Permit CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2002 -00173
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/18/02
SITE ADDRESS; 08015 SW HUNZIKER ST PARCEL: 2S101BD -00300
SUBDIVISION: ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS: 30
CLASS OF WORK: ALT DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: 1.9 EDU increase, previous fixture count was 96. This permit added 30 fixture values for a new
total of 126 fixture values or 7.9 EDU's, for an increase of 1.9EDU.
Owner: FEES
PERFORMANCE CONTRACTING INC
8015 SW HUNZIKER ST Type By Date Amount Receipt
TIGARD, OR 97223 PRMT CTR 6/18/02 $4,370.00 '27200200000
Phone: 503 - 684 -5533 Total $4,370.00
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" Perm
Issued by: � Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Accumulative Sewer Tally
Tenant Name: Performance Contracting This SWRt 2002 -00173
Site Address: 8015 SW Hunziker This PLM# 2002 -00164
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 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 4 8 4 8
- 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 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 1 1 1 1
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 3 6 6 12 3 6
- Bradley 5 0 0 0 0 0
- Commercial 3 0 1 3 2 6 1 3
- 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 6 36 7 42 1 6
Urinal 6 0 2' 12 3 18 1 6
Previous EDU Count 6 96 96
Capped EDU Credit 0
TOTALS 0 96 12 57 23 87 11 126
•
Current Fixture Value 126 divided by 16 = 7.9 Current EDU 1 EDU = $2,300.00
Previous Fixture Value 96 divided by 16 = 6.0 Previous EDU
Change 30 divided by 16 = 1.9 over (under) $ _4,370.00
Enter EDU Change Here 1.9
HISTORY
Notes: Previous PLM# EDU# SWR#
EDU count of 6 from Amanda PLM# EDU# SWR#
PLM# EDU# SWR#
Name: /50. 156,,, ez,b Date: 1/4 -j__9 -�__
Signature of person that calculated this tally sheet and date perfromed is required