Permit CITY TIGARD SEWER CONNECTION PERMIT
4 DEVELOPMENT SERVICES PERMIT #: SWR98 -00120
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" '�I I 13125 SW H I Blvd., Ti • at*. OR 97223 (503) 639 -4171 DATE ISSUED: 8/23/99
•'�'' PARCEL: 2S 1'01 AA -09108
SITE ADDRESS; 1 9 SW : •
SUBDIVISION: EST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 030 JURISDICTION: TIG
TENANT NAME: BENNETT /PORTER
USA NO:
FIXTURE UNITS: 138
CLASS OF WORK: NEW ELLIN UNITS: 1
V NO. OF BUILDINGS: 0
TYPE OF USE: COM Q��
INSTALL TYPE: BUSWR IMPERV SURFACE: 0
Remarks: Sewer, this permit attached to PLM1999- 00217. Add 1 to current EDU count of 8 = 9. 6/21/99
address change NEW: 12559 PREVIOUS: 12555
Owner: FEES
BENNETT /PORTER & ASSOC Type By Date Amount Receipt
12559 SW 69TH AVE
TIGARD, OR 97223 PRMT DEB 8/23/99 $2,300.00 99- 317840
Total $2,300.00
Phone:
Contractor:
Phone:
Reg #:
Required Inspections
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 Se - ' • - • I it and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by t Oregon Utilit otification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
Yo may obtain copies • f thes les o • irect questions to OUNC by calling (503) 246 -1987.
Is ued by: ( 0 I AL_ I k ,f 1 ' L _!, ! 1 Permittee Signature:
Cali (503) 639 75 by 7:00 P.M. for an inspection needed the next business day
02T� Accumulative Sewer Tally tt,�
Tenant Name: /I This SWR# d )2 9' - a° / � -O
Address: , 4N l/1 F} This PLM #: t-M) - 00d17
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
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 / V
- Domestic . _ 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2 •
-3inch 5
- 4 inch 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
- Stall 2
Sink - Bar /Lavatory 2 3
- Bradley 5 _
- Commercial 3 / 3
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6 .
Water Closet - Toilet 6 3. /g
Urinal 6
TOTALS 106 7 .3 3 /-:-''
Total fixture values: Jag divided by 16 = ?. 3 EDU — 9 E279 S 19r7? / T 0gfw -7J
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HISTORY
PLM# X999 -cc EDU# • 7 SWR #/q99 -6o/4' ( PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# I PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
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