next available inspection date.
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.