Permit (114) CITY OF TIGARD PLUMBING PERMIT
s.- < COMMUNITY DEVELOPMENT Permit#: PLM2019 00251
44 07/16/2019
:
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' ., t `It. . "F. Date Issued:
0 /AC00800
DiF Jurisdiction: Tigard
Site address: 7148 SW GONZAGA ST 280
Project: The Adrienne Subdivision: BEVELAND NO.2 Lot: 14
Project Description: Rough-in only of plumbing line work to convert a second floor B occupancy unit to an R-2 residential unit. Relocate
existing double check,cap lay,water closet and hand sink; rough-in drainage for kitchen sink,dishwasher,
tub/shower, lay and clothes washer. Actual fixtures to be set by another contractor. 9/16/19:REPRINTED permit
Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: ROGERS, ROY R
853 NE HARLOW RD 13690 SW TWELVE OAKS CT
TROUTDALE, OR 97060 TIGARD, OR 97224
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
1 ea Backwater Valve 06/17/2019 $12.51
Specifics: 1 ea Clothes Washer 06/17/2019 $25.02
1 ea Dishwasher 06/17/2019 $25.02
Type of Use: MF 3 ea Fixture/Sewer Cap 06/17/2019 $75.06
Class of Work: ALT 1 ea Sink 06/17/2019 $25.02
Type of Const: 1 ea Lavatories 06/17/2019 $25.02
Occupancy Grp: 1 ea Tub/Shower/Shower Pan 06/17/2019 $12.51
Stories: 1 ea Water Closet 06/17/2019 $25.02
1 ea Water Heater 06/17/2019 $37.52
1 12%State Surcharge- 06/17/2019 $31.52
Plumbing
Total $294.22
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 :00.332.2344.
Issued By: Permittee Signature:
Cge
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.
CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit#: PLM2019 00251
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/16/2019
Parcel: 2S 101 AC00800
Jurisdiction: Tigard
Site address: 7148 SW GONZAGA ST 280
Project: The Adrienne Subdivision: BEVELAND NO.2 Lot: 14
Project Description: Rough-in only of plumbing line work to convert a second floor B occupancy unit to an R-2 residential unit. Relocate
existing double check,cap lay,water closet and hand sink; rough-in drainage for kitchen sink,dishwasher,
tub/shower, lay and clothes washer. Actual fixtures to be set by another contractor.
Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: ROGERS, ROY R
853 NE HARLOW RD 13690 SW TWELVE OAKS CT
TROUTDALE, OR 97060 TIGARD, OR 97224
PHONE: 503-239-8801 PHONE:
FAX: 503-669-9568
FEES
Quantity Description Date Amount
1 ea Backwater Valve 06/17/2019 $12.51
Specifics: 1 ea Clothes Washer 06/17/2019 $25.02
1 ea Dishwasher 06/17/2019 $25.02
Type of Use: MF 3 ea Fixture/Sewer Cap 06/17/2019 $75.06
Class of Work: ALT 1 ea Sink 06/17/2019 $25.02
Type of Const: 1 ea Lavatories 06/17/2019 $25.02
Occupancy Grp: 1 ea Tub/Shower/Shower Pan 06/17/2019 $12.51
Stories: 1 ea Water Closet 06/17/2019 $25.02
1 ea Water Heater 06/17/2019 $37.52
1 12%State Surcharge- 06/17/2019 $31.52
Plumbing
Total $294.22
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
UtilityNotification cat on 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: 4G= � 1:2e[mittee Signature: •
L/L
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.
