Permit CITY OF TIGARD PLUMBING PERMIT
1 I COMMUNITY DEVELOPMENT Permit#: PLM2022-00426
Date Issued: 8/31/2023
T I GA R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102A602100
Jurisdiction: Tigard
Site address: 12547 SW MAIN ST
Project: Ava Tigard Subdivision: AVA MIXED USE Lot: 15
Project Description: Interior plumbing for a new three-story apartment building with(22)dwelling units and retail on the first Floor.
Contractor: CALIBER PLUMBING AND MECHANICAL SERVICES Owner: AVA TIGARD DEVELOPMENT LLC
2615 NW SAINT HELENS ROAD 4770 SW HALL BLVD
PORTLAND,OR 97210 BEAVERTON, OR 97005
PHONE: 971-563-1672 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Drywell,Leach Line or Trench 03/09/2023 $18.76
Specifics: Drain
22 ea Clothes Washer 03/09/2023 $550.44
Type of Use: MF 25 ea Dishwasher 08/23/2023 $625.50
Class of Work: NEW 1 ea Ejectors/Sump 03/09/2023 $25.02
Type of Const: 25 ea Expansion Tank 03/09/2023 $312.75
Occupancy Grp: 16 ea Floor Drain/Floor Sink/Hub 08/23/2023 $400.32
Stories: P2 ea Garbage Disposal 03/09/2023 $550.44
4 ea Hose Bib 08/23/2023 $100.08
1 ea Interceptor/Grease Trap 03/09/2023 $25.02
3 ea Primer 03/09/2023 $37.53
8 ea Roof Drain(Commercial) 03/09/2023 $100.08
37 ea Sink 08/23/2023 $925.74
Y6 ea Lavatories 08/23/2023 $650.52
8 ea Tub/Shower/Shower Pan 03/09/2023 $100.08
26 ea Water Closet 08/23/2023 $650.52
25 ea Water Heater 03/09/2023 $938.00
Total $8,475.14
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
Issued By: r ( 7)0 Permittee Signature:
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.
1111101umbing Permit ApplicationRECEIVED 2- - a
Building Fixtures
City of Tigard O C T - A Received
:�= • 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: tv/t r I7Y Permit No.: �y'4 ���, r
Phone: 503.718.2434 Fax: 503.598(I�DY OF TIGARU Plan Review p� ,,., �
"ItC;naD Inspection Line: 503.639.4175 BUll_DINGD►VISION natDatexeadyi y(^�-2o22.Q,,f otherPermHt4 e Page
2 for
�Y CJe -an
Internet: www.tigard-or.gov Notified/Method:i/)'1/ ' �- - Supplemental Information
TYPE OF WORK WEelor:.t FEE* SCHEDULE
El New construction 0 Demolition For special information age checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-fanny dwellings(includes 100 ft.for each utility connection):
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building IN Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
f k JOBFORMATION AND LOCATION Site h basics:
Job site address: 1 W Main St - I :.541- S W AkGli,n 4-• Catch basin or area drain 18.76
City/State/ZIP: Tigard, OR 41 1-Z-2-3 Drywell,Ieach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg/apt.no.: I Project name:AVA se
, -71,+.aas.f Manufactured home utilities 50.03
Cross street/directions to job site: / /V/I '7 Manholes 18.76
Install plumbing for 22 dwelling units with individual r heaters. Rain drain connector 18.76
Provide water, waste, and vent stub outs in shell space for future Sanitary sewer(ne.Linear ft.: ) Page 2
, _ 1 Storm sewer(no.linear ft.: ): Page 2
connection. Ptt-AtsC _ e .I-k- Water service(no.linear ft.:_J: Page 2
Subdivision: ( T; I Lot no.: Fixture or item:
Tax map/parcel no.: lO/(ai/-i Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Iv..S -ci.M Y1v u.ki oA.c -4( 2Z 4.W-U l U Ax.k5 Clothes washer 22 25.02 550.44
(� 11 i Dishwasher 22 25.02 550-44
(,0•�4v I oV,V:s`f d9- W w'Q'L L�fS , ( tt J•A.Q.. 4.j c&y t Drinking fountain 25.02
(A 5 fel e✓A Wt. 51/4-J10 f)dc c. ... svig se acp. - Ejectors/sump 1 25.02 25.02
Cts'I PROPERTY OWNER 0 TENANT Expansion tank 22 12.51 275.22
Name: >4 V�--r.' at- �,& j-c �C Fixture/sewer cap 25.020 I Floor drain/floor sink/hub 3 25.02 75.06
Address: p_o,%Ic >L 2l3
Garbage disposal 22 25.02 850.44.
