Permit CITY OF TIGARD SEWER CONNECTION PERMIT
:1111111 s COMMUNITY DEVELOPMENT Permit#: SWR2015-00109
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/09/2015
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 550
Project: LoanStar Lending Subdivision: 2005-035 PARTITION PLAT Lot: 3
Project Description: .13 EDU increase
Contractor: Owner: WISCO REAL ESTATE EQUITY FUND I
1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 09/09/2015 $663.00
Type of Use:
Class of Work:
Install Type:
Fixture Units:
Number of Dwelling Units:
Total $663.00
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 rules are 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 calling 503.232.1987 or 1.800.332.2344. _
Issued By: Permittee Signature:
Call 50-9.4175 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.
Si Tenant Name: Loantitar Lending Sewer Tally
SWR# 2015-00109
Site Address: 9020 SW Washington Square Rd#550 PLM# 2015-00251
Parcel#: 1S126BC01506
Fixture A:ilu( Previous Previous Credits Capped Fixture I i.1w, New New
# value count capped#s value count added# .u1■1,.1 \.1I■„ total#s total 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 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator I 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic ) 0 0 1 2 1 2
Drinking Fountain I 0 0 0 0 0
Eye Wash I 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3inch 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 3/411P) 16 0 0 0 0 0
-Commercial(to 5 1IP) 32 0 0 0 0 I I
-Industrial(over 5 Ill') 4 2 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 (1
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-1.av/Bar-Non-Food Related 2 0 0 0 0 0
-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 (1
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 1 2 1 2
Current Fixture Value 2 divided by 16= 0.125 Current EDU 1 EDU= 55,100.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 2 divided by 16= 0.125 over (under) $ 663.00
Enter EDU Change Here 0.130 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
9/8/15,revised plumbing permit to add dishwasher.
Authorized Name/Signature: Debbie Adamski Date: 9/8/2015
Building Division
Note: The property owner shall retain the ORIGIN.],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:\Building\Sewer Tally\Sever TallySheet_5100_070115.xlsx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9020 SW WASHINGTON SQUARE RD 550,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00251
Inspection Type: Inspector:
399 Plumbing final Geor. - - •
Result: n 7
FAIL
Comments:
1 . Dishwasher hose to be securely anchored to underside of cabinet top. 807.4
2. Add to existing permit a dishwasher. 103.1.1
3. Provide hot water. 502.5
4. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor
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