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
City of Tigard MAY 13 2019 DateBReceivedy: ti',: i, /5' 444/1 Permit Nie4/1,,201--e 0 ';215.t
II/ 11 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.196p[Y OF TIGARD Date/By: Other PermitNo.:
Inspection Line: 503.639.4175
TIGARD Internet. www.ti and-or. ov BUILDING DIVISION Date Ready/By„I `2' .. r Juris: BI plemene2for
g g Notified/Methorfo' / 'K•-,-- SupplementalInformation
❑New construction ';241."'L'14:-;;;;;;;;I:::: "'"''''''''.-4-
Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
:,' ', .... €": GOR' OF d `rl:a . .. I SFR(1)bath 312.70
❑ 1-and 2-family dwelling �❑Commercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
. ,.., .R JOB FF .I O ...,. .,® .. .;, . . 'T N i x. rE z Site utilities:
Job site address: 7 l� 5 u3 Go,-,,,,q0, s \-- �g('‘ Catch basin or area drain 18.76
v Drywell,leach line,or trench drain 18.76
City/State/ZIP: V 0\vV`1 0 a 9-7 ' a3
g
/�, Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 'Q Project name: '-'?u,.�
s•- ifs°'(r'1 CA/Alt.,- Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
/ >
/'�./LG1-f.V 7: h/N 6;1161-711 . /1/1
- Sanitary sewer(no.linear ft.:_) Page 2
/< U/ Storm sewer(no.linear ft.: ) Page 2
/X 7-1((te- 7 i e T' -S. 7 4977/ - Water service(no.linear ft.:_) Page 2
Subdivision: ,/ ,q.e/o.�� • I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
® ';a' = Backwater valve 12.51
�n 1n ��q,t`,�(� {,,, ` Clothes washer 1 25.02
II2Q\OCOr''�tAC �X(5�11��y v^'�v o`t (Kt c li CCk 1 tD. Wk / Dishwasher 1 25.02
a YlOY CJ grik. • 1`�UL�r' 1'11 (�1\r1(k(k 1 ,fit {1t�Q(� sink) Drinking fountain 25.02
S1Jt-V1 t 3-w(j0% -1 10V-9,0e. „19,17„ Ejectors/sump 25.02
al, :, N, Expansion tank 12.51
Name:
Fixture/sewer cap 3 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
' :4f-,..,€ t
'W--:;"'
gs .:,.,f IsI A '' RSyQ..
Interceptor/grease trap 25.02
.i ' I .
Medical gas(value:$ ) Page 2
Business name: picc011C Occkv+n �. IoA,V
^ Primer 12.51
I Contact name: K ',Q Q `�
Roof drain(commercial) 12.51
Address: q5 1, \{„ \O' �� n. �
1V 1. � --§i, asi avato � 25.02
City/State/ZIP: • ro ( i 0 9` 7 0 cg 0 Solar units(potable water) 62.54
- 'done: I
a.. -9---=--8%.3 ax: :( __�-- - TubJshower/shower pan I 12.51
E-mail: 1 Urinal 25.02
l.Fit 11�
'�� �40-i� ,l Water closet i 25.02
t, . ,,, _ Water heater [ 37.52
Business name: t I t I Water piping/DWV 56.29
Address: C. a t , Other: 25.02
City/State/ZIP: ' \ t Subtotal
Phone:( ) . Jz 2 2- 1 Fax:( ) Minimum permit fee: $72.50
L�y�` �b-s3�� Plan review (25%of permit fee)
CCB Lic.. I 1 PlumbingLic.no.:
�,�,QQ /�� State surcharge(12%of permit fee)
Authorized signature: ``J' " - 7Il/.
TOTAL PERMIT FEE
Print name: 1(.V 4.Q 4_£(.-,Y Date: 5) I This permit application expires if a permit is not obtained within 180 days
II after it has been accepted as complete.
� 3 2o 4 - J�1 as / _ *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/099 C•/ Y' 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
e,Utilities `: "' �., Q Fee ea) °t Square Footage ..,,. .. 'er. m TiftPe
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 {{ ` ?- , ,.
Storm&Rain Drain-1st 100' 62.54 Iuaiti n 4-5.4.,--,1,Permit. ee ' :' "
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
F o'' Pet(ea Total each additional$100.00 or fraction thereof,to
Other Inspee L�(lall s o "` s_ • .. __ • e,' t)° and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
=• ' -u ►ty by Fixture Type ' '-i''''
uant ®� o° t ' a 1 i I
- ..� � � = ate...�...�. �.� ` 5 y.>
Fixture Type for , Replace!
Work Performed.. , , " Capped Added° Relocate..: P.an review is required for any of the following.
Baptistry/Font 'lease check all that apply.
Bath -Tull/Shower J ❑ Any new commercial building with water service 2"and
7acuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each S Ilengineer.
-Drive T ,;r ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator `' / as defined in OAR918-780-0040.
Dishwasher Commercial` /, D Medical gas and vacuum systems for health care facilities.
-Domestic °' D Any multipurpose fire sprinkler system.
Drinking Fountain / 1=1Any complex structure as defined in OAR918-780-0040.
Eye Wash �\
Floor Drain/sink -2" °s,
Submit 2 sets of plans with any of the above.
