Permit - CITY OF TIGARD PLUMBING PERMIT
-; " a COMMUNITY DEVELOPMENT Permit #: PLM2009-00355
;T: (GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/17/2009
Parcel: 1S133DB11800
Jurisdiction: TIG
Site address: 11371 SW SYCAMORE PL
Subdivision: Lot:
Project: SHAVEY
Project Description: Replace w/h with tankless gas fired w /h.
Owner: FEES
DIANA SHAVEY Quantity Description Date Amount
11371 SW SYCAMORE PL
TIGARD, OR 97223 1 ea Water Heater 12/17/2009 $37.52
PHONE: 503-590-7077 1 12% State Surcharge - 12/17/2009 $8.70
Plumbing
35 ea Minimum Fee Adjustment - 12/17/2009 $34.98
Contractor: Plumbing
WEST COAST CENTRAL PLUMBING LLC
12714 SE MAJESTIC LN
HAPPY VALLEY, OR 97086
PHONE: 503 - 298 -0435
FAX: 503 - 855 -3264
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 `A � `� s toOUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: (a^ f n _ `\ n u n Permittee Signature: ...„, f ,t�yy�
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. v t,AVld
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.
Dec 16 09 . 12:31p West Coast Central Plumbi (503)298 -0435 p.1
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MED Received 4 13125 SW/ Hall Blvd., Tigard, OR DaterHy art No.. (KR /,f<2
� / 0 Phone: 503.639.4171 Fax. 503.598.1960 Plan aerie.. ul1"t jy
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❑ New construction ^i V1 ei4?a: t it t rrr r.. ,SG Sz :mod
For
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7 Additionlaluratit >ttlrsplacetnent " biller: New . lion av . Eo. Total
.4; A , y New 1- 2-family dwelllrtgs (includes 1 fl. for each util'
I c �`.1S' - "' �L'A'' ",:•'fre,d'.: . .-� ti , T f •.� . ,
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,._ i . r: .'y. Y Gconnection) s�r;rlch.t C ! • ; • 6 ' 'J' " SFR I b ath
�, to�s .:_ l�a �> tr�i' ?n�i�{': _ ,• ; <:ikrs F { ) 312.79
A 1- and 2- fbmily dwelling ❑ Ctm+mercialiinduubial SFR (2) both 437.78
❑ Mv hi -far ily (3) bath
Accessory building Jt 500.32
Each additional hath/kitchen
❑ Master builder ❑ Othe 23.02
r .
y = "'- Fire sprinkler ( sq. ft.) Page 2
.i 4. e I.^r, „ iy, ..,,r - A -...e. a�. t c�.-.,• ...,-�. #` ' 2.. 7 3''-g Sitentilitini
Job site address: I ! .. 1 ary -re, pr - Catch basin or arca drain 18.76
City/State/ZIP: ' ,, / Orywelt, leach litre or trench dram 18.76
Foot drain (no. linear ft: ) Page 2
Suite/bldg. /apt. no,• P r act name:
Manulbetursd home utilities 1 50.03
Cross stseet/direetioms to job site: i ,i. t 1 5 i ' Manholes 18.76
i S j M / / / • Rrnr drain connector 18.76
Sanitary scorer (no. linear R.: _) _ Page 2
Storm sewer (so. li near ft.: 1 Page 2
• Water service (no. linear ft,; _ Pogo 2
Subdivision;
1 iotno,: Fiatpreorltem:
Tax mnp /parecl no.: Oaekfow prevcnter 31.27
h Pt' *4:', �.1a'.e - @t �r' ; , � ` "iii' ii lr e, .. i • -: 4r`t r ;,..�:,.. �:. Sa6kwoter'" 1 251
t t : - i:� a i'+it�;'= '� • ;v! � ! , "• ..�: +;� °: '�' :.�: �'.ci.: s
1 ` ' ` firE f -: Gotha ght washer 25.02
4 " nor I tr;/ �f f� Dlahwa 25.02
t ..�. l.4c ) � - w -}'f'r � -ter• P1 ffW is 1 I(JP - D rinking fountain 25.02
` - ■ ' Q • Ejectors/sump 25.02
, ir .5a.�r .. r d $ •,, . ' i•;= :s ' . ' 1T �. , ' . . ", - T'' ExpNlSion tank 1251
Name: ) . r i y. i / � ,! FixunrJSemrcap _ 25 02
lc
Address: � Floor draiNFlottr sink/hub 25 02
1;31 1 to . P' (y - Garbage disposal 25.02
City/5eatrJZIP= as • j •
Hose bib t 25.02
Phone: ( ^ , r Fax: ( ) lee maker 12,51
fti 1 � - % - =::.."4-.:
r,, ,, o. j:.s u "` n e 1Meroep[odgreaycttaap 25.
1111 t iLVE ss ili ne ' 1 �1rh i i. t it/l rl i Medical (value: $ ) Page 2
Primer
Contact wile: r 1 S C.1,� 1-i f r r_e ■
12.s 1
p Roof drain (commerci
Address: Z L 4_, +A ' �) 12,5 t.
.,�� Sink/basin/lavatory � �7 i /.ell •' 1 r ` a Solar tents (potable water) 25.02
62.54
• M 1)1111 Fax: : ( 4 ) - ` .1 ini Tub/Shower/showerpan 12.51
I
• ii.• a <
Urinal 25.02
h, r:4 ti .v ].�^. �°� a•^ , N 7 r : . . ' .. ff; ,� r.. - : - •:,...., : - Water closet 25.02
Buainc95 name: , 7 �`��)/ R. '; '' w ater heater 1 37.52 r '1 . 5Z
y Mt Waterpiping/DWV
Addreys; _ SG.29 • - L4-e. Jt_ - 1 Other: 25.02
m
n. It ft. / 1 . 1 \ t! i g • Subtotal
Phone: . : ti • fareefell f ( i "AO . 210 us Minimum permit foe .872.50 _ . 5a
CC$ Liu,: l �� l /SCJ 4 9 to Plumbing Lia no.: P6 89 Plan review (25%ofpermit fita) ��
gna 7 / 11 State surcharge (12%ofpermit fee) o 70
ture:
Authorized s \, r/ /
1 TOfALPEEtMITFEE 0 . L er ,
Print name: Date: sTI This trrnalt aparea:ion expire/1;f • perarat :t<not obtained .Hein L , days
artier it hug trees wrested as cemptctr:
'Fcc mechodnlory act by Tri.County Bolld;ne lndu7i y Service Bond. 3/ J
r: 1 & dldra pOrer..rMP tryo1 r09 .10. 6 t67(16rtt:IR.'OMANEA) et .2°
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