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Permit y CITY OF TIGARD SEWER CONNECTION PERMIT • COMMUNITY DEVELOPMENT Permit#: SWR2014-00011 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2014 Parcel: 1 S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD Project: Lincoln Three Subdivision: METZGER,TOWN OF Lot: 9 Project Description: 2.38 EDU increase Contractor: Owner: LINCOLN CENTER LLC BY SHORENSTEIN PROPERTIES LLC 555 CALIFORNIA ST 49TH FL SAN FRANCISCO,CA 94104 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 02/18/2014 $11,424.00 Type of Use: COM Class of Work: ALT Install Type: Building Sewer Fixture Units: Number of Dwelling Units: 2.38 Total $11,424.00 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspe .:e .r more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T••se rules • e set forth in OAR 952-001-0010 through OAR 952-001-0090. You may.-ebtain a copy of the rules or direct questions to OUNC .y calling 503.23'.1987 800.332.2344. C Issue. By: Permittee Signatur 0/0/1 Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Accumulative Sewer Tally Tenant Name: Lincoln Three SWR# 2014-00011 Site Address: 10220 SW Grecnburg(1st Floor) PLM# 2014-00043 Parcel#: 1S135AB01004 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value count capped#s value count added# added value total#s total 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 0 0 0 -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 3 6 3 6 -3 inch 5 0 0 0 0 0 -4 inch 6 0 0 0 0 0 -Car Wash 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) 42 0 0 0 0 II Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 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) I 0 0 0 0 0 -Stall 2 0 0 6 12 6 12 Sink: -Lav/Bar-Non-Food Related 2 0 0 4 8 4 8 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 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 2 12 2 12 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 15 38 15 38 Current Fixture Value 38 divided by 16= 2.375 Current EDU 1 EDU = $4,800.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 38 divided by 16= 2.375 over (under) $ 11,424.00 Enter EDU Change Here 2.380 Notes: Authorized Name/Signature: Debbie Adamski Date: 2/18/2014 Building Division rote: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be ubmitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer Tally\SewerTallySheet_4801)._070113.xlsx