Permit CITY OF TIGARD SEWER CONNECTION PERMIT
_ COMMUNITY DEVELOPMENT Permit#: SWR2021-00277
Date Issued: 11/18/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9463 SW WASHINGTON SQUARE RD Al2
Project: Sunglass Hut Subdivision: None Lot: None
Project Description: 0.810 EDU increase.
Contractor: Owner: PPR WASHINGTON SQUARE LLC
BY MACERICH RET
PO BOX 4085
SANTA MONICA, CA 90411
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 11/01/2021 $4,928.85
Sewer Inspection-Commercial 11/01/2021 $45.00
Type of Use: COM
Class of Work: ALT
Install Type:
Fixture Units:
Number of Dwelling Units: 0.810
Total $4,973.85
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: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those les are set fo in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: A / 461"e\rmittee Signature: Gr--,ff i/G47
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.
Accumulative Sewer Tally
i IN a Tenant Name: SUNGLASS HUT SWR# SWR2021-00277
Site Address: 9463 SW WASI IINGTON SQUARE PLM# PLM2021-00448
TIGARD
Parcel#: 1 S 1260000300
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
-3 inch 5 0 0 1 5 1 5
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 IIP) 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 1 2 1 2
-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 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 3 13 3 13
Current Fixture Value 13 divided by 16= 0.813 Current EDU 1 EDU= $6,085.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 13 divided by 16= 0.813 over (under) $ 4,928.85
Enter EDU Change Here 0.810 *
*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:
Authorized Name/Signature: JULIE DRINKWATER X2804 Date: 10/28/2021
Building Division
Note: The property owner shall retain the ORIGINAL 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:A Building\Sewer Tally\Sewcr1allyShcet_6085_070121.x1sx