Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2013-00580
T LGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2013
Parcel: 2S 103DA04500
Jurisdiction: Tigard
Site address: 10600 SW PARK ST
Project: Weese Subdivision: FANTASY HILL Lot: 2
Project Description: Install wood stove insert
Contractor: LUDEMANS INC Owner: WEESE,TERRY& DORI
12675 SW BEAVERDAM RD 10600 SW PARK ST
BEAVERTON,OR 97005 TIGARD,OR 97223
PHONE: 503-646-6409 PHONE: 971-344-1843
FAX: 503-646-8034
FEES
Specifics: Description Date Amount
Wood Fireplace/Insert 10/02/2013 $23.32
Type of Use: SF Chimney/Liner/FlueNent 10/02/2013 $23.32
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/02/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/02/2013 $43.36
Stories:
Fuel
Fuel Types: Solid Fuel
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific- -. ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct•,estions to O C • .Ili.• 503.232.1987 or 1.800.332.2344.
Issued =y: "1— ////Udk, Permittee Signatu
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
09/27/2013 17:09 503 64668034 LUDEMANS #5734 P. 002/003
I
Mechanical Permit A licatio
City of Tigard 1 V E may: io A �3 C Pernutmvo.: I`/le,70/3 Qa5- 0
13125 SW Hall Blvd,Tigard,OR 9 P�Review I
' V Phone: 503.639.4171 Fax 503398.1 paWgy . Other Permit
A,<t> Inspcctiat,Line: v75 EP 3.0 2013 2 for
Internet.: www.ti
CITY OF TIGARD � �����d�
,E �'��11°-nm a'�yy'' � "z'� n fVf,.t Lr^ ._ J a'"Cr,71,-X7,C 7 i 1m� r• ....i 7. PI 47'rye M1n 'r.Y v- 2{i - trrt M 4G. x -i..�.4..1.4�.�$ ..�R;:;-:.nJl ri:7.,_y 'l`:. s .r AY `.c:__.:....ew...u.1__i�...N..:t w._�::.L. ]«"r-a-v..L: :��S"•
❑New construction Ur Addition/altcration/replaeetncnt Mechanical permit fees`are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: meehsnieal materials,-. i. -.t,labor overhead aid. .fit
ti J J r i.741 '.,�C..T, .-:.`.i ... 1 w, ",'7R,4.- M:' 7.7..yA M 1 y Value:$
0ez., ',:4 X9.. .ve i :1 rt z `,.r. _`:,..iu:r`,, : :..& a x a. .X... ... .. rs, .r',.
_w,ww,3b- i s ui t _ ilFk
'.� 1--and 2-family dwelling ❑.CotrnrmerciaUindustria] 0 Accessory building '
[]Multi-family ❑Master builder ❑Other: For special information use checklist
a s• �7i r k -r i r m z a �� Description j Qty. I Ea. I Total
,,74. � +tam r h -giT- • : iiz i ^31r ,s Y M r .
i `i'cY'w!c.,x.._1,5'S .e_,.,.,,..,if 1 ..i. ,, V �.�'v' z o�+t ... a'..ar: lax,:`~ Aeating/cooiing
Job site address: /9 ' p� Air(requires pin
.. ■ (req�es site plan showing placement) 46.75
City/State/ZIP: j/ ez.r • O/C ¢l 7 .. 3 Furnace 100,000 BTU(d>kw,en ) 46.75
Furnace 100,000+BTU(ductsrvrnra) 54.91
Suitc/bldgiapt.no.: Project name: Q Heat pump 61:06 ��?
