Permit 1,11 CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2012 -00029
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16/2012
Parcel: 2S112BD07000
Jurisdiction: Tigard
Site address: 14709 SW 79TH AVE
Project: Brittany Meadows, Lot 6 Subdivision: BRITTANY MEADOWS Lot: 6
Project Description: Sewer connection for new SF
Contractor: Owner: PACIFIC EVERGREEN HOMES
7410 SW OLESON RD STE 133
PORTLAND, OR 97223
PHONE: PHONE: 503 - 664 -6423
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/16/2012 $4,500.00
Sewer Inspection - Residential 03/16/2012 $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 $4,535.00
Required Items and Reports (Conditions)
AI
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all •ther =pplicable
law. All wor • - • •ne in accordance with approved plans. This permit will expire if work is not started ,' in 80 days •f issu• nce, or if
work is s : .ended for mo - the 180 days. ATTENTION: Oregon law requires you to follow the rules adopt % by the Orego- Utility Notification
Center. hose rules are se fort - *AR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a opy of e rule or dir' questions
to OUN • by calli `g 503.232.198 • 1.800. .2. 344.
Issu d By: • 1 L Permittee Signature: ,1/Nril_L
Call 503.639.4175 by 7:00 a.m. for the next available inspectio - • e.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each Inspection.