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Permit Plumbing Permit Application Building Fixtures 1 ,•.,, II, City of Tigard ta.:3 r',, _ .. it-Atvel a 1 i,,,.., 4 Nntifipc,fi,io 24,-4.2357 a.n., ,._..,., __Jj..tff A ., 14 ., 12.5 SW 14611 1-31uti.Tipral,OH 97221 nos trg.taraa Otter Poinn No, ,r I, ,,,„il buggcrfax,Lint: 511.3.,639 4175 , tlfrig ftrarig.114y: a/ it. SI St.nape 1.fir " Entrrne. A-mg rigard-rtr gtav mufti I/ft i SO 4-0 Skorliggarged tafarmatig. , Ptrt: OF Wf)14 li. '..ir* 1-7-sAl&'4 -to al N OA' At15,6,2k.klnot' <A(.147-1i01Va itA:r.r&11 .1" ,"2:1::. 0 bum:all 1.636 ' „.,.. Li°ODestrogga 1 .13 agar veriirlfrignrwrirtartamtrAterStrar. 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'''..-9,g. 1.4x- I Ogle:IS_2.572.-il .60.r it 6...Egg.arrragraf 2$Etralpi roc *i"rx andhoLitylom vtlA by 70,-.4:0444y Hmkhlsv lodo-r3N.5-er,r.•/30.06 MI:-PtIng,hgt,kkv 14eMON 4.41.404,ToNmiumtvati./ CC' -gf dc a r Viz r- & /4_11 lei fl/c .Co 11..‘„ ___ . -- . Plumbing Permit Application -City of Tigard Page 2-Supplemental information Fee Schedule: Residential Fire S preiou Systems: .,. Site Utilities Qty.. Foe Otalg Total 9.r uf i r 1 e Footage: Permit Fee: Fttoting drain-I'or mei .0.to 2.000 2,001 tal.600 SI00-0 Ircongt drain.involl additional CO.r 37.52 . -- - t t 1 WI to 7_,ttild S22Z20 412.54 , I 7,2DT and_ntester S-127,g. 'i - , I addinnenn IVY Water Service t 1st.Itar 62.54 Medical Cias S stuns: t —A Waer Seggvine-each addogonat 100* 37,52 ,_ — - Valuation: i Permit Feta Sterot At Rain Main-l g Illat 62.54 SI"- -oil to is.to 00 Maill110/X1 fee S72,50 ...- Sircin& rin term-cattit 4111&1Orffe 1(10' 37 la , sstittm to SititliXt 00 S72.50fte inc.6gA15,0Mat and SI.52 nog I- cacti additional Slal 00 ix fradion dierodf.to Other Ins eel-ions or Feet Qq- , tkv OW Tana 357g3 irlS144.1.1k SIO.N0.00. lospoction 0re...tinging 0.taistra.te of far SICtge31.00 to S25,6111.1.10 $148.5931ar the first Sf6telb/Cgd and$1.54 rot Mika no fee i,:wet tintal. indicated 91),Ctiadz • tech additioned 3140.90 fir fraction ilietani,to ° {minimum thane-tel.'liou anti inchainaA S2SACKI.G0- , Invtnt inns maids awned falsities* 00.0.6413. s25,110 I_OD to sta-:1160,00 S3 tit°tit oto first S25.000 flIndI 45jrag boors unintungel Margo-2 rtets)ett men additional 0.0 Si00. Or fracton i tbetcgiC to RCIMiliDdifill krto OD.C4cRalf flati 4'410111ra V41,000 cq. ..__ meliiiit Ilion review log revisions CO1031hr $50.001.00 sod op T742 Itia-far the first S50,13,00-011.indl I 2.0 te; each addinnuat Slett.00 Of ItUtgifAbi 411000r. i manna=nit:gm-la knot) - Sitinintal: Commercial Fixture Work: Arn you capping,adding or replacing fixtures? ir-), -, please indkate work performed by fixture. Failure tO ,,, ,... ..... . ,. _ ,,__ accurately report litsrurm CO tad Milk.in increased sewer ims*. Plan KeirleW tor riumning mammenetems t t IlltkeLLata.A.44"LAI Plars review is required for arty of the following, Fixture li..iitpe air'W 4-40P4 IIME33 Please theck all ulna apply.ork Performed: ' 0 Any new commercial building with neater scsvilCIn 2-dud 13 g nortgltani 111111IMMIIIIIIIIIIMIIII grcakz,cxmit systems designed and Ninumik by lictiand Rah. -roielshower 111111igliiill11=11 engineer. rris'Whin , in=lial..1111111110. 0 New exterior plumbing site giiiiiin for oily eesoolex A-moot C O Liael!...attl 101111111111111/11111 IIIIIIIIIII as defined ift OAR9IF.