Permit y ��n CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2009-00259
ThhA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/18/2009
Parcel: 2S103DB10300
Jurisdiction: Tigard
Site address: 13220 SW GENESIS LP
Subdivision: Lot: 0
Project: Cutonilli
Project Description: Installation of tankless water heater.
Owner: FEES
CUTONILLI, STEPHEN & DIANA Quantity Description Date Amount
13220 SW GENESIS LOOP 1 ea Water Heater 09/18/2009 $16.60
TIGARD, OR 97223 1 12% State Surcharge - 09/18/2009 $8.70
PHONE: 503 - 684 -7915 Plumbing
56 ea Minimum Fee Adjustment - 09/18/2009 $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 direc es io -to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu By: C 0lCQ/L�1�4 -�Q Permittee Signature:/
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 18 09 01:37p 5038248251 p.2
5.
Plumbing Permit Application
Building Fixtures RECEIVE
Received
City of Tigard / � G PermitNo.:'
lig
• 131 ll
SW Hall Blvd., Tigard, OR 97223 S E P 18 2009 pateBy: /d / 420-425-9
C Plan Review
P hone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639 CITY OF T IGARD Date Ready /By: Jar CO See Page 2 for
r.gov UILDING DIVISIO1 /Method: 7, Supplemental Informafi
Intemet: www.tigard- o on
TYPE OF WO FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. 1 Ea. 1 Total
Addition/alteration /replacement ❑ Other: New t- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
►:1 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION, Site utilities
Job site address: _ A / y .�I / #� _I /Q Catch basin or area drain 16.60
City /State /ZIP: - 77 -
r , / :I1 w _ [
garipegimm / � Dr}wvell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions 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 valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
_AV Il .t� ./, i l/ _ �'� / /. / I/. Backwater valve 16,60
W . / � Clothes washer 16.60
r „y, Dishwasher 16.60
0 PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: L/ 707,1_, 71V . Expansion tank 16.60
Address: / a 6' II _1 .:di ` / // Fixture/sewer cap 16.60
_
City /State/ZIP: "!J �1,_ // Floor drain/floor sink/hub 16.60
Phone: o3) a - ge. Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
. Ice maker 16.60
Business name: �_ J , • ././ ./Win Interceptor/grease trap 16.60
Contact name: / - e . , Medical gas (value: $ ) Page 2
Address: a 4 / /.. 0 e /. Primer 16 60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: u.3 c7 m/ 7 L/ Fax: 3) 6 S{'7. ' Sink/basin/lavatory 16.60
` /1 Tub/shower/shower pan 16 60
E -mail: I • ` t ' e 7/ ', 1/U , /177 Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: e , he;„, / f r f iika . Water heater 1 16.60
Address: . i Other:
PA /� b i�
City/State/ZIP: GX1 4( O W 9'71 `d Subtotal
Y / �/
Minimum permit fee $72.50 ��
Phone: (p �7 ,i_tyl/ Fax: (i 75 (O � c g�\
/ / 53 Residential backflow minimum permit fee: $36.25
/ /
CCB Lic.: Plumbing Lie. no A . , _ / .0 r Plan review (25% of permit fee)
C!/
Authorized signature: // . /� State surcharge (12% of permit fee) #f `
TOTAL PERMIT FEE MOP
Print name: 1 . /2 W Date: 7 /g This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.