Permit •
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/07/2013
Parcel: 2S103AA03300
Jurisdiction: Tigard
Site address: 10450 SW CLYDESDALE PL
Project: Heller /Gilliam Subdivision: CLYDESDALE Lot: 13
Project Description: (1) wood stove installation and (1) flue /vent
Contractor: LUDEMANS INC Owner: HELLER /GILLIAM
12675 SW BEAVERDAM RD 10450 SW CLYDESDALE PL
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503 - 646 -6409 PHONE: 503 - 708 -5484
FAX: 503 - 646 -8034
FEES
Specifics: Description Date Amount
Wood /Pellet Stove 01/07/2013 $33.39
Type of Use: SF Chimney /Liner /FlueNent 01/07/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/07/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 01/07/2013 $33.29
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: d Permittee Signature: A ,4P, . e, i7 J
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
01/04/2013 15:58 503 64668034 LUDEMANS #4094 P.002/003
Mechanical Permit Applicatio��� I:OR O1' l' 1( 1: l NI. ON 1.1
i� PG - 0000 t
City of Tigard Date/By: I El 1-
l 13125 S W Hall Blvd., Tigard, OR 97223 Flan gM�
1 p hone:: 503.639.4171 Fax 503.598.1960 JAN 0 7 2013 ° Y °tbm Perron.
T r Inspection Line: 503.639.4175 . Ann dy y: El see Ps 2 for
Internet: www.tigsrd CITY OF TIGAJUJ NOIified/Memod � S�Plcme d1 Information
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Mechanical permit fees" am based on the value of the work
❑ New construction if Addition/alteration/rcplacement performed. indicate the value (rounded to the nearest dollar) of
❑ Demolition ❑ Other. mechanical materials, equipment, labor. overhead, and profit.
r ,»r �z•tr+� r 7 x a xl t . ';, >,s 4 !�{ °e ' ' ','",: . i al
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t
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ij 1- and 2- family dwelling ❑. Commercial/industrial ❑ Accessory building w y For specia! iafot information use checklist � -r
❑ Multi- family ❑ Master builder ❑ Other.. Description . Qty. Ea. Tote,'
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`a .50 I ( r Air cond
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Job site address eel � � � g /e. (+ear site sim`vca� v� 46.75
City/State/ZIP: � 4 , rd ` - 7�03 Furnace 100:000 BT (ducts/vents) 46.75
. Furnace 100;000+ BTU (ducts!vents) 54.9I
Suite/bldgJapt. no.: Project name: - e r "/ 0 it Heat • ! 61.06
Cross street/directions t4 job site. Duct work : 23.32 II
Fiydronic hei water system 2332
Residential boiler (radiator or
drone , 23.32
Unit i-duct suspended, eI curie), III
in-wall, in n -duct. suspenndededd , ert e. 46.75
Flue/vent for an of above 23 -32
Subdivision: Lot no.: Other 23.32
Tax map/parcel no.: Other fuel appliances
r K a ^ , n r Waterheatet 23.32
3" i %. t. a '" r x a r i , I M1 t r „ lY n 4
E � a r z. ; .. .._.1. "sue....,: k ,.._ . .... ..'. _ ., v.:- _.s ::..:.__.. . . ,, = -- -... -. ..,, Gas fireplace 3339 ll
L ' Aav / 1 0 d r $ Flue vent for water heater or gas
fireplace ; 23.32 I ..
Lo_ li: ter 23.32
Wood/. llet stove WA 33.39 MU
Wood •lace/nsert MIMI
, - y.:.. lf. ....- : .. . { ? _ . rW.- , r % . i:. ; . 1 .�_. .
" : . , . - i Other: -' 2332 •
��� . ° , : - r , ,s . t ' III
E• nvironmcntal exhaust and ventilation
Range hood/other kitchen
Address: /J 0 Z * - . - 42- 33.39
City/State/ZIP: Ti or i i2 �—, Clothes dryer exhaust. 3339 Egli
Single•ducx exhaust (bathrooms, 23.32 ■1
Phone. (503 7Q� , j /," 7 Fax ( ) toilet compartments, utility rooms)
2332 1111111 Attic taw' .: ce f ans
t,.4 **t, • ` .r . •-;'"i ._... c : . ..._ , r'� ....,..47. Other: — 23.32 M-
M
Business name: + 1.I Duel philtti IIII Contact name: �� �/ 511t.15 for first four $4.03 for each additional M
4 / . G /1 C :" Furnace, etc. 111 Ell
Address: , co 7 , _ ., S e , - . ,7 L. Gas heat , ,,.
,. rr
City/State/ZIP: 4 ., c , l ° 700 Wall/st ided/unitheater
Water heater
Phone: ( D ! Fax: : (3 6, r Fireplace
,
E --mail; Oil a /G1oe c;? . '1 liange__ '
, ' ,r , z s ,, ` S Barbecue
Milli
v s ' . r..vJ'�.•�.. a . 7,._.7.C.:d:- ,. ....._ .r.... ' l .t h _L_... .. ..... L i . . ,. w NMI
Business name: - es 9 . 5 Other: �MIN
Address: --, by @.. 7,1::-::„-.-• :.._—
I Subtotal .5Ze. ''
City/Stator/JP; ! Minim permit fcc ($90.00) 90, Or
Phone: ( ) Fax: ( ) Plan review (2596 of permit fee)
CCB lie.: I State surcharge (12% of permit fee) /0. 9
TOTAL PERMIT FEE .4. ,i •
i % This mash application expires if a permit is not obtained widths ■ 80
Authorized signature: �' n days after it has be accepted as complete.
Print name: r --- n . ( - . .1�9'C.. Date: l - ,/ -- /.3 • Fee methodology set by Tni•County BmYfrag try sew B .
01/04/2013 15:58'503 64668034 LUDEMANS #4094 P.001/003
Aafia
. F
6464409
126T5 SW CANYON ROAD
/ / BEAVERTON, OR 97005
.8004111114683
1
F I F. FAX 5O3446*8034
FACSIMILE TRANSMITTAL
To: C/74 0/ T/Cfi w c ' Date: /—
&03 . 9� /9(
Orr' ; ccA4nico / �L r01,7Z-5
From: Joni Hacker
CUSTOMER SERVICE Pages including this. .
Ph: 503-646-6409
Fax: 503- 646 -8034
jonih@ludemans.com
Re:
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