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Permit _„ CITY OF TIGARD f. PLUMBING PERMIT COMMUNITY DEVELOPMENT Wx 5-A Permit #: PLM2010 00198 TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 D ate Issued: 06/16/2010 Parcel: 2S 102AA01100 Jurisdiction: Tigard Site address: 12035 SW PACIFIC HWY A Project: Tigard Auto Stop - Spec Space Subdivision: Lot: 0 Project Description: 50' of new water service. 8/10/10 adding 3 relocated fixtures: (1) sink, (1) water closet and (1) water heater. 1/25/11, reprinted to correct project name. Contractor: BEAVERTON PLUMBING INC Owner: TIGARD AUTO STOP PARTNERS 13980 SW TV HWY 2829 RUCKER AVE STE #100 BEAVERTON, OR 97005 EVERETT, WA 98201 PHONE: 503 - 643 -7619 PHONE: 503 - 796 -2887 FAX: 503 - 643 -7620 FEES Quantity Description Date Amount 50 If Water Service 06/16/2010 $62.54 Specifics: 1 12% State Surcharge - 06/16/2010 $8.70 Plumbing Type of Use: COM 10 ea Minimum Fee Adjustment - 06/16/2010 $9.96 Plumbing Class of Work: ALT 88 Plumbing Permit 08/10/2010 $87.56 Type of Const: 11 12% State Surcharge 08/10/2010 $10.51 Occupancy Grp: Stories: Total $179.27 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 • • I ication ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or di—ct questions to O • by - ling 503.232.1987 or 1.800.332.2344. • Is- ued By: / ! , Permittee Sig 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. CITY OF TIGARD PLUMBING PERMIT .1111 . COMMUNITY DEVELOPMENT Permit #: PLM2010 -00198 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2010 T f G;1 R C� 9 Parcel: 2S102AA01100 Jurisdiction: Tigard Site address: 12035 SW PACIFIC HWY A Subdivision: Lot: 0 Project: Tigard Auto Stop Project Description: 50' of new water service. Electrical permit may be required if replacement piping affects house grounding. 8/10/10 added (1) sink, (1) water closet and (1) water heater. Owner: / FEES TIGARD AUTO STOP PARTNERS Quantity Description Date Amount 2829 RUCKER AVE STE #100 EVERETT, WA 98201 50 If Water Service 06/16/2010 $62.54 1 12% State Surcharge - 06/16/2010 $8.70 PHONE: 503 - 796 -2887 Plumbing 10 ea Minimum Fee Adjustment - 06/16/2010 $9.96 Contractor: Plumbing BEAVERTON PLUMBING INC 88 da Plumbing Permit 08/10/2010 $87.56 11 da 12% State Surcharge 08/10/2010 $10.51 13980 SW TV HWY BEAVERTON, OR 97005 PHONE: 503 - 643 -7619 FAX: 503 -643 -7620 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $179.27 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: . Perrnittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. IN t CITY OF TIGARD PLUMBING PERMIT 2 :'. COMMUNITY DEVELOPMENT Permit #: PLM2010 -00198 TIGR AD% 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2010 Parcel: 2S102AA01100 Jurisdiction: Tigard Site address: 12035 SW PACIFIC HWY A Subdivision: Lot: 0 Project: Tigard Auto Stop Project Description: 50' of new water service Owner: FEES TIGARD AUTO STOP PARTNERS Quantity Description Date Amount 2829 RUCKER AVE STE #100 EVERETT, WA 98201 50 If Water Service 06/16/2010 $62.54 PHONE: 503 796 -2887 1 12% State Surcharge - 06/16/2010 $8.70 Plumbing 10 ea Minimum Fee Adjustment - 06/16/2010 $9.96 Contractor: Plumbing BEAVERTON PLUMBING INC 13980 SW TV HWY BEAVERTON, OR 97005 PHONE: 503 - 643 -7619 FAX: 503 - 643 -7620 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. / Issued By: ® Permittee Signature: l _ %/ / Oit/ mz ( #. / Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. Jun 11 2010 10:09AM BEAVERTON PLUMBING INC. 5036437620 page 2 Plumbing Permit Application Site. Utilities p � � ' � . n,, .... fx a +g d 3` i l ti l w() \ I .EA� vt krK ' i 'k` City of Tigard i f ,.. ^ s� Rece 4. _ Permit Na� .� / a�� -di i Date/By: / : i *' 13125 SW Hall Blvd., Tigard, OR 972 4 1 0 Plan Review • f 0 Phone: 503.639.4171 Fax: 503.598.1 ' . 