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Permit CITY OF TIGARD SEWER CONNECTION PERMIT COMMUNITY • DEVELOPMENT Permit#: SWR2018-00001 T f CA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/03/2018 Parcel: 1 S136CD01401 Site address: 11646 SW PACIFIC HWY Jurisdiction: Tigard Project: Tigard Transmission Project Description: Sewer connection for existing business: 1 EDU increase. Subdivision: None Lot: None Contractor: Owner: PACIFIC REALTY ASSOCIATES LP ATTN:ACCOUNTING DEPARTMENT 15350 SW SEQUOIA PKWY STE 300 PORTLAND, OR 97224 PHONE: PHONE: FAX: Description Specifics: Date Amount Sewer Connection Fee 01/03/2018 Type of Use: COM Sewer Inspection-Commercial $5,500.00 01/03/2018 $45.00 Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $5,545.00 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 work is suspended for more the 180 days. ATTENTION: Oregon law requires you expire if work is not started within 180 days of issuance, or if aication Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. follow You may rted obtain ules a copybyhe tt e OregonrulesorUtility ctNquestions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: f Permittee • _ C.II 503.•t''. 5 by 7:00 a.m.for the next available ins ction date. This permit card shall be kept in a conspicuous place on the job site until completion of the proj Approved plans are required on the job site at the time of each inspection. Accumulative Sewer Tally s ilk Tenant Name: TIGARD TRANSMISSION T I G A R D Site Address: 11646 SW PACIFIC HWY SWR# 2018-00001 Parcel#: 1 S 136C D01401 PLM# 2018-00007 Fixture Value Previous Previous Credits Capped Fixture Fixture # value count caed#s value count added# New New „ Ba,tise /Font 4 added value total#s total values 0EMI 0 Bath: -Tub/Shower 4 MI 0 0 0 0IIIIIIII 0IIIIIIIII - acuzzi/Whirl,ool 4 0 0 0 0111111111 0MN Car Wash: -Each Stall 6 0 0 0 0 0 ME-Drive throu:h 16 0 0 0 0111111111 0111111111 Cus,idor/WaterAs,irator 1 0 0 0 0111111111 011111111 Dishwasher: -Commercial 4 0 0 0 0IIIIIIIII 0MI -Domestic 2 0 0 0 0MN 0 Drinkin:Fountain 1 0 0 0 0 0 -EeWash 1 0 0 0 0MI 0 Floor Drain/Sink: -2 inch 2 IIIIIIII 0 0 0 0 IIIIIIII -3 inch 5 MI 0 0 IIIIIIIIII 0 0 0 0 MN -4 inch 6 0 MI 0 0 0 - IIIIIIIII 0 0 0 0 -Car Wash 6 0 Garba__e Dis•osal: 111111111 0 MO 0 0 0 -Domestic to 3/4 HP 16 0 MI 0 - -Commercial to 5 HP 32 0 0 0 0111111111 0111111111 -Industrial over 5 HP 42 0 0 0 0 111111111 01111111._erator Drain 1 0 0 0 Ice Machine/Refri _ 0IIIIIIIII 0 - Livin:Unit 16 0 0 0 MN 0 MN 0 - Oil Se. Gas Station 6 0 0 0 0111111111 0 - 0 0 0 Rec.Vehicle Dum, station 16 0IIIIIIII 0 Shower: -Gan: .er head 1 0 0 0 0 Stall 111111111 2 p 0 111111 0 1111111111 O 0 0 Sink: Mil 0 0 -Lay/Bar-Non-Food Related 2 - 0 0 OBradle 5 4 2 4 0 0 -Com/Sere/Util-Food Related 3 0 0 0 0111111111 0 Swimmin:Pool Filter 1 0 0 0 0IIIIIIII 0 Washer-Clothes 6 0 0 0 0MI 0 Water Extractor 6 111111111 0 0 0 0MN 0 Water Closet-Toilet 6 0 2 0 0 111111111 0 © Urinal 6 0 0 0 0 212 Previous EDU Count_ 0 0 0 0 Capped EDU Credit_ 0 TOTALS 0 0 0 0 0 4 Current Fixture Value 16 divided b 16= 16 4 16 Previous Fixture Value 0 y 1.000 Current EDU divided by 16= 0.000 Previous EDU 1 EDU= $5,500.00 Change 16 divided by 16= 1.000 Enter EDU Change Here 1.000 over (under) $ 5,500.00 *Round EDUs to the nearest 1/100th: a count endin. in.005 shall be rounded us to.01, ' and a count endin.in.014 or less shall be rounded down to.01. Notes: Authorized Name/Signature: BRANDEN TAGGART X2449 Building Division Date: 1/3/2018 I 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. I:\Building\Sewer Tally\SewerTallySheet_5500_070117.xlsx