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Permit CITY OF TIGARD PLUMBING PERMIT n COMMUNITY DEVELOPMENT Permit# PLM2009 -00077 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171 Date Issued 04/06/2009 Parcel 2S104CCO5300 Jurisdiction Tigard Site address 13609 SW ESSEX DR Subdivision Lot 0 Project Dolan Project Description Install shower pan Owner FEES DOLAN, ANTHONY F & MARLYS M Quantity Description Date Amount 13609 SW ESSEX DR TIGARD, OR 97223 1 ea Tub /Shower /Shower Pan 04/06/2009 $16 60 1 12% State Surcharge - 04/06/2009 $8 70 PHONE Plumbing 56 ea Minimum Fee Adjustment 04/06/2009 $55 90 Contractor - Plumbing LARRY DURHAM CONSTRUCTION 2131 GOODALL CT LAKE OSWEGO, OR 97034 PHONE 503 - 699 -8758 FAX 503 - 697 -5935 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 Issued By ' I Permittee Signature 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 ,rlpr 06 09 08:35a Larry Durham 15031697 -6935 p.3 Plumbing Permit Application p�� Building Fixtures c� 'I r49i: y. :n r ri ) RhaU 1 1 Y IC, r . ESEsO z a � 6 r A 2 y City of Tigard d Y d Y d Y § �L . > 7 " ' L Received -( V l ' Pea" No PLrn2c3 w ''. C1 % 0)00 - 7 7 * 13125 SW Hall Blvd , Tigard OR 97221 . Y • Phone 503 639 4171 Fax 503 59 $ CL I 460- 6 zoo _ Fa lanRme y vww T IC Penn-000n I inc 503 6 39,4 175 n l ant Other Puma Nn 1 k D : taw ue.w m - - Internet www I Ig tad -or goy Y Y mm q sec Page 2 for rc�rxr ,yr I .. , p, nn NaifmVbt.d'od I ICs) Supplemental Information f' � r.• +Y_ ;-,1,41,,f, °`, FEE *- SC'HF,DIII,E U New construction ir� , 1� ' t,��fkmolIlion For Ipecha MFormorron nee rheel Lwr ❑ Description J -f� j Fa 1 fWul 0 Addition/alteration/replacement Oth _ New 1- 2- family dwellings (includes 100 d for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) both - -_ 249 20 _. . -„ 0 I- and 2- family dwelling C] ConuncicaaUmdunlrial SFR (2) huh 150 00 ❑ Accessory budding ❑ 'Viulti -family SIR (3) bath 199 00 - path additional badVknchen _ 45 00 ❑ Minter builder ❑ Other •' - - -•_ _ Fire sprinkler (_ set I)) Paget ' JOB SITE INFORMATION ,AND LOC AT /ON , ' -.- Sate u[ih tier Job site address 13609 SW Essex Dr. ( amt basin oI arca dram 16 60 CityiSlate/ /IP 'I Igard, OR 97223 Drvwcll leach line, or trench drain 16 60 - Suite/bldg /apt no Project name Dolan Dionne drum (nn linear Il, ) Pagc -� -- -- " " " - Manutacturcd home utilities 110 00 Cross Street /directions to ph site Re nc hview /M isleto9 /Essen _ -- - - - — Manholes 16.60 ' - . _ Ram dram connector •• 16 60 Samar/ Sewer (no linear ft ) Page • - - Storm sewer (no linear It ) Page 2 - - - Subdivision I of no `air service (nn Iwa9r 0 1 Page 2 - - -- I Tax map /parcel no - I Fixture or item „- Y _ „ . . ”" Ahsorptmn valve 16 60 - - -- DESCTUPTION• 15ORli • _-- Rncktlow presenter _ Page install new fiberglass shower 6aekwnmr valve r 16 60 Clothes hes washer 16 611 Dishwasher I6 60 0'PROPERTY OWNER ". -_ -._. - Drinking fountain • 1660 © TE NANT _ ...._•.._ �` , nc I lectors/sump 16 M) Name Anthony and M arlys Dolan - - - _ __ - r- Fxpenswn tank 16 60 Address 13609 SW PAWS Or, 1 rxture /sewer cap 16 60 I Cats Slate ZIP Tigard, - OR 97223 "" • Floor drain/door sink /huh It 60 Phone (503)590 -2348 I ax ( ) Gartagc disposal 16 r,1) 0 APPLICANT ' ' ® C hERSON now brh 16 " -- Ice make 16 611 IJusiness name flatters %Construction, Inc. _ - _ Interceptor /grease dap 16,60 Contact name Larry Durham _ Medical gas (valux $ 1 Page 2 Address 2131 Goodall Cl. - - Primer 16 60 I Cite State ZIP Lake Oswego, OR 97033 Roof drums (commercial) _ 16 60 Phone' (50J) 699 -0758 I Fax (593)697 -6935 _Sink /basin4avamry 1660 Tub /shower / pan I 16 60 1 16,60 h - tiled larrycu hafrerassoasRUCnon.com _ Urinal 1660 CONTRACTOR • Water closet 16 _ _.__ . Business name Hatteras C onvlruelion, Inc Water heater I6 611 Address Other ' C dyLStatc / /lP Subtotal muluuu Sinai Ice 572 FhOnc 8910 -- ---• _ - -- M p ( ) Fax ( ) 0 ce�d erltl11 hack flow minimum permit fee 136 25 Cat fat 116793 -_ " - -- Plumbing Lid no' P1366R -��" -� -� Plan review 125/ of point! feel " - - Stale,urcharge ( 12% e 1' permit Ile) Authonm 11 \ 1 d stgnalu _ __ � - tUI Al, I'I 11M11 II-1 Print name I arry D gem { I )arc, 4.6 - 1 l Thin period iipplitalion expire% if a permit et not obtained within 189 days after it has been accepted as complete °1'ee methodology sd by In-County Budding Industry Service Board