Permit (167) A CITY OF TIGARD SEWER CONNECTION PERMIT
PERMIT #: SWR2000 -00233
__ W4.4.4.14, i DEVE H BMEN S R9 2Tigard, ' 639 -4171 DATE ISSUED: 8/8/00
SITE ADDRESS; 16200 SW PACIFIC HY E PARCEL: 2S115A6 -01900
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Tenant improvement for Hair Masters in Suite E. Fixture count increased from 469 to 484,
increasing the DU count by one (1).
Owner: FEES
BIT HOLDINGS LTD PARTNERSHIP Type By Date Amount Receipt
BY FORUM PROPERTIES INC
FIVE CENTERPOINTE DR STE 290 PRMT DLH 8/8/00 $2,300.00 0004351
LAKE OSWEGO, OR 97035 Total $2,300.00
Phone:
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008
Phone: 503 - 642 -7323
Reg #: LIC 00000241
PLM 26 -162PB
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling 5 246 -1987.
Issued by: ate, Permittee Signat &
_ 4544i— Call (503) 639 -4175 by 7:00 P.M. for an inspection need he next siness day
• Accumulative Sewer Tally
Tenant Name: hyi/Z f,4s X2.5 This SWR# 2 000 -DOA 33
Add'es:' % on sw /oee /<,. /iw y Su „ This PLM #: ,q4-77-79 — 00,*
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- JacuzziiWhirtpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain /sink - 2 inch 2
- 3 inch . 5
- 4 inch 6
- Car Wash Drn 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2
- Bradley 5
- Commercial , — 3
- Service 3
Swimming Pool Filter 1
•
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6
Urinal 6
TOTALS
.�J
Total fixture values: y� divided by 16 = EDU = .3D 1 CI-A4 2G-6
HISTORY •
PLM#/9y9-00 37.2.EDU# 9 SWR # PLM #97- •0o3 EDU# .2 c SWR # 9 7 - bo3-CP
PLM# 0,0.237 EDU# y SWR# /y99- oo/.a2. PLM # pooyy EDU# SWR #97 -oo0yd
PLM# ?e_ •Gbio EDU# SWR# y c p -6 PLM# EDU# SWR#
PLM# 9 'p -0000, EDU# a/ SWR# 9 p- oaoo�., PLM# EDU# SWR#
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