Permit ;:1, A CITY OF TIGARD SEWER CONNECTION PERMIT
,G DEVELOPMENT SERVICES PERMIT #: SWR2000 -00008
--,44. �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/25/2000
SITE ADDRESS; 11834 SW PACIFIC HWY PARCEL: 2S101BB -00301
SUBDIVISION: TIGARD ROAD GARDENS ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
TENANT NAME: TEXACO
USA NO: FIXTURE UNITS: 25
CLASS OF WORK: ALT DWELLING UNITS: 1 •
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Sewer permit for plumbing TI. Exiting fixture count 16 add 34 for new, minus 25 for capped fixtures
= 25 or 1.56 EDUs = 2 EDUs. Current EDU count 1.
Owner: FEES
EQUIVA SERVICES
3800 NW STE HELENS RD Type By Date Amount Receipt
PORTLAND, OR 97296 PRMT DST 01/25/200C $2,300.00 00- 321372
Total $2,300.00
Phone:
Contractor:
Phone:
Reg #: ORIGINAL
Required Inspections
Fr/Lige—
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 ou to ollow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -01 •110 throu! V. - 952 - 001 -0080.
You may obtain copies of th- se rules or direct questions to OUNC by cal . • : • : 9: 9:
Issued by: f/ /ea Permittee , ignature: ey
Call (503) 639 -4175 by 7:00 P.M. for an inspection nee • e • - - - day
p Accumulative Sewer Tally /
Tenant Name: lej(G_CO l This SWR# 200b -Beind
Add 11`1, 5(,t) Vetr � f'T (, oci This PLM #: -- LOCO - bDDD - 7
Fixture Value 1( 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 _
Cuspidor/Water Aspirator 1 '
Dishwasher - Commercial 4
- Domestic 2 •
Drinking Fountain 1 I. " /
Eye Wash 1 .
Floor Drain/sink - 2 inch 2 "" ;2 y
- 3 inch 5 / -. J . Vii; J • R5 .
- 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 I
- Stall 2 _
Sink - Bar avato 2 n2 — 4 / ✓ 7-
- Bradley 5
- Commercial - 3 /- - ..J
- Service 3 _ 1 ' 3
Swimming Pool Filter 1 _
Washer - Clothes 6 • .
Water Extractor 6
•
Water Closet - Toilet 6 02 - - I R '
Urinal 6 2�f
TOTALS /6' - 7 -.25" -9 4 3. l ,R5
Total fixture values: Z 3 divided by 16 = / 56 EDU . . -- ei e rfj/ 5 )PD ! rd.
Cu /t,e4,1)r erovi.cr --
HISTORY
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
04/07/2000 Activities for Case #: SWR2000 -00008
2:55:08 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
SWRC003 Application received 01/05/2000 KJP RECD No Hold BON 01/10/2000
• SWRC008 Permit Created 01/10/2000 BON DONE No Hold BON 01/10/2000
SWRCO25 USA Sewer Card Processed 01/10/2000 BON DONE No Hold BON 01/10/2000 •
SWRCO32 DST Post - Review Completed 01/21/2000 GEO DONE No Hold GEO 01/21/2000
SWRA070 Ready to issue 01/21/2000 GEO DONE No Hold GEO 01/21/2000
SWRC080 (F) Issue permit 01/25/2000 GEO DONE No Hold DST 01/25/2000
SWRA720 Case Finaled 01/26/2000 JMT DONE No Hold JMT 01/26/2000 no inspection required
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