Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2012 -00002
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2012
Parcel: 2S103CB02100
Jurisdiction: Tigard
Site address: 12190 SW JAMES ST
Project: Wilson Partition Subdivision: Lot: 0
Project Description: Connect existing house to sewer service.
Contractor: Owner: STEVE WILSON
BIG MOOSE DEVELOPMENT
9450 SW JAMIESON RD
BEAVERTON, OR 97005
PHONE: PHONE: 503 - 522 -0426
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/04/2012 $4,500.00
Sewer Inspection - Residential 01/04/2012 $35.00
Type of Use: Reimbursement District Fee 01/04/2012 $18,023.08
Class of Work:
Install Type:
Fixture Units:
Number of Dwelling Units:
Total $22,558.08
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of • R. Specialty Codes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is n t started within 180 days of issuance, or if
work is sus nci 4_f r more the 180 days. ATTENTION: Oregon law requires you to follow the rule` adopted by the Oregon Utility Notification
Center. ose rules ar- set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may \. a copy of the rules or direct questions
to OU by calling 503.232. •87 • 800.332.2344.
Is ued By: ` _ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection
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.