Permit CITY TIGARD SEWER CONNECTION PERMIT
it DEVELOPMENT SERVICES PERMIT #: SWR1999 - 00203
�= �, f �l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/14/1999
SITE ADDRESS; 14865 SW 74TH AVE * ** PARCEL: 2S112AC 01200
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 020 JURISDICTION: TIG
TENANT NAME: KNHS DEVELOPMENT INC
USA NO: FIXTURE UNITS: 156
CLASS OF WORK: ALT DWELLING UNITS: 10
TYPE OF USE: COM NO. OF BUILDINGS: 1
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Plumbing for a basis new building.
Owner: FEES
KHNS DEVELOPMENT Type By Date Amount Receipt
26262 S MERIDIAN ROAD
AURORA, OR 97002 PRMT GEO 10/14/199C, $23,000.00 99- 319075
INSP GEO 10/14/199 $45.00 99- 319075
Phone: Total $23,045.00
Contractor:
Phone: •
Reg #:
Required Inspections
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 the r- rules or ect questions to OUNC by calling (503) 246 -1987.
Issued b / Permittee Signature: /
Issu by �� ` -
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Accumulative Sewer Tally
Tenant Name: / <07-5 This SWR# /999 ' O
Addres: ,/ 4/9 : c,} tf = - This PLM #: 0
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
- JacuzziM/hiripool 4
•
Car Wash - Each Stall 6
- Drive Through 16 •
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1 ••
Eye Wash 1
Floor Drain /sink - 2 inch 2 (o Jn
- 3 inch 5
- 4 inch 6
- Car Wash Drn 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 1/•/ ..36
- Bradley 5
- Commercial 3
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
1� /0
Water Closet - Toilet 6
Urinal 6
e. i
TOTALS
Total fixture values: Pc divided by 16 = C, 7 EDU /' r .1 `
HISTORY .: • e p
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