Permit L .
CITY OF TIGARD PLUMBING PERMIT
• 3 ' COMMUNITY DEVELOPMENT Permit #: PLM2009 -00227
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2009
- TIGARD g Parcel: 1 S125DC01700
Jurisdiction: Tigard
Site address: 7105 SW VENTURA DR
Subdivision: Lot: 0
Project: Peterson
Project Description: Installation of Rheem tankless direct vent water heater and 40 feet of piping.
Owner: FEES
PETERSON, SHERI Quantity Description Date Amount
7105 SW VENTURA DR
TIGARD, OR 97223 1 ea Water Heater 08/18/2009 $16.60
PHONE: 503-245-5775 55 da Missc Other Fee 08/18/2009 $55.00
1 12% State Surcharge - 08/18/2009 $8.70
Plumbing
Contractor: 1 ea Minimum Fee Adjustment - 08/18/2009 $0 90
GEO A MORLAN PLUMBING & APPL CO Plumbing
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: di a, /L Permittee Signature: D� "7-7-pe../ l
69-770 ,/
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.
Rug 18 09 08:46a 5036248251 p.
Plumbing Permit Applica ) CEVED
. Building Fixtures ion OFI -IC 1 , t tiE o�1
== City of Tigard AUG 18 2009 Receives
• 13125 S W Hall Blvd., Tigard, OR 97223
Date /By: ( � A � r l /� Permit N o.
s Phone: 503.639.4171 Fax: 5036®F P1aaate Revre
9 P�f�oo9 ovaa7
Inspection Line: 503.639.4175 Date Other Permit N aMQ for ��
TIGn
.L) Internet: wwwUgard- or.gov
BUILDING DIVISION DateReadyBy
1u+i+ p S
n a , /1� � A � 6 AN p/ Notified/Method. Suppte m 2 [oformetioa
,GG+ �!L/ O FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Addition/alteration/replacement ❑ Other: Description Qty. Ee Total
. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath I 249.20
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
00
❑ Accessory building ❑ Multi- family SFR (3) bath 399
❑Master builder ❑ Other:
Each additional bathilatchen 45 00
JOB SITE INFORMATION AND LOCATION Fire sprinkler ( sq ft.) Page 2
`711 0 5 5 � , Ti J Catch basin Job site address: 1 v Catch basin or area drain
16.60
City /State/ZIP: --TTG D , g �L7 a? ` t q� C'1a Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: l ]C Footing drain (no linear ft.. ) Page 2
Cross street/directions to job site: Manufactured home utilities _ 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no linear ft.: ___) Page 2
Storm sewer (no linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear Page 2
Tax map /parcel no.: Fixture or item
DESCR t• ION OF WORK Absorption valve 16.60
• I Backflow prevcnter Page 2
I !j 1 �a /J Backwater valve
Jt ' UJ N 1 r 16.60
�6 �`e�� We� Clothes washer 16.60
l d t Dishwasher 16 60
PROPERTY OWNER 1 ❑ TENANT Drinking fountain 16 60
Name: S ``�� —r -1)-)Ps.)
Ejectors/sump 16.60
.y ! D r C Expansion tank 16.60
Address: l `] J U ink o f C
(} �� Fixture/sewer cap 16.60
City/ State/ZIP: 1 6 1A : �V(__tL y\ 2'7 Floor drain/floor sink/hub 16.60
Phone: L2) a4.1.- 1 77c Fax: ( ) Garbage disposal 16.60
APPLICANT ❑ CONTAq PERSON Hose bib 16.60
Business name. C zti M . A (U t'L k V n �, Ice r maker 16 60
VVV UUUJJJ v tL7' Interceptor/grease trap 16.60
Contact name: c 111n otz ✓'
^� 1 W Medical gas (value: $') Page 2
Address: a !�} L- 1 4 - 1 --- 4 - 1 --- P nmer 16,60
City/ State/ZIP: , q ' q R oo f drain
!N � ( l,, 1 1 7 � i D (commercial) 16.60
Phone: (6bib (-7 IL /L/ 1 1 Fax :: (5/) ) Lo 34 ll )1 Sinlc/basin/lavatory 16.60
E -mail: tl Tub/shower/shower pan 16.60
Urinal 16.60
CONTRACTOR ^ ' f� n - Water closet
' 1O t � 16.60
Business name: A ' • � �sjl I J 4 & Water heater / 16.60
g��
Address: )) , 1 S
. +� . L Other: i/o O P /P //�/(� 7
Y 7
City/ State/ZIP: N—a tl/ / D ' � �a iD Subtotal
Phone: 67)3) a l..1.L L -114 Fax: (�� 'T T 1( -C Minimum permit fee: $72.50 -.7
Residential backflow minimum permit fee: $36.25 ! ��L
CCB Lie.: a-7 ., Plumbing Lic.po.: a / PS ' Plan review (25% of permit fee)
Authorized signature: 411P State surcharge (12% of permit fee) 9 7 0
./1" GZ �. y
TOTAL PERMIT FEE v/ r Z
Print nameY . I on t 'ra (AS 0 Date : / This permit application expires if a permit is not obtained within
6 D ISO days after it bas been accepted as complete.
6