3„ \
4„ r
Car Wash Dram f}111etI' f)ir .,.,. . ... :
Garbage Domestic-non-food ,' ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
relates.. _,
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station Ark Fye'..- h f [ eve-: G_Je/.4Z./G Q N L_y r"
Shower -Gang
-Stall c=t-ef,tvr = G f= /-f >c 7--1,11-4...--T ,
Sink/Lav -Non-food related ;i 1/ L~ L- <•>.'.- S. "...to- G')c C-'e=
-Bradley C c-t'r /'=zr"4't-- S r.'j, -L-E A.2,= L c wit j
-Commercial-foo related . --1,3Z:=1.1---
-Service
( ye_-Service /
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet / fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\dispa\Downloads\PLMF_PermitApp(1).doc 2
III
a Tenant Name: The Adrienne Accumulative Sewer Tally SWR# 2013-00204_REV3
1I GAKD Site Address: 7148 SW Gonzaga St PLM# 2013-00420
Parcel#: 2S1 01 AC00800
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 0 0 0
-Domestic 2 1 2 0 0 1 2
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 3 6 1 2 0 2 4
-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 3/4 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 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:
-Lay/Bar-Non-Food Related 2 6 12 2 4 0 4 8
-Bradley 5 0 0 0 0 0
-Com/Sery/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 4 24 1 6 0 3 18
Urinal 6 1 6 0 0 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
TOVfL5------ T — 13 r 50 _ 4 12 0 0 11 38
Current Fixture Value 38 divided by 16= 2.375 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 50 divided by 16= 3.125 Previous EDU
Change 12 divided by 16= -0.750 over (under) $ 49,824.00
Enter EDU Change Here 10.380
Notes: REVISED to convert upper level office back to apartment. Building is a 3-story mixed use building,lower level office space
and upper level with(8)apartments. Residential apartments=8 EDU's,plus commercial=2.38 EDU's,for a total of 10.38 EDU's.
Authorized Name/Signature: Dianna Howse Date: 7/29/2019
Building Division
Note: 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_4800._070113.xlsx
Accumulative Sewer Tally
Tenant Name:The Adrienne SWR# 2013-00204_REV2
� Site Address:7148 SW Gonzaga St PLM# 2013-00420
Parcel#: 2S 101 A000800
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 0 0 0
-Domestic 2 0 0 1 2 1 2
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 3 6 3 6
-3inch 5 0 0 0 0 0
-4inch 6 0 0 0 0 0
-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 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 6 12 6 12
-Bradley 5 0 0 0 0 0
-Com/Sery/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 4 24 4 24
Urinal 6 0 0 1 6 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
' TOTALS 0 0 0 0 15 50 15 50
Current Fixture Value 50 divided by 16= 3.125 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 50 divided by 16= 3.125 over (under) $ 48,624.00
Enter EDU Change Here 10.130
Notes: REVISED: This building is a 3-story mixed use building. Lower level is office space and upper levels are(7)apartments plus(1)office space.
Residential apartments=7 EDU's,plus commercial=3.13 EDU's,for a total of 10.13 EDU's.
Authorized Name/Signature: Dianna Howse Date: 11/17/2014
Building Division
Note: 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_4800._070113.xlsx
I Accumulative Sewer Tally
a
Tenant Name:The Adrienne SWR# 2013-00204 REV1
- Site Address: 7148 SW Gonzaga St PLM# 2013-00420
TIGARD Parcel#: 2S101AC00800
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 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 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
-4inch 6 0 0 0 0 0
-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 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 6 12 6 12
-Bradley 5 0 0 0 0 0
-Com/Sery/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 4 24 4 24
Urinal 6 0 0 1 6 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 13 46 13 46
Current Fixture Value 46 divided by 16= 2.875 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 46 divided by 16= 2.875 over (under) $ 47,424.00
Enter EDU Change Here 9.880
Notes: REVISED: This building is a mixed use building,lower level is commercial,upper level are(7)apartments plus(1)commercial office.
Upper level(apts)=7 DU's+lower level 2.88 DU's=9.88 DU's for total fee of$47,424.00.
Authorized Name/Signature:Dianna Howse Date: 5/20/2014
Building Division
Note: 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_4800._070113.xlsx
p
Accumulative Sewer Tally
III _ Tenant Name:The Adrienne SWR# 201300204 10I I&)ikiot.-
Site Address: 7148 SW Gonzaga St PLM# 2013-00420
TIGARD
Parcel#:-2S101AC00800
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 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 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 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 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 3 6 3 6
-Bradley 5 0 0 0 0 0
-Com/Sery/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 2 12 2 12
Urinal 6 0 0 1 6 1 6
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 8 28 8 28
Current Fixture Value 28 divided by 16= 1.750 Current EDU 1 EDU= $4,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 28 divided by 16= 1.750 over (under) $ 46,800.00
Enter EDU Change Here 9.750
Notes: This building is a mixed use building,lower level is commercial,upper level are(8)apartments.
Upper level(apts)=8 DU's+lower level 1.75 DU's=9.75 DU's for total fee of$46,800.
Authorized Name/Signature:Debbie Adamski Date: 11/26/2013
Building Division
Note: 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_4800._070113.xlsx