Permit CITY OF TIGARD I SEWER CONNECTION PERMIT
3 COMMUNITY DEVELOPMENT / Permit#: SWR2013-00156
Date Issued: 07115!2013
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 2S102DC05900
Jurisdiction: TIGARD
Site address: 13801 SW 90TH AVE
Project: Edgewood No.2, Lot 8 Subdivision: 3ERTZ HOMES AT EDGEWOOD NO 2 Lot. 0
Project Description: Sewer connection for new SF. 1114/14,reprinted to correct parcel lot#from 11 to 8.
Contractor: Owner: GERTZ CONSTRUCTION CO INC
19200 SW 46TH AVE
TUALATIN, OR 97062
PHONE. PHONE: 503-692-3390
FAX
•
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/15/2013 $4,800.00
' Sewer Inspection-Residential 07/15/2013 $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 $4 835 00
Required Items and Reports{Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. Slate 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 calling 503\232.1 87 yor 1 800.33/2.2344.
Issu d By: (—�BfdL {L Permittee Signatuw, . t�
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.
CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2013 00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/15/2013
Parcel: 2S102DCO5900
Jurisdiction: TIGARD
Site address: 13801 SW 90TH AVE
Project: Edgewood No. 2, Lot 8 Subdivision: EDGEWOOD Lot: 11
Project Description: Sewer connection for new SF
Contractor: Owner: GERTZ CONSTRUCTION CO INC
19200 SW 46TH AVE
TUALATIN, OR 97062
PHONE: PHONE: 503 - 692 -3390
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/15/2013 $4,800.00
Sewer Inspection - Residential 07/15/2013 $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 $4,835.00
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 sus .eo . - • or more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. ose rules ar- et fo h in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to O C by c. ing 503.232.1 • : or ;50.332.2344.
I sued By: / 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.