Permit CITY OF TIGARD PLUMBING PERMIT
j COMMUNITY DEVELOPMENT Permit #: PLM2009 00271
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2009
T1,C'oARD Parcel: 2S115AA06000
Jurisdiction: Tigard
Site address: 10878 SW CHATEAU LN
Subdivision: Lot: 0
Project: Brost
Project Description: Install tankless w /h.
Owner: FEES
BROST, KATHLEEN Quantity Description Date Amount
10878 SW CHATEAU LN 1 ea Water Heater 09/30/2009 $16.60
TIGARD, OR 97224 1 12% State Surcharge - 09/30/2009 $8.70
PHONE: 503 - 620 - 9055 Plumbing
56 ea Minimum Fee Adjustment - 09/30/2009 $55.90
Plumbing
Contractor:
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: Qc\ CLUM ttUlA Permittee Signature: ' � n
X Call 503.6399.4175 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.
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RECEIVED
Plumbing Permit Application
Building Fixtures 5 EP 2 9 2009 Fart >o�FiE L SI o� V
Ci of Tigard CITY OF TIGARD Date e ' ' PLUY�
e' Date/By: Permit No.: C14 d O D 7
rt 13125 SW Flail 131vd Tigard, O (�� f �G DIVISION Plan Review �
Phone 503.639.4171
03.639.4171 Fax: 5 99b"I A Date/By:
Other Permit No • Q 2n - 00051C
inspection Line: 503.639.4175
T I'GARD Date Ready /By. Jur. El See Page 2 for
Internet: www.ttgard or.gov Notiticd /Method: Supplemental Information
TYPE OF WORK FEE° SCHEDULE
❑ New construction ❑ Demol ition For special information use checklist.
Description I Qty [ Ea. I Total
AdditionJalterationireplacement ❑ Other: New 1 - 2 - fancily dwellings (includes 100 0. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 i
4 - I -and 2- Ihmily 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 AN LOCATION Site utilities
/M7
Job site address: S�/ e �-A, ./ 7f /( Catch basin or area drain 16.60
City /State /ZIP: 71.640 J 7 477 1R V V Drywell, leach line, or trench drain 16.60
Footing drain (no. linear It: _) Page 2
Suite /bldg. /apt. no.: Project name:
Manufactured home utilities 110.00
Cross strecudirections to job site:
Manholes 16.60
_ Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Pale 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 I
■SCRI.PTION. f WO t K � 13acktlow preventer Page 2
WM % /i/i/1%a�����'' wm Backwater valve 16.60
' f i7B IF�� All Clothes washer 16.60
Dishwasher 16.60 I
0 PROPERTY OWNER Drinking, fountain 16.60
❑ TENANT
Ejectors /sump 16.60
Name: :ar; �� Expansion tank 16.60
Address: / .; ` '�
�� ��� Fixture/sewer cap 16.60
City /State /ZIP: / / i A Floor drain /floor sink/hub 16.60 AIANIMMIMINIE
Phone: T 40 `.- # . .- Fax: ( ) Garbage disposal 16.60
Tg APPLICANT ❑ CONTACT PERSON ]lose bib 16.60
Ice maker 16.60
Business name: i /
r �J �� �� /'�� -� //i ...td1% interceptor/grease trap 16.60 v
Contact name: ee /y7Q.1/ Medical gas (value: $ �) Page 2
Address: • i , , Pruner ` I 16.60
�i li i� 4 � /
,'�
/� /�r,� /' ��rr /6W Roof drain (commercial) 16.60
Phone: • /1) g L •�'
Sink/basin/lavatory /lavatory 16.
��� /� Tub /shower /shower pan 16.60
E -mail: ,, ���. Ore % ,. 6x , ,,,,ti • am f
Urinal 16.60
CONTACTOR R Water closet 16 60
Business name: 6-L J f, i ` , /Ad Water heater 16.60
I Address: // FA I I.-Frff- .- Other:
/= ' f ' ` - '_ d Subtotal
,j Minimum permit fee. 572.50
Phone: 01 ) a • _ Fax: , ` /P t�I _ Residential hackllow minimum permit fee: 536.25 7 t
Numbing 1 Lie. uo.: r7/ : jr1 i Plan review (25% ol'pennit fee)
CFiI � ^
Authorized signature: / �, State surcharge (12% of permit lee) Of�tl
g L� f `. " TOTAL PERMIT FEE ' /,
Print name: G AgNIMINEE Date: D - This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete. ,
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