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Permit MECHANICAL PERMIT 1r ` CITY OF TIGARD ,` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00589 :` I 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009 Tlr Parcel: 2S104CA05900 • .. Jurisdiction: Tigard • Site address: 13601 SW WESTRIDGE TER Subdivision: Lot: 0 Project: Hrizuk Project Description: Install natural gas insert Owner: FEES HRIZUK, MICHAEL J Description Date Amount 13601 SW'WESTRIDGE TERR Wood Fireplace /Insert 11/03/2009 $23.32 TIGARD, OR 97223 Chimney /Liner /Flue/Vent 11/03/2009 $33.39 PHONE: 503 -590 -6555 12% State Surcharge- Mechanical 11/03/2009 $10.80 Minimum Fee Adjustment - Mechanical 11/03/2009 $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 503.246.6699 or 1.800.332.2344. c Issued By: r f l I/n , Permittee Signature: • n , n p • t a� • v` � � - CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. / � This permit shalt 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. ..-R., 'NOV. 2. 2009 3 : 46PM NO . 776 P. 2/3 Mechanical Permit r � �ra Or r'r ',i ` w., I City of Tigard AataBy: permit �p', vV d n • . 13125 SW HaII,BIvd.,, Tigard, OR 97223 N 0 2 2009 PIan Review _ g Phone: 503.639.4171 Fax: 503598:1960 Date/By: Uiharl'cmlit: Inspection Line: 503.639.4175 1)dte Itendy /8 du LE See I e Z for T CITY OF TIGARD y Internet: tsnvw.tigard- or.gov Notifted/Metbod: Supplemental Informatio BUILDINGDIVISION, t• I y r �} { M% a IJ ad}t. u t l I1 iyN "•i °, .Ii7 i', ! � • i'i ° ,I °i ., 1 D o p'11.1.5 Ctic1 . ,' bn ItY.G at y:" ��: • k p a e' 1, '°'R!•t ti 1 IlJ,• , i1 be nN ' r� C .. +i' ;F , ,.v p, Ii ,.y,. o4itr.Jd'i ;y' r.� " I I� k� r,,,, �`c9M "', ., r"-'!1, ,. y r Q New construction 1:1 Addition /alterotion /replacement n9eehanic3l perintffecs" ore based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other; mechanical materials, equipment, labor, overhead, and profit, II ° '� 5 ' i r a Pp � �1 G " r, ", I�1^ 1w��t t'I 1 ' l,ti : t Value: $ • I v ,, t e 1 i 7 r I ) C ' o. , 1 S d r I lli t. . „ !b • 3 ,r r rs 1:1 1- and 2- family dwelling L7 Commercial /industrial © Accessory building 1 ,P• ' ' ' " ' 'I ' � For special information tae checklist, Mulri- family 0 Mastcr builder ❑ O t h e r El Description 1 Qty. Ea. Total i' ,�r ;.'iS •'r :r ij , i #,I ; ll�l`41103P,. 'g�r'.' d{ ,',:: ;', i, ".