Permit r � CITY OF TIGARD MECHANICAL PERMIT
: '1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00193
Date Issued: 05/03/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S1126B05600
Jurisdiction: Tigard
Site address: 8285 SW FANNO CREEK DR
Project: Konrad Subdivision: COLONY CREEK ESTATES NO.2 Lot: 39
Project Description: Install gas fireplace insert and gas piping.
Contractor: LUDEMANS INC Owner: KONRAD, DEE ANN & MARK 0
12675 SW BEAVERDAM RD 8285 SW FANNO CREEK DR
BEAVERTON, OR 97005 TIGARD, OR 97224
PHONE: 503 - 646 -6409 PHONE: 503 - 639 -9550
FAX: 503 - 646 -8034
FEES
Specifics: Description Date Amount
Gas Fireplace 05/03/2011 $33.39
Type of Use: SF Chimney /Liner /FlueNent 05/03/2011 $33.39
Class of Work: ALT Type of Const: Fuel Piping 05/03/2011 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 05/03/2011 $10.80
Stories: Minimum Fee Adjustment - Mechanical 05/03/2011 $9.07
Fuel
Fuel Types: Natural Gas
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: 401 Permittee Signature: OA /9-7 /et/5477
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.
Mechanical Permit A t • Ilcatio t 1'012 01.11( t sl: ONI.
City of Tigard '1 CEIVED r _ ••- P.itN. .,0//`'--0 -
..---- 13125 SW Hall Blvd -, Tigard, OR 97223 Pl R ev i ew
6- ' Phone: 503.639.4171 Fax: 503.592.19:4 M AY 3 2011 naten3y: Other Permit:
r i e, :■ l;. D Inspedtion Line: 503 - 639.4175 Date Ready/By: I�
Internet www.tigard•or_gov Notified /Method: 1 / CI LEEBBENII
SIT)! OFTIGARD
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El New construction Addition/ahem. on/replaccment Mechanical perm fees arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition U Other mechanical materials, equipment, labor, overhead and . ofit.
M s Value: $
A� i'. d 7' r r 1. "..., �
e i� ...:. :...( .... . ..:.� .": MC a.,. .. ,. . m...'' ..;M r ..' .....1'J...., ' ...,..: a,., ta„:'. m�` r , ^ r Y :.,.; c .
� 1- and 2- family dwelling D Commercial/in. ustrial ❑ Accessory building " "^ " ' ` "„ " N. ` "' ` '" ' '
For special information use checklist-
0 Multi- family ❑ Master builder LI Other: Description Qty Ea. Total
a rw , - a' .i ✓t' I " f Aa t a w$a t M � + � .¢ L 5 � J r- ti "'' «xn ;.w 7. U. Beating/000
ng
Job site address:
Ms� srsLn , .anW., a .w,'�..a1u. .,.�,. ,a a.h .R,X, r, X. w« N. EG. a(... .:.u..»3.7,,,..�uriW.. - M,.�:f.:. .•.,rvgw ..hL,C.. .... ,
' •' Air conditioni
� . + . - tries site • latr SkoM'in:.lae<ment 46.75
city/State/ZIP: �( <7'- OK 7. D. Furnace 100,000 BTU Wes/vents ME
SuitClbidglapt no.: Project name: f Furnace 100,000+ BTU (ducts/vants) 54.91
A Oi r 0 Heat .e 61.06
Cross street/directions to job site: Duct work MIMI
drone hot waters stern MIIMEMI
Residential boiler (radiator or Imps=
h • tunic
Unit heaters (fuel -type, not electric),
in -wall, in -duct, su etc. 46.75
Subdivision: [ Lo no• _ Flue/vent for and of above 23.32
f_ Other: 23.32
Tax map/parcel no Other fuel appliances
a w , r; Water heater 23.32 Mil
tom' _ a. - 4-:.. .r . ,.. .,.. ''' Gas fireplace i15er f ( 33.39
21 1 • Fl ue vent for water hea or gas
fir lace 23.32
Ron 'r Leg lighter kas) � 23.32
dr Wood/. - let stove
Wood fireplace/insert IIII 23.32 Eli
Chimne Amer /fluc/vent 23.32
i ' _ '_....,. , ;, .. r .. . W... _ , ,...:, , «..J., . ".. .r. n;,
.,..� ,.' ', r ,. +. O t h er: 23.32
Name: / �/ /yAJ2 � D e9t7 A r d Environmental exhaust and ventilation
Range hood/other kitchen
Address: 8ct24, ,5 _ („) . h h , - ia llOrlalEll equipment 33,39 _
City /State/ZIP: 7 ,- 0 0 A . g '7 Clothes d -. exhaust
Single -duct exhaust (bathrooms,
Phone: {50 • / 0 0 I , . toilet . r.... ts, utili rooms 23.32 23.32
s Attic/crawlspace fans 11 23.32
.,-,.,ii: - , i , , . . , . ....._ ... . :. e ' ' .., '.. , Other. 23.32
Business name. k 4 _/gym <112 5 Fuel piping
Contact nine: T �/ $14.15 for first four; $4.03 for add itional
/ n Furnace, etc. ���
Address: /a 6 7 --- , 4 e .... . . - Z • eras heat pumy _
City/State/ZIP: . a[JC/ !'7 o g - 'DO , Waltfsuspended/unit heater II EMI
Phone: 6 4 :: (--523 67 4'673) Water heater
E-mail: D/i • C]7 h1 c7P 4,, 1.1
1' y' t r . ' y Barb
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Clothes .
Business name: 44-04'.779,9 5 Other
q{hr v 7 " :yN'1 q 4 ry J 4 µ
y1 t0
Address: x/"3'1 -r_. r.- w• t.:. r.. w. :.iau,�«.^''t ".lr.
1' (�
Ci /State/ZtP: Minimum permit fee ($90.00) 901_61
Phone: ( ) E Pl ) /o.fee
CCB lie.: v 6 9 State surcharge (12% of permit fee) ,t
TOTAL PERMIT FEE /Q 0 .' •" *
41111111P-; IPA l This permit application expires if A permit Is not obtaiped within ISO
Authorized signature days -. days alter it has been accepted as complete.
- ." dr .•-," _ . i/.....- Date:. 1 — Fee methodology set by T 1'i Cow.b Building Industry Service Bawd
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6464409
12675 SW CANYON ROAD
BEAVERTON. OR 97005
1$804$64683
i , F. I . FAX 588.846.8034
FACSINIILE TRANSMITTAL
To: eq O7 7 Date: 5--„,3
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From: Joni Hacker
CUSTOMER SERVICE Pages including this: - S
Ph: 503 - 646 6409
Fax: 503.646 -8034
jonih @ludemans.com
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