Permit CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2003 -00317
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/7/03
SITE ADDRESS; 15757 SW 74TH AVE BLD D PARCEL: 2S112DC -01500
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 006 JURISDICTION: TIG
TENANT NAME: 74TH INDUSTRIAL PARK
USA NO: FIXTURE UNITS: 8
CLASS OF WORK: ADD DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: .5 EDU increase, previous fixtures values were 163.2, this permit adds 8 fixture units, for a new
total of 171.2 fixture units.
Owner: FEES
74TH AVENUE INDUSTRIAL PARK LL
8100 SW DURHAM RD Description Date Amount
TIGARD, OR 97224 [SWUSA] Swr Connect 8/7/03 $1,200.00
[SWUSA] Swr Connect 8/7/03 $0.00
Phone: Total $1,200.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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" Perm
// Permittee Signaur:
Issued t
iC`
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the gif xt business day
Accumulative Sewer Tally
Tenant Name: 4ith In'Sustrial Park This SWR# 2003 -00317
Site Address: 15757 SW 74th Ave This PLM# 2003 -00407
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisery/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 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
-3inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash Drr 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) 48 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 0 1 2 1 2
- 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 0 1 6 1 6
Urinal 6 0 0 0 0 # 0
Previous EDU Count 10.2 163.2 163.2
Capped EDU Credit 0
TOTALS 0 163.2 0 0 2 8 2 # 171.2
Current Fixture Value 171.2 divided by 16 = 10.7 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 163.2 divided by 16 = 10.2 Previous EDU
Change 8 divided by 16 = 0.5 over (under) $ 1,200.00
Enter EDU Change Here 0.5
HISTORY
Notes: Per Jaime, 10.2 EDU's PLM# EDU# SWR#
PLM# EDU# SWR#
PZM — — EDU# SWR#
Name: k , a , ,.f I 4 1 Date: 05_
signature of p= son that calculated this tally sheet and date perfromed is required