Permit CITY OF TIGARD PLUMBING PERMIT
`'! COMMUNITY DEVELOPMENT Permit #: PLM2011 00324
13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 11/01/2011
TIGARD g Parcel: 2S 115AA02900
Jurisdiction: Tigard
Site address: 10680 SW KENT ST
Project: KILDERS Subdivision: DOVER LANDING NO 2 Lot: 68
Project Description: Tankless water heater installation.
Contractor: HEAT RELIEF CO Owner: KILDERS, FRANK
13122 NE DAVID CIR # 800 BUOY, LISA
PORTLAND, OR 97230 10680 SW KENT ST
TIGARD, OR 97224
PHONE' 503 - 261 -9915 PHONE
FAX 503 - 261 -9814
FEES
Quantity Description Date Amount
1 ea Water Heater 11/01/2011 $37 52
Specifics: 1 12% State Surcharge - 11/01/2011 $8.70
Plumbing
Type of Use: SF 35 ea Minimum Fee Adjustment - 11/01/2011 $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: .- ._.P.ermittee Signature: "
Ca 51 .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.
10/31/2011 MON 14:30 FAX 503 261 9814 Heat Relief 0003 /003
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
City of 'Tigard Received
Date/B• iU 31 /l Permit No : •,1U
IN
a 13125 SW Hall Blvd., Tigard, OR 972 3 19
f �lT �r r 'J� � ��� ��1 1
Plan Review Date/By. Phone: 503.718.2439 Fax: 503,9 0 Other Permit No.
Inspection Line: 503.639.4175 +(
TI CA RD 1 `\ Date Ready/By y Janis: See Page 2 for
Internet: www•tigard- or.gov ). �O Notified/Method:
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gg _ - � Supplemental Information
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❑New construction ❑ Dgt�' vl ' For special information use checklist
'1 ' ` G�� Description I Qty. Ea. I Total
® Addition/alteration/replacement DI • 00 New 1- 2- family dwellings (includes 100 ft. for each utility connection)
�":".( 'sl;. _. .. r a;,rer ,tN t' a � .1 oj � S f " e ` a +p4x { SFR (1) bath 312.70
. a`" ._,f.� .'•,3�1,*21 , 1�:• , a • •,114 . vanua�: fli Itil
® 1 - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
❑ Accessory building 1:j Multi-family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire kl
• t E ` ; (1 . ,. 3 h z t 510,7 . ,.. , � r Site util ties: ( sq. ft.) Page 2
s. P ae
Job site address: 10680 SW KENT ST Catch basin or area drain 18.76
Drywell, 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: R......}.12-361111 /�,{�' _1
"`l IfJ'�/) 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: 1 Lot no.: ' Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
, y + 1 s . , ` "�^ c r r 430;g Backwater valve 12.51
Clothes washer 25.02
INSTALL TANKLESS WATER HEATER Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
ul a ., : r I Ir��'.- ttA 11 ' _ „; _" IblitilkilibarVe. �� E x ansion ta 12.51
Name: FRANK KILDERS Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: SAME AS ABOVE
Garbage disposal 25.02
City /State /ZIP:
Hose bib 25.02
i
Phone: ( ) Fax: ( ) Ice maker 12.51
'0,Y, lk ;i W * , it rfrr S 113, ice• t T1 Et i Interceptor /grease trap 25,02
Business name: HEAT RELIEF Medical gas (value: $ ) Page 2
Primer 12,51
Contact name: KARINA GRANT
Roof drain (commercial) 12.51
Address: 13122 NE DAVID CIR #800 Sink/basin / lavatory 25.02
City /State /ZIP: PORTLAND OR 97230 Solar units (potable water) 62.54
Phone: (503) 2619915 Fax: : (503) 2619814 Tub /shower /shower pan 12.51
E- mail: ROFFICE @HEATRELIEFTODAY.COM Urinal 25.02
I•I
7 't .4 -won -1..� �G.A )_ 1r ii {a .T l x g+ " IY k i &4 rn 0 . . .,. -, ' , i k o !'l� 2 �m '. 1,a it . G } f , � : � ` ` Prk+ : l Water closet 25.02
" '
Water heater 37.52 37.52
Business name: SAME AS ABOVE Water piping/DW V 56 29
Address: Other- 25.02
City /State/ZIP: Subtotal 37.52
Phone: ( ) j/ / " „, : ( ) Minimum permit fee: $72.50 72.50
CCB Lie.: 122424 I - Plumbing Lie, no,: PB703 . /r `/1
Plan review (25% of permit flee) 0
/ State surcharge (12% of permit fee) 8.70
Authorized signature:
j -\,_ --- /-_-- -- - .__ -_,�_ ___ _ TOTAL PERMIT FEE 81.20
Print name: KARINA GRANT . Date: 10/31/11 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
IN3uilding \Permns\PLMU- PermitApp dot 10/01/09 440- 4616T(10 /02 /COM/wJi3)