Permit . — ,
� • . . ,
''_ . •' CITY OF TIGARD .,
, . , ..
��y� „M, . DEVELOPMENT SERVICES SEWER CONNECTION -
"� PERMIT, ,
—'!�!L' °- 13 ., - 4171 , PERMIT * : SWR98-0239
' ' DATE ISSUED':' 09/17/98
PARCEL: S i i. `DD -0 i 600
SITE ADDRESS °' ° ° :15495 SW SEQUOIA PKWY 1 #;130
- -SUBDI•V ° . ° : � ZONIN : I• -P .
BLOCK' ° ° °° . LOT.. ” ° ° ° °° ° ° JURIS DICTION: T •TG ,
TENANT 'NAME ' °.NORTH .AMERICAN VAN LINE '
USA 'NO° 9 - - FIXTURE UNITS... : ,, 124 ,
CLASS OF WORK'. ° ° : ALT . DWELLING UNITS., ° : i .
TYPE OF USE ° COM 'NO.. OF BUILDINGS:: ' , 0 . •
INSTALL TYPE ° BUSWR , • I'MPERV SURFACE': ' sf . ' '
Remarks: Add plumbing to a tenant }pace° .
Owner! - - - - --- FEES -- --
'PACTRUST. ,- type amount by date recpt
- .15350 SW' SEQUOIA PKWY STE 300 '"^rr ' 2300 °.00 B 09/17/98 98- 309E36
PORTLAND OR 97224 �I NSP $ 75° 00 B • 09/17/98 98-309236 •
phone #: VJl« li .
Contr ^actor ^•: ---------------- ..___._ i .
OWNER • • - . - , -
.
Phone #:' $ • 2375.' 00 TOTAL
.Reg #.. °
- REQIJI-RED INSPECTIONS - •- --- - - --
This Applicant agrees to co ®ply with .all the rules and regulations Case F i na l ed ,
,',of the Unified Sewage Agency., The permit expires 180 days from : - ___
the date issued. The total amount paid will be forfeited if the _ T
; ,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 adapted by the
_ Oregon. Utility'Notification Center. Those rules are' set forth in'OAR , - '
.
952- 001 -0010 through OAR 952 -0001 -0080: You may obtain copies of - ,
these rules or direct questions to OUNC by calling (503)246-1987. r -
'I _M_ —____✓ —__� 'Permittee Signature:
+++ + ++ + +++ ++ + ++ + ++ + + + + ++ + + + + +44 +-f + ++ +++ + + + +• --F-h-F• - + + + ++ + + + ++ + + + + +-h- F+ + ++ + + +4. I- + + +++
Call 639-4175 by 7:00 p °m °'for an inspection needed the next business day
++++++++t++++++++++++++++++++-l-++++++++++ + +•i-++ ++ ++ + + ++, + + +-F-6+ + ++ + +-1 ++ + + +++ +-F••F + +++ F•
V/71)2/ Accumulative Sewer Tally
!pant Name:deg_R of glJ Uih)2/ This SWR# 9 -0a37
idress: j 5 S 5w This PLM #: 9.53 — 0 3o'Z5
duce Value Previous Previous Credits Capped Fixtures Fixtures New total New
Value Capped off value added # added #s total
Count off #s count value values
iptistry/Font 4
ith - Tub /Shower 4
- Jacuzzi/Whirlpool 4
ar Wash - Each Stall 6
- Drive Through 16
uspidor/Water Aspirator 1
ishwasher - Commercial 4
- Domestic 2
rinking Fountain 1
ye Wash 1
loor Drain/sink - 2 inch 2
- 3 inch 5
- 4 inch 6
- Car Wash Dm 6
.arbage Disposal 16
- Domestic (to 3/4 HP) r
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
;e Machine /Refrigerator Drains 1
)il Sep (Gas Station) 6
:ec. Vehicle Dump Station 16
shower - Gang (Per Head) 1
- Stall 2
;ink - Bar/Lavatory 2 1 - Z
- Bradley 5
- Commercial 3 I 3 3
- Service 3
swimming Pool Filter 1
Masher - Clothes 6
Nater Extractor 6
Nater Closet - Toilet 6 I G
Jrinal 6
rOTALS 1/3 / l ay do-7 er4ezte- fl
Total fixture values: / 2 divided by 16 = EDU `' /
HISTORY
PLM# 9 7 - p, /%' EDU# SWR# 99 -o /oP PLM# EDU# SWR#
PLM# q y- o c y'a EDU# - SWR# 9 y -oaoa PLM# EDU# SWR#
PLM# 9 /- 00o / EDU# 'I SWR #9 - 0 PLM# EDU# SWR#
PLM# 93 oa s8' EDU# (D SWR# 4R - o/q ' PLM# EDU# SWR#
rldsts\swrtaly.doc
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