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Permit
CITY TIGARD SEWER CONNECTION PERMIT A DEVELOPMENT SERVICES PERMIT #: SWR1999 -00172 ' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/12/99 SITE ADDRESS; 12447 SW 69TH AVE PARCEL: 2S101AA -TTOOC SUBDIVISION: TIGARD TRIANGLE OFFICE COMPLEX ZONING: MUE BLOCK: LOT: OOC JURISDICTION: TIG TENANT NAME: TIGARD CORPORATE CENTER USA NO: FIXTURE UNITS: 106 CLASS OF WORK: NEW DWELLING UNITS: 7 TYPE OF USE: COM NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer permit - shell Owner: FEES TIGARD CORPORATE CENTER LP Type By Date Amount Receipt 15400 SW MILLIKAN WAY BEAVERTON, OR 97 PRMT BON 8/12/99 $16,100.00 99- 317596 INSP BON 8/12/99 $45.00 99- 317596 Phone: Total $16,145.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection ORIGINAL This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by callin • ! 46 -1987. 1 Issued by: � ✓ ��L /lQ� Permittee Sign • • Call (503) 639 -4175 by 7:00 P.M. for an inspection needed • : next business day lA {-� ,� Accumulative Sewer Tally Tenant Name: 1 ►/, X A CerP )4 -- �pw g Address:. This SWR #_�A � 0 ©t 7l . ,- Z I-( 7 O joC�''`' This PLM #: (Gt' `l - ' -1 . 1 W � Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added # added #s total Count off #s count value values Baptistry/Font 4 Bath - Tub /Shower 4 - Jacuui/VVhirlpool 4 , Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commercial 4 , - Domestic 2 / n Drinking Fountain 1 ✓a, o`er /..._ 7.— Eye Wash 1 Floor Drain/sink - 2 inch 2 v' ' - / c< L - 3 inch 5 -flinch 6 , -Car Wash Dm 6 . Garbage Disposal 16 - Domestic (to 3/4 HP). - Commercial (to 5 HP) 32 , - Industrial (over 5 HP) 48 Ice Machine/Refrigerator Drains 1 Oil Sep (Gas Station) 6 , Rec. Vehicle Dump Station 16 Shower - Gang (Per Head) . 1 Vo a Z Z - Stall - 2 Sink - Bar/Lavatory 2 ✓g ` / (I % / CP - Bradley 5 - Commercial 3 /9_, L - Service 3 Swimming Pool Filter 1 Washer - Clothes 6 Water Extractor 6 Water Closet - Toilet 6 14 6 4 6 ` 0 Co D Urinal 6 I . c- r ) A 2 t 1_ O 10(v 30 M TOTALS - Total fixture values: 1 b & divided by 16 = ( /� ill77 EDU . — 7 '5 1 EbU -$2 00 °a HISTORY PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# i:Ndsts .swrtaiy.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ` BUP Date Requested �' le7 //0( AM PM BLD Location /a `1 7 5a) Cv ? Suite MEC //�� Q I cy ` Contact Person �('r �C1-C �ttr- Ph 57 - ag l (o PLM Contractor Ph SWR fR Q41- 6173/7 BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: / ,L Slab / �► SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler .. / O 1,i 6. z:77 Fire Alarm Susp'd Ceiling Roof Misc: Final /, / PASS PART FAIL v(/ PLUMBING Post & Beam Una - fo.oI . Sanitary Sewer Rain Drains Final PASS - FAIL MECH AL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA I 11t Approach /Sidewalk Date 1 � I �� Ins Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.