Permit
CITY OF TIGARD MECHANICAL PERMIT
4
COMMUNITY DEVELOPMENT Permit#: MEC2010-00078
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/23/2010
Parcel: 1 S134BD05300
Jurisdiction: Tigard
Site address: 11570 SW GLENWOOD CT
Subdivision: ENGLEWOOD NO. 2 Lot: 141
Project: Burns
Project Description: Install wood insert.
Owner: FEES
BURNS, EDWIN & JANET Description Date Amount
11570 GLENWOOD CT Wood Fireplace/Insert 02/23/2010 $23.32
TIGARD, OR 97223 12% State Surcharge - Mechanical 02/23/2010 $10.80
PHONE: 503-590-5656 Minimum Fee Adjustment - Mechanical 02/23/2010 $66.68
Contractor:
LUDEMANSINC
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: Solid Fuel
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.
Issued By: Lf 6la:'~c^ n e ~Q p~ ^ Permittee Signature: Q ~
n, , ~ d.4 Y-' ~ Qi It
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.
Mechanical Permit ApnlicklLon
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Other Peartit:
„ ,-;,,-- `F '13125 SW 1 Blvd„ Tigar ,.Ofz. 9 2._ • - - Plan Review
; 1, , (71 ...l.,,. phone; 503.639.4171 Fax: 503 it 4) 2 9016 Date/By: .,
-"--- I ns tion Line 503 639 4175 L.D ,,k1 ''f . ,
' Daie Ready/By; • IM $ee A 2 for
4.1'G Al'itii. P - ' -
*-1.... -: Internet'. wWw.tigaid-or .gov . Notified/M ethod: Supptcmintat infortuation
Mt OF T - IGARD , . .
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.,-',.., c',:t ,Xfic&tigkiV„Vt:',Jf-4-.::',.:.. 4'4:it 6 4. , _•1t401., 4 ,404 5 , ... law ;4. '7. koti. - J., ,,,,eklighiersiLst. 4 t
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Mechanical penriit rees ate 'oased on the value of thc work
O NeN'ai construction (tr Additiontaitcratioivrc.oacernerit • performed. Indicate the value (rounded to the nearest dollar) of ail
0 Demolition 0 Other: inechanical materials, "tthment, labor, overhead, and • rot.
"" ' '-47f7T
.::...1::'..,,:...;'..,;:j..''"g:,:!-:;%,;0',.1'2,EV:0:4ki9.1,,lattalMil',,;:t.aw.:,a,i.4.:62i,w.,,iNggri:FACtielifettik■'d ,:,z4L_,!.',71:17rmlor"4.42.4AFFF.F.VP..T:F.-71111
Ai 1- and 2-family dwel I ing 0 Commercial/industrial 1:1 Accessory building For special' thformirt(oiCusech
0 MLitt-family 0 Master builder 0 Other: Description
Qty: Ea. Total
' 1:' Yit:317;- ,;, ;..1, ''.',...; .. . '..'. ;..... i'irl.
Heatin coolin.
Air conditioning
kb site address: 1/ 7 0 ,s. . - - , g. • 74-. ..u.ires site . Ian showit . .1acenient 1111101111111 •
--. Furnace 100,000 BTU ducts/vents) 11.1 46.75
City/Statc/Z // 0 af c Q/ 97a ,..,.9,_ Furnace 100,0004- BTU (d/vents) 54.91
Suite/bldg./apt. no.: 0. project name: e/ „ : . L ,. ? Heat *u . 61.06 MINI
Cross strceticlirections to job site: •Ductwork 1111111M1
_ liydronic, hot water system Ern 23.32
Residential boiler (radiator or illel
• h dronic
. - Unit heaters (fuel-type, not electric), 1111111.1111
in-wall, in-duct, s .ended, etc.
Fluelvent for an of above IM
.--.--- INE:11111111•1
I Subdivision: Lot no.: Other: MMUS.