City/State/ZIP: aEy4t(`.er \L per I 012 }O - Hose bib
3 25.02 75.06
Phone:(505) 321- 3-7-1‘„ Fax:( ) Ice maker 12.51
0 APPLICANT A CONTACT PERSON Interceptor/grease trap 1 25.02 25.02
Business name: Na&" �y�t �p.A %` Z�C._. Medical gas(value:$_) Page 2
Contact name: /„wv1 &-10 42r tyurn dPrimer 3 12.51 '7.53
ll t� - Roof drain(commercial) 12.51
Address: t.�-c�O v'J &&\ %�JG1,�
Sink/basin/lavatory 47 25.02 1175.94
City/State/ZIP: B,ed,V,e()to t D 12 Ct'-OQ 5 Solar units(potable water) 62.54
Phone:(,593) g-60 4 33S Fax::( ) Tub/shower/shower pan 22 I2.51 275.22
E-mail:(,e,w,tf S CZ LW 0.�(O Qcu .�v0... Co Urinal 25.02
- Water closet 22 25.02 550.44
CONTRACTOR -
g Water heater 37.52 862.96i
Business name: / ' ,� I ,�
'`-r+A*1t��,1 .'s3"k.�.J) �,-.-. ... -� Waterp�nS��'o' 2330 56.29
Address: ( - /1. - Other: 25.02
City/State/ZIP: c- g44..
� C //!, t f Sab1Mal
Phone:,. C-�^'� - .i`]!�/, .tT,..5 7_1� Fax:( ) Minimum permit fee: $72.50. S*-02.. ',.
b lf/ n,-, `, Plan review (25%of permit fee) I t Z
CCB Lie.: `- t aa�?„. Plumbing Lic.no.'
-EJv ICJ Statesurcharge(12%.ofpermetfee) 6
Authorized signature: TOTAL PERMIT FEE
Print name: This permit application expires if a per®it is nut obtahted
Date:
�^� �'�2'��� aker it beem ateepfed as eompleCe
�t *Fee methodology set by Tn-County nuilding Indu
L1Buading�Permils�PLMU-PemvtApp.doc ID101/09 440-4416T(10/O2/COM/WEB)
I
1
RECEIVED
iflumbing Permit Application - City of Tigard o c T - 6 2(:
Page 2 - Supplemental Information k.;ITy OF TIGARD
BUILDING DIVIS I
Fee Schedule: Residentialre Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr ' $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font 0 Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower 22 engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure
Drive tallThr as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial CI Any multipurpose fire sprinkler system.
-Domestic 22 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3 Isometric or Riser Diagram
-4" ❑ Isometric or riser diagram is required for new buildings
Car Wash Drain Garbage -Domestic non-food 22 that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mack/Rettig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non-food related 44
-Bradley
-Com/Serv/Util food related
-Service 3 *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes 22 fees assessed for the sewer increase must be paid befor
Water Extractor
Water Closet-Toilet 22 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
-lialumbin2 Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received /
Date/By: f ' /�-j�- PermitNo.: (" 00'12 j)
• 13125 SW Hall Blvd.,Tigard,OR 97223 �� 'i I P�1 '1b�2
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /i-2 2-a02 2sC Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: fur;:: See Page_tract
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
1W New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
❑ Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
ElAccessory building AT Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12 5-j q S,W, fvl 0.r 14 St, Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/zIP: r;p,,i, OR (112`Z3 l8.�6
t Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: pod A M i x ea L.L.Se. Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.:
Fixture or Item:
Tax map/parcel no.: Backflow reverter 31.27
931 Cl4Q 024(0 preventer
OF WORK Backwater valve 12.51
Clothes washer )1. 25.02 5 co,tfy
J-Vi,t'cYi UY 6
r`�0 r V'1, Dishwasher 1` �� 25.02 c5-0.r.fcr
Drinking fountain 25.02
Ejectors/sump ,_F / 25.02 25j,U2
0 PROPERTY OWNER 0 TENANT Expansion tank ., .25 12.51 312,75
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub , . 3 25.02 175,06,
Garbage disposal r ». 25.02 S545 yy
City/State/ZIP: Hose bib f-/ 3 25.02 13 06
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 1 25.02 a5.02.
Business name: Medical gas(value:$_) Page 2
Contact name: Primer 3 12.51 37,53
Roof drain(commercial) 8 12.51 /CIt,o
Address:
Sink/basin/lavatory 3 25.02 05,74
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 0 V' 2 a. 12.51 `.2`!5, 22
E-mail: Urinal 25.02
CONTRACTOR Water closet ,/ 4-If ..22 25.02 556,yy
Water heater .; a 5 37.52 938 o0
Business name:
Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal sa t;o,to
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.:
Plan review (25%of permit fee) OK,0 5
State surcharge(12%of permit fee) 634 22
Authorized signature: TOTAL PERMIT FEE 7a 06,y7
Print name: Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Pee methodology set by Tri-County Building Industry Service Board.
