Permit CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit #: SWR2012 -00207
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/30/2012
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Parcel: 1 S127DD01200
Jurisdiction: TIGARD
Site address: 10031 SW CASCADE AVE
Project: Orchard Supply Hardware Subdivision: CORAL COMMONS CONDO Lot: 14
Project Description: 2.88 EDU increase
Contractor: Owner: KRAUSZ PUENTE LLC
BY THE KRUASZ COMPANIES INC
44 MONTGOMERY ST STE 3300
SAN FRANCISCO, CA 94104
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PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/30/2012 $13,435.20
Type Use: COM •
Class of Work: "ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 2.88
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Total $13,435.20
Required Items and Reports (Conditions)
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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 sta d within 180 days of issuance, or if
work is suspended.Jor more the 180 days. ATTENTION: Oregon law requires you to follow the rules a. •,•ted by the Oregon Utility Notification
Center. ose rules ar set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtai . copy of the rule : direct questions
to OU by calling 503.232.1 1.800.332.2344.
Is ed By: Permittee Signature: (
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Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
711 0
Accumulative Sewer Tally
0 Tena Name: Orchard Supply I Iardware SWR # 2012 -00207
TIGARI3 Site Address: 10031 SW Cascade Ave PLM # 2012 -00294
Parcel #: 1S127DD01200
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
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 8 48 8 48
- Car Wash 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 I-IP) 32 0 0 0 0 0
- Industrial (over 5 HP) 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 1 2 0 -1 -2
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 0 0 0 0
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 1 2 8 48 7 46
Current Fixture Value 46 divided by 16 = 2.875 Current EDU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 46 divided by 16 = 2.875 over (under) $ 13,435.20
Enter EDU Change Here 2.880
Notes:
Authorized Name /Signature: Debbie Adamski Date: 10/16/2012
Building Division
r ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
bmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\ Building \Sewer Tally \SewerTallySheet- 4665.xls 07/01/12