------
Tax rnap/parccl Other fuel a. . iiances
.,,. . ,..• •,•7.- .,.: '...• -..-nv; --,,, .,FR37.4=41,7fria274,.4: • ; ":"y .i. , ;. , ,p/; 111, Water heater 11.
Gas fir- dace WM 33.39
..-----
er .
-. - , I' C: I CP • /9 . Flue vent for water heater or gas
fi - . lace 1
-_------.-------- . Lo: li - to . - 1111 23.32
t - -
Wood/. 'let stove 1111.113 12111111111
Wood fi . lace/insert
1169311111=11a1 Ba
-r - , x .% .1r4 • 17 '4' 4. "2 ' ' morw..... Chirnne tliner/flue/vent
:., ■ra ,...,..:Ati...:4,... other; Mang
Name: c ,/ r ,___. ..,,,, / 4 .) 3 Environmental exhaust and ventilation
_ Range hood/other kitchen
Addrp . .. 5' ess: 70 . . rr ....) Oci ci C • 1111 33.39
., __--- Clesid er exhaust 1•111111112.
City/State/Z1P. / /6, cf) A oth
9 Sine-duet exhaust (aatbrooms 1.11MINI
Phone: (-543) 590 - --5-&5-6 toilet co artments, utili roorns
' Aarig:WrIr:74',VgiSlefil Attickinwtspace fans
:.':•.:,:-. ':',•-";,4,::;,:';',.'-k..'" 4 , - ,-7: ; .;.: :: • ' ;, ; ;,d . •V7 ', - • , ;•,,.: a x;i p i d, , yr i..1 .47.,' 14 11.11M111111
Other: 2332 MN
Business name: L - c id ,., i Fuel • i.
Contact Paine: . _, diele ' S14-15 for first four $4.03 for each addltionai
. inameumninfurnace, etc. 11.11.1111=111
•
Address: 4 C, .
City/State/ZIP: A, - , me ,r) Ole 1700_5 MIENIMMINII
vaaivsu.. ended/unit heatcr moo
Phone:67. ) , A,.. _ . Fax: : (03 . 4 • 6. :co .,
E-rnail Ji . MININ11.111.111111M1
. . 4D ifflaill111111.1.111111.1
a/
on e 4.4 41 _
:.: s C# . ,-- , ..; _,,..7,117r. . „i... .;,,•,'' 7 ;,' 0,4,,A•; ,:te:4^4 .": 111111 111111111
, . , -..,..'-.:':;,' , .';) , ,7 . .?; . ,f , Y ,,, ievv: , ..'' , ;Y:; 4 ;ii ,..,, i'lw; -: , ' -"'"... ' '"'"'''' "'''' -'''"'-' ' "`"' ' • - - - - Clothes d .cf - . •
n. • .1111.1111111.1.11
lousiness manic: 4 _ . .. Other: " r.: .' t ,..."
Address: C1.50° ,...- e.. r : ..'. • •-ramagats...A.frank . - ,
Subtotal (a. V
• .
City/State/ZIP: • 'Minintum permit fee (S90.00) ago
.
Phone: ( ) Plan review (25% of permit fee)
10111111111111111111111111 State surcharge (12 of permit fec) d.
CCB I ic.: TOTAL PERMIT FEE I'd 0- "4
-------
' - , f' ceta„is-4"" This permit .pplieatlop expires if a permit is not obtsined within ISO
days a fter it has beta accepted as complete.
Authorized signatu .:. - .'"
....., %Cowl Stitt' indusuy Serv3oara
Print name: Pe 41111C. ,,,,,- c. ler D ate - /6 . Fee methodohogy set by Tri tY g
. 440-40 ITT (1 i/02/COMMEM
€00/Z00 . d 9 8 l 0# ,--r-- ,SNVIN301118 -iNor
to cc 1(7\ Pret_c71-0%r----- VE0899179 E0g 1.1):17 I o1.0//o