Permit CITY TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2005 -00163
�I�� DEVELOPMENT r S O R 9 A CES - 639 -4171 DATE ISSUED: 7/15/2005
PARCEL 1S12600-00300
SITE ADDRESS: 09309 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: 27.8 EDU increase.
TENANT NAME:
CWS NO: FIXTURE UNITS: 103
CLASS OF WORK: ALT DWELLING UNITS: 27.8
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Owner: FEES
WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY Description Date Amount
9585 SW WASHINGTON SQUARE RD [SWUSA] Sewer Connection Fee 7/15/2005 $72,800.00
TIGARD, OR 97223
Total $72,800.00
Phone:
Contractor:
REQUIRED ITEMS AND REPORTS
Phone:
Reg #:
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" 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 - 001 -0100. You may obtain copies
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued by: Permittee Signature: ',j f l �i , .„
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit carol 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.
Accumulative Sewer Tally Parcel # 1S12600 -00300
Tenant Name: Cheesecake Factory This SW R# 2005 -00163
Site Addrbss: 9309 Washington Sq. Rd. This PLM# 2005 -00204
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 1 4 1 4
- 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 11 22 11 22
- 3 inch 5 0 0 47 235 47 235
- 4 inch 6 0 0 2 12 2 12
- 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 1 32 1 32
- Industrial (over 5 HP) 42 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 3 3 3 3
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 7 14 7 14
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 19 57 19 57
- Service 3 0 0 2 6 2 6
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 8 48 8 48
Urinal 6 0 0 2 12 2 12
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 103 445 103 445
Current Fixture Value 445 divided by 16 = 27.8 Current EDU 1 EDU = $ 2,600
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change 445 divided by 16 = 27.8 over (under) $ 72,280.00
Enter EDU Change Here 27.8
Notes:
Signature: Dodie Rossetti Date: 7/1/2005
Building Division
(Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher
hich must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
i:\Building\Sewer Tally \SewerTallySheet.xls 7/1/04