Permit . .1
CITY OF TIGARD SEWER CONNECTION PERMIT
ill IS COMMUNITY DEVELOPMENT Permit#: SWR2014-00010
Date Issued: 03/10/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 1S135BC01100
Jurisdiction: Tigard
Site address: 11117 SW GREENBURG RD
Project: Kayu International Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: 1.75 EDU increase
Contractor: Owner: GREENBURG SPACE CENTER LLC
PO BOX 91305
PORTLAND, OR 97291
PHONE. PHONE
FAX
FEES
Description Date Amount
Specifics: Sewer Connection Fee 03/10/2014 $8.400 00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 1 75
Total $8.400 00
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. r if
work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notific ti n
Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt. . opy of the r — direct quest s
to OUNC by Cg-
i 503.232.1987 or 1 800 332.2344
J I `I ssued B \ )ut f, ,,t� {, . Permittee Signature: ,`mil/L f L A• i ■
Call 503.639.4175 by 7:00 a.m.for the next available inspection d.
This permit card shall be kept in a conspicuous place on the job site until comple ion of the project.
Approved plans are required on the job site at the time of each insp• tion.
IIIAccumulative Sewer Tally
Or 'Tenant Name: K:1YU International SWR# 2014-00010
Site.\ddres.. 1 111'SW(;rccnl)urg Rd PJ.Nl# 2014-00039
Parcel#: 1 S 135BC01100
Fixture Value Prcvuuus Previous Credits (:.upped Fixture I'usrure New New
# value count capped#s value taunt added# added value it tal :#x :.ital 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 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 2 0 0 1 2 1 2
Drinking Fountain 1 0 0 0 0 0
1:ve Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 4 8 4 8
-3 inch F, 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 11 0
-Commercial(to 5 I W) 32 0 0 0 0 0
-Industrial(over 5 III') 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 9 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle I)ump station 16 0 0 0 0 0
Shower. -Gang(per head) 1 0 0 0 0 _ 0
-Stall 2 0 0 9 0 0
Sink:
-l.av/Bar-Non-Food Related 2 0 0 3 6 i 6
-Bradley 5 0 0 0 0 0
-Com/Scrv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 I I 0
Water Extractor 6 0 0 0 0 0
Water Closet-'Toilet 6 0 0 2 12 2 12
Urinal 6 0 0 0 I I 0
Previous EDU Count 0 0
Capped EDU Credit, 0
'TOTALS 0 0 _ 0 _ 0 10 28 10 28
Current Fixture Value 28 divided by 16= 1.750 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous E1)IJ
Change 28 divided by 16= 1.750 over (under) S 8,400.00
Enter EDU Change Here 1.750
Notes:
Authorized Name/Signature: Dehhie.ldamski Date: 2/13/2014
Building Division
Note: The property owner shall retain the ORIGIN.1l.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 Tally\Sewer 1'allyShcet_48t/0._0711113.XIss