` ' ;':. IIIIc ∎, !Rutinn /cooling .. - �..... / 1 / 7 Air conditioning or heat pump Job sae address: � 0 � �� _ � ' S 7"t /Cr 's / c r - , (re site Dien sbo°vin plaeemant) 14.00 City/Slate /Z1P: 776)p - a /:' ?7o?.1:,-5 Furnace .00000.BTU(ductss /vents) 14,00 � / Furnace 100,000+ BTU (ducts/vents1 17.90 �Suite/bldg. /apt. no.; Project name: )4//'-/ . e. Gas hcatpump 14.00 Cross street /directions to job site: Ductwork 10,00 . _Ilvdronie hot water system 14.00 Residential holler (radiator or hydronic) 14 00 Unit heaters (fuel -type, not electric), — • in -wall, in -duct, suspended. etc. 14.00 Subdivision: Lot no,: Fluelvent for any of above 6.80 _ Other: 10.00 Tax map /parcel no,: Other Ihel appliances I' "`;I ,i; al , " ,TCt u l e , l �,.,,p. , . .1:..1'r• Water heater 10.00 ; ' I � " i't , '' ' Ia ,. 'f ^' 6 ' ' c , , m J I "i ��� ,1 " u , t� � J ^' c ,i '�fi ! ;, ,t< ,,. ��� . I t, '41( tl,. l, { ,. 1'� ..i _ Oes fireplace 10.00 ,,_Z ( ' /, . 22 6 '/?_s e r L . Flue vent for water heater ar gee fireplace 10.00 Log lighter (gas) 10,00 Wood /pellet stove 10.00 Wood fireplace/insert /)1. / 1000 / 0. en I � ..i ;� , al l ' a ` y i } r '.41,r p� ; ;l I �y ,i. , i , r , . i ,� , 1. �{{n� ^.f�'dlt � ; hr , ti Clt ;nute� /liner /Pue/vcllt 10.00 /0. • 7 N ITIOPf� •�'"""^ ll 4 : 1 ?tT9` tR:f uu • ` 4' Ri'i g'" l I Ifi '. °I 'i�k' li111ii1,1tr'''''' 1, 1 I �7M 7''( ^ I'1I )`' !4 L ' i t l' l ` 10 00 l Other: [`jaw= 77 a "2 /r2 4 e / fi,/ / � , 4( Environmental exhaust and ventilation /" _ AddfCSS: /0/(7 �� �.. Runge hood /other kitchen /36x7 / Ge es / r e., - equipment I0.00 _ • Clty/State /Z1P: Gq r O R -7,.�,p 3 Clothes dryer exhaust 10.00 Single-duet exhaust (bathrooms, Phone: (5 0 [ Fax: ( ) toilet compartments, utility rooms) 6,g0 ' ,•r.y m, .. A . �. r r 11,',44.1:.(4, d ' a ru � , r ': , . , l g , V 1,.' 1 1 : . , ∎ 1 i;r,1 i r a • I° ; n I1 1 r , , - .t u' "' l d i . '''1 AILICiCfANrlspace fans 10.00 " m 'h, V 11, ,U t -� 7 v ! i.i Z. fi � 1 ,1 , „�. b. i . 1� L 1 q . ; ^ Business Warne: L Other: 10.00 _ L G! cle �?'1 a I� . — Fuel piping Contact name: h j° g e, ge ) ' e A _ $5.40 for first lour; 51,00 for each additional Furnace. etc. A _Id tess. .54) 13 ea. u -e r darn R.( .._.r Gras heat pumps City /State /ZIP: ft, e4 uer, ,L p) 0 i 9' 70Q5 Wall/suspended /unit healer Phune: 45 6 q e 6 90 7 Fax: :.C'43 C yz• ,QJ7' Water heater Fireplace L rtlall: ion; AlCM4d .S' . cg,em Range — ` :,' I l ''IdLf,, a ., clot (J'1$ ., Ua il, ..71 ;,i , ' !-It7- ,∎ „1•I' I�' , -;1 ,d' ', J,1 � Barbecue none:91� C Clothes dryer (gas) Other: Address: 2400 0.' 'q' Cily /StateJZ1P: Subtotnl aQ,p p Phone: ( ) Fax: ( ) Minimumperntit fee (572,50) I Pion review (25% of permit fee) CCB lie.: ..5/1,6 ? State surcharge (12% of permit fee) ",' 70 TOTAL PERMIT FEE ,y/ n 7,0 1 Authorized' signature. - N� This permit a pplication expires If a p ermit is not obtalued within IRO // _ days alter it h94 .heed I,eeepled AN complete. t U' Print name: do, - -- - g/9c,✓e a /t Date: //— . q ” Fee ieetbodoloay Set by Tri- County Building lndu4Ly Service Board I 'Bunet1Verlrllrfi'MOC.p iltApp due o1/19'07 , :0-eeI7T (11 /021CCMlwSB)