Permit CITY TI GARD SEWER CONNECTION PERMIT
�y DEVELOPMENT SERVICES PERMIT #: SWR2003 -00343
' =-° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/03
SITE ADDRESS; 09530 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS: 4
CLASS OF WORK: ALT DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: .2 EDU increase, previous fixture units were 1878, this permit adds 4 units for a new total of 1882.
Owner:
FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQ. RD. [SWUSA] Swr Connect 9/9/03 $480.00
PORTLAND, OR 97223 [SWUSA] Swr Connect 9/9/03 $0.00
Phone:
Total $480.00
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
Issued b _ _ _ ,/ :� _ _ _ Permittee Signat A , � „� �.•
Call (503) 639 -4175 by 7:00 P.M. for an inspection need.. • the next business day
Accumulative Sewer Tally
Tenant Name: Apple Computer Store This SWR# 2003 -00343
Site Address: 9530 SW Washington Square Rd This PLM# 2003 -00426
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 1 1 1 1
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 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 117.4 1878.4 1878.4
Capped EDU Credit 0
TOTALS 0 1878.4 0 0 2 4 2 1882.4
Current Fixture Value 1882.4 divided by 16 = _ 117.7 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 1878.4 divided by 16 = 117.4 Previous EDU
Change 4 divided by 16 = 0.3 over (under) $ 480.00
Enter EDU Change Here 0.2
HISTORY
Notes: PLM# 2003 -00160 EDU# 117.4 SWR# 2003 -00131
EDU# 117 per Jaime SWR#
EDU# SWR#
I '-gLM#
• Vii,.` �;���� 1' � i R.L. "'C._ Date: 9/ 4 /3
Mature of • erson that calculated this tally sheet and date perfromed is required