Permit (7) CITY OF TIGARD SEWER CONNECTION PERMIT
I COMMUNITY DEVELOPMENT Permit#: SWR2019-00278
ii r\R o 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2019
Parcel: 2S115BA00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY N
Project: Planet Fitness Subdivision: None Lot: None
Project Description: 7.5 EDU increase.
Contractor: Owner: TECOLOTE RESOURCES INC
KELLY'S LEGACY LLC, ET AL
BY HESSLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE:
PHONE: 503-764-7595
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/30/2019 $43,500.00
Sewer Inspection-Commercial 09/30/2019 $45.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 7.5
Total $43,545.00
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 se 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 47 or 1.800.3 2344/
Issued By: Permittee Signature:
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.