Permit CITY - OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00233
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/23/2008
PARCEL: 2511 ODD -05800
SITE ADDRESS: 10680 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 158 JURISDICTION: TIG
PROJECT: DAHLGREN
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ROY & VAL DAHLGREN
10680 SW HIGHLAND DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 5/23/2008 $36.25
[TAX] 12% State Surch 5/23/2008 $4.35
Phone : 503- 624 -7984 Total $40.60
Contractor:
AGENT PLUMBING, INC.
9340 SW JASPER DR.
BEAVERTON, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -579 -3132
FAX 503 -579 -3132
Reg #: LIC 175492
PLM PB348
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 rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued : / ��i / � . _ . Permittee Signature: , ;L
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.
., FROM : AGENT PLUMBING INC FAX NO. : 5035793201 May. 23 2008 02: 56PM P1
®•' .•,tied
Plumbing Permit Application - ' ` - , c_.t\L - WI � - --' l\ Nuf'1. ' -r__
Building Fixtures RECEIVED t ill 01 rlt l t r: t1�I �', a ,, '
II g City of Tigard mg Bytl a - "77 'Permit loo,. e y � d
13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 3 2008 Plrn RCV,w
Phone: 503.639,4.171 Fax: 503.598.196 naceBy,: r)n,er Permit No.:
T'1 C. l` R 1? - inspection Line: 503.639.4175 p ate � Resd d/M Y ria: El Sec Page 2 for
Internet; www.tlgtvd ot.gov CITY OF TIGARD �liGeethod: �1, Supplemental Information
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„ ❑ New construction ❑ Demolition For special information use checklist ,
Description I Qty. j Ea. j Total
® Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
,,, • .,. W.kg, „/.t , 41#0. 0 * ,`4' ,0, Ckt..4 #6 _)TO.'��'�i"I; it,' `,i gM6''r `ill`:, n'p SFR (1) bath I 24920
2 I- and 2- family dwelling U Commercial /industrial SFR (2) bath 350.00
❑ Accessory building 0 Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other
a v ,�r i a ,s M , A % , i 1 l'''-••'; , Fire sprinkler (- sq. ft.) Page 2
"' ; " Q M4iii 4. *V i*iik viii : ; }� (X tigli 5°,wt li v „
l: H•,... T „ ° r �' n. a.h � •�� 1 mY ,dY c, , " Site utilities
Job site address: 10680 SW Highland Drive Catch basin or area drain 16.60
City /State /ZTP: Tigard, OR Drywell, leach line, or trench drain III. 16.60 MIN
Suite/bldg. /apt. no.; Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
- - Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (nil. linear H.:., ) Page 2
Storm sewer (no. linear R: _) Page 2 MI
Subdivision: Lot no.: Water service (no. linear ft.: , ) Page 2
Fixture or item
Tax map /parcel no
Absorption valve 1.6.60
, yam t !fin h! ','. , • ,' ., ;�� i' l q l : a '{ii' i. i "'i, ,. w tV 4 t " �..:...
'?i 7 ui i:b „e , w:C 4„� n .ra � j i ,. 0,,, , . . ,, ".' ': t,o AAA, \ ,. 6, , a. ,, B preventer I Page 2
Install double check for sprinkler system. Backwater valve 16.60
Clothes washer 16.60
. Dishwasher 16.60
g a m rx Y { + o i',b yl�I: �:a�
V1 prinking
N9,i,je fountain 16.60
', 1,1 /Jl \L1 n ,., r 1;, ����i�� I l� .
y ,nf Ejectors /Sump 16. 60
Name: Roy Dahigren Expansion tank I6.60
Address: 10680 SW Highland Drive Fixture/sewer cap 16 - 60
C1ty/State/Z1P: Tigard, OR Floor drain/floor sink/hub 16,60
Phone: (503)624 -7984 Fax: ( ) Garbage disposal 16.60
k t ' v u rw .,i ° � „ Y d , ,,, : „� v : r u l !, Hose bib
1 16.60
r4� 1 i ' N't: ° h ti EMI
7 itif wn , ,. r� (( in , ;f�" i. <.5 ..x A t g a r . ,7A.$,,,„„� ,- t , N , } , ' ;. 1' I,„tm??yi d. ; Ice maker
•
Business name: Agent Plumbing, Inc, - _ Interceptor /grease trap 16,60
Contact name: Steve Moon . • ' Medical gas (value: $ ) Page 2
Address: 9340 SW Jasper Drive Primer 16.60
City /State/ZIP: Beaverton, OR 97007 Roof drain (commercial) 16.60
sink/basin/lavatory 16.60
Phone: (503) 579-3132 I Fax: : ( )
_.. .. Tub/shower/shower pan 16.60
.,
E -mail: stev�agentplumbing.com U 16.60
.v � m .a° ,.,i;l'� a ,�, „x h " "+`� " "� ��`� °'� 1*�w' 1r��. �F9"^,kw {�w 4cy�q���v��4, d .,*
•n�S a >' , pF� y +# l I6,60
w + h r lf` �t w '�'ry , ,�3.",�� �Y 1 t q Water closet ',�r,lW [`�w ��d ir ,h ,, r+y��n �� �ar�c9 /i.$�lt�wd�{k� „Prl�'f��2t i�.��"3�
Business name: Agent Plumbing, Inc - Water heater - 16.60
Address: 9340 SW Jasper Drive Other:
-- Subtotal 36.25
City/State /ZIP: Beaverton, OR 97007 • Minimum permit Pee: $72-50
Phone: (503) 579-3132 Fax: ( )
Residential bacldlow minimum permit fee: $36.25 36'25
-~ Plan review (25% of permit fee)
CCB Lie.: 175492 Plumbing Lie. no.; PB348 •-
State surcharge (12o /u of permit fee) 4.35
Authorized signature: .. iv TOTAL PERMIT FEE 40.60
print name: Steven Nl Date: 052308 This permit application expires if a permit is not obtained within
__m. 180 days after it bus been accepted as complete.
*Fee methodnlnuv get by Tti- Cnnnty Rnildine Indnetry Servire Rnatd
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008.00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 512312008
Phone: (503) 639 -4171 ks v�Npupipe "�
Inspection Requests (24 Hrs.): (503) 639 -4175 ±�i .
INSPECTION WORKSHEET FOR DATE: 5/2/2008 TIME: 7:02A1 PAGE: 24
SITE ADDRESS: 10680 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 158 TYPE OF USE:
PROJECT NAME: DAHLGREN
DESCRIPTION: Installing backfiouu preventer.
OWNER: DAHLGREN, ROY & VAL PHONE #: 503624 -7984
CONTRACTOR: AGENT PLUMBING, INC. PHONE #: 503. 579 -3132
Inspection Request Scheduled For: Date: 6/2/2008 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 070626-01 503.579.3132 N
A.c- . C el) �� L
Corrections/Comments/Instructions:
0
C Jut- Le-A 9t,./
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CAVvn�wA \ Date: C, Phone #: (503) 718-