Permit (151) CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT
Permit
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 #: SWR2017-00053
l [GARD Date Issued: 02/23/2017
Parcel: 2S 106D B 19000
Site address: 13370 SW BEACH PLUM TER Jurisdiction: Tigard
Project: River Terrace Northwest, Lot 190
Project Description: Sewer connection for new SFA. Building/unit 9.1 Subdivision: RIVER TERRACE NORTHWEST Lot: 190
Contractor:
Owner: ADLV LAND HOLDINGS LLC
BY FORSUM, MICHAEL
7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE:
FAX:
PHONE: 602-694-4031
Description
Specifics: Date Amount
Sewer Connection Fee
Type of Use: 02/23/2017 $5,300.00
Sewer
SFA Inspection-Residential
Class of Work: NEW 02/23/2017 $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)
Thislaw. permitAllwork is isswilluedbe subject in to theaccordance regulationswith a contained inl the Tigard Municipal Code, Statek oif OR. Specialty Codes and all other applicable
p
T
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 p952�001i10090ireYou maysobtainstarted within 180 days of issuance, or if
copy of the rules or direct questions
to OUNC by calling 503.232.1987 or 1.8011.332.2344.
fIssued By: L' zi,c, ' Permittee •Signature.
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.