Permit CITY TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR1999 -00171
rl 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/12/99
SITE ADDRESS; 12123 SW 69TH AVE PARCEL: 2S101AA -TTOOA
SUBDIVISION: TIGARD TRIANGLE OFFICE COMPLEX ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
TENANT NAME: TIGARD CORPORATE CENTER
USA NO: FIXTURE UNITS: 106
CLASS OF WORK: NEW DWELLING UNITS: 7
TYPE OF USE: COM NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer permit - shell
Owner: FEES
TIGARD CORPORATE CENTER LP Type By Date Amount Receipt
15400 SW MILLIKAN
BEAVERTON, OR 97006 PRMT BON 8/12/99 $16,100.00 99- 317597
INSP BON 8/12/99 $45.00 99- 317597
Phone: Total $16,145.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
ORIGINAL
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 (503) 246 -1987.
Issued by: 43. f i jii Permittee Sig .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed :.:'"<t business day
/� , -}—, ,� Accumulative Sewer Tally
Tenant Name: 1 V4A.YA �`�Q I)AtiX — o ows This swR# t . iolvi - Gl7
Address:_ 2_1)_, xj U let This PLM #: 1 Kqi - c7DZ
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
- Jacuzzi/VVhirlpool 4 .
Car Wash - Each Stall 6 _
- Drive Through 16 1 .
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 .
- Domestic 2 1n a
Drinking Fountain 1 " , R Z -
Eye Wash 1 J
Floor Drain/sink - 2 inch 2 `/`, 7 c<
- 3 inch 5 • _
-4 inch 6 t
- Car Wash Dm 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 ✓e a Z
- Stall 2 /_
Sink - Bar/Lavatory 2 ` / 12 /P
- Bradley 5
- Commercial 3 _
- Service 3 ✓9, (O , Z
Swimming Pool Filter 1 ,
Washer - Clothes 6 .
Water Extractor 6
Water Closet - Toilet 6 4 4%6 I 0 (9O
Urinal 6 ci r 1 a Z ` TL
TOTALS 36 l 060 30 I
Total fixture values: I b t`o divided by 16 = LP , (,l 7-, EDU — 1 3
HISTORY 1 E U _ 47-7O
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
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