Permit (6) x „ CITY OF TIGARD SEWER CONNECTION PERMIT
f, le COMMUNITY DEVELOPMENT Permit#: SWR2019-00229
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/01/2019
TIGARD 13125 2S111ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Interior plumbing for a new two-story school.
Contractor: TRIPLETT WELLMAN INC Owner: UNION HIGH SCHOOL DISTRICT
PO BOX 160 NO. 3 JT
WOODBURN, OR 97071 00000
PHONE: 503-982-4188 PHONE:
FAX: 503-982-0390
FEES
Description Date Amount
Specifics: Sewer Connection Fee 07/30/2019 $68,150.00
Sewer Inspection-Commercial 07/30/2019 $45.00
Type of Use: COM
Class of Work: ALT
Install Type: Building Sewer
Fixture Units:
Number of Dwelling Units: 11.75
Total $68,195.00
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 ii
work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatior
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.
Issued By: ,/ Permittee Signature: - _ A
Call '0 9.4175 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: 'I'WALITY MIDDLISCHOOL SWR# 2019-00229
TIGARD Site Address: 14650 SW 97TH ST. PLM# 2019-00107
Parcel#: 2S 111 ACO2700
Fixture Value Previous Previous Credits Capped Fixture I ixture 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 1 4 1 4 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 6 6 17 17 11 11
Eye Wash 1 0 2 2 2 2 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 22 110 44 220 22 110
flinch 6 0 2 12 2 12 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 I IP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 1 1 1 1 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) 1 0 0 0 0 0
-Stall 2 0 8 16 5 10 -3 -6
Sink:
-Lay/Bar-Non-Food Related 2 0 89 178 85 170 -4 -8
-Bradley 5 0 0 0 0 0
-Com/Scrv/Util-Food Related 3 0 9 27 10 30 1 3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 2 12 3 18 1 6
Water I:Atractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 42 252 52 312 10 60
Urinal 6 0 8 48 10 60 2 12
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 192 l 668 232 856 40 188
Current Fixture Value 188 divided by 16= 11.750 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 188 divided by 16= 11.750 over (under) $ 68,150.00
Enter EDU Change Here 11.750 *
*Round l?DUs 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 TAGGAR'I'X2449 Date: 7/23/2019
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 development charges.
I:A Building\Sewer Tally\Sewerl'allyShcet_5800_070119.xlsx