Permit CITY TIGARD SEWER CONNECTION PERMIT
i DEVELOPMENT SERVICES PERMIT #: SWR2000 -00007
A,I! DATE ISSUED: 01/18/2000
13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS; 09575 SW LOCUST ST PARCEL: 1 S126DC -04500
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT: 007 JURISDICTION: TIG
TENANT NAME: PHOENIX INN
USA NO: FIXTURE UNITS: 652
CLASS OF WORK: ADD DWELLING UNITS: 38
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Sewer permit for 45 unit expansion to existing motel. Current fixture count is 848, add 652 = 1500
fixtures. Current EDU count is 53 add 41 = 94 EDUs. Credit for Demo of two (3) SFD and one (1)
office bldg. Credit for 3 EDU's for demos.
Owner:
FEES
VIP MOTOR INNS INC
29757 SW BOONES FERRY RD Type By Date Amount Receipt
WILSONVILLE, OR 97070 PRMT GEO 01/18/200C $87,400.00 00 321204
Phone: 503682 - 9284 Total $87,400.00
Contractor:
Phone:
Reg #:
Required Inspections
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 co- ,f these rules or dir- t questions to OUNC by calling (503) 246 -1987.
Issued by: /L Permittee Signature: i, A / a,
i
Call (503) 63!.-4 75 by 7:00 P.M. for an inspection needed the next business day
' Accumulative Sewer Tally
Temsn it Name: \ko 1:N) i x I iJ IJ This SWR# ca000 - aoca7
Address: C15-7S raa�. L.;cu,F51- This PLM #: Acc - 0000 /
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added Us total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4 , 147 /q-
- JacuzzW/hirlpool - 4 -
Car Wash - Each Stall 6
- Drive Through 16 -
Cuspidor/Water Aspirator 1 -
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2 17 sp 4
-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 4 ,
Oil Sep.(Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1 _ ,
- Stall 2
Sink - Bar/Lavatory 2 I 4/7 A; q ,
- Bradley 5 - /
- Commercial . 3 /` 2 "^c - - � ,
- Service 3
Swimming Pool Filter 1 .
Washer - Clothes 6
Water Extractor 6
" Water Closet - Toilet 6 , 5-C ''t 3D
Urinal 6 _ X /a
TOTALS
84/5 7 --;2 Jsor
Total fixture values: /5 divided by 16 = 9
! EDU gy
00 'JAN- - 0 , e 12.1 , --. FP. 3 D UB
HISTORY ease: ) F isyo = 9/ ED /is q
PLM# EDU# 53 SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU #. SWR#
PLM# • EDU# SWR# PLM# EDU# SWR#
r:kdstskswrtaty.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MsT
,24 =Hour Inspection Line: 639 -4175 Business Line: 639 -4171 x
,. '6 003 7
_ Date Requested )-- VS'- 0 0 AM PM BLD
Location 0 C -2 S � til.\ , C 'ST Suite 44:P 000°' 00 1. /
Contact Person - Ph ` PLM
Contrac Ph I WR tC k 0 0 0 a 7
63 ',:',::f2,,;',,':*' Tenant/Owner
WA ELC
Retamin`g Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: /? G
Slab - `C9.i l 0 0 0 4q
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear . T
Framing / e 4, u L._. ■ 1 . 1 1— - , '2— 22.-- 1
Insulation
Drywall Nailing U.CjA C cyLx-- k".-- - k 1 \ c - \� 4 ^ o � Firewall
Fire Sprinkler
Fire Alarm ? G (T 1 1, 0 0 0 4 O, l � v
_ n, l
Susp'd Ceiling
Roof
Misc
, A 1M;o L- - 2060- O O t c 1 — 0 �i
PASS PART `.gam.
PLUMBING' "'`
Post & Beam
Under Slab 0 (51",f /
l eAq - 3 a -5
Top Out `
Water Service - 4) C I S .� \ d v (.�Q I d.
Sanitary Sewer JJ�
Rain Drains 1b... , ,�r--45 12 L �
Final i I �, n �� r f Q
�-FhetS�p,�RT FAIL '��� `t'e.�n/■ �-C/v �2.,�J� ,, _.
I
Post & Beam � O ,) ✓ t 4 `�'1 S i\ � -.._. Rough In r t✓y- \rQ � n
Gas Line `� . C� /
S �� . ke D o00 N k+-3 L,o1 `sue ',�-
� �► S ' PART FAIL 1�ZQ- �/) ` _OM �' ■ L vjce RICAL __ 3) J LA—C , 9,-L
Rough ,4 \ l� c) I`r �c 4 q U
UG /Slab J
Low Voltage 40' Fire Alarm /� ' \ v\ L- A.
Final
PA S PART FAIL
:ackfill /Grading Sanitary Sewer
Storm Drain ,Aoki
[ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fir Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA' r
pproach /Sidewalk k II ate 7 1 ` u v Inspector ��� C� Ext C)
er'A A AI(
Fina.
ip PART FAIL DO NOT REMOVE this inspection record from the job site.