0 A` '1 , . .v Date/By: Other Permit Ng��Jtl /O W/25 t ,; / Inspection Line: 503.639.4175 J t? , Date Ready/By: 1 13 See Page 2 for Internet www.tigard- ar.gov `� otdtM ethod: • , Su , . mental Wormation r. 't, '* ��`l. �Ss ,�-m •; s i+frrd6 jc�.,;�{,'4ra ay-4 �.'t.rs��•�',�# r : ti. K' �" i�r sey.�fy�t¢tL.s 8y. +��tl•y 'a, f'r F ] . 5 I' }L t �r r t v y S +k I a rI .i ' a�t r } G q a. r IR. .7ws ��.��i�k. °�� ` " 1 1 ti ' i�. r�,Rf,✓�'da'� uL_x..�i:L..tt. .a�. f::Ca, rY .- , ,� � £ . ' .I �61,r1. � . t �,..r.�. �S. Jn.�.=)A.tr� }� s�� .. �j�+''' ti ❑ New cod . b uction ❑ De .. � ' ♦ n For special irl ornmrion use checklist , Description 1 Qty. 1 Ea J Total ® Addition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft for each utility connection) .k 1 , t•_ r t }.. �, waxy 4 7 4 = si a- i, C l `r' . tiv E�> `/. Via- SFR (1) bath 312.70 ❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 437.78 ❑ Accessory building SFR (3) bath 500.32 ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_ sq• ft.) Page 2 3 w� 7 .�a �4Fttaq rflR'Fr[S'ikA. J t ,.. ' .1 , .t �L. , i {.. = se • L t ' . ....- '! K W ; a3 tad - , 9 + f ib-..." t s ,. �. i2.,ime.. -...0 ... 4 ., ,Site Ut�lltlea; Job site address: 12035 SW Pacific Hwy Catch basin or area drain 18.76 City/State /ZIP: Tiga , I r egon 97223 13rYpell, leach line, or trend] drain 18.76 �/ Footing drain (no, linear ft.: ) Page 2 Suite/bldg. /apt. n+ . / A 1 Project name: Tigard Auto S tp Manufactured home utilities 50.03 Cross street/diregt'ons to job site: Manholes 18.76 Ram drain connector 18.76 Sanitary sewer (no linear ft: _) Page 2 Storm sewer (no. linear &.: _____) Page 2 Water service (no. linear ft.: S) Page 2 62.54 Subdivision: I Lot no.: Fixture or item: Tax )nap /parcel nn.: Backflow prevenmer 31.27 a , 1 ,iti'e y`��~ sa :� :'<�• (ltm�'a'.' � _ Y� + at,;'. Backwater valve 12.51 A t a O - t r, d t ]:1:.k31 ,,, ' L� /`o s a I Y .. .��:� a�. t~�. � � . ,7 - ss4J1.9 )53.���+• axcr� AyfS��.L.} wti'�.ti�� �fiw"'v �{ V:^ .w ak� \ _ Clothes washer 25.02 Bore a new 1" water service Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 . e set s yi -,110 a ..tt w . . q r � 4 Oe� rf .r14. ^k4,'; is 'C e:td ) �1, ' '' ' li ' t �,,, s ; , x,' s Expansion tank 12.51 Name: Tigard Auto Shop Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12035 SW Pacific Hwy Bldg. B Garbage disposal 25.02 City /State/Z1P: Tigard, Oregon 97223 Hosc bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 7 ` `sz''�t'`G `∎ i o 's , Y °ty f� °'v n 7+ `rt�' G i } ,p-mr ' 1r :.` ' ,, v,,„ Interceptor /grease trap Business name: Beaverton Plumbing, Inc Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Casey Stephens Roof drain (commercial) 12.51 Address: 13980 SW Tualatin Valley Hwy Sink/basin/lavatory 25.02 City/State/Z1P: Beaverton, Oregon 97005 Solar units (potable water) 62.54 Phone: (503) 643.7619 Fax:: (503) 643.7620 Tub /shower /shower pan 12.51 E -mail: Sue®beavertonplumbing.com Urinal 25.02 a Water closet 25.02 a a. }' r r, z1gg n p- a. it )Y ' n;�{. "1 if iii �q �.�� � 0 y .. .p `•' j §� w. &31L+ >r- ^° r"k'.,.0 + ., ,rr -`�d'" of 5. - -. • * ' 'Water heater 37.52 Business name: Beaverton Plumbing, Inc Water piping/DWV 56.29 Address: 13980 SW Tualatin Valley Hwy Other: _ 25.02 City/State/ZIP: Beaverton, Oregon 97005 Subtotal 62.54 Phone: (503) 643.7619 / Fax: (503) 643.7620 Minimum permit fee: $72.50 _ 72.50 - , Lic.: 012889 Y Plumbing Lic, no.: 34-4PB V Plan review (25% of permit fee) ,� ,� � • ,,� State surcharge (129'0 of permit fbe) 8.70 Authorized signature: `. `�.1 -io(1 TOTAL PERMIT FEE 81.20 Print name: Susan Dean Date: 6/11/2010 this permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. "Fee methodology, set by Tri- County Building Industry Service Beard. l:£swldingU'ennitiaL u- PerattApp.doc 10/0 440.46161(10/02/COM/WEB) Aug 10 2010 6:23AM BEAVERTON PLUMBING INC. 