Permit CITY OF TIGARD SEWER CONNECTION PERMIT
11111 - COMMUNITY DEVELOPMENT Permit #: SWR2011 -00135
Date Issued: 09/21/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Parcel: 2S111 BD00303
Jurisdiction: Tigard
Site address: 9900 SW INEZ ST
Project: Powers Subdivision: PEMBROOK HEIGHTS Lot: 3
Project Description: Connect existing house to sewer service.
Contractor: Owner: POWERS, RICHARD & JEAN
9900 SW INEZ STREET
TIGARD, OR 97224
PHONE. PHONE: 503 - 639 -5776
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/21/2011 $4,500.00
Sewer Inspection - Residential 09/21/2011 $35.00
Type of Use: SF Reimbursement District Revenue 09/21/2011 $6,000 00
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $10,535 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 b calling 50 .' 2.19: 1.: !0.332.2344. ClK-f"
Issued y: ' /. 40 s ir Permittee Signatur
_ - r
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.