Permit • CITY OF TI GARD SEWER CONNECTION PERMIT
«l DEVELOPMENT SERVICES PERMIT #: SWR2000 -00306
'%41,911 DEVELOPMENT
SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/13/00
SITE ADDRESS; 13535 SW 72ND AVE PARCEL: 2S101 DC -00300
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS: / y/
CLASS OF WORK: NEW DWELLING UNITS: 9
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer permit for new building.
Owner: FEES
PACIFIC NW PROPERTIES Type By Date Amount Receipt
9965 SW ALLEN BLVD
SUITE 115 PRMT CTR 10/13/00 $20,700.00 27200000000
BEAVERTON, OR 97005 INSP CTR 10/13/00 $45.00 27200000000
Phone: Total $20,745.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
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 Ore • ility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ma obtain cop of these rules or direct questions to OUNC by calling (503 6 -1987.
Issued . : //, Permittee Signature: A •&.
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busin ay
4111
4 Accumulative Sewer Tally
Tenant Name: 712 rive Q i -c i31 7. This SWR# 2000 - Od 3�
Address: l' 535' 54.) 7 2' ' J This PLM #: 2000 — Co 36
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
- JacuzziM/hirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2 1 2
Drinking Fountain 1 2
Eye Wash 1
Floor Drain /sink - 2 inch 2 (Z-
- 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 2 1-1
Sink - Bar /Lavatory 2 ( 6
- Bradley 5
- Commercial 3 6 1 9
- Service 3 1 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 10 60
Urinal 6 24
TOTALS 1 0 t y
Total fixture values: I l ) divided by 16 = 9 - ( EDU ( EDV y $ 2,3O 2 _ 1 700.60
V5. 0°
HISTORY t
12.0 7 95%0V PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
is \dsts\swrtaly.doc