Permit CITY OF TIGARD
k j '' SEWER CONNECTION PERMIT
III a . COMMUNITY DEVELOPMENT broom Permit#: SWR2013 00141
T LGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2013
Parcel: 1 S126DB04100
Jurisdiction: Tigard
Site address: 9401 SW 92ND AVE
Project: Montage,Lot 12 Subdivision: MONTAGE Lot: 12
Project Description: Building 2-Sewer connection for new SFA. ;11/7/13,reprinted to add ASI info
Contractor: Owner: NW AREA INVESTMENTS LLC
11150 SW RIVERWOOD RD
PORTLAND,OR 97219
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/05/2013 $4,665.00
Sewer Inspection-Residential 09/05/2013 $35.00
Type of Use: SFA
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 obtain a copy of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: - ��L'dr�c'�Y�—�,o Permittee Signature: f, . c
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 00141
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2013
T[G�\R t? 9 Parcel: 1 S 126 DB04100
Jurisdiction: Tigard
Site address: 9401 SW 92ND AVE
Project: Montage,Lot 12 Subdivision: MONTAGE Lot: 12
Project Description: Building 2-New SFA
Contractor: Owner: NW AREA INVESTMENTS LLC
11150 SW RIVERWOOD RD
PORTLAND, OR 97219
PHONE: PHONE:
FAX:
• FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/05/2013 $4,665.00
Sewer Inspection-Residential 09/05/2013 $35.00
Type of Use:
Class of Work:
Install Type:
Fixture Units:
Number of Dwelling Units:
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 calling 503.232.1987 or 1.800.332.2 ••
Issued By: �- Permittee Signature:
Call 503.•'• .y :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.