Permit (117) CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT
Permit#: SWR2018-00227
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2018
T r C;;�It.C� 9 Parcel: 2S109BB02903
Jurisdiction: Tigard
Site address: 14305 SW HIGH TOR DR
Project: HASHIMA Subdivision: HIGH TOR WEST Lot: 29
Project Description: New sewer connection. Septic tank to be pumped and filled or removed and pump/fill receipt required at final
inspection.
Contractor: ENVIRONMENTAL WORKS LLC Owner: HASHIMA FAMILY TRUST
2634 SE STEELE ST BY HASHIMA,JASON N&LISA K TRS
PORTLAND, OR 97202 14305 SW HIGH TOR DR
TIGARD, OR 97224
PHONE: 503-719-6715 PHONE:
FAX: 503-972-1866
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/16/2018 $5,650.00
Sewer Inspection-Residential 10/16/2018 $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 $5,685.00
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 1.800.332 344.
Issued By: / .„,..-e,43°'
�/ Permittee Signature: �� - �1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. G% /���
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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.