Permit � - . CITY OF TIGARD ME CHANICAL PERMIT
-
` - a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00017
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 01/10/2013
Parcel: 2S1046D10400
Jurisdiction: Tigard
Site address: 12615 SW 136TH CT
Project: Scherzer Subdivision: 2008 -023 PARTITION PLAT Lot: 3
Project Description: (1) gas insert, (1) flue /vent and (1) fireplace fuel piping
Contractor: LUDEMANS INC Owner: SCHERZER, RICHARD & JODY ,
12675 SW BEAVERDAM RD 12615 SW 136TH CT '
BEAVERTON, OR 97005 TIGARD, OR 97223
•
PHONE' 503 - 646 -6409 PHONE 503- 948 -6000
FAX: 503 - 646 -8034
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 01/10/2013 $23.32
Type of Use: SF Chimney /Liner /FlueNent 01/10/2013 $23.32
Class of Work: ALT Type of Const: Fuel Piping 01/10/2013 $14 15
Occupancy Grp: 12% State Surcharge - Mechanical 01/10/2013 $10.80
Stories: Minimum Fee Adjustment - Mechanical 01/10/2013 $29 21
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: L A 1 / / ' ' Ji / Permittee Signature: D( opt, e r'i_Ti 00.
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.
01/09/2013 15 503 64668034 �� LUDEMANS #4161 P.002/003
I
Mechanical Permit Application FOR Ogrit►•: l s►: crsi.V
Cl of Ti and JAN 0 9 2013 013 Received , '
tY g , Br. ill U 1 Permit Nodee j 3 - e
i 13125 SW Hall Blvd., Tigard, OR 97223 rmJ TIG�D Plan Review
Rev
' Phone: 503.639.4171 Fax: 503.598.19 aly owxr Permit
r i r: ,, R r � Inspection Line: 503.639A175 BUILDING DNISIO ReadyiBr g 65 S« Rage 2 for
Internet www.tigard- or.gov Notified/Method: SoyptonmtalInformation
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fees* are based on the value of the work
ID
New construction -! Addition/alteration/replacement eplacemerit Mechanical • ,- t
performed_ • dicate the value (rounded to die nearest dollar) of all
0 Demolition Q Other: mechanical • , terials, ecquipment, labor, overhead, and profit.
u .. . _. ,w .. n . -. .... .... �.. . - .. - • .nr f 7 -
'. 1- and 2 -family dwelling 0. Commercial/industrial El Accessory building . ..- _ _._ .
. :.`. .. : . -.w r' :, • .,, . ..e ._.,,t .;, - ;1
For special nrfonnation use checklist.
CI Multi-family El Master builder ❑ Other: Description I I Qt r Ea. I Total
f •? ?i. aim r 11r 0 ' k a l o. Heatinpfcochag
,..uS,...w '` .�..:.+ w c .r.M..:?.,.,.[;..,.,...N�.. w.«.�._.x .•...,0,:2..C?. :, ..,. .�i.... {...,.J .cr.- .::'
Job site address: --� j An conditicritmg
/Of 6,/ ,.,See.,) / , 1 �. A (requires plan showing placement) 46.75
City/StatcJZIP: / • o S O C "700.. Furnace 1001000 BTU (duete/vcros 46.75
Furnace 10010004- BTU (dncts/vents) 54.91
Suite/bldg./apt. no.: Project name:. C e Heat pump I 61.06
Cross stteet/dinections to job site: Duct work I 23.32
Hydronic hdt water system 23.32
Residential boiler (radiator or
hydronic) I 2332
Unit heatasl(fuel - type, not electric),
in-wall, in Act, suspended, etc. 46.75
Subdivision Lot no.: F1ue/vent fol. an of above 23.32
Other. 2332
Tax map/parcel no Other fuel ))Oilmen
r; ., ., Kt.. ^, ... ti v. r ; C r . ;, t l 5. Water beater 23.32
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ate u W , '''::".0e.:',! ,�1... . va. .........:::::::''1 . ,. � .. �� _ v. :_ 3.,.... � •,.^...--..,2--,..".•- _ _._.,...,...,_
_ yi s _r., fax , lac'e 3339
L - a / • n a#7 0/ Flue vent water heater or gas
5r • lax 23.32 . .
Log lighter ( 23.32
• wood/pellet stove 33.39
Wood fineptnce/inscrt / 2332 .4
s himneyAi flue/vent 2332 3_-3 •
max_ L ',
1 X & + ' { P '� C�
} a } n :=,:.2: C lied
r,c.,...., ,- �,.. ,i . r: -_ --- - -- _ ... ,. • .w.� -t. ,, . �-- -.._. _._..a., -c :�_.,t_ _- ...u:.._ -.,�s Other I 2332
Name: C �4/ y _ • t C f - e Environmental exhaust and ventilation
Range hood /other idteben
Address: /a 6 / .3 el • • • t 3339
City/State/ZIP: T/ eta /id O X 97 e) 3 Clothes dryer exhaust 3339
Sing eKluet exhaust (batturoms,
Phone: (503 • /goo° Fax ( ) toilet co •• :. ••ts, Mali rooms 2332
-, -- - ; x• �� -r r' , 3- , Attic/craw 1 , . ce fans 2332
xY*�+ ti 2132
- -... ' . r' ......_ Other:
13 usiness name: ` • 1 e- A s
Fuel , i.f,_
Contact name: .
r. Am . $14.15 for first four, $4.03 for each additional
Furnace. eta.
Address: /0 (.o 7 r . . . S - . • • A" • Gas heat primp
City /State/ZIP: to 02 ° 7 Wall/suspepded/ nit heater -
Water heater
Phone: -3 .r , 6, O .. Fax:: (52 ea - .‘,.0 r
F dace I
_ _ / .
E -mail O �� pyi
h C/t",,gr 4, , Barbecue
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r,.. _. ti... "L ..: __...._. ... ...:.- r�3 ... ..�..., ail ..w .,_ + Clothes d>yIC +°!(i�)
Business name . • e" g .5'
other 1 1
4; r S i7 J - t.
Add ress: /77 r .,... __ - ..,..,. _..,._ =c.. -.__ ` .,__ � .., - _ .,. ■
City/StaterLIP: • Subtotal `ea 7_2
Miairrami permit fee ($90.00) 9 V
Phone: ( ) Fax: ( ) I Plan review (25% of permit fee)
CCB lie.: / eO� 1 State surcharge (12% of permit fee) /0. ,PO
- I TOTAL PERMIT FEE /an ,Ir)
This ' application espirn if'a permit is Dot obtained within /SO
Authorized signature: days after it has ban accepted as complett
// I Da te. / — 9 -4-73-7 logy by Service Bowe
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I P,;n! name:
t C
, ?-‘01 2 c-;
, z f .ciC I Fa set 1ti CwouY Building Y
01/09/2013 15:49 503 64668034 LUOEMANS #4161 P.001 /003
646$4$
1 2675 5W CANYQN ROAD
BEAVERTON. OR 97005
1.800418683
• FAX 303 8034
FACSIMILE TRANSMITTAL
To: c /7' c i' T/C5g2c
c -03y 59�- ♦96
4977,7 : 7V ecAgnicg / P"-
From: Joni Hacker
CUSTOMER SERVICE Pag including this:
Ph: 503 -646 -6409
Fax: 503-646-8034
jonih@ludemans.com
Re:
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