Permit CITY OF TIGARD SEWER CONNECTION PERMIT
j� : COMMUNITY DEVELOPMENT Permit#: SWR2015 00100
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016
Parcel: 2S111BA06800
Jurisdiction: Tigard
Site address: 9541 SW INEZ ST
Project: Ban Subdivision: BUTLER TERRACE Lot: 2
Project Description: 2 EDU increase. Adding(5)additional bedrooms,for a total of 10 bedrooms in this house.
Contractor: Owner: BAN, MIRCEA& DIANA
9541 SW INEZ ST
TIGARD, OR 97224
PHONE: PHONE: 425-919-2705
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/28/2016 $10,200.00
Type of Use: SF
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 2
Total $10,200.00
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 th- 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 t e rules or direct questions
to OUNC calling 56' 32.1•:7 or 1.800.332.2344. _111
/,
Issue By: I , / t Permittee ue: 1/��
Call 503.639.4175 by 7:00 a.m.for the next availableSignatinsA
pectionrdate.
This permit card shall be kept in a conspicuous place on the job site until completion of the plect.
Approved plans are required on the job site at the time of each inspection.