Permit CITY OF TIGARD SEWER CONNECTION PERMIT
. .. '• COMMUNITY DEVELOPMENT Permit#: SWR201900261
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2019
Parcel: 2S115AB06000
Jurisdiction: Tigard
Site address: 11444 SW GABRIEL ST
Project: Willow Brook, Lot 5 Subdivision: WILLOW BROOK SUBDIVISION Lot: 5
Project Description: Sewer connection for 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 11/13/2019 $5,800.00
Sewer Inspection-Residential 11/13/2019 $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 rule adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may ob in a copy of the rules or direct questi s
to OUNC by calling 503.232.1987 or 1.800.332.2344. -
A 1 , ,
Issued By: , � / �-P.err7tittee Signature: "1,�.�� .0
Call` . 39.4175 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.