Permit III CITY OF TIGARD SEWER CONNECTION PERMIT
41
s COMMUNITY DEVELOPMENT Permit #: SWR2010 -00062
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/25/2010
. Parcel: 2S 109AB 12900
Jurisdiction: Tigard
Site address: 14204 SW STELLER'S JAY LN
Project: Alpine View Subdivision: Alpine View Lot: 10
Project Description: Sewer connection for new SF. 12/10/10, Reprint to correct street name spelling.
Contractor: Owner: WEST HILLS DEVELOPMENT
735 SW 158TH
BEAVERTON, OR 97006
PHONE: PHONE: 503 - 641 -7342
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 08/25/2010 $3,600.00
Sewer Inspection - Residential 08/25/2010 $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 $3,635.00
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 r s e 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 mg 503.23' •r 1.800.332.2344.
Issued � � P ermittee Signatu � 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.
a CITY OF TIGARD SEWER CONNECTION PERMIT
iiii
COMMUNITY DEVELOPMENT Permit #: SWR2010 00062
T f G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2010
Parcel: 2S109AB12900
Jurisdiction: Tigard
Site address: 14204 SW STELLARS JAY TER
Subdivision: Alpine View Lot: 10
Project: Alpine View
Project Description: Sewer connection for new SF.
FEES
Owner:
WEST HILLS DEVELOPMENT Description Date Amount
735 SW 158TH Sewer Connection Fee 08/25/2010 $3,600.00
BEAVERTON, OR 97006 Sewer Inspection - Residential 08/25/2010 $35.00
PHONE: 503 - 641 -7342
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,635.00
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 - I -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct qu- - ons to OU , by c- ling 503.246.6699 or 1.800.332.2344.
Issu: d By: , 0 it ` ` r Permittee Signature
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.