Permit r
CITY OF TIGARD SEWER CONNECTION PERMIT
- COMMUNITY DEVELOPMENT Permit #: SWR2009 -00083
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639 4171 Date Issued: 08/14/2009
Parcel: 25101 CA00200
Jurisdiction: Tigard
Site address: 7904 SW HUNZIKER RD
Subdivision: Lot: 0
Project: PIas2Fuel
Project Description: 0.8 EDU increase
Owner: FEES
WALL STREET INDUSTRIAL LLC Description Date Amount
7000 SW VARNS ST Sewer Connection Fee 08/14/2009 $2,880.00
PORTLAND, OR 97223
PHONE:
Contractor:
EDWARD MULLEN PLUMBING
1601 SE RIVER RD
HILLSBORO, OR 97123
PHONE 503 - 640 -0113
FAX 503 - 640 -4483
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: .8
Total $2,880.00
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 adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 246 6699 or 1.800.332.2344.
Issued By: 6/VO L �n (j ti)dtvL Permittee Signature: r A
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
r Accumulative Sewer Tally Parcel # 2s101ca00100
Tenant Name: Plas2Fuel This SWR# 2009 - 00083
Site Address: 7904 Hunziker This PLM# 2009 - 00225
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
Baptistry/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
Dnnking 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 Drn 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 l -IP) 16 0 0 0 0 0
- Commercial (to 5 FIP) 32 0 0 0 0 0
- Industrial (over 5 1 -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 1 2 1 2
Sink - Bar /Lavatory 2 0 0 1 2 1 2
- 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 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
'TOTALS _ 0 0 0 0 4 13 4 13
Current Fixture Value 13 divided by 16 = 0.8 Current EDU 1 EDU = S 3,600
Previous Fixture Value 0 divided by 16 = 0 0 Previous EDU
Change 13 divided by 16 = 0.8 over (under) S 2,880.00
Enter EDU Change Here 0.8
Notes:
Authorized Name /Signature: Loraine Sellers Date: 8/18/2009
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. I f 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 \ScwerTallySheet -3600 xls 06/25/08