Permit CITY OF TIGARD SEWER CONNECTION PERMIT
11 11 COMMUNITY DEVELOPMENT Permit #: SWR2013 00071
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013
Parcel: 1 S135BD00500
Jurisdiction: Tigard
Site address: 10855 SW 95TH AVE
Project: Gertz Subdivision: MEADOW VIEW Lot: 8
Project Description: Sewer connection for new duplex address 10855 SW 95th and 10875 SW 95th. 5/15/13, demo credits from
BUP2013 -00061 applied to this permit.
Contractor: Owner: GERTZ FINE HOMES
19200 SW 46TH
TUALATIN, OR 97062
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Inspection - Residential 05/15/2013 $35.00
Sewer Connection Fee 05/15/2013 $4,665.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 2
Total $4,700.00
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 by c. mg 51 232.1987 or 1.800.332.2344.
Issued By 0 , Permittee Signature:
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.