Permit CITY OF TIGARD SEWER CONNECTION PERMIT
' 1 ' COMMUNITY DEVELOPMENT Permit#: SWR2020-00058
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/10/2020
T f t1,1R L9 9 Parcel: 2S113AB00300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 300
Project: Oregon State Bar Subdivision: FANNO CREEK ACRE TRACTS Lot: 38
Project Description: .44 EDU increase.
Contractor: Owner: OREGON STATE BAR,THE
16037 SW UPPER BOONES FERRY RD
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Description Date Amount
•
Specifics: Sewer Connection Fee 03/10/2020 52,552.00
Type of Use: COM
Class of Work: ALT
Install Type:
Fixture Units:
Number of Dwelling Units: .44
Total $2,552.00
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 issue or if
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted Oregon o' scion
Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo -y obtain g.141111tre rules • ew -.tions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee ignatu
Cal . 9.4175 by 7:00 a.m.for the next ay.'ab a inspection date.
This permit card shall be kept in a conspicuous place on the job ' - - - • - •n o the project.
Approved plans are required on the job site at the time of each inspection.
Accumulative Sewer Tally
III i Tenant Name: OREGON STATE BAR SWR# 2020-00058
RD Site Address: 16037 SW UPPER BOONES FERRY RD 300 PLM# 2020-00108
TIGA
Parcel#: 2S113AB00300
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 1 1 0 -1 -1
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
- 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
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 1 2 1 2
-Bradley 5 0 0 0 0 0
-Com/Serv/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 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 1 1 2 8 1 7
Current Fixture Value 7 divided by 16= 0.438 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 7 divided by 16= 0.438 over (under) $ 2,552.00
Enter EDU Change Here 0.440 *
*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: 3/10/2020
Building Division
ote: 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.
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1:\Building\Sewer Tally\ScwcrTallyShee t_5800_070119.xlsx