Permit SEWER CONNECTION PERMIT
CITY OF TIGARD b`G
6.
permit#:
111
SWR20
2-00132
COMMUNITY DEVELOPMENT Date Issued: 10/19/2022
T I G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102DB09600
Jurisdiction: Tigard
Site address: 8803 SW OMARA ST TIGARD SENIOR HOUSING Lot: 1
Project: Tigard Senior Housing
Subdivision:
Project Description: Sewer connection for a new 58-unit senior living building.58 EDU increase.
Owner: TIGARD, CITY OF
Contractor: 13125 SW HALL BLVD
TIGARD, OR 97223
PHONE:
PHONE:
FAX:
FEES
Description
Date Amount
Specifics: Sewer Inspection-Commercial 10/19/2022 $45.0010/1912022 $352,930.00
Sewer Connection Fee
Type of Use: MF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 58
Total $352,975.00
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 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 rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
_� �— Permittee Signature: Q��
Issued By: ! r/
Call STWg.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.
I : Accumulative Sewer Tally
Tenant Name:TIGARD SENIOR HOUSING SWR# 2022-00132
Site Address: 8803 SW OMARA ST PLM# 2022-00211
TIGARDParcel#: 2S102DB09600
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
4 0 0 0 0 0
Bath: -Tub/Shower
-Jacuzzi/Whirlpool 4
0 0 0 0 0
Car Wash: -Each Stall 6
0 0 0 0 0
0 0 0 0 0
-Drive through 16
0 0 0 0 0
Cuspidor/Water Aspirator 1
Dishwasher: -Commercial 4
0 0 0 0 0
-Domestic
2 0 0 0 0 0
Drinking Fountain
1 0 0 0 0 0
h
1 0 0 0 0 0
F, c Wash 0 0 0
Floor Drain/Sink: -2 inch 2 0 0
-3 inch 5
0 0 0 0 0
-flinch 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 SIIP) 32
0 0 0 0 0
-Indus-trial(over 5 HP) 42 0 0 0 0 0
0 0 0 0 0
Ice Machine/Refrigerator Drain 1
Living Unit 16 0 0 58 928 58 928
Oil Sep(Gas Station)
6 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
5 0 0 0 0 0
-Bradley
0 0 0 0 0
-Com/Serv/Util-Food Related 3
1 0 0 0 0 0
Swimming Pool Filter
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 0 0 0 0
0
Previous EDU Count 0
0
Capped EDU Credit
TOTALS 0 0 0 0 58 928 58 928
Current Fixture Value 928 divided by 16 = 58.000 Current EDU
1 EDU= $6,085.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 928 divided by 16= 58.000 over (under) $ 352,930.00
Enter EDU Change Here 58.000 *
*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: BRANDF,N TAGGART X2449
Date: 9/19/2022
Building Division
ote: 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.
1:\Building\Sewer'rally\SewerTallySheet_6085_070121.xhsx