(,au: 2(�
I:\Building\PermitsTLMU-PermitApp.doc 10/01/09 440-0616T(10102/CObpWEB)
50444=)0 '2'
Plumbing Permit Application - City of Tigard n
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems: _
Site Utilities Qty. Fee(ea) Total „Square Footage: Permit Fee: _
Footing drain-1°' 100' 50.03 0 to 2,000 $121.90 1
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-I st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional S100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first S25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up S742.00 for the first$50,000.00 and$1.20 for
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower D, engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
-Domestic Qa 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3„ 3 Isometric or Riser Diagram
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food 2 2
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -lav/Bar non-food related L/z/
-Bradley
-Com/Serv/Util food related
_ -Service 3 *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes as fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet D2 plumbing permit can be issued.
Urinal
Other Fixtures:
1:1Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
bingPermit Application
wilding Fixtures 1 h FOR OFFICE USE ONLY
'' City of Tigard
Rece I;pI
d q 1q
,. • 13125 SW Hall Blvd.,Tigard,OR 97223 Date/i : W l t I(}r - Penn No �1 rl`o(�LC_ 42 6
Phone: 503.7182439 Fax: 503.598.1960 an I;view `
slit
`T I G A R D 11
Inspection Line: 503.639.4175 / I ��,, ate ,: I/-1 Q-Zp Z 2 �4�Jr� Other Permit No.P .2 11 e��
Internet: www.tigard-or.gov V V\ f tare !'-adyBy: lurir. S See P%ental Itif`r
oh ��_ ethod: Supplemental Information
TYOF `th
RI New construction
❑Demolition 11111k, For special information use checklist~`�
Description I '' �'
I Total
❑Addition/alteration/replacement 0 Other:
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRU ,'. SFR(I)bath 312.70
❑ I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building J$Multi-family SFR(3)bath 500.32
❑Master builder - Each additional bath/kitchen 25.02
❑Other:
Fire sprinkler(_sq.ft.) Page 2
SITE INFORM, Site utilities:
Job site address: 12$L r1 S,W, fh Q i vt S 4-• Catch basic or area drain 18.76
City/State/ZIP: a tk i O R 99 223 Drywell,leach line,or trench drain r� f 18.76 /g 76 ✓
Ti ct
/ Footing drain(no.linear ft.: ) Page 2
Suite/bldg.Iapt.no.: I Project name: P V A N i) le 1 _se_
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: Lot no.:
Fixture or Item:
Tax map/parcel no.: �j 01,40 OD Backflow preventer 31.27
Y DESCRIPTION OF WORK i Backwater valve 12.51
„tom Clothes washer
.14-k-e.r;cY Dishwasher ) * A .?‹ 25.02
O Drinking fountain R SSaYy
c�,^ 25.02
Ejectors/sump oil- ) 25.02 25,02
.❑-PROPERTY OWNER 0 TENANT Expansion tank ylt 2.5 12.51 312.7S '..---
Name: Fixture/sewer cap 25.02
Address: Floor drai(floor sink/hub (lam F 19 25.02 f7,5,06
City/State/ZIP: Garbage disposal 014 125.02 556,yer.r .-
Hose bib (-0 -ri-/ 25.02 75, b ..---
Phone:( ) Fax:( ) Ice maker 12.51
IIIIIIIIIIMKICANT ❑ CONTACT PERSON Interceptor/grease 11a
__ P Gk / 25.02 25.02/'
Business name: Medical gas(value:$_) Page 2
Contact name: Primer 0q 12.51 37,S3
Roof drain(commercial) d' 8 12.51 /AJp.c Address:
f►Sink/basin/lavatory 63 lic 25.02 /195,7y.."--
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan pk 2 a 12.51 `�95, 22 /
E-mail: ' Urinal 25.02
CONTRACTOR Water closet bl ::/-y 5
„a2 25.02 50,yy
Business name:
Water heater D K 25 37.52 (438,00 -
Water piping/DWV 56.29
Address:
Other: 25.02
City/State/ZIP: Subtotal 5, io,l o-''
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee) (5 t 4 5
CCB Lie.: Plumbing Lic.no.:
State surcharge(12%of it ) h
Authorized signature: pem 63�2
TOTAL PERM FEE 72 o 6.92.9
This permit application expires if a permit is not obtained within 190 days
Print name: Date:
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:IBuildieg'Pe,mits\PLMU-PermisApp.doc 10/01/09 440-4616T(10/02/COM/WEB) L4U 16
y Sister( 37
Accumulative Sewer Tally
111 C • Tenant Name: AVA TIGARD SWR# 2022-00230
Site Address: 12547 SW MAIN STREET PLM# 2022-00426
I IGARD
Parcel#: 2S102AB02100
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 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 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 22 352 22 352
Oil Sep(Gas Station) 6 0 c , 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 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 2 32
TOTALS 0 0 0 0 22 352 22 320
Current Fixture Value 320 divided by 16= 20.000 Current EDU 1 EDU= $6,625.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 320 divided by 16= 20.000 over (under) $ 132,500.00
Enter EDU Change Here 20.000 *
*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: (2)EDU'S OF DEMO CREDITS APPLIED FROM BUP2017-00217.
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 11/28/2022
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:\Budding\Sewer Tally\SewcrTalySheet_6625_070122.xlsx