Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 00487
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/05/2010
Parcel: 2S110AB01700
Jurisdiction: Tigard
Site address: 14220 SW 114TH AVE
Subdivision: COLE'S ACRES Lot: 4
Project: Gunter
Project Description: Wood fireplace insert.
Owner: FEES
GUNTER, MICHAEL R Description Date Amount
14220 SW 114TH AVE
TIGARD, OR 97224 Wood Fireplace /Insert 10/05/2010 $23.32
12% State Surcharge - Mechanical 10/05/2010 $10.80
PHONE: 503 - 684 -2621 Minimum Fee Adjustment - Mechanical 10/05/2010 $66.68
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 OU. by calling 503.246.6699 or 1.: r ' .. 344.
Issued By: 4111AIL Permittee Signature: , ,
CaII 51 .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 Applicati4ECEIVED FOIL 01 "IC 1;11•: O \1 1
City of Tigard I Received .
13125 SW Hall Blvd, Tigard, OR 9722 1 2 010 Y- 1 S
' MIA j/ Permit No.: 1Y G� to - Q-1 0 7
s.: Phone: 503.639.4171 Fax: 503.598.1 ,,,„OCT O C T DuttcB W Other Permit:
Tic, ,1 K c) Inspection Line: 503.639.4175 CITY OF TIGARD Date Itndy/Br ® see Page 2 for
Internet: www.tigard-Or.gov Notified/ Method: RN Supplemental Information
B111ILDING DIVISION
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❑ New construction G Addition/alterition/rcplaccmcnt Mechanical permit fees* arc based on the value of the work
1 performed. Indicate the value (rounded to the nearest dollar) of all
❑ D emolition
❑ O ther. 1 mechanical materials, equipment, labor, overhead, and profit.
'-' dl ','' b•.. '1 .. \ ''''''l d r i 44, . rr l _- -:. Value $
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►ii 1 - and 2 - family dwelling ❑ Conuncrcial/industrial ❑ Accessory building " = " { w?C ` '^^ � ^'`" y3
❑ Multi- family ❑ Masts buildci [] Other
For .special information use cl:erlrlito
y;T3 . , .+:K::,: s :1./ yt * „ ya ....�_ -.nr.. ..rent,,TUa. Description I Qty. I Ia. 1 Total
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r .ia'..'ti�i�sr�i.4.:• 44 .z., ;°;^ 1 .. -A.,. =:e.,< y %.. r:.';. , tr•w i =t Hearin coal
. ^rwernr,.,,. -„ �• :�= :+'ra4ai4::rr;;,;,ue.Y.,.,. r.
/ -yd cpo S I, /9 . Air conditioning
Job site address: X
' -- site •lanaho• " •}acemem 46.75
City /Statt/Z1P: 77 q b R q . f/ Fumacc 100,000 BTVSdu/vents) 46.75
Furnace 100,000+ BTUsducis/venrs) 54.91
Suite/bldg./apt. no.: I Project name: I t��4,,h 7Le. r Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 2332
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 46.75
Subdivision: I I Lot : Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel ppliances
,,.:, i .. .. :::7.- f''' _. ,�i•n'•?T_ :,!'J :: c ..: ir. � , . � .m... ; .. ,,, r Water heater 23.32
:.
�1!- �:��ii .�:.w.. r l',.�.+. a.s. x:: .v::a�i+:i:� :'.'; k •, y3: " ``^'�^rr:�£.:�^is�3!. ;:'i;: r t v r 7 ,,.�" l ` Gas ■ • lace 33.39
2- /7. S / /l �ocfc / I / 1'!.5 ems/ 4. y Flue vent for water heater OT gas
fireplace 23.32
Los lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
t)r,er ::T, . -;err- _ ::- i, - •iruaii�:.',,`,`r'? , :.1•Ii?'r:: , a.- .,r ,a,, -n•mr -
U G ..: • ` a, t:i ra _ a r' •+ , i nG ' , rr '- .. a ' r n., q.
1."r...... a ��'�. �? I-P // - � y , ;:y4 / s ^ . - . *r .t .r,- y,; (.: Other. 2332
C�`3 7 l
Name: ���� Environmental exhaust and ventilation
Address: ,/,"/, O z- 4) J/ r� Range hood/other kitchen
oquipn nt 33.39
City/StatcaZJP: 6 / p/ O/z 9 yo Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (als) 6 f _ _ 6„a / F ( ) toilet compartments, utility rooms) 23.32
• �� *fir+ ` ".• st7q,n:'4ry:..... S_ '^ i :21: rr rh r. R AT { r ` �• xr +: ( '. l , y ,- ,,,.. a • Attic /crawl ace fans 23.32
.,,� a. ,.� a 4 -..d ?.L.. 53. �.n,..,A ,,, ,. w�ss3oaTa+i
�,// G 23.32
Business name:
1 efCt/t'/71a - Fuel ,'.i,._
Contact name: � oJ2/' War f r $14.15 for Grst four; $4.03 for each additional
Address: � Furnace, etc.
� 5 Gc) - 4 �4 Ur / . 4 �� Gas heat pump
City/State/ZIP: 4 -r 1p I ox 9 - 7O0 .7" Wall/su,cpcnded/unt heater
Phone: (R3) 6, 5/4 6 ye, q F'ax:: ( 3) 6x,6 -6'. / Water heater
Fireplace
yy /
E Oh % h a Aec%�.9.3 . i M Rune
h7 ;•:; ...... ,,�
,:;,:r6'i= '�"�+'+:1, -.r,, ...,1, ,,, rr'�:• � " . Barbecue
-,,. _ ear' ,,,,, ��2`:. w , , , -.:�.,., -*- • +
i r$„"l 'r `;tt�:L,G,eiri. � ..6, %! 1'.i:1.:G� �sa.� �;i:tEi�iriui�:ic!: ':; • . rv':4�,. :� in _, 1, ,..� , . i Cite:,a
B»sinrss name: i Clothes dryer (gas)
a /n c' ,, --7 Other: _
�� R� I 1 , r +> 3 - �i - -- .. � ' �" n' l - 7
Address: `. ,7, tY'W
9/�° 1 _ d .4, nr',1:i.&.l.'1 : •,. . - - r.:S S:b 1-
City/State/ZIP: I Subtotal Iri ll
Minimum permit fee ($90.00) 9a
Phone: ( ) )lax: ( ) Plan review (25% of permit fee)
CCB lie.: - at 1 State surcharge (12% of permit fee) /O. , _Q
TOTAL PERMIT FEE /00. - Q
This perm application expires if a permit Is not obtained within ISO
Authotizcd signature: 1 days after It has been accepted as complete.
C //7 r � 1 Hate: q �0 -/d
I Print name: `�,/OJ 5:44,a A
/' • Fee methodology set by Tri- County Balding Industry Service Board
name:
,,,^l Vie ...n n1 .e.n. WRR,
600 /Z00'd 9a " " � sNv 3on1@ -INo D C0899179 809 Ll:91. 0L0Z/0C/60