Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00057
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/17/2011
Parcel: 2S112BB01000
Jurisdiction: Tigard
Site address: 8375 SW COLONY CREEK CT
Project: LOFTUS Subdivision: Lot: 0
Project Description: Tankless water heater.
Contractor: HEAT RELIEF CO Owner: LOFTUS, VICKIE L
13122 NE DAVID CIR # 800 8375 SW COLONY CREEK CT
PORTLAND, OR 97230 TIGARD, OR 97224
PHONE: 503 - 261 -9915 PHONE:
FAX: 503 - 261 -9814
FEES
Quantity Description Date Amount
1 ea Water Heater 02/17/2011 $37.52
Specifics: 1 12% State Surcharge - 02/17/2011 $8.70
Plumbing
Type of Use: SF 35 ea Minimum Fee Adjustment - 02/17/2011 $34.98
Plumbing
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: v% e g .„7„1„ % ri Permittee Signature:
C• II 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
02/16/2011 WED 13:39 FAX 5032619814 Z1001/002
Plumbing Permit Appl T . t 6 4% 0
Building Fixtures FEB Il 6 2011 FOR OFFICE USE ONLY • City of
III ut Received l II C- 7
. Tigard Received
Penult No.:
13125 SW Hall Blvd., Tigard, OR�97223 o d' • Date /By: w .
g v98:1! • • pf ~I�, A:1® Plan Review
Phone: 503.639.4171 Fax: 503.594 i D ate/ B y: Other Permit No.: 0, - 20 1 (-cto 71
TIGA Inspection Line: 503.639.4175bUILU{I'' DIVISION ISIS„ I
Date Ready/By: )uric: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information •
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❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
:'4" l '.5' , t lfi t ,s „ 0 4.711.0... ,7,° ;< SFR(1)bath 312.70
c a s - ` ..;;;:,4.n ,.-,,, -t:- td...., ..w s
® 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 •
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: _ Fire sprinkler ( s q - ft.) Page g e 2
•, ,: '� Q S "C ' I,OA Wr ;.; Site utilities:
Job site address: 8375 SW Colony Creek Ct Catch basin or area drain 18.76
Drywcll, leach line, or trench drain 18.76
City/State /ZIP: Tigard Or., 97224
Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: ( Project name: R11029C Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
• Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: , _) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
• w G v nn r• Backwater valve 12.51
x„'grcr u � .r., ...o.ax rwxmas R Clothes washer 25.02
Install Tankless Water Heater •
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02 • . h a mil' ,''t gil r�, Ex anion tank 12.51 •
Name: Vickie Loftus Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 8375 SW Colony Creek Ct -
Garbage disposal 25.02
City/State /ZIP: Tigard Or., 97224 Hose bib 25.02
Phone: (503)639 -9830 Fax: ( ) Ice maker 12.51
p i f a Y T " '_V Interceptor/ tra
► < • 4, b 6 ra tg a ati a:t C 0 - .1�E : e y " trap 25.02 '
. iq; - . +� °tc.u...0 •t•••• . . «axa • tst.ry...r - as .rsuv :,._ s..>.
Business name: Heat Relief Heating & Cooling Medical gas (value: $ _) Page 2
Primer 12.51
Contact name: Karma Grant •
Roof drain (commercial) 12.51
Address: 13122 NE David Circle # 800 Sink /basin/lavatory 25.02
City/State /ZIP: Portland Or., 97230 Solar units (potable water) 62.54 '
Phone: (503) 261 -9915 Fax: : (503) 261 -9814 Tub /shower /shower pan 12.51
E- mail: hroffice@heatrelieftoday.com
Urinal 25.02
r - P .. mow .. ' :. . a - r, ..., c . 0 s e - Water closet 25.02
• ai 4 ` ' 1 ' '" a 1 Water heater 1 37.52 37.52
Business name: Heat Relief Heating & Cooling Water piping/DWV 56.29
Address: 13122 NE David Circle # 800 Other: 25.02
City/State/ZIP: Portland Or., 97230 Subtotal 37.52
Phone: (503) 261 -9915 Fax: (503) 261 -9814 Minimum permit fee: 572.50 72.50
Plan review (25% of permit fee) 0.00
CCB Lia 122424 Prtbing Lic. no.: PB703 State surcharge (12% of permit fee) 8.70
Authorized signature: v � TOTAL PERMIT FEE 81.20
Print name: Karma Grant Date: 02/16/2011 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
`Fee methodology set by Tri- County Building Industry Service Board.
P\ Building \Permitsu'LMU- PermitApp.doc 10/01/09 440- 4616T(10/02/COM/WEB)