Permit CITY OF TIGARD SEWER CONNECTION PERMIT
IIN
P 2..',. COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: SWR2016 00477
Date Issued: 02/01/2017
Parcel: 2S 104AC 15200
Site address: 12881 SW 133RD AVE Jurisdiction: Tigard
Project: Walnut Ridge, Lot 6
Project Description: Sewer connection for a new SF. Subdivision: WALNUT RIDGE
Lot: 6
Contractor:
Owner: RIVERSIDE HOMES LLC
17933 NW EVERGREEN PKWY,#370
BEAVERTON, OR 97006
PHONE:
FAX:
PHONE
a-r-�
Description
Spe_ cifc l Date Amount
Sewer Connection Fee
Type of Use: SF Sewer Inspection-Residential 02/01/2017 $5,300.00
Class of Work: ALT 02/01/2017 $35.00
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
work is suspended for more the 180 days. ATTENTION Oregon law equiresplans. This permit wyou toill lrfollow the e if work 'rules t dortte. within• 180 days of issuance, or if
Center. Thos s are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a -op of the rule
to OUNC calling 50 . 32.1987 or 1.800.332.2344. p the Oregon it,..‘re Notification
direct questions
Issu d By:
yi
Permittee Signature: '�G/�
Call 503.639.4175 by 7:00 a.m.for the next available inspec '. .a e.
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.