Permit CITY OF TIGARD SEWER CONNECTION PERMIT
11 COMMUNITY DEVELOPMENT Permit #: SWR2012 -00187
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/25/2012
Parcel: 1 S135DD03301
Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 246
Project: El Porvenir Subdivision: METZGER ACRE TRACTS Lot: 9
Project Description: .81 EDU increase.
Contractor: Owner: COMMERCIAL ENTERPRISES LLC
8320 NW HWY 99
VANCOUVER, WA 98665
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/25/2012 $3,778.65
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units: 13
Number of Dwelling Units: .81
Total $3,778.65
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 ado. -,T►1'a -D regon Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain of \ e rules or direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: {j / , 1'/ �1 p �J nr Permittee Signature:
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Call C 503.639.4175 by 7:00 a.m. for the next available inspection date. _E.•
This permit card shall be kept in a conspicuous place on the job site until completion o 41r - projec .
Approved plans are required on the job site at the time of each inspection.
5114 Accumulative Sewer Tally
a
I . T enant Name: El Porvcnir SWR # 2012 -00187
1+ Ft, s) Site Address: 11945 SW Pacific Hwy., Ste. 246 PLM # 2012 -00262
"" Parcel #: 1S1350003301
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value count added # added value total #s total 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
Eyc Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 0 2 4 2 4
- 3 inch 5 0 0 0 0 0
- 4inch 6 0 0 0 0 0
- Car Wash 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 I -IP) 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: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- Lav /Bar - Non -Food Related 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 0 3 9 3 9
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 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 5 13 5 13
Current Fixture Value 13 divided by 16 = 0.813 Current EDU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 13 divided by 16 = 0.813 over (under) $ 3,778.65
Enter EDU Change Here 0.810
Notes:
Authorized Name /Signature: Dianna Howse Date: 9/11/2012
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 \Sewerl'allySheet- 4665.xls 07/01/12