Permit 4114.1 CITY OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT #: SWR2003 -00311
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/6/03
SITE ADDRESS; 08530 SW PFAFFLE ST PARCEL: 1S135DA -01000
SUBDIVISION: METZGER ACRE TRACTS ZONING: C - P
BLOCK: LOT: 020 JURISDICTION: TIG
TENANT NAME: DALTON'S CATERING
USA NO: FIXTURE UNITS: 21
CLASS OF WORK: ADD DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: 1.3 EDU increase, previous fixture units were 16, this permit adds 21 fixture units for a new total of
37 units.
Owner:
FEES
DAVE DALTON
17930 SW MCEWAN Description Date Amount
TUALATIN, OR 97062 [SWUSA] Swr Connect 8/6/03 $3,120.00
[SWUSA] Swr Connect 8/6/03 $0.00
Phone: 503 267 - 4419
Total $3,120.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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" Perm
Issued by: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Accumulative Sewer Tally
Tenant Name.: Dalton s Catering This SWR# 2003 -00311
Site Address: 8530 Sw Pfeifle St This PLM# 2002 -00274
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisery/Font 4 0 0 0 0 0
Bath - Tub /Shower 4 0 0 0 0 0
- Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 0 1 4 1 4
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink - 2 inch 2 0 0 2 4 2 4
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash Drr 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 HP) 48 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 0 2 4 2 4
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 1 3 1 3
- Service 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 0 1 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU Count 1 16 16
Capped EDU Credit 0
TOTALS 0 16 0 0 7 21 7 37
Current Fixture Value 37 divided by 16 = 2.3 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 16 divided by 16 = 1.0 Previous EDU
Change 21 divided by 16 = 1.3 over (under) $ 3,120.00
Enter EDU Change Here 1.3
HISTORY
Notes: Per Jamie, 1 EDU PLM# EDU# SWR#
PLM# EDU# SWR#
PLM# EDU# SWR#
C : � 1 .\ -. • ct i wt...4/ Date: ` � �3
-•• Si of p- rson that calculated this tally sheet and date perfro ed is required