Permit CITY OF TIGARD
q PLUMBING PERMIT
`! B COMMUNITY DEVELOPMENT Permit #: PLM2009-00273
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009
Parcel: 2S109AA00400
Jurisdiction: Tigard
Site address: 14101 SW 125TH AVE
Subdivision: Lot: 0
Project: Walker
Project Description: Install tankless water heater.
Owner: FEES
WALKER, MELISSA Quantity Description Date Amount
14101 SW 125TH AVE
TIGARD, OR 97224 1 ea Water Heater 10/02/2009 $16.60
PHONE: 503-639-3536 1 12% State Surcharge - 10/02/2009 $8.70
Plumbing
56 ea Minimum Fee Adjustment - 10/02/2009 $55.90
Contractor: Plumbing
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:
Total $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: Permittee Signature: QP
Call 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.
Sep 30 09 09:32e 5036248251 p.1
PIumbin2 Permit ADDlicatiolRECEJVED
Building Fixtures .z FOR OFF USF. " Y' { .
City of Tigard S E P 3 0 2009 I�cCe1 ( ' Penile No. uate ;By. P L rtizoOQ . 0407
'. 1 3125 SW Hall Blvd.. Tigard. 012 97223 Plan Review /"� ti�pQ f�L,
Phone • 5 03h39.71'I Fax: St)3.59O OF TIGARD OilierPerait'�e 2W` • 0
L) ,uvl3y ..
7I GARD • IIUpCCOUll LAIC 503 639 4175 I D.uc KcaJv'E �los RI See Page? fur
Internet: www ligard g BUILDING DIVISION I hotlied/Method: i 1 f Supplemental (idol-motion
—
TYPE OF WORK FEE* SC EDULE
I: New construction I ❑ Demolition
For special infornsuthnt use checklist
�/ f l Descri lion Q E: ___Ti
ULI AdditiolUattei tti nteni ❑ Other: New ireplaee I- 2- family dwellings (includes 100 It. Co, each utility connect :on)
_
CATEGORY OF CONSTRUCTION SFR (I) bath 249 20
14 I - and 2- tamil) dwelling ❑ Commercial /industrial SFR (2) bath • 350 00
❑ Accessor building ❑ Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other:
Fire sprinkler (_ sq. it) Page 2
JOB SITE INFORMATION ANA LOCATION _ Site utilities —
Job site address: 6 ,/, Catch basin or area drain _ — I 16.60
/ I Dell, leach line, or trench drain 10 60
C'ityiStatciZll': ////L L, / !// ry
Footing ° dram (no. linear ft.: : _) Passe
Suite /bldg. /apt. no.. Project name:
Manufactured home utilities 110 00
Cross streevdireetions to job site:
Manholes 16 60
_
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: —) Page 2
Fixture or item
Tax map /parcel no.• — - --
Absorption vatic I6.60
, 1)ES('Ri'TI ON OFF RK �� /� f3ackllowpreventer Page T
IUA / /. /� r inf / / /� � VITA Backwater valve 16.60 - H
��jr�
/ , i/ /`: /,/ % �� . - 6' Clothes washer 16.60
!A / f/ � Dishwasher 16.60
Drinking fountain 16.61)
PROPS TY OWNER ❑ TENANT Ejectors/sump Ib 60
Name' G _/ / ///��'// Expansion tank 16.(ii)
Address: / . & Fixture /sewer cap 10 1,0
City /State/ZIP: j,/ /j �ii 'IF / / Floor drain /floor sink /hub 1660
Phone: O` a dr— 10 I Fax: ( ) Garbage disposal E 16 60
Huse bib . 16 60
Ig APPLICANT ❑ CONTACT PERSON ,________H
' lee maker • Io 60
Business name i Interceptor/grease trap lb 6i) — Contact name: _ GEORGE MORLAN PLUMBING _ Medical gas (value: S —) Page 2
Address: 2222 N.W. RALEIGH ST. Primer ` ` 16 60
PORTLAND OREG _
ON 97210 Roof drain (commercial) 16.60
City/State/ZIP: / ,
Phone: dal �7//- .�0tf Fax:: 4 ly3 ) A�[� �/ Sinklbasin/lavatory 16 6t)
/ Tub/shower/shower pan 16 60 I
E -mail: Urinal 16.60 j —
CONTRACTOR Water closet 16.60 •
Business name ^ I Water healer 16.641
Address: GLUHUE MUHLAN PLUMBING Other:
—222241X-RALEIGH-ST .__..___
Subtotal
City /State/2IP: PORTLAND, OREGON 97210 Minimum permit fee: S72 50
Phone: `M) a7 /75/ Fax: � 6,4*u„ 1 Residential backtlow minimum permit tee. 536.25
Plan review CC (25 % otpermi: Ice) ,
B L / Plumbing Lie, no.: u. •, // —
/ State surcharge (12% of permit li et . ' O
Authorized signature k / / TOTAL PERMIT FEE ! g D
Print name: r / 7,6 7 ' ie Date: f_ . 7 This permit application expires if a permit is not obtained within
1N0 days after it has been accepted as complete.
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