Permit � k -; CITY OF - - 'G/�R® PLUMBING PERMIT
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` COMMUNITY DEVELOPMENT Permit #: PLM2009 -00301
TIGARD` 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/22/2009
Parcel: 1 S 133AD06600
Jurisdiction: Tigard
Site address: 10895 SW SUMMER LAKE DR
Subdivision: Lot: 0
Project: Lange
Project Description: Install tankless water heater to existing interior water line.
Owner: FEES
LANGE, TERRY E Quantity Description Date Amount
10895 SW SUMMER LAKE DR
TIGARD, OR 97223 1 ea Water Heater 10/22/2009 $37.52
PHONE: 503 - 579 -0685 1 12% State Surcharge - 10/22/2009 $8.70
Plumbing
35 ea Minimum Fee Adjustment - 10/22/2009 $34.98
Plumbing
Contractor:
GEO A MORLAN PLUMBING & APPL CO
2222 NW RALEIGH ST
PORTLAND, OR 97210
PHONE: 503 - 274 -1444
FAX: 503- 624 -8251
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Tota $81.20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
c) .
�.�f .—SC_ Permittee Signature: D Signature: A)p�pL/ 69 /I
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��, ���CCC c/' Calll 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
- •Oct. 1 9 09 08:19a 5036248251 p . 1
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Plumbiniz Permit Application RECEIV ,.■,,-,:.:„..,._...,...,.....,............,,,,............,..„..,..,... .---..--. ,. --
g ...........,...;,..„.,.,.„..:,..„..,.,,.........,4,,..:f.:';- ----.- 4.•;-..:1. '. '
Building Fixtures .:- :.
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City of Tigard
.1 I ' I ildi I.ilvd . 1 igard, OR 97223
° • 11 2 f ' 441111 : i.. ..■ .--'''''.- „
= -. 1 503 6.3'; -1171 Fax 503.598 .1960 CITY T O F 1 9 C
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7 Ra ::::,,,t, r
lercved n /" 11 1°
- .:...,-,:-.:,..,:i inspection Lille' 51)3 639 1175
::0.0./NAD• BUILDING DIVISI6NiRedct-h':.d i, (_ See Pne 2 ior
.. v•k.,, oiler wtvo (iv:au-or gov
to SUNIICIllelltUi havrt1111:1.4
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TYt OF WORK FEE* SCI E
0 New construction E Demolition For special information use elmetilist.
o
Description 1 Oty. j Ea J fault _
Additionialterationireplateinent 0 Other:
New I- 2-family thsellines (includes 100 11. ror et1Ch ■IIIIIIN CLIIIIIC,11,111)
CATI.GOWY OF CONSTRUCTION SFR (I) bath
Xr I- and 2-fainik dwelling D Commercial/industrial SFR (2) bath 350 ri0
___
SFR (5) bah 39q n
t
E Accessory building 0 Multi-fami I> _ .. --
- Each additional bath/kitchen .
0 Master builier 0 Other:
Fire sprinkler ( sti tt.) Pap. 2
.1013 SIT1.: INFORMATION AM) LOC:A
Site utilities
--- 2 ---
'
2(6 Sib.: ot:11V;., & - Li Ryin . ..., - 5: j yy AlW , a/ 1 4 9
CLItCh basin or arQii drain
----
---__—",/
pl g7A
Dryvvell, leach line. or trench drain 16.66
L/
C i :‘/StateiZ IP
..__Z29.&) i .. •
Yooting dram (no. linear ft.: i Ptec: 2
SuiternIdgjapt no . 1 Project name:
Manufactured home utilities I 10ii6 ---li
Cross streetidirec6uits to job site: _
Manholes 16 66
Rain drain connector 1 6 60
Sanitary sewer (no. linear ft.: 1 Pagi 2
Storni sewer (no linear ft.: : Pain; 2
_
---•
ubdivision: 1 Lor o.:
Water service (no linear ft.• ■ Pane ..
S n
- -
Fixture or iteni
Tax map/parcel no. _
Absorption valve 16 oil
DESCRIPTION OF WORK
Backtlow preventei Pane 2 1
. - --•
/ 11 2/i it G ' (./1,11IN W I ,. G:(.1 B(tekwater valve 1
--i
/ - -- Clothes washer 16 oti
Dishwasher 16 6()
Drinking fountain I 3.611
------- PROPERTY OWNER 0 TENANT -
F_jectorsisump 10 0
Name: / . . Expansion tank 16 66
Address: ---- 5/j7W/"1/&16. itati2, FixtureseNver cap 16 61.:
City/State/Z1P _ -- . 1,: - e 9.7 Floor drain/tloor sinklimb
16.6ii
g/k7_
Ciarbage dispo,n1 16 6 1
11!_fili.±LIZi „.. -1,ix : ( )
Hose bib 10 6u 1 -
_. X ■PPLICAN' .... l E CONTACT PERSON
Ice maker 10 66
Business name
Interceptor/grease trap 16th
GEORGENICIRrATTPLDNEING
Contact name.
2222 N.W, RALEIGI-4-ST Medical gas (value: S ) Piiee 2
Adap„..ss: PORTLAND, OREGON 97210 Printer
Roof drain (commercial') I (
City/State/ZIP: 1 ;
Sinktbasinllavator) 16 110
Phone: t , iip_. _ ' ir Fax: s i_V - 0 ) %A --7 Tub/shower/shower pan 16 Nt
E-mail: idivic -e-e_2&-z)pei22(2z/zzm. 02 Urinal
CONIRACTOR
Water closet i h ht.
h ot t 4 37 . 52
31 51)105 tl illne
EOROLELAN PLUMBING W;Ircr heater
_ /
Address: 2222 N.W. RALEIGH ST. Other 1
--- -- PORTLIADTOREG0N-g721-i subtutio
Citv/StittelZIP:
Minimum pernui lee 3 56
■ ''''.11 ( LY , 5 1 ,./V I Fax: ( j / ) .
, .t.' -I — AZI. Residcznial backflownlininturn permit fee S36 2
Plan review (25" or permit leer ' 1
3 Lie.: 2
h., / fo 1 Plumbing Lie. ito.:-1
State surcharge (12% of permit fee Li F
Authorized sig.nature• if
i I / ' C,/ 1 0 //if
10T AI. PERiMIT
Print name: / A O X 1 Date: / 0 7 /7
c , A° This permit application expires if a permit is not au:lined o 11 11
I80 da)s after it has been accepted as coin piete. 4W---