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Permit • C ITY OF TIGARD SEWER CONNECTION PERMIT , DEVELOPMENT SERVICES PERMIT #: SWR2004 -00139 �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/10/2004 SITE ADDRESS; 09000 SW DURHAM RD PARCEL: 2S114AA -00100 SUBDIVISION: ZONING: R - 4.5 BLOCK: LOT: JURISDICTION: TIG TENANT NAME: TIGARD HIGH SCHOOL USA NO: FIXTURE UNITS: 200 CLASS OF WORK: ADD DWELLING UNITS: TYPE OF USE: NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .3 EDU increase. Per Gary Lampella, ok to figure EDU's for all 3 phases so we won't need to refund when demo work is done at 2nd & 3rd phases. Owner: FEES SCHOOL DISTRICT 23J 13137 SW PACIFIC HWY Description Date Amount TIGARD, OR 97223 [SWUSA] Swr Connectic 5/10/2004 $720.00 [SWUSA] Swr Connectic 5/10/2004 $0.00 Phone: Total $720.00 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" 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 throw. OAR 952 - 001 -0100. You may ob •'es of these rules or direct questions to OUNC by calling (503) 246 -6699 Iss ed by: 4 �� , A Permittee Signature: Y _ Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 0 0 Cr U► Se e , ' Accumulative Sewer Tally Parcel # 1S114AA - 00100 Tenant Nam', Tigard Hign School - Cumlative Tally for Phases I - III This SWR# 2004 - 00139 Site Address: 9000 SW Durham Rd This PLM# 2004 -00084 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 0 0 0 0 0 - Domestic 2 0 0 2 4 2 4 Drinking Fountain 1 0 0 1 1 1 1 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 0 2 4 2 4 - 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 15 15 2 2 - - - 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 1 3 1 3 - Service 3 0 0 18 54 18 54 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 1 6 1 6 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 4 24 0 - - Urinal 6 0 6 36 0 - 6 - 36 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 25 75 30 80 5 5 Current Fixture Value 5 divided by 16 = 0.3 Current EDU 1 EDU = $ 2,400 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 5 divided by 16 = 0.3 over (under) $ 720.00 Enter EDU Change Here 0.3 Notes: Per Gary L, ok to figure sewer DU's for all 3 phases so we will not need to refund when demo work is done during the 2nd & 3rd iijim. : _ IOahaS4S Si' nature k ',, • __ , ' Date: �J /'L//2 � __ Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. i:\Building\Sewer Tally \SewerTallySheet.xls 11/19/03 -? 1 eke I to`LA' s= "111( l'°‘) 4'\ b 6- S ,, ,,ixr Tigard High School -DOWA No. 02054 + is 6 i 3 it Fixture Count 1 d 14` 5L Existing Lower Level Eye wash r ' n W/C Urinals Sinks D.F. Mop sink Showers Fir. Drain Washer & shower D. Washer 13 3 16 2 1 0 Existing Main level Eye wash B W/C Urinals Sinks D.F. Mop sink Showers Flr. Drain Washer & shower D. Washer 43 13 103 6 2 28 r1 7 5 6 Ib 1161 cR 3 Z °o 1© 0 7 6 Existing Plus New Lower Level Eye wash !' W/C Urinals Sinks D.F. Mop sink Showers Flr. Drain Washer & shower D. Washer t � 16 3 47 2 1 '7 , 3 1 t • a z le/v c�S j) ' -(3 � Existing Plus New Main Level � K; S + "'$ '�' '� Eye wash ?o S � J - W/C Urinals Sinks D.F. Mop sink Showers Flr. Drain Washer & shower D. Washer L tU 36 7 93 7 3 13 2 1 6 1 5 l0 1ti0 9 q i3 q I a 2. 0 Total Additional Fixtures c., Ply t ct ' 3 toff ptdtl -,,}: s,, ` Total 1 -4 1 -61 211 11 11 -151 21 11 21 21 f G , 7 i e,ke ; u G.'''''' s =urAKs ' r.� -r D �l 0 Tigard High School -D O WA No. 02054 + , o � � � ,r � ,� ,2 Fixture Count 16_ e' c` 3 ■,,...- S :" co Existing Lower Level a o-----":"------4, i IAM9�D E 4 ECEtl V Eye wash � , A, W/C Urinals Sinks D.F. Mop sink Showers Flr. Drain Washer & shower D. Washer o 13 3 16 2 1 0 MAY 10 2004 _, CITY OF TIGARD Existing Main level BUILDING DIVISION Eye wash (-6 W/C Urinals Sinks D.F. Mop sink Showers Fir. Drain Washer & shower D. Washer 43 13 103 6 2 28 1 7 56 1 1 161 R 3 Zo 1. o 7 b Existing Plus New Lower Level Eye wash C W/C Urinals Sinks D.F. Mop sink Showers Flr. Drain Washer & shower D. Washer 16 3 47 2 1 '7 , 3 1 Existing Plus New Main Level e.g.; S +r'8 ."", ��S ��� cik dc-stir' - Eye wash rpl u S0.J - WIC Urinals Sinks D.F. Mop sink Showers Fir. Drain Washer & shower D. Washer S fv r f: N tit -.] 36 7 93 7 3 13 2 1 6 1! ` up 5z 10 1L-10 9 q 13 9 I o Z N 0 Total Additional Fixtures c-,,, Ply 1 it Z A 3 � l! U' 1 7` Total -4 -6 An 1 1 -15 2 1 2 2 (C- J �� o W ry r\J- I 7/1/200 Tags for Parcel # :2S114AA -00100 10:57:00AM T I D E M A R K COMPUTER SYSTEMS, INC Use Code Value Value Hold Description Notes Updated By SWR N Warning Sewer EDU Tracking 5/10/04, per authorization of Gary Lampella, sewer fees 5/11/2004 DEB were calculated and assessed for all 3 phases of the Tigard High School addition /remodel. The end result of all the fixture additions & capping is a net gain of .3 EDUs. This amount was assessed on SWR2004- 00139. Deb loft ParcelTags..rpt