Permit CITY OF TIGARD
COMMUNITY DEVELOPMENT PLUMBING PERMIT
PLUMBING
PLM2008 - 00441
T,CGAftD` 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/26/2008
PARCEL: 25111 CB -01711
SITE ADDRESS: 10125 SW HOODVIEW DR ZONING: R -3.5
SUBDIVISION: HOOD VIEW LOT: 010 JURISDICTION: TIG
PROJECT: SESNON
Project Description: Bathroom remodel, (2) shower pans and (1) lay.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROBERT & K SESNON
10125 SW HOODVIEW Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 11/26/200E $72.50
[TAX] 12% State Surch 11/26/200€ $8.70
Phone : 503- 684 -0173 Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rul r i questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
■
Issu By: /�I it �� Permittee Signature.' , l / tm
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.
7Plumbing Permit Application
Building Fixtures (�.''`R '°, a >'x " +IOR t n! 1 l Ic1 USI 0 11q a ,; ,•
' � Ci of Tigard Received , I Permit No ,/
` 4 .. � �' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
11 X( Of : 1 N� 7
C D an R y Other Permit No.: ew
� .4 Ill 503.639.4171 Fax: 503.598.1960 Date/
By:
�'�
. Inspection Line: 503.639.4175 Date Ready/By: : tygr>!p ® See Page 2 for
x. scat -e*1 4 Internet: www.tigard - or.gov Notified/Method: ° l ( 1 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
® Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El 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 AND LOCATION Site utilities
Job site address: 10125 SW Hoodview Drive Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Hoodview and Kable
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
•
Bathroom remodels - two shower pans, relocate sink plumbing Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
0 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Robert Sesnon Expansion tank 16.60
Address: 10125 SW Hoodview Drive Fixture /sewer cap 16.60
City/State /ZIP: Tigard, OR 97224 Floor drain/floor sink/hub 16.60
Phone: (503)684 -0173 Fax: ( ) Garbage disposal 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Robert Sesnon Medical gas (value: $ ) Page 2
Address: 10125 SW Hoodview Drive Primer 16.60
City/State /ZIP: Tigard, OR 97224 Roof drain (commercial) 16.60
Phone: (503) 684 -0173 Fax: : ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: rksesnon @hotmail.com Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: (D I n '\ ee-(1 Water heater 16.60
Address: l�-) Other:
City /State /ZIP: Subtotal
-
Minimum permit fee: $72.50 7g .60
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) -&-
(� State surcharge (12% of permit fee) S. 70
Authorized signature: , hlr'�L. TOTAL PERMIT FEE 3
Print name e - J $,6 Nc A ) Date: / jkila This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee mrthnrinInov cet by Tri- Cnnnty Ruildino Inrinctry cervirr Rnarrl
T
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM22001.3- 00441
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 - 4175 '.� "'I �
INSPECTION WORKSHEET FOR DATE: 12I19/20 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 10125 SW HOODVIEW DR CLASS OF WORK:
SUBDIVISION: HOOD VIEW LOT #: 010 TYPE OF USE:
PROJECT NAME: SE SNON
DESCRIPTION: Bathroom remodel, (2) shower pans and (1) lay.
OWNER: SESNON, ROBERT & KAREN PHONE #: 503684-0173
CONTRACTOR: OWNER PH$:
Inspection Request Scheduled For: Date: 12/1912008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes-age
320 Plumbing rough -in 079143 -01 503 -367 -86 N r lr 1
( N" I L.f •
Corrections /Comments /Instructions: I,, V '
biP
❑ PASS FRARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
k (2 .. ; c. ) / 6 Inspector: Date: `' / Phone #: (503) 718 -