Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2015-00206
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2016
Parcel: 2S110CB13400
Jurisdiction: TIGARD
Site address: 12068 SW AUTUMNVIEW ST
Project: Southview Heights,Lot 22 Subdivision: SOUTH VIEW HEIGHTS Lot: 22
Project Description: Sewer connection for new SF
Contractor: Owner: STONE BRIDGE HOMES NW LLC
4230 GALEWOOD ST, STE 100
LAKE OSWEGO, OR 97035
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 02/04/2016 $5,100.00
Type of Use: SF Sewer Inspection-Residential 02/04/2016 $35.00
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 ob copy of the rules or direct questions
to OUNC by calling 503.2A 1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspectio
This permit card shall be kept in a conspicuous place on thejob site until completion of the roject.
Approved plans are required on the job site at the time of each inspection.