Permit (6) CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2019-00305
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2020
T I t�''� �� g Parcel: 2S115AB07800
Jurisdiction: Tigard
Site address: 11199 SW GABRIEL ST
Project: Willow Brook,Lot 23 Subdivision: WILLOW BROOK SUBDIVISION Lot: 23
Project Description: Sewer connection for a new SF.
Contractor: Owner: PACIFIC LIFESTYLE HOMES INC
11815 NE 99TH ST STE 1200
VANCOUVER,WA 98682
PHONE PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 01/30/2020 $5,800.00
Sewer Inspection-Residential 01/30/2020 $35.00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $5,835.00
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 pproved 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. ATT NTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. Those rules are set f in OAR 95 1-0010 roug OAR 952-001-0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503.232.1 1.800 .23 .
Issued By: Permittee Signature: l
Ca 1503.639.4175 by 7:00 a.m.for the next available inspection d2I . G v
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.