Permit (29) CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2017-00146
Date Issued: 05/31/2017
TT g A q n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135DC09000
Jurisdiction: Tigard
Site address: 11625 SW 91ST AVE
Project: Pacific Evergreen Homes Subdivision: CHARBEN Lot: 8
Project Description: Sewer connection for new SF
Contractor: Owner: PACIFIC EVERGREEN HOMES
7410 SW OLESON RD STE 133
PORTLAND, OR 97223
PHONE:
PHONE: 503-664-6423
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/24/2017 $5,300.00
Sewer Inspection-Residential 05/24/2017 $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 $5,335.00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Special Co.-s and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not started ithi 180 day• of issuance, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopte.rby he Orego Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a c.iy o' the rule or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
44.
Issued By: Permittee Signature:
Cal .639.4175 by 7:00 a.m.for the next available inspe 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.