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Permit CITY TI GARD. SEWER CONNECTION PERMIT i DEVELOPMENT SERVICES PERMIT #: SWR2003 -00188 t- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/17/03 SITE ADDRESS; 06650 SW REDWOOD LN J '190 PARCEL: 2S112DA -01400 SUBDIVISION: PP1996 -048 ZONING: I -P BLOCK: LOT: 002 JURISDICTION: TIG TENANT NAME: REID MIDDLETON INC USA NO: FIXTURE UNITS: 2 CLASS OF WORK: ADD DWELLING UNITS: TYPE OF USE: COM NO. OF BUILDINGS: INSTALL TYPE: BUSWR IMPERV SURFACE: Remarks: .2 EDU increase. Previous fixture values were 235.6, this permit added 2, for a new total of 238.6. Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 -WM I PORTLAND, OR 97224 [SWUSA] Swr Connect 6/17/03 $460.00 [SWUSA] Swr Connect 6/17/03 $0.00 Phone: Total $460.00 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 Issue y: y r.jnitti Permittee Signature: Call (503) 639 , 175 by 7:00 P.M. for an inspection needed the next busine s day Accumulative Sewer Tally Tenant Name: Reid Middleton Inc This SWR# 2003 -00188 Site Address: 6650 SW Redwood #190 This PLM# 2003 -00263 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 0 0 0 - 3 inch 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 0 0 0 - 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 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 14.7 235.2 • 235.2 Capped EDU Credit 0 TOTALS 0 235.2 0 0 1 3 1 238.2 Current Fixture Value 238.2 divided by 16 = 14.9 Current EDU 1 EDU = $2,300.00 Previous Fixture Value 235.2 divided by 16 = 14.7 Previous EDU Change 3 divided by 16 = 0.2 over (under) $ 460.00 Enter EDU Change Here 0.2 HISTORY Notes: PLM# 2003 -00163 EDU# 14.7 SWR# 2003 -00135 PLM# 2002 -00091 EDU# 14.6 SWR# 2002 -00125 98 -00421 EDU# 14.13 SWR# 98 -00312 1 am ,� `∎ - � 6 ) Date: /! 43 �.- ature of pe - on that calculated this tally sheet and date pen` ed is required