Permit (65) CITY OF TIGARD SEWER CONNECTION PERMIT
: ?' COMMUNITY DEVELOPMENT Permit#: SWR2016-00288
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/07/2016
Parcel: 2S112CB18600
Jurisdiction: Tigard
Site address: 8026 SW BARNUM ST
Project: Corbin Estates,Lot 3 Subdivision: CORBIN ESTATES Lot: 3
Project Description: Sewer connection for new SF
Contractor: Owner: JT ROTH CONSTRUCTION INC
12600 SW 72ND AVE,STE 200
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/07/2016 $5,300.00
Type of Use: SF Sewer Inspection-Residential 09/07/2016
$35.00
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $5,335.00
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: Or-•-- -w requires you to follow the rules adopted by the Or-gon Utility Notification
Center. Those rules are set forth in OAR 952-001-0010 t rough OA- 952-001-0090. You may obtain a copy of r•- s or direct questions
to OUNC by calling 503. 1987 or 1.800.3 .'�
Issued By: ,40.1° �l
Permittee Sig [� .
Call 503.• '411. by 7:00 a.m.for the next available inspectio .ate.
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.