Permit CITY OF TIGARD SEWER CONNECTION PERMIT
.114
COMMUNITY DEVELOPMENT Permit#: SWR2016-00117
T l GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/26/2016
Parcel: 1 S125DA12500
Jurisdiction: Tigard
Site address: 6810 SW WALNUT TER
Project: Gilbert Partition, Lot 2 Subdivision: 2013-010 PARTITION PLAT Lot: 2
Project Description: Sewer connection for new SF
Contractor: Owner: URBAN REVIVAL LLC
1824 S EVANS ST
PORTLAND, OR 97219
PHONE: PHONE: 503-425-9048
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/26/2016 $5,100.00
Sewer Inspection-Residential 05/26/2016 $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 t e Oregon Utility Notification
Center. Tho are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of he rules or direct questions
to OUNC b calling 503. .19Caear____/76,L,a
87oor1.800.3332..2344.
Issued , ,rPermittee Signature: `A
Call 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.