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Permit (155) CITY OF TIGARD SEWER CONNECTION PERMIT IN �� COMMUNITY DEVELOPMENT Permit#: SWR2018-00116 Date Issued: 07/01/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1010001600 Jurisdiction: Tigard Site address: 7820 SW HUNZIKER RD Project: The Fields Apartments-Building 4 Subdivision: FIELDS APARTMENTS Lot: None Project Description: Building 4-Sewer connection for new 48-unit apartment building. Contractor: Owner: FIELDS, FRED W REVOCABLE LIVING 111 SW 5TH AVE#3675 PORTLAND, OR 97204 PHONE: PHONE: FAX: FEES • Description Date Amount • Specifics: Sewer Connection Fee 07/01/2019 $271,200.00 Sewer Inspection-Commercial 07/01/2019 $45.00 Type of Use: MF Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 48 Total $271,245.00 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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / 1111110 `� � ` Issued By: Permittee Signature: c ��,�,4'11 Cal (.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. mu = Tenant Name: THE FIELDSAAPARccuTMENTSlative Sewer Tally SWR# 2018-00116 T I G A K D Site Address: 7820 SW HUNZIKER RD BLDG 4 PLM# 2018-00189 Parcel#: 2S1010001600 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 0 0 0 -3 inch 5 0 0 0 0 0 -4inch 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 0 Ice Machine/Refrigerator Drain 1 0 0 0 0 0 Living Unit 16 0 0 48 768 48 768 Oil Sep(Gas Station) 6 0 0 00 0 Rec.Vehicle Dump station 16 0 0 0 I 0 0 Shower: -Gang(per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0 0 Sink: -Lay/Bar-Non-Food Related 2 0 0 0 0 0 -Bradley 5 0 0 0 0 0 -Com/Sere/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 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 48 768 48 768 Current Fixture Value 768 divided by 16= 48.000 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 768 divided by 16= 48.000 over (under) $ 264,000.00 Enter EDU Change Here 48.000 * *Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 9/25/2018 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system_rlevelopmwiitcharges I:\Building\Sewer Tally\SewerTallySheet_5500_070117.xlsx