Permit CITY OF TIGARD SEWER CONNECTION PERMIT
a COMMUNITY DEVELOPMENT Permit#: SWR2013 00169
T[G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013
Parcel: 2S112BD07700
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Jurisdiction: TIGARD
Slte address: 7790 SW HANSEN LN
Project: Brittany Meadows,Lot 13 Subdivision: BRITTANY MEADOWS Lot: 13
Project Description: Sewer connection for new SF
Contractor: Owner: PACIFIC EVERGREEN HOMES LLC
7410 SW OLESON RD#133
PORTLAND,OR 97223
PHONE: PHONE: 503-664-6423
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 08/28/2013 $4,800.00
Sewer Inspection-Residential 08/28/2013 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
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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 :yes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not started in :0 days of issuance, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by e Oregon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a •py • he les o d• -ct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344. !/
Issued By: -Permittee Signature:
Call 503. 7:00 a.m,for the next available inspection•••te.
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.