Permit CITY OF TIGARD SEWER CONNECTION PERMIT
111
COMMUNITY DEVELOPMENT Permit#: SWR2019-00272
Date Issued: 10/22/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S136DD02300
Jurisdiction: TIG
Site address: 11799 SW 69TH AVE
Project: HAMPTON INN&SUITES Subdivision: Lot:
Project Description: Sewer connection for a new 87,872 sq.ft.five-story, 152 room hotel:74 DUE's.
Contractor: Owner: DVKOCR TIGARD, LLC
1419 W MAIN STREET, SUITE 110
BATTLEGROUND,WA 98604
PHONE: PHONE: 360-723-0024
FAX:
FEES
Description Date Amount
Specifics: Sewer Connection Fee 10/08/2019 $429,200.00
Sewer Inspection-Commercial 10/08/2019 $45.00
Type of Use: COM
Class of Work: NEW
Install Type:
Fixture Units:
Number of Dwelling Units:
Total $429,245.00
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 95 -001-0010 throu.h OAR 952-001-0090. You may obtain a copy of the rules or direct questions
to OUNC by calling 503.232.1987 r 1.800.332.23,4
Issued By: 7r Permittee Signature:
Call 503.639.4175 by 7:00 a.m.fur 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
II Z
Tenant Name: HAMPTON INN&SUITES SWR# 2019-00272
Site Address: 11799 SW 69TH AVE PLM# 2019-00245
TIGARD
Parcel#: 1S136DD02300
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
-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 IIP) 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 74 1184 74 1184
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 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 0 0 0
-Bradley 5 0 0 0 0 0
-Com/Sery/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 74 1184 74 1184
Current Fixture Value 1184 divided by 16= 74.000 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 1184 divided by 16= 74.000 over (under) $ 429,200.00
Enter EDU Change Here 74.000 *
*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: 9/12/2019
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:ABuilding\Sewer Tally\Sewer I'allySheet_5800_070119.xlsx