Permit IN �� CITY OF TIGA SEWER CONNECTION PERMIT
I COMMUNITY DEVELOPMENT Permit #: SWR2013 -00060
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/28!2013
Parcel: 2S 101 AB01400
Jurisdiction: Tigard
Site address: 7600 SW DARTMOUTH ST
Project: Walmart Subdivision: HERMOSO PARK Lot: 8
Project Description: Sewer connection for new 137,900 square foot retail store. 32.81 EDU's
Contractor: Owner: PACIFIC REALTY ASSOCIATES LP
15350 SW SEQUOIA PARKWAY #300
PORTLAND, OR 97224
PHONE: PHONE: 503 - 624 -6300
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 05/28/2013 $153,058.65
Sewer Inspection - Commercial 05/28/2013 $45.00
Type of Use: COM
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 32.81
Total $153,103.65
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 su • - • - • • •.ore the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. hose rules are -t forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may o• =in a copy of the rules or direct questions
to OU C by callin. 503.232.19:' • .:. a 32.2344.
Is �,
ued By: 0 �/, /,` ` ` i Permittee ignature: � �� j 1
!f✓�
Call 503.639.4175 by 7:00 a.m. for the next availa. e nspection dat :.
This permit card shall be kept in a conspicuous place on the job site until col • etion of the project.
Approved plans are required on the job site at the time of each inspection.
Si c
Tenant Name: Walmart SWR # 2013 -00060
Site Address: 7600 SW llarton um St PLM # 2013 -00089
Parcel #: 2S101AB01400 ulative Sewer Tally
Fixture \ . lu, I'r, \ i,.0, Previous Credits Gapped fixture Fixture New \ew
%.clue count capped #s \;due count added # added value total #s 1( /ial v alues
Baptisery/Font 4 0 0 0 0 0
Bath: - Tub/Shower 4 0 0 0 (1 0
- Jacuzzi /Whirlpool 4 0 0 0 0 0
Car Wash: - Each Stall 6 0 0 0 (1 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 ) 0 0 0 0 0
Drinking Fountain 1 0 (I 5 5 5 5
Eye Wash I 0 II 1 1 1 1
Floor Drain /Sink: - 2 inch 2 0 0 51 102 51 102
- 3 inch 3 0 0 15 75 15 75
- 4 inch 6 0 0 30 180 30 18(I
- Car Wash 6 I I 11 0 0 II
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) 42 0 (I 0 0 0
Ice Machine /Refrigerator Drain 1 0 (I 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:
- Lav /Bar - Non -Food Related 2 0 O 15 30 15 30
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 II 9 27 9 27
Swimming Pool Filter I 0 0 0 0 0
Washer - Clothes 6 0 (1 0 0 0
Water Extractor 6 0 II 0 0 ((
Water Closet - Toilet 6 0 0 12 72 12 72
Urinal 6 0 0 5 30 5 30
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 146 525 146 525
Current Fixture Value 525 divided by 16 = 32.813 Current EDU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 525 divided by 16 = 32.813 over (under) S 153,058.65
Enter EDU Change Here 32.810
Notes: 4/4/13, per Mark, fixture count on plans = (15) lays & (9) sery sinks w /out floor sinks.(Only counted sinks w /out floor sinks for calculation)
Total floor drains /sinks = 96 ((51) 2 ", (15) 3" & (30) 4")
Authorized Name /Signature: Debbie .1damski Date: 4/1/2013
Building Division
ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
r
1: \Building \Sewer Tally \SewerTallySheet- 4665.xls 07/01/12