Permit CITY TI GARD SEWER CONNECTION PERMIT
A. . /8 DEVELOPMENT SERVICES PERMIT #: SWR2001 -00131
Al f I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/26/01
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SITE ADDRESS; 14865 SW 74TH AVE 270 PARCEL: 2S112AC 01200
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 020 JURISDICTION: TIG
TENANT NAME: WEST HILLS CATERING COMPANY
USA NO: FIXTURE UNITS: 15
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Previous fixture values were 156 units, 15 fixture units were added for an increase of .7 EDU's.
Owner: FEES
KNHS DEVELOPMENT CO Type By Date Amount Receipt
26262 S MERIDIAN RD
AURORA, OR 97002 PRMT CTR 3/26/01 $1,610.00 27200100000
Total $1,610.00
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 Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by th ,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 calling (503) 246 -1987.
Iss d by f.,44 , Permittee Signature: )( h/72
Call (503) -: 9 -4175 by 7:00 P.M. for an inspection needed the next busines day
Accumulative Sewer Tally
Tenant Name: � S ' /4-c.S 04--7-/A/cc oPa bG / co . This SWR# �/ — 3
Address: 1 yd'4 s'd y %"d& 4e" 0270 This PLM #: c 9c,/ - (,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
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6 .
- Drive Through 16
Cuspidor/Water Aspirator 1 _ //
Dishwasher . Commercial 4 -- / `7
- Domestic 2
Drinking Fountain 1 _
Eye Wash 1 _ / 2
Floor Drain /sink - 2 inch 2 ✓ >
-3inch 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
- Bradley 5 _
- Commercial 3 `/ 0
- Service • 3 / 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6 -
Water Closet Toilet 6 .
Urinal 6
• /S� / /71
TOTALS
• �'4 EDU /, C A'�l �t.�1�, 7 � TjG(S
Total fixture values: / V divided by 16 = / / ((//
HISTORY - 70 ; = o f 6 /oie°
PLM# /pw-Do3/7 EDU# 70, SWR# /9i7- 2o3 PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# . EDU# SWR#
is \dsts\swrtaly.doc
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