Permit CITY OF TIGARD SEWER CONNECTION PERMIT
1 . 1 1 e - COMMUNITY DEVELOPMENT Permit #: SWR2013 -00083
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2013
Parcel: 1 S135CA11000
Jurisdiction: TIGARD
Site address: 11431 SW 96TH AVE
Project: Everett Terrace, Lot 9 Subdivision: EVERETT TERRACE Lot: 9
Project Description: Sewer connection for new SF
Contractor: Owner: SAGE BUILT HOMES
16280 NW BETHANY CT
BEAVERTON, OR 97006
PHONE: PHONE: 503 - 502 -6623
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/21/2013 $4,665.00
Sewer Inspection - Residential 05/21/2013 $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 $4,700.00
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 •bta'• . copy of rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,/ Permittee Signature: / A k, d1 L 4
Call 503.639.4175 by 7:00 a.m. for the next available inspe • Ion ate. I
This permit card shall be kept in a conspicuous place on the job site u I co • pletion of the • roject.
Approved plans are required on the job site at the time of :a • nspectlon.