5036437620 page 1 Plumbing Permit AnDlication _ y a j , ,,, ,�1FIIl�•I,IIri ✓BtaC.D Building Fixtures ��� c,,-.,,I, a Ink art IN t 1,1 0.1‘ SW Hall Blvd., Tigard, OR 972 Ci of Ti d \ t \ � 25 lB 2 ) \ NJ t ateJBy: w'' 1 iv p" ' No.: PIM2010-00198 r 131 Phone: 503.639.4171 Fax: 503,598.1 *. '3 'c\'‘'\= � , y p,b • , ,,;, i Inspection n Line: 503.639.4175 r ` c t c . �tLl • Roa A.1. BI see Page 2 for tG :15x: 1i. f i} 1 f l lr ii.11 :`i ti I 4ti ., tl ,3Y', h ' F S ' #i " i is ( \4 rfir I 4 / ; I I :',',',1.i.,' .i1lii. „3z.. . %': - J,...i 1 .1 i,^Z.1ur::i :' ,GJ.y,.' ::) k ,.iti:l 1.:�5 . ::�4j..: ,SUG 1�( f... .. 4,1 FL_. :;.:'11_1 i .2 _,: I 4f ❑ New construction ❑ DemolitioPj‘ For apecfallnjan>,agon use checklist Description 1 Qty. 1 Ea. l Total ® Addition/alteration/replace rent ❑ Other New 1-2-family dwellings (includes 100 ft. for each utility connection) s r .:., , 18. 2.. y f . i:,:i � . , . � 1 . . ' 7� ., ?�� . - iu :.= 3FR (1) bath 312,70 1 E.: . .1 S..i_, * . ..s,,, iiLt 1? ,.<..s: i,:„L;tcL ti ,._;. i� .r ti ❑ 1- and 2- family dwelling 181 Commercial/Industrial SFR (2) bath 437.78 - ❑ Accessory building ❑ Multi- family SFR (3) bath 500.32 ❑ Master builder Each additional bathlkitchen 25,02 ; R i (C - i F S i K. t i ❑ O i L :1'''.'''. r ` Fare sprinkler (_- s1• L) Page 2 I . L iitr..' . 26....E ..:' i, .::,. ,1.. - ..___� ,: ,.._ . ...„,.. 1 ! ::61; r_.1. r .: � .1g aff.1i,4:,f, ..... ,.1. Site ut<title& Job site address: 12035 SW PACIFIC HWY Catch basin or area drain 18.76 City/State/ZIP: TIGARD, OREGON 97223 Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: _J Page 2 Suite/bldg. /apt. no.: B 1 Project name: TIGARD AUTO STOP home utilities _ 50.03 Cross sweet/directions to job site: Manholes 18.76 _ Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: _j Page 2 Water service (no. linear 11: _j Page 2 Subdivision: I Lot no.: Fixture or item: Tax num/parcel no,: Backflow preventer 31.27 .:0,,,, w i h ' Backwater valve 12.51 ge:cti,a i .._t.._i .tia . :,...C.__.a,. :i,i..0 . .,: ::., �, __ ,,. �. .,,.... J..is.r'a . :t. c... .. ,.,_ril,..�. :. ., Clothes washe t 25.02 ADD TO EXISTING PERMIT 3 FIXTURES A u_ �,r� j 5 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 1 Y 1 10 . ' i i .� 5 1 a .W 1 . I i � 2�.nt I * � I i� b, E xpffils 1011 tank 12.51 ��st�a..�c ._.__.' tf 1.11 : 1.111. .. ..:.2 e ... ..ILn.,flais3zG , .."�a��. ,�i ,.. ....�� nf. 1 S�.ra....�_,'- :'.. _ Name: TIGARD AUTO STOPS PARTNERS Fixhmrc/sewer cap 25.02 Address: 2829 RUCIu3;R AVE„ STE #100 Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City /State/ZtP: EVERETT, WA 98201 Hose bib 25.02 Phone: (503)796.2887 Fax ( ) Ice maker 12.51 r ; n.I. 'in 1.:11.. It ,; f s .r x",11 t,, r r 3 . ' . ,, }r Interceptor/grease ,per '��� . .. _t.,... _.._L... i �n;: ate+.' it.` at, . r._:. cL^ .1,. ..._.3..: _. ��....f,�: ""Y 25.02 Business name: BEAVERTON PLUMBING, INC Medical gas (value: $ ) p 2 Contact name: CASEY STEPHENS Pruner 12.51 Roof drain (oonunercial) 12.51 Address: 13980 SW TUALATIN VALLEY HWY Sinkl 1 25.02 25.02 City/State/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62.54 Phone: (503) 643.7619 + Fax:: (503) 643.7620 Tub/shower/shower pan 12.51 E -mail: Urinal 25.02 l_ rie,�r[ t � i i to r` c ,4, 1L i ii J r rr W „ 1 i r. Water claret g<...� t �i., .�..a.i 4,,,a:.` . A : t .,:c1 . ...i.� �.. �.:..1,. "SY � r 1'+ 1s 11 . :Azt � i, v tYda Lea � lt, . .P Water heat„ 37.5 I 25.02 / 1 25.02 37.52 2 Business name: BEAVERTON PLUMBING, INC Water piping/DWV 56.29 Address: 13980 SW TUALATIN VALLEY HWY Other, 25.02 City/State/ZIP: BEAVERTON, OREGON 97005 Subtotal 87.56 _ Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.50 CCB Lic.: 12889 Plumbing Lic. no.: 34-4PB Plan review (25% of permit fee) i. lve V. .J State surcharge (12•% of permit fro) 10.51 Authorized signature: TOTAL PERMIT FEE 98.07 Print name: SUSAN DEAN Date: 8/9/2010 permit application eapires Ira per:ab is not obtained withla 180 days after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board 1:1BuildnpPe miuIPLMU- PerndtApp.doc ]0/01)09 440461611(Io /coM/WEa) 45 SO'N OC41%) Jun 11 2010 10:09AM BEAVERTON PLUMBING INC. 5036437620 page 3 Plumbiiw Permit Annlication - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su a . ression S stems: • - v f i a r w I ..