Permit (173) CITY OF TIGARD SEWER CONNECTION PERMIT
COMMUNITY DEVELOPMENT Permit#: SWR2018-00189
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/21/2018
Tic;AI=.i� g Parcel: 2S111ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: 21.31 EDU increase for a new 2-story,80,000 sq.ft.elementary school building.
Contractor: Owner: TIGARD-TUALATIN SCHOOL
DISTRICT 23J
6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Sewer Inspection-Commercial 08/20/2018 $45.00
Sewer Connection Fee 08/20/2018 $117,205.00
Type of Use: COM
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 21.31
Total $117,250.00
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 Airect questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /./(4L� C Permittee Signature: ..
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 compleon of the project.
Approved plans are required on the job site at the time of each inspection.
Accumulative Sewer Tally
I Tenant Name: TEMPLETON ELEMENTARY SCHOOL SWR# 2018-00189
TIGARD Site Address: 9500 SW MURDOCK ST. PLM# 2018-00083
Parcel#: 2S1 1 1 ACO2901
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: -Each 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 1 4 1 4
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 3 3 3 3
Eye Wash 1 0 0 1 1 1 1
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 8 40 46 230 38 190
-4 inch 6 0 10 60 2 12 -8 -48
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-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 1 1 1 1
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 2 4 2 4
Sink:
-Lay/Bar-Non-Food Related 2 0 50 100 62 124 12 24
-Bradley 5 0 0 0 0 0
-Com/Sery/Util-Food Related 3 0 0 10 30 10 30
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 2 12 2 12
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 20 120 52 312 32 192
Urinal 6 0 12 72 0 -12 -72
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 100 392 182 733 82 341
Current Fixture Value 341 divided by 16= 21.313 Current EDU 1 EDU= $5,500.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 341 divided by 16= 21.313 over (under) $ 117,205.00
Enter EDU Change Here 21.310 *
*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: BRANDEN TAGGART X2449 Date: 7/26/2018
Building Division
INote: 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:\Building\Sewer Tally\SewerTallySheet_5500_070117.xlsx