Permit CITY OF TIGARD
a ,�e� DEVELOPMENT SERVICES SEWER CONNECTION
� I I
--tow 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171
PERMIT # FERMI T SWR97 -0334 •
DATE ISSUED: 10/07/97
PARCEL: 25112DC -01500
SITE ADDRESS... :15615 SW 74TH AVE #BLD
SUBDIVISION •FANNO CREEK ACRE TRACTS ZONING: I —P
BLOCK LOT -004 JURISDICTION: TIG
TENANT NAME °JAMES CASTILE
USA NO • FIXTURE UNITS...: 55
CLASS OF WORK... :NEW DWELLING UNITS..: 3
TYPE OF USE •COM NO. OF BUILDINGS: 1
INSTALL TYPE :LTPSWR IMPERV SURFACE: 86711 sf
Remarks: Add sewer connection to new proposed 6,400 sq.ft. warehouse.
Owner: FEES
JIM CASTILE type amount by date recpt
8100 SW DURHAM ROAD PRMT $ 6600.00 JDA 10/07/97 97 -299844
TIGARD OR 97224 INSP $ 75.00 JDA 10/07/97 97- 299843
Phone #:
Contractor:
OWNER
Phone #: $ 6675.00 TOTAL
Reg #..
-- - -- - -- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspect ion
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.
ATTINfION: 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 - 0001-. . You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued by: dhteVit
Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + + ++ + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
C TYOi= TIGARD Commercial Building Permit Recd By
r 3125 SW HALL BLVD. Tenant Improvement Date Recd v /o
TIGARD, OR 97223 Date toP.E.
Date to DST
(503) 6394171 Permit # ?
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
Job
Address Street Address C Suite Building
j( Data
Bldg # City /State Zip Existing Use of Building or Property:
Name
Property
Proposed Use of Building or Property:
Owner Mailing Address Suite •
No. Of Stories:
City/State Zip Phone
Sq. Ft. Of Project:
Occupant Name
Occupancy Class(es)
Name •
Contractor Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy Will this project have a Fire Suppression System?
of all licenses Yes ❑ No ❑
are required if City/State Zip Phone (ADA)
with Disabilities Act
expired in C.O.T. ( )
database Valuation X 25% = $ Participation
Oregon Const. Cont. Board Licit Exp. Date Complete Accessibility Form
Project $
Name Valuation
Architect Plans Required: See Matrix for number of sets to submit
• Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws.
Engineer Name
Signature of Owner /Agent Date
Mailing Address Suite
Contact Person Name Phone
City /State Zip Phone
•
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition O Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 Notes:
Description of work: 1 j
TIF:
Parks: Estimated # of Employees
Note: Site Work Permit Application must precede or accompany Building
Permit Application
1: \COMNEW.DOC (DST) 8/97 /4 •
. \
''■.,..,
COMM RCIiii PLAN SUBMITTAL
RE UIREMENT MATRIX
Appli nt DSTs to Plans Exam' -er Plans Examiner to DSTs
Initial o. Plans required to complete
Plans 'outing (processing (see note a.)
Submitte .,
TYPE OF SUBMITTAL ': .' CPE PPE EPE CPE PPE EPE
SITE 1 -- -- 3 (j,o,u) -- --
.........................................................
B (New or Add) Ilii::::::::::::::::::g: 1 -- -- 3 (j,o,w) -- --
.......„..............................-....
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
. .
........................................
M (New or Add. or Alt) -- 2 (j,o) -- --
.---------------- -
-..,,,„:„.„:„...„.:.:„.:.:„........„4:. •
B & M New or Add) iiiii:1;i::::::4::::::::::: iiiinn 1 ', -- -- 3 (j,o,w) -- --
.................................................................
'',...---,........:•:•:•:.:•-•:•:•-•.- v
P (New, Add. or Alt) 11 -- '1 2 -- -- 2(j,o) --
,i,:,:-.,:,:,:,.:,:,:,.: ,
B & M & P New Air Add.) Illi:::::::::::::"::::::::::::$:::::::: 1 ', 1 -- 3 (j,o,w) 2(j,o) --
E (New, Add, .• Alt) :' -- -- 2 -- • -- 2(j,o)
B & M & P E (New, Add) ::::::::::::::M:::.:: N::' 1 .
' 1 3 (j,o,w) 2(j,o) 2 (j,o)
:
B or B & ! (Alt) iiiiiiiiKaiiiiii$4§:iiiiiNiti 1 - \ -- 2 (j,o) -- --
B & M & P (Alt)
gailiaium 1 2 ',, -- - 2 (j,o) 2 (j,o) --
• B&M&P&E(Alt) :::::::::M.:::' 1 1 \ 1 2 (j,o) 2 (j,o) 2 (j,o)
NOTES:
KEY:
a. The applicant will be requested to submit the correct number of j = Job B = BUP
revised plans when all plan review issues have been resolved. o = Office M = MEC
f = Fire P = PLm
Ai,41,4 u = USA E = ELC
,.,.
n t n r� - umulative Sewer Tally •
Tenant Name: Alff J V L foul G This SWR# 7 — cl
Address:J5 o ls- - 7 K\ Ea.) This PLM #: 7 8 7
. _ Pp .
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/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16 T
CuspidorlWater Aspirator 1 \ /
Dishwasher - Commercial 4
- Domestic 2 / v
Drinking Fountain 1 •
Eye Wash 1
Floor Drain /sink - 2 inch 2
-3inch 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
Sink - Bar/Lavatory 2 / (% ; /6
- Bradley 5
- Commercial 3 G;" / S cl" %
- Service 3
Swimming Pool Filter 1
-
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 S w C ‘ 7C- )
•
Urinal 6
TOTALS K-6- L r
• Total fixture values: � �� divided by 16 = 5 3 EDU ---- t C -• - 5 - x' , I
HISTORY .`- 1
PLM# f q0# / u 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