Permit e e
CITY TIGA MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00733
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/17/2007
PARCEL: 2S103DB - 11500
SITE ADDRESS: 11210 SW ARBRE CT ZONING: R -4.5
SUBDIVISION: GENESIS NO. 3 LOT: 062 JURISDICTION: TIG
PROJECT: TROGDON
Project Description: Gas fireplace insert and gas line.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
BRAD TROGDON Description Date Amount
12210 SW ARBRE CT
TIGARD, OR 97223 [MECH] Permit Fee 12/17/20C $72.50
[TAX] 8% State Surcha 12/17/20C $5.80
Total $78.30
Phone: 503- 747 -7602
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 646 -6409
FAX 503- 646 -8034
Reg #: LIC 51469
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: r a4r2
Call 503.639.4175 by 7:00 a.m. for inspections 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.
. _! I
' DEC.17.2007 10 :22RM 0.768 - .2/3
Mechanical Permit A.pplica I'on - 1.Ol (,rim( I. t :)1F: O\I.\
City of Tigard ..... Received PermitNo,:�,�. e► — e 13125 SW Hall Blvd -, Tigard O ' + Plan hence
Phone: 503.639.4171 Fax: 03), ' :. .,, ' . 0 �. A lh, , i , j{ tyat�lBY; Other P "t
Inspection Line: 503 - 639.4175 pE . 1 1 . f "°1 _ } � _I I Date Rcody /By: RI Sex Page 2 for
Internet www.ei.
gucd.or.us Notd'icdR�telhod; Supplemental Information
; %. Y 0i [ I,�R ". ®tkl -
., .; 1 ,,nor. t1 . 7 COMMERCIAL FEE' SCHEDULE — USE CRECKLLST
Mechanical permit fees* are based on the value of the work
❑ New construction a Addition/a - ration/replacemcnt performed. Indicate the value (rounded to tlic neatest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment labor, overhead, and profit.
- Value: $
CATEGORY OF t ONSTRUCTION
— " RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- fannily dwelling ❑ Commterci /industrial ❑ Accessory building For specs/ Wormation Ws checklist
❑ Multi - Cannily ❑ Master bui der ❑ Other: _ Qty. Ca. Total
JOB SITE INFORMA r N AND LOCATION Henting(cooliue •
Air conditioning or heat pump
Job site address: // eP J Q r 1 r C CI 7` re.uires cite ,man showin' .lacemcetl 14.00
City /State/ZIP: l /Corr . a it' dm 709- Furnace 100.000 BTU ducts/vents Nil 14.00 MI
Furnace 100,0004 BTU (duets /vents) [7 .90
Suite/bldg./apt. no -: Project name: / , c7,7 Gas hcaty_ump 14.00
Er
Cross street/directions to job site: Duct work _ _ 14.00
Hydronic hot water system 14,00 all
Residential boiler (radiator or
h drone 14,00
— Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above _ 10.00
, Other: (0.00
Tax map /parcel no,: Other fuel a , 'fiances
DESCRTPTI01' OF WORK Water heater IIIIII 10.00 WM
_ � s Gas f • .lace 10,00
_ g 7 41J ,2 6 -.-� � 5'r/ / c ,7 0/ Flue vent for water heater or gas
f :lace - 10.00
eea/7 qS /,. - Lo: Ii: ter .,as 10.00
Wood/, ellet stove 10.00
W Wood fi eplacefrnsett _ / 10.00 /t7 C
(PROPERTY OWNER I 0 T ENANT Chinese /liner /1luelvent 10:00 /d.
Other 10.00
:_________a2____52/ 52 ' 7 c/c, 0'7 Environmental exhaust and ventilation
Range hood/other kitchen
Address:
// /tom t� I, equipment 10.00
-
City /State/ZIP: 7 /a* O`P"-CF! p / c 9 7l- Clothes dryer exhaust 10,00
- Singic -duct exhaust (bathrooms,
Phone: (.s0) 74( 7 _ -7, p -, Fax: ( ) toilet compartments. uti rooms) 6"80
�` ' APPLICANT d CONTACT PERSON Attic /crawlspacefuns 10.00
Business name: 4 were» a 09 5 Other: 10,00
Fu el pip
Contact name: 5 • Q ke A T 55.40 for first limn Sin for each additiona
Adijres Furnace, etc.
,. i!gP _ i. _ - Gas heat pump
City /State/Z et? ver 7404 / O2 9' 700,5-- Wall/suspended/unitheater
P ( jam Fa :: (0 ) Co W2 - G P C1.3 Water heater
Fireplace / Sit) 5:q6.
E -mail: Ran e
CONTRACTOR Barbecue -
Business name: Clothes dryer (gas)
Other: •
Address: matANICAL PERMIT FEES*
City/State/ZIP: . Subtotal - a, ,, ,i
-
- Minimum permit tee ($72.50)
Phone: ( ) Fax: ( ) -- _ __ Plan review (25% of permit fee)
Cl " C��q �.. 83 r _ State surcharge (8% Of permit fee) J �'".�p Q _
/o? ^ 3', Q
Authorized signature: This permit applkation expires if a permit is not obtained within 1813
days niter ii has been accepted as complete.
Print name`m r . s ( � / (/l� I rata I • roe methodology set by TYi- County Building lndusuy Service Board
, .
. :
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: MFC2007-00733
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1712007
Phone: (503) 639-4171 J
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/19/2007 TIME: 7:00AM PAGE: 36
1 SITE ADDRESS: 11210 SW ARBRE CT CLASS OF WORK:
SUBDIVISION: GENESIS NO. 3 LOT #: 062 TYPE OF USE:
PROJECT NAME: TROGDON
DESCRIPTION: Gas fireplace insert and gas line. 1
OWNER: TROGDON, BRAD PHONE #: 503-747-7802
CONTRACTOR: LUDEMAN'S FIREPLACE & PATIO PHONE #: 503-846.8489
Inspection Request Scheduled For: Date: 12/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 061824-01 360-731-8899 It
4't, /6
Corrections/Comments/Instructions:
0 wo - , II - A. il L... 4-S _ — A/ —1 Z- - 5444 v —7z)
- - .AA/0 - • .: A' e , . , s 6 ic r0 eer
n ASS 0 PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
I I FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: . Date: 11.---/g —67 Phone #: (503) 718- ".-4-4-,-,------