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Permit CITY OF TIGARD PLUMBING PERMIT » COMMUNITY DEVELOPMENT 41111414401 / Permit #: PLM2013-00098 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/26/2013 Parcel: 1 S135DC00200 Jurisdiction: TIGARD Site address: 11845 SW GREENBURG RD 100 Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8 Project Description: Cap (2) water closets and (2) lays, add (1) water closet and (1) lay. 7/23/13, adding (1) hand sink Contractor: LIVESAY PLUMBING Owner: TWO G'S REAL ESTATE LLC 175 NE 5TH AVE 18395 WOOD THRUSH ST CANBY, OR 97013 LAKE OSWEGO, OR 97035 PHONE: 503 - 619 -7594 PHONE: 503 - 684 -0550 FAX: FEES Quantity Description Date Amount 4 ea Fixture /Sewer Cap 03/26/2013 $100.08 Specifics: 1 ea Lavatories 03/26/2013 $25.02 1 ea Water Closet 03/26/2013 $25.02 Type of Use: COM 1 12% State Surcharge - 03/26/2013 $18.01 Class of Work: ALT Plumbing Type of Const: 1 ea Sink 07/23/2013 $25.02 Occupancy Grp: 0 12% State Surcharge - 07/23/2013 $3.01 Stories: Plumbing Total $196.16 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 Noti ion Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direr uestions to OUNC b a • • . 503.232.1987 or 1.800.332.2344. Iss d By: '/ ,4 Permittee Signat , re: 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. y u CITY OF TIGARD PLUMBING PERMIT /1111 2 ' . COMMUNITY DEVELOPMENT Permit #: PLM2013 -00098 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/26/2013 Parcel: 1 S135DC00200 Jurisdiction: TIGARD Site address: 11845 SW GREENBURG RD 100 Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8 Project Description: Cap (2) water closets and (2) lays, add (1) water closet and (1) lay. Contractor: LIVESAY PLUMBING Owner: TWO G'S REAL ESTATE LLC 175 NE 5TH AVE 18395 WOOD THRUSH ST CANBY, OR 97013 LAKE OSWEGO, OR 97035 P PHONE: 503 - 684 -0550 PHONE: 503 - 619 -7594 FAX: FEES Quantity Description Date Amount 4 ea Fixture /Sewer Cap 03/26/2013 $100.08 Specifics: 1 ea Lavatories 03/26/2013 $25.02 1 ea Water Closet 03/26/2013 $25.02 Type of Use: COM 1 12% State Surcharge - 03/26/2013 $18.01 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $168.13 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 ' .t started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foil. , the rules adopted • - e Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0091 Yo may obtain - opy •f the rules or direct questions to OUNC ` by calling 503.232.1987 or 1.800.332.2344. Issued By: ./ e (/L =r —Ir:/ gel Permittee Signature: /� Call 503.639.4175 by 7:00 a.m. for the next available i spec '= date. This permit card shall be kept in a conspicuous place on the job site u I completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Applicat' Building Fixtures�4j�� r ED FOR OFFICE USE ONLY City of Tigard BAR 2 6 2013 Received C� �/_ / • I PermitNo.:' y _f.62 0 1c5..��g U 13125 SW Hall Blvd., Tigard,OR 972 Date/By: �, r Plan Review 0 Phone: 503.718.2439 Fax: 503.5 coo DDate/By: o TIGARD Other Permit No.: 1 � Inspection Line: 503.639.4175 OF T Date Ready/By: lung: 55 See Page 2 for r I G n R u Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 Demolition For special information use check list Description I Qty. I Ea. I Total Al Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 ❑ 1- and 2- family dwelling ig Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: \ \9A C e�gvafs. Nc-. -. \ Drywell, leach line, or trench drain 18.76 City /State /ZIP: \C tp Cr?2z - Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: \ bo I Project name: \t 6n f_e_ sP/t - af Manufactured home utilities 50.03 Cross street/directions to job site: \ ) U . �w v 99 Manholes 18.76 NC�NNu •C� , Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ff.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: / l i ?J S`DCoa . Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 N'G•4■4Cp/Q Z iS C1t_ ' 5 'f._ Dishwasher 25.02 \-\ f.. N.O \C_ € N \ \--..Ni Drinking fountain 25.02 Ejectors /sump 25.02 ig PROPERTY OWNER I 0 TENANT Expansion tank 12.51 �`� C-_-- Fixture /sewer cap 7 25.02 med Na\W b G . \ '�•e �_ G� L l Floor drain/floor sinlc/hub 25.02 Address: Vez7' • Iuv VA, S �7 Garbage disposal 25.02 City /State /ZIP: �p)1_,,e C &v,r+eCc,co j L G a1 - 7e3 S Hose bib 25.02 Phone: 0:0 21 1 1�� Fax 27_0 -" %`- Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 - Contact name: Primer 12.51 �v��C�� Q'� Roof drain (commercial) 12.51 Address: \4%, `I 5 Sr‘Nc V... \-\ �----'( Sink/basi avatory / 25.02 City/State /ZIP: \_ .-a-( 'W- e (..o - b ) O € .- (7o35 , Solar units (potable water) 62.54 Phone: i5 o 3 )` 4.3 b °1 Fax:: (,3) lii p S C- 3 Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet / 25.02 CONTRACTOR Water heater 37.52 Business name: L, V es " PI v,Mb ,, 4 M 7 L. Water piping/DW V 56.29 Address: 1-75- N g -i-1' Si-- '+ Other: a 25.02 City /State /ZIP:C( A3 0 Q q1 bi 3 Subtotal Phone: (5 11 ) (0 I el ' -' \ Pi y Fax: ( ) Minimum permit fee: $72.50 CCB Lic.: I 1-12-1 0 Plumbing Lic. no.: IV QM" Plan review (25% of permit fee) State surcharge (12% of permit fee) Authorized signature: L ! / TOTAL PERMIT FEE ( Print name: v 4,2%.„ Li vPJ4� Date: 3 2.03 /� This permit application expires if a permit is not obtained within 180 days / after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1: \Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 46I6T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1 st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1 st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to P and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2" and Baptistry/Font greater, except systems designed and stamped by licensed Bath: - Tub /Shower engineer. - Jacuzzi/Whirlpool Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918- 780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" 3" Isometric or Riser Diagram 4 " ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non -food that meet the qualifications above. Disposal: - Domestic food related - Commercial food related - Industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar non -food related - Bradley - Com/Serv/Util food related - Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet - Toilet � plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2 Accumulative Sewer Tally 71 p Tenant Name: Spec Space ** CRI {l�l'1'S' ** SWR # N /.