Permit (31) CITY OF TIGARD SEWER CONNECTION PERMIT
11 COMMUNITY DEVELOPMENT Permit#: SWR2018-00083
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/29/2018
T t C_.A R O g Parcel: 1S135BD00300
Jurisdiction: Tigard
Site address: 9735 SW SHADY LN 201
Project: Renew Sleep Solutions Subdivision: None Lot: None
Project Description: .25 EDU increase.
Contractor: Owner: TIGARD MEDICAL MALL LLC
PO BOX 98
POULSBO,WA 98370
PHONE PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/29/2018 $1,375.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: .25
Total $1,375.00
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. 44.
Issued By: %;��i Permittee Signature:
i 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.