Permit CITY OF TIGARD BUILDING PERMIT
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DEVELOPMENT BUILDING
SWR2022-00231
Date Issued: 12/7/2022
T t GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109ACO2500
Jurisdiction: Tigard
Site address: 13001 SW BULL MOUNTAIN RD
Project: City of Tigard-ASR#3 Subdivision: 2000-086 PARTITION PLAT Lot: 2
Project Description: 2.190 EDU addition
Contractor: Owner: TIGARD, CITY OF
13125 SW HALL BLVD
TIGARD, OR 97223
PHONE: PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: Sewer Connection Fee 12/05/2022 $14,508.75
Class of Work: Type of Const: Sewer Inspection-Commercial 12/05/2022 $45.00
Occupancy Grp: Occupancy Load:
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value:
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $14,553.75
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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
wit 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 OAR952-001-0090. You may obtfain a copy of the rules or direct questions to OUNC by ca ' g 5 .232.1987 or 1.800.332.2344.
. /
Issued By
: r f,.- / ,. y. -t ✓_ Permittee Signature: _ �& .,.1 (—
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.
IIIAccumulative Sewer Tally
II " Tenant Name: Tigard ASR#3 SWR#k R2022-00231
Site Address: 13001 SW Bull Mnt Road PLM#71-1422022-00472
T IGARD
Parcel#: 2S109ACO2500
Fixture 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 1 1 1 1
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 4 20 4 20
-4 inch 6 0 0 2 12 2 12
-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 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 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 8 35 8 35
Current Fixture Value 35 divided by 16= 2.188 Current EDU 1 EDU = $6,625.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 35 divided by 16= 2.188 over (under) $ 14,508.75
Enter EDU Change Here 2.190
*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.ol.
Notes: �,,,� ����/J
Authorized Name/Signature: i ""'t " 1 (1SO L(- ` Date:"' 11
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:\Building\Sewer Tally\SewerTallySheet_6625_070122.xlsx