Permit CITY TIGAR SEWER CONNECTION PERMIT
1� DEVELOPMENT SERVICE PERMIT #: SWR1999 -00265
��� �! DATE ISSUED: 12/15/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 71
SITE ADDRESS; 10330 SW SCHOLLS FERRY RD PARCEL: 1S134AB -03300
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME: MUSLIM EDUCATION TRUST
USA NO: FIXTURE UNITS: 4
CLASS OF WORK: ALT DWELLING UNITS:
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Dummy sewer permit. Original fixture value count was 16, capped 13 and added 17 for a new total
of 20 fixtures values. This did not increase the EDU count.
Owner:
FEES
MUSLIM EDUCATION TRUST ISLAMIC . Type By Date Amount Receipt
PO BOX 283
PORTLAND, OR 97207
Total
Phone:
Contractor:
Phone:
Reg #:
•
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 Or Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain copies •f these rules or direct questions to OUNC by calling (503) 246 -1987.
I sued by: ` _ • , y 1Y / / /:! ' Permittee Signature:
Call (503) 639 " 75 by 7:00 P.M. for an inspection needed the next business day
Tenant Name: H. f, , l . Accumulative Sewer Tally This SWR#: 5-0 2 04 99 -60aGIS
Ac Jress: &0 , o 5d-dot-Le FLY This PLM#: P .M 199 9'604/31
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added # added total #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- Jacuz/Whpl 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
- 3 inch 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 d■
Sink - Bar /Lavatory 2 42 9
- Bradley 5 .
- Commercial 3
- Service 3 1 )
Swimming Pool Filter 1 r,,
Washer. Clothes 6 I �Y
Water Extractor 6 nn
Water Closet. Toilet 6 d /
Urinal 6
TOTALS Pe 9 / 3 5 1 " - °
Total fixture values: /. divided by 16 = /.a EDU . I - b` - � , `te■O eke--"-e,
HISTORY J
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR# .
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#