Permit CITY OF TIGARD f`' SEWER CONNECTION PERMIT
ail COMMUNITY DEVELOPMENT �� Permit #: SWR2010 00029
T I W, A g D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/03/2010
Parcel: 25101 DC04000
Jurisdiction: Tigard
Site address: 7550 SW TECH CENTER DR 220
Project: Cochran Subdivision: Lot: 0
Project Description: 1.8 EDU increase. 2/3/11, reprinted to correct suite number from 250 to 220.
Contractor: Owner: WALTON CWOR SOUTHRIDGE 12 LLC
BY TTA/EPROPERTYTAX DEPT 325
PO BOX 4900
SCOTTSDALE, AZ 85261
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/03/2010 $6,480.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1.8
Total $6,480.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if
work is suspende more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. Tho rules are et forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions
to OUNC b ailing 503.232.1 r 1. 0 . 32.2344.
Issued By: k $ 1 . 4 � Permittee Sig + 1 , i11 i�, —�
Call 503.639.4175 by 7:00 a.m. for the next available inspec io l �.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2010-00029
. e 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
Parcel: 2S101 DC04000
Jurisdiction: Tigard
Site address: 7550 SW TECH CENTER DR 250
Subdivision: Lot: 0
Project: Cochran
Project Description: 1.8 EDU increase.
Owner: FEES
WALTON CWOR SOUTHRIDGE 12 LLC Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX Sewer Connection Fee 03/0312010 $6,480.00
4900
PHONE:
Contractor:
PHONE:
FAX:
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1.8
Total $6,480.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Accumulative Sewer Tally Parcel # 2s101 DC04000
Tenant Name: Cochran This SWR# 2010-00029
Site Address: 7550 Tech Center Dr 250 This PLM# 2010-00061
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
Ba tisc /Font 4 0 0 0 0 0
Bath -Tub/Shower 4 0 0 0 0 0
acuzzi/Whirl ool 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 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 1 2 1 2
3 inch 5 0 0 0 0 0
4 inch 6 0 0 0 0 0
Car Wash Drn 6 0 0 0 0 0
Garbage Disposal
Domestic to 3/4 1-111) 16 0 0 0 0 0
Commercial to 5 1-IP 32 0 0 0 0 0
Industrial over 5 1111- 42 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 - Gan (per head 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar/Lavatory 2 0 0 3 6 3 6
Bradley 5 0 0 0 0 0
Commercial 3 0 0 0 0 0
Service 3 0 0 1 3 1 3
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 2 12 2 12
Urinal 6 0 0 1 6 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
"TOTALS 0 0 0 0 8 29 8 29
Current Fixture Value 29 divided by 16 = 1.8 Current IDU 1 EDU = S 3,600
Previous Fixture Value 0 divided by 16 = 0.0 Previous 1DU
Change 29 divided by 16 = 1.8 over (under) S 6,480.00
Enter EDU Change Here 1.8
Notes:
Authorized Name/Signature: Loraine Sellers Date: 3/3/2010
Building Division
ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
r bmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\Buildinx\Sewer'l'ally\Sewerl'allyShect-3600.x18 06/25/08