Permit q CITY OF TIGARD SEWER CONNECTION PERMIT
a COMMUNITY DEVELOPMENT Permit#: SWR2014-00082
i G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/03/2014
T
Parcel: 1 S135BC01100
Jurisdiction: Tigard
Site address: 11101 SW GREENBURG RD
Project: Computer Solutions Tech Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: .69 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 09/03/2014 $3,381.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: .69
Total $3,381.00
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, or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center. Those e set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions
to OUNC by Iling 503.23 . 987 or 1 00.332.2344.
Issued
y: t,�2��6�ELI Permittee Sign ore` �A. ///
Call 503.639.4175 by 7:00 a.m.for the next available inspection ••te.
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.
Accumulative Sewer Tally
ITenant Name: Computer Solutions"Tech SWR# 2014-00082
Site Address: 1 1 101 `W Grecnburg Rd PLM# 2014-00284
TIC:ARD
Parcel#: 1S135BC01100
Fixture \al■. I'r ci( us Previous Credits I:apped Fixture Fixture New New
it value count capped#s ‘,due count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 I I
-Jacuzzi/Whirlpool 4 0 0 0 0 Il
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 I I
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 I 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 HP) 32 0 0 II 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 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 0 0 0 0 0
-Bradley 5 i 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 1 3 1 3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor to 0 0 0 0 0
Water Closet-'Toilet 6 0 0 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 3 11 3 11
Current Fixture Value 11 divided by 16= 0.688 Current EDU 1 EDU= $4,900.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 11 divided by 16= 0.688 over (under) S 3,381.00
Enter EDU Change Here 0.690
Notes:
Authorized Name/Signature: Debbie Adamski Date: 8/25/2014
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.
I:\Bull ding\Sewer Tally\SewerTallySheet_4900._070114.xlsx