Permit CITY TIGARD SEWER CONNECTION PERMIT
Y DEVELOPMENT SERVICES • , PERMIT #: SWR1999 -00115
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/24/99
II
SITE ADDRESS; 15055 SW SEQUOIA PKWY 130 ORIGINAL PARCEL: 2S112DA -00800
SUBDIVISION: ZONING: I -P
BLOCK: LOT: • • JURISDICTION: TIG'
TENANT NAME: EMCON
USA NO: FIXTURE UNITS: 21
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM • NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Sewer permit for increase of 1 EDU due to installation of additional plumbing fixtures on plumbing
permit on PLM1999- 00160. See case notes for actual fixture counts.
Owner: FEES
PAC -TRUST
15350 SW SEQUOIA PKWY Type By Date Amount Receipt
SUITE 300 PRMT GEO 5/24/99 $2,300.00 99- 315605
PORTLAND, OR 97224 Total $2,300.00
Phone:
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202.
Phone: 236 -4152 V
Reg #: LIC 00000172
PLM 26 -83PB
Required Inspections
•
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 copies of the e rule or direct questions to OUNC by calling (503) 246 -1987.
Issued by: / Permittee Signature:
Call (503) 6 - • -4175 by 7:00 P.M. for an inspection needed the next business day
Tenant Name: EMCv Accurrulative Sewer Tally This SWR #: 499-0
Address: I5055 `3%. -Q I (f1' /OD • This PLM #: 160
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added if added total #s total
Count off #s count value values
Baptistry/Font 4 ,
Bath - Tub /Shower 4
- JacuzlWhpl 4
Car Wash - Each Stall 6 .
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4
- Domest 2 '
Drinking -Fountain 1
Eye Wash 1 -
Floor Drain /sink - 2 inch 2 1 .�
-3inch 5
- 4 inch 6 ■
. - Car Wash Drain 6
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind (over 5 HP) 48 •
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16 , - . -
Shower - Gang (Per Head) 1 -
- Stall 2 2 -
Sink - Bar/Lavatory 2 " .
- - Bradley .. 5 -
- Commercial 3
- Service 3 I -
Swimming Pool Alter 1 _ a • —
Washer, Clothes - 6 — "
Water Extractor 6 _ ' n , n
Water Closet. Toilet 6 O� d .
Urinal 6
TOTALS Siss o2 -
Total fixture values: MID divided by 16 = /7. EDU l b ET Jt,� � S O.-' --
tanc - a.A.., a / -0LL _ •
HISTORY
PLM #9s- oo3g$EDU# / SWR# 78- OOaLO PLM# EDU# SWR#
PLM# EDU# • SWR# PLM# EDU# SWR#
PLM# EDU# SWR# - PLM# EDU# SWRI/•
PLM# EDU# SWR# PLM# EDU# , SWR#