Cross street/directions t4 job site: Duct work 23.32
•i Hydronic hot water system 23.32
■ Residential boiler(radiator or
i hydronic) _ 23-32
Unit heaters(fuel-type,not electric),'
in-wall,in-duct,suspended,etc. 46.75
Subdivision:
Lot 1 Flue/vent for any of above 23.32
Other: 2332
Tax map/par el no.: Other fuel appliances
-r/.+`TiT+ v. r -o J 5'a 4 'd
water hCStCr S ,.t't.i 7..rvZ,5s -i 7 r. _ r ,, 1 ,- ii 'Y _ 2332
tR+ C ?..,-,e1.>.,.�::.�.. i..�..:ti�"'�J....r.-. �n . ..=.•=__?�s�r.,_____i: 1_..r -.----.�L_, Gas frvlace 33.39
_ 1
L - AV/ : O O c`
r Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert / 23.32 ,0_3...5 .
•
s�. / 23-32 073.3 ry{x'���1 i t r y ti`v�+ A � r r�v� r i
..Z--- ,-:.--w..K, .,.:..... + r� ..,.��_s.,_� �:�K,.,.r::� „.�._u:.�n�._._�,:.vim,:.,.�%s
Other: L 2332
Environmental exhaust and ventilation
Range hood/other kitchen
Address:/a ,14 /_ 04. f' c -/-. equipment 33-39
I
City/State/ZIP: /Co, II a e .P--7 ac s' Clothes dryer exhaust 33.39
Single-duct exhaust(bathrovna,
Phone:(9 7/) .3 ' ' - /p' Fax:( )
- -! ,
-. toilet comptments,utility rooms) . 23.32
,zr5 ,,,,.4-5e,,.: ii r 44 1. P z :F v r t r 5'/ ` .w , T At ccrawlspaccfans 2332
? N t Ssv_ .. 2 !rU,__. . C.__»�., _., _ . ' r.s_.v:ia.:t. z
Other 2.3 32
to r Fuel piping ,
Contact name: $14.15 for first four$4.03 for each addrtional
... it -
Furnace,etc.
Address:/a Co 7 - _ .4.e.- • ? L'• _Gas heat pump
City/State/ZIP: `, r Q f ° 7 )C . WaWsusperided/unit heater
Phone:(p3 , O w Fax::(5 LO _ •m 7` waver heater -,
Fireplace
E-mail: do ' cD /4,0/P q� •r,'I Range _ -
w4�`.Y.y Ti:B s�i i; ,X'n r r ,T. 'r --t7 n 1 1 :5.-f'',i , wy."";, ^ Barbecue
-
Six^s�•$� rtiF )� . _i r_._v1r_2.?.T i.,.'.).r..._X...e.._ ...-1.�.,:1....:_�?.,atli,.'..ait w.r.�,.s... r;.. ',
Clothes dryer(gas)
Business PM11.111Pr”e: • Other- .
Address: r /7y .;fr..4 y� '*.t .Y. r l ! 4,1. ,, ,- ;',7:4,.
City/State/ZIP:
' Subtotal
Minimum permit fee($90.00) G92Q?►
Fax:( ) Plan review(25%of permit fee)
CCB lic.: / (, State surcharge(12%of permit fee) /010
TOTAL PERMIT FEE /
i This permit application expires ire permit is not obtained withiinII O /_ ,
Authorized signature: - days after it has been accepted as complete. B
Print name-(' 2' i CZ _,, Date: 9 O?7-2 i • Fee methodology set by T -Coenty Building Industry Service Board
09/27/2013 17:09 503 64668034 LUDEMANS #5734 P. 001/003
6464409
1267 jW 5 CANYON ROAD
f BEAVERTON, oR 97005
18 -886.583
I _ F: i .'F. : ,._ FAXIS034464034
tir
FACSIMILE TRANSMITTAL
To: C/,L 071' T/46QRCX2 Date: 9- c9 7-
(SOY-
SO3 %”'61"- 96,0 1
( 77 ; 7cc 40n/G4 / 1Orm
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From: Joni Hacker
CUSTOMER SERVICE Pages including this:
Ph: 503-646-6409
Fax: 503-646-8034
jonih @ludemans.com
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