Permit (13) CITY OF TIGARD SEWER CONNECTION PERMIT
,. COMMUNITY DEVELOPMENT Permit#: SWR2019-00275
TI G A R L} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2019
Parcel: 2S115AB06600
Jurisdiction: Tigard
Site address: 11453 SW GABRIEL ST
Project: Willow Brook,Lot 11 Subdivision: WILLOW BROOK SUBDIVISION Lot: 11
Project Description: Sewer connection New SF.
Contractor: Owner: PACIFIC LIFESTYLE HOMES INC
11815 NE 99TH ST STE 1200
VANCOUVER, WA 98682
PHONE: PHONE: 360-573-8081
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/09/2019 $5,800.00
Sewer Inspection-Residential 10/09/2019 $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 $5,835.00
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 orth i AR 952- 01-0010 through OAR 952-001-0090. You may obtai a copy of the rules or direct questions
to OUNC by calling 503.232.1::/or 1 0.332.2 4
4Issued By: /Permittee Signature: � � / / ti
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.