\ TIGARD Site Address: 11845 SW Grccnburg Rd #100 PI ,M # 2013 -00098 Parcel #: 1S135DC00200 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped #s value count added # added value total #s total values Baptiscry/ 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 0 0 0 - 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 1 -1P) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 0 0 0 Oil Scp (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: - Lay /Bar - Non -Food Related 2 0 2 4 1 2 -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 2 12 1 6 -1 -6 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 4 16 2 8 -2 -8 Current Fixture Value -8 divided by 16 = -0.500 Current EDU 1 EDU = $4,665.00 Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU Change -8 divided by 16 = -0.500 over (under) S (2,332.50) Enter EDU Change Here -0.500 Notes: ** *CREDITS * ** Authorized Name /Signature: Debbie . \damski Date: 3/26/2013 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If 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. l: \ Building \ Sewer 'rally \Sewer I'allySheet- 4665.xls 07/01/12 Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY Recived City of Tigard JUL 2 3 2013 Date /By: 7AWN. Permit No.: ,[. / /i{.. /�n ,, n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review I B Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: p CITY O F TI Date/By: Inspection Line: 503.639.4175 Date Ready/By: lads: Ia See Page 2 for Pa TIGARD Y Y g Internet: www.tigard - or.gov RUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORK • FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 312.70 ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler (_ sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site ) i C/S � 8 u, 2 '0 Catch basin or area drain 18.76 City /State /ZIP: [ Drywell, leach line, or trench drain 18.76 ` n Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: /ay Project name: S 0 c c/ 4-C. 6_ Manufactured home utilities 50.03 Cross job site: - -- - - Manholes 18:76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ki. T 0 �� c% j �� n e2H/ r Clothes washer 25.02 r Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT' Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib • 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: R drain (commercial) 12.51 Address: Si asin/lavatory 1 25.02 z,; c z City /State /ZIP: Solar units (potable water) 62.54 • Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Water piping/DWV • 56.29 Address: Other: ' 25.02 City /State /ZIP: Subtotal ;S. Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 ,---- CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) -' State surcharge (12% of permit fee) .. U Authorized signature: TOTAL PERMIT FEE a g . 03 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\PLMU- PermitApp.doc 10/01/09 440 -4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: 'Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total .Square Footage: Permit Fee: Footing drain - 1' 100' 50.03 .0 to 2,000 _ $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees • Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. • Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower - Jacuzzi/Whirlpool engineer. El Car Wash: Each Stall New exterior plumbing site utilities for any complex structure Drive Stall as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918- 780 -0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: - 2" 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings - Car Wash Drain Garbage Domestic non - food that meet the qualifications above. Disposal: - Domestic food related - Commercial food related - Industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang -Stall Sink: - Lav/Bar non -food related - Bradley - Com/Serv/Util food related - Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet Toilet plumbing permit can be issued. Urinal Other Fixtures: I: \Building\Petmm its \PLMF _PermitApp.doc 08/04/2011 2 A Sewer Tally 1 ,11 a p Tenant Name:,Spec Space * * *C3D1'I'S * ** SWR # N/A TIGARD Site Address:.11845 SW Greenburg Rd #100 PLNI # 2013 -00098 Parcel #: ' 1 S135DC00200 Fixture Value Previous Previous Credits Capped ' Fixture Fixture New New # value count capped #5 value count added # added value total #s total 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 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 _ 0 0 0 - Car Wash 6 0 0 0 0 0 Garbage Disposal: - Domestic (to 3/4 I -IP) 16 0 0 0 0 0 - Commercial (to 5 I -1P) 32 0 0 0 0 0 - Industrial (over 5 I -1P) 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: - l,av /Bar - Non -Food Related 2 0 0 1 2 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 0 0 Capped EDU Credit 0.5 8 '1 0 0 0 0 1 _ 2 1 -6 Current Fixture Value -6 divided by 16 = -0.375 Current EDU 1 EDU = $4,665.00 Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU Change -6 divided by 16 = -0.375 over (under) S (1,772.70) Enter EDU Change Here ' -0.380 Notes: ** *CREDIT'S * ** 7/23/13, adding (1) hand sink to scope of work. DIU Authorized Name /Signature: Debbie Adamski Date: 3/26/2013 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: \Bull ding \Sewer Tally \Sewer I'allyShcer- 4665.xIs 07/01/12