` " �A , t • �. »G? , J ri't ., �::[ :l.u.<...st. 4,1,41trii . la, 't il " 3 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 Sewer - 1st 100' 62.54 3,601 to 7,200 $233.20 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 1 62.54 62.54 Medical Gas S steins: Water Service - each additional 100' 37.52 , ' > r s Storm & Rain Drain -let 100' 62.54 a, e +_�` + #�b „?��' $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to 810,000.00 $72.50 for the fast $5,000.00 and $1.52 for -ro "�,�� : *t + f' t x each additional $100.00 or fraction thereof, to '�" 141} 'i,t" `lr M 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 8100.00 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 8379.50 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 5100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", a «` ,tit +�6 please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees*. Please check all that apply. ? Qttaadtl by fFiatitre)Worlc BMfdtinted:'r ❑ Any new commercial building with water service 2" liUttlrelYPet:, greater, except systems designed and stamped by licensed P . , - . Pravio,u :,, 'faltoid Added F.iilitin! engineer. Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure Bath - Tub /Shower as defined in OAR918- 780 -0040. -Jacuzzi/Whirlpool ❑ Medical gas and vacuum systems for health care facilities. Car Wash -Each Stall -Drive Thru ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher -Commercial -Domestic Submit 2 sets of plans with any of the above. Drinking Fountain z4 77,��, ,.i °,;... . s . P.t. " ' a �k?t d�� 3i" Eye Wash ' : � �#Jill� $t ' ± r + Floor Drain/sink - 2" 0 Isometric or riser diagram is required for new buildings that meet the qualifications above. Car Wash Drain Garbage - Domestic Disposal - Commercial - Industrial - Comments regarding fixture work: Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *Note: If the fixture work under this permit results in an -Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be paid before the Washer - Clothes Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: http : / /www.tigard- or.gov /city_hal Udepartments /c d/docs/PL MU- PermitAp2doc Accumulative Sewer Tally Parcel # 2S102AA01100 Tenant Name: TIGARD AUTO STOP ** *VOIDED * ** This SWR# SWR2010 00105* *VOIDED ** Site Address: 12035 SW PACIFIC HWY A This PLM# PLM2010 - 00198 fixture Value Previous Previous Credits Capped Fixture Fixture New Ncw # value capped off value added added total total count off #s count # value #s values Baptistry/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 Drn 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 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 - Bar /Lavatory 2 0 1 2 1 2 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - Service 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 1 6 1 6 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 2 8 2 8 0 0 Current Fixture Value 0 divided by 16 = 0.0 Current EDU 1 EDU = $ 4,100 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 0 divided by 16 = 0.0 over (under) $ - Enter EDU Change Here 0 Notes: * *VOIDED ** Fixtures ended up being relocates and not new installs. Deb 9/15/10 Authorized Name /Signature: BRANDEN TAGGART X2449 Date: 8/11 /2010 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. l: \ Building \ Sewer Tally \Sewer I'allyShcct- 3600.xls 06/25/08