Permit CITY OF TI CARD SEWER CONNECTION PERMIT
41 1 DEVELOPMENT SERVICES PERMIT #: SWR2000 -00098
" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/15/00
SITE ADDRESS; 16160 SW UPPER BOONES FERRYRD PARCEL: 2S113AB -00600
SUBDIVISION: BANt4O CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
TENANT NAME: AGRITOPE
USA NO: FIXTURE UNITS: 176
CLASS OF WORK: ALT DWELLING UNITS: 1
TYPE OF USE: COM NO. OF BUILDINGS:
INSTALL TYPE: BUSWR IMPERV SURFACE:
• Remarks: Plumbing for tenant improvements. See PLM2000- 00147.
Owner:
FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 PRMT DEB 5/15/00 $2,300.00 0002192
Phone: Total $2,300.00
Contractor:
Phone:
Reg #:
•
Required Inspections
Sewer Inspection •
C
•
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 • : - in co..- of these ru - or direct questions to OUNC by calling (503) 246 -1987.
Issue by: ` , :: oak, ��_ Permittee Signature:
Call (503) 639 - 75 by 7:00 P.M. for an inspection needed the next business day
Accumulative Sewer Tally
Tenant Name: Mg/ roet This SWR# aR" - 66 09'
Address: /6 /6O 56J (,(7 69b4e5 Feet 12D This PLM #: 01o00 DOI Y 7-
Fixture Value 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/Whirtpool 4 , ,
Car Wash - Each Stall 6 .
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 i
- Domestic 2
Drinking Fountain 1 1 , ,
Eye Wash 1
Floor Drain/sink - 2 inch 2 _
- 3 inch 5 / -
-4inch 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
- Stall 2 .
Sink - Bar/Lavatory 2 - .
- Bradley 5 - -
- Commercial 3 _ °
- Service 3
Swimming Pool Filter 1 __
Washer - Clothes 6 .
Water Extractor 6 ,
Water Closet - Toilet 6 .
Urinal 6
TOTALS
Total fixture values: /76 • divided by 16 = //, 0 EDU - 'f// 5 /9 DD% 1 E124 re C6utP
. (Ics vIvr eF /O ,
HISTORY
PLM # /9qq EDU# /p SWR #,y9q -6 /7 PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
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