Permit • , I CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
i„,,^' I ' j PERMIT
- * "'� �-. 13125 SW Hall Blvd., Tigard, 0R 97223 (503) 639.4171 PERMIT # • SWR97 -0261
DATE ISSUED: 09/22/97
PARCEL: 19136CC -00100
SITE ADDRESS...:11765 SW PACIFIC HWY
SUBDIVISION • ZONING: C —P
BLOCK LOT • JURISDICTION: TIG
TENANT NAME •GENERAL MOTORS TRAINING CENTER
USA NO • FIXTURE UNITS...: 0
CLASS OF WORK...:ALT DWELLING UNITS..: —12
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Tenant improvement for PLM97 -0291 & PLM97 -0362.
Owner: FEES
GENERAL MOTORS INC. type amount by date recpt
11765 SW PACIFIC HWY PRMT $ 0.00 JDA 09/22/97 —
TIGARD OR 97223
Phone #:
Contractor:
OWNER
Phone #: $ 0.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Case Finaled
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 the
Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952-8991-9489. You may obtain copies of
these rules or direct questions to OUNC by calling (583)246 -1987.
Issued by: Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++ ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CAP -
Tenant NameOrall f 406r ' 1r a Accumulative Sewer Tally This SwR #: q (: ) 7 -46(
Address: f /oS Stti a,c-c y This PLM #: 'f - 07-''
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added # added total #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4
- Domest 2 .
Drinking Fountain 1 _ — / 1 1
Eye Wash 1 _____._20.9_____---
_____ --- w
Floor Drain /sink - 2 inch 2
- 3 inch 5
- 4 inch b
- Car Wash Drain 6 ,
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind (over 5 HP) 48 _ i
Ice Machine /Refrigerator Drains 1 _
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16 -
Shower - Gang (Per Head) 1 ,
- Stall 2 ,
Sink - Bar /Lavatory 2 / 2°
- Bradley 5
- Commercial 3
- Service 3 _ —
Swimming Pool Filter 1 1
—
Washer, Clothes 6 1
Water Extractor 6 _ j,, !
Water Closet, Toilet 6 1. tL'
lo I
Urinal 6 _ j
TOTALS " a
Total fixture values: divided by 16 = '23.t l EDU '2,3 x 1 (p 3 b g 'r
HISTORY J1' 4 i b = =1 N.
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR# c
■
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7/26/99 Activities for Case #: SWR97 -00281
1:52:53 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
. SWRC003 Application received 7/16/97 B RECD BON 7/23/97
SWRC008 Permit Created 7/23/97 B PASS BON 7/23/97
SWRC070 Ready to issue 8/15/97 JDA PASS JDA 8/15/97 Issue before or with
PLM97 -0291.
SWRC720 Case Finaled 9/22/97 JDA PASS JDA 9/22/97 DU issues resolved
SWRC080 (F) Issue permit 9/22/97 JDA ' PASS JDA 9/22/97 Issued for billing purposes
only...forward a copy to Utility
• billing
•
•
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