Permit CITY OF TIGARD SEWER CONNECTION PERMIT
` E •,1 Permit#: SWR2015-00134
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2015
T I G ARD Parcel: 2S 112AD00500
Jurisdiction: Tigard
Site address: 14650 SW 72ND AVE
Project: Rogers Machinery Company,Inc. Subdivision: BONITA GARDENS Lot: 4
Project Description: 3.31 EDU increase
Contractor: Owner: ROGERS MACHINERY COMPANY
INC
PO BOX 230429
PORTLAND, OR 97281
PHONE
PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/21/2015 $16,881.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 3.31
Total $16,881.00
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. T • - I - 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 • calling 503.2 .1987 or 1.800.332.2344.
Issue. By: / 'i_' Permittee Signature: Imo\ ^`��f�
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.
Tenant Name: Rogers Machinery Sewer Tally SWR# 2015-00134
Site Address: 14650 SW 72nd Ave PLM# 2015-00362
Ti( ARD
Parcel#: 2S 112AD00500
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value 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: -Mach 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 II
Drinking Fountain 1 0 0 1 1 1 1
1Eye Wash I 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 2 4 2 4
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car\\.1x11 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 I I1') 16 0 0 0 0 Il
-Commercial(to 5 HP) 32 0 0 0 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 2 0 0 2 4 2 4
-Bradley 5 0 0 1 5 1 5
-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 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 4 24 4 24
Urinal 6 0 0 2 12 2 12
Previous 1?DU Count 11 0
Capped EDU Credit 0
TOTALS 0 0 0 11 13 53 13 _ 53
Current Fixture Value 53 divided by 16= 3.313 Current EDU 1 EDU= $5,100.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 53 divided by 16= 3.313 over (under) $ 16,881.00
Enter EDU Change Here 3.310 *
*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:
Authorized Name/Signature: Debbie Adamski Date: 10/21/2015 _
Building Division
ri ote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
u bmitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\Building\Sewer Tally\Sewer I'allyShect_5100_070115.xlsx
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