Permit CITY OF TIGAR® PLUMBING PERMIT
use V
t o .„, COMMUNITY DEVELOPMENT Permit #: PLM2010 -00161
T [GAR6 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/20/2010
Parcel: 2S104BB04400
Jurisdiction: Tigard
Site address: 14119 SW LIDEN DR
Subdivision: Lot: 0
Project: Hoskinson
Project Description: (1) toilet & (1) tub for master bath remodel.
Owner: FEES
HOSKINSON, DONALD & ROBIN Quantity Description Date Amount
14119 SW LIDEN DR
TIGARD, OR 97223 1 ea Tub /Shower /Shower Pan 05/20/2010 $12.51
1 ea Water Closet 05/20/2010 $25.02
PHONE: 503 - 579 -6924 1 12% State Surcharge - 05/20/2010 $8.70
Plumbing
Contractor: 35 ea Minimum Fee Adjustment - 05/20/2010 $34.97
OASIS PLUMBING INC Plumbing
11177 S ALLEN CT
OREGON CITY, OR 97045
PHONE: 503 - 351 -0743
FAX: 503 - 212 -0165
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 N. ' . i. t r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or d' -ct questions to OUN . • lin. 503.246.6699 or 1.800.332.2344.
I ued By: Permittee Sig ature:
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.
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Plumbing Permit Ap .'sa ' t • IVED
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mil Of Tigard n( 20�� Received (O Permit No.: 1 11 c r <1 1
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i � n 13125 S Hall Blvd., Ti 7 23 Plan Review
Phon 503.639.4171 Fax: 503.5 8 96 Other Permit No.
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`����i\$I Inspection Line: 503 639.4 Date Ready/By: 1 ® Sec Page 2 for
, y,n, rgi1 Internet: www tigard or ' ■ t IV ISIUI g Notified/method. 1 ` Suppkmenta .
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fa-rs♦ti�� ,. ': i s iirl - 7,31
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❑ New construction ❑ Demolition For special i.glarntotlon use checklist
- Dcscri,tion • . Ea. Total
ED Addition/alteration/replacemcnt ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
ril [��5r }= 4 " *� c ad! - '!f ! ' C . t ��.fiz. -,y� �� ?" 1 z , r � a .SFR 1 bath
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® 1- and 2- family dwelling ❑ Commercial /industrial
SFR (2) bath 437.78
SFR (3) bath 500.32
0 Accessory building ❑ Multi- family
Each additional bath/kitchen 25.
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
t++ N ri z #m it 37t7e
}� - 31t�' d Site utilities;
YI =r. f8t/ -�� Tx .at T ..,. _a ._ t r .lztrt?,. :, ,_ _
Job site address: 14119 SW Liden Dr Catch basin or area drain 18 76
Drywell, leach line, or trench drain 18.76
City /State /ZIP: Tigard / Oregon 97223
Footing drain (no. linear ft.: ___) Page 2
Suite/bldg. /apt. no.: Project name: Hoskinson 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:; 1 Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: r Sackflow preventer 31.27
c 4 i. r Y u it z ns v Backwater valve MI
. $r - A 14 ; .... -_t.:„ jh c�_r31- $'i _: _z_-F �
- Clothes washer
moving master toilet Dishwasher III 25.02
changing master tub Drinking fountain 25 02
Ejectors/sump NM 25.02 IIIII
y 7, ¢ _' t r 1 `r - r �F ' Expansion tank I= 12.51
Fixture/sewer cap 1111 2.02 MI
Name: Do n Hoskinaon
-- Floor drain/floor sink/hub 25.02
Address: 14119 SW Liden Dr - _ Garbage disposal 25.02 MEM
City / State/ZIP: Tigard, Oregon 97223 Hose bib 1.1111 25.02 III
Phone: (503)579-6924 Ice maker W» 12.51 ill
N z i f » i I ' r "' - tom 74
� Interce tor/ rcasc tra 25.
1 _ ^ :' h - . ..t.a „'r'i_�..i�` ii i.. _ i1; P g P
Business name: Oasis Plumbing Inc Medical gas (value: $ 1 Page 2
_
Primcr 12. 1
Contact name: Jason Teeee Roof drain (commercial) 12.51
Address: 11177 S Allen Ct Sink/basin/lavatory 25.02 IMII
City /State/ZIP: Oregon City, Oregon Solar units (potable water) MIE 62.54 IMO
Phone: (503 -) 351 -0743 Fax: : (503) 212 -0165 Tub /shower /shower pan 12.51
- Urinal 25.02
E-mail: Jason ®oasis plumbing corn
Y r Water CIOSCt 25.02
4 .. ., 1 � F r'* p ,,.; j t = ;t %r" , u � � 1 Water heater
Business name: Oasis Plumbing Inc Water pipinglDWV MEM
Address: 11177 S. Allen Ct Other 25.02
Subtotal 72.50
City / State/ZIP: Oregon City , Oregon 97045
Phone: (503) 351 -0743 Fax: (503) 212-0165 Minimum permit fee: $72.50
Plan review (25% of permit fee) AM
CCB Lic.: 169234 3 Plumbing Lic. no.: PR-96 ' PO State surcharge (12% of permit fee) g. X)
Authorized signature: TOTAL PERMIT FEE g (. a-O
���� Date: 5 - - 2010 This permit application expires if a permit is not o within [ 80 days
Print name: Jason Teec after er it has been accepted as complete.
*Fee methodology set by Tn- County Building Industry Service Board:
I:\ Building \Permits\PLMU PumitApp 10/01/09 4404616T(10/02/COM/WEB)
TO 39dd 9NIHN(l1d SISt7O S555L55E05 o':1 0102 /81/50