Permit A
' '... -?- CITY OF TIGARD MECHANICAL PERMIT
4 - r g ' c:` - - COMMUNITY DEVELOPMENT Permit #: MEC2009-00634
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/30/2009
IIGARD' g Parcel: 2S103BC06300
Jurisdiction: Tigard
Site address: 12132 SW LANSDOWNE LN
Subdivision: FYRESTONE Lot: 2
Project: Hudson
Project Description: Install NG Insert
Owner: FEES
HUDSON, ERIC C & Description Date Amount
TERAMOTO, NAMI, 12132 SW LANSDOWNE Wood Fireplace /Insert 11/30/2009 $23.32
LN Chimney /Liner /Flue/Vent 11/30/2009 $33.39
PHONE: 503 - 579 -1050 12% State Surcharge - Mechanical 11/30/2009 $10.80
Minimum Fee Adjustment - Mechanical 11/30/2009 $33.29
Contractor:
LUDEMANS INC
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005
PHONE: 503 - 646 -6409
FAX: 503- 646 -8034
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
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
or direct questions to OUNC by calling 50 3..246.6699 or 1.800.332.2344.
,
Issued By: /. 1�AL A Permittee Signature: 6� /j 15 � e_ -UL�
///"`"'"' Call 503.639.4175 by 7:00 a.m. for an inspection that business day. r '
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.
v NOV. 25. 2009 6 26PM c.' , vJ ,j • - j,'plt,Oh l +{CI?" t 0. 892 -' 2/3 •
Permit A heat><o eemrltNO.: ECG � Ub1Q��
Mechanical Received
C ity of Tigard e 1 2 009 natdav:
r "- NO V , Plan Review Other Permit:
u 1 3125 SW Hall Blvd., Tigard, OR 97223 t
2 � Td ha � see raeo a for
E Phone 503.639.4171 Fax 503.5981 960 (,�. dy1°y` Supplemental [n(armRtiou
Inspee[ion Line: 503.639.41 C1T O e 1 �d J Me tliad:
Internet: www,tiBa P UI,N l�,:OI 90
y ell ttF �r�r i v9 1, {rtlFm ' l i d M1 ' fi 7 ' .
q tr :,, 'c , 'r � '1' +�iY�;f P 1) x t' JM . i t hlk � �iv7nt�t � "�fd�tw -' ` �,' S work
tri nt i " �1' �} „ "',t` r r p e i t t rLI,i'+� Mechanical permit fees' etc based on the value of the r',.,..• 4°'; �°; �; t;; t` ?n��; �); �:' ;�(, <.;',,,;,,,�.,,�� „��., 5 fall
performed. indicate the value (rounded to the nearest dollar) ❑ N construction 0 WI O itiott/altcrationlreplacement mechanical materials, u •meet, labor. overhead,
❑ Other: p�� r^
❑Demolition + 1� � 1 t ,li yP' 'p r•mr.rn; tVI y l;,Tiir o q °Ea �. , t
. ��, v ttp`�,�� 1�3a,� ( t��p �gP�I`lit S+ ° 1 61°3∎210• ,� i
. 1 ,. , � t..a; ''' 1 G a de a tk ! ��ljry�3t.021tr7altf. Idi d4 x„drsffiBYiCw It
. u 1 ` {” Aceeseory building F or s pif n niation use theeklis1.
❑ Cotnmerciallindusn-ial ❑ Q. Ea. Total
0 M lti ?-family dwelling Other: Description a Multi faintly ❑ Master builder
a � rrt '' .;'.4 ''�,rti ° vt , r Mrcoi coolin
i..' ' t ,��` t?el ....? fi:W�� °f ; 2 r � o y Air conditioning 1111 46,75
b. site / A re•uirea site Inn sl owin_ 'laceruen 46.75
I r. �IOGJ '
Job site addrrss: - Fumaee 100,000 BTU duots/vcnts) NM
Q /e- Purace 100,000k BTU dttcmlventa) M�
City/State/ZIP: /(r r 61.06
Hydronlc hot water s tens no
Suite/bldg./apt, no.: Project name: y. . * , Duct work 6
Cross street/directions to job site: Residential boiler (radiator or MINI
h dt heat 1§�
Unit heaters (fuel -type, not electric),
in -wall, in -duct, su- •ended, etc. 23 -32
_ Flue /vent for an of above 11.111 121111.1 L no.: Other:
Subdivision: Other 11X1 a r Due. 1111101111111011 Taz map /parcel no.: �i+ , ,
v ,i r 1 H ., r. Y�� ,! J' rE P q' A.elt • ' � i . '7 ,i: ,.
,. ' / ,.a,P r °`,.' 'r'1�i "' "',ltTn.• , ''(r'Pt °f�1t�,t'.aSm�P�� *' 1;; ,
1rYtR'� Flue vent for water hearer or gas 23.32
r. / e f fir •lace 2332
tkloadl•ellct stove 33.39 NNE
Wood fire lace /insert /)G ma
w L -,.' .. ' t r /pl1i f<,' I 1 hd7 !E 1 '1v�' . Other: 111111M111111 r • i ' "� o t i '.! pt '' °`' + t j, t.. ",faM.r E t,,er:
mental exhaust
Name: .2. i.. 0 Range hood /other kitchen 33.39
04 nent 33,39
Address: _ e•ui.t C l othes dr er exhaust
Ciq'IStatelZlP: �^ p r Q 0 97 °� Single -duct exhaust (bathrooms. 23,32
���
—_
Phone: O 7 /4-2.:;1• toilet com artments, utili rooms) ,� ra , t �° Attie/crawls • ace fans ��
1 d ;. f f r . la � ,r @ r fl 1 "6 U ut� n
, P rl 'r � , } 9 � � Y� , t�1y�t {. �ii>��� , • Other: ;.p, ,ri`f r �� 1 : :. P r � r�f2ld � tr 1 t } ,:i :ra4 1F . r 1 L F oele
• L ie ie + Fuel .I An.
Contact name: Iy- G'r / $14.15 for first four; $4.03 for�add l
K� 1
Contact name: < Furnace, etc, �
Address: 4 -' CPS - R : 00 5 — ~ � �
City/SlatelZlP; ue '» OA Water heats'
Phone:�j�), " 6, 40 Fire lace ���
:: :,1 1 . , ,„1..
_—
fi•mai: JO
l J . e pd�a7.yl 'CG/�t�) 11,,,r''4,,,141)° 'wl" ;R,;ti Barbecue �
c �
Y ," f a'fit ,q 4! ,(.fay [ . � ,Qr° t � 2 �'� ^, .41 , 1'+S';�' , J Clothes dl' er ' as ���
Other; 111111•111111111111
, a' ,,•'
Address:
City /StatetZIP: 'Minimum pmt fee ($90110) - `0 •Xi
Fax: ( )
Plan review (2 { % of permit tbe)
Phone: ) State surcharge (12% of permit [be) 0 0
TOTAL PERMIT FEE /0 a. ed
' - . 52“2.04$10.%—* This permit eppllcodan expires if a permit is not obtained within 180
Authorized lie.:
day after It has been necePmd pa contour.. Authorized signa r41 /� ' � �, � F ee tttethodofoEy set by Tn- County Building lndaas SerService 0oSemi J 6 A. Date// - 0 Print name; rr aaa -abi>t (I i>ovcahitwta)