-730-00,10, -Oriw Ran 11111111111111111.111 „ 0 Mi.xlieel vs and unclean systems for health care lw.' ilesoes" . C ut sr. itkodWer As t'407 .............. ,.., Nitro:mem •cemerorttu M111101111•111111111111111MM r:1 Any otadticiorpcoge urn Sprink lt!:SySteifia. -1)OffIdlIC IIMIIIIIIIIIIIIMINE 0 Any eni*es NtIlletillie as&final in OAR918-780-0040. Dontert;,Soutett 1110.1.11.11.1.1111111111.1 minsumm issztimimmemisimma Submit 2 sets of plans with soy of tee above. Moot DrilirAlitsti: -r 111111111111111111111111111111111M =1111111miall1110111 , isometricor Riser Diagram -4" 111111.1.11.101.11 ,,,, CI Isometric oi riser diagram is required for new buildings -co t Wufri Dram IIIIIIIIIIIIIIIIIIIIIIIIIIIOMIIIIIII ..... that meet the qualifications above_ tinnuae -Uwowitc wo-food IIIMUNIMMISOMMI 1 rispilwai. -Dalartkic f,-"wd re-1w) IIIIIIMIMIIIIIIBIIIIIIIIIIIII ommercial Nkoe relawd .1111111111110MINIMMI -Indwrial Sionl gentled lee mach merrig.Iliwro 111 Comments rj. riling fixture work: , .---, IA Se areee"t:{iiK SWAM) illemone 1CALC ‘...‘ . Ca) g, ...—k - - Rte.Vehicle Duo Stnticm - 11.111111.11.111.1111111.1111 - IIIMIIMIIIIIIIII -- ca,4 •Shower: ,, Got; -SAO 111111.11111. Sul,' -1-7viBur son-fixxl WNW 1M 11111111 INEIMII --itrazilty 7f 1111111111111111111111111111 MIIIIIIIIII (...,0 . \- 1.......-)4., • .. ..cut :nr.avt l:4 i'.:row rid gommainorippos ' -tierViSC , illIllMaIIIIIIINIIIIIIIR 4 Note l If tbe fixture work under the.permit tilts Us MI SWitrattiltg Pool l'ilter MIIIIIIMIN increase of sewer EDUs,n sewer permit will be'Mined and Washer.Chew MI 11.11.1 Water ir:St4)00r 111111.111111111111111111 fees assessed for the sewer increase must be paid before the wkner neset-Toilet iliMiliiiiilliangE *alibiing permit can be issue& _ - urinal .41111111=111111111111lillI e-C1--0 cA—r-s. (t) ahavrctii.: imiiiill11=111111111011 ) kixtuildmvq,cmtit-0131.MF_PrrnutApp.doc 01h4t°201 1 2 ...._ Accumulative Sewer Tally 11 C Tenant Name: Burger King SWR# N/A 1 G it Site Address: 11539 SW Pacific Hwy PLM#2020-00358 Parcel#: 1 S 136AD04001 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total values Baptisery/Font 4 0 0 0 0 0 Bath: -Tub/Shower 4 0 0 0 0 0 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash: -Each Stall 6 0 0 0 0 0 -Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 0 0 0 0 -Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: -2 inch 2 0 0 0 0 0 -3inch 5 0 0 0 0 0 -4 inch 6 0 0 0 0 0 -Car Wash 6 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 0 0 0 0 -Industrial(over 5 HP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 0 0 0 0 0 Oil Sep(Gas Station) 6 0 0 0 0 0 Rec.Vehicle Dump station 16 0 0 0 0 0 Shower: -Gang(per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 0 0 0 0 0 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 0 0 0 Urinal 6 0 1 6 0 -1 -6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 1 6 0 0 -1 -6 Current Fixture Value -6 divided by 16= -0.375 Current EDU 1 EDU= $5,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -6 divided by 16= -0.375 over (under) $ (2,204.00) Enter EDU Change Here -0.380 *Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: .38 EDU CREDIT towards future EDU increase. Authorized Name/Signature: Dianna Omelas Date: 9/11/2020 Building Division Note: The property owner shall retain the ORIGIN AL sewer tally record. If credits exist,this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer Tally\SewerTally Sheet_5500_070119.xlsx