Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00087
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/13/2006
PARCEL: 1S134AD-02900
SITE ADDRESS: 10820 SW BLACK DIAMOND WAY ZONING: R -4.5
SUBDIVISION: BLACK BULL PARK LOT: 017 JURISDICTION: TIG
Project Description: Gas fireplace insert and outlet.
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: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
LINDA LUTHER Description Date Amount
10820 SW BLACK DIAMOND WAY [MECH] Permit Fee 2/13/200€ $72.50
TIGARD, OR 97223 [TAX] 8% State Surchaq 2/13/200€ $5.80
Phone: 503- 639 -0690 Total $78.30
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97005 - 2129
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:
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.
FEE .11.2a06 6 :59PM 0.279 '.2/3
I I E e l S 1 teal Permit El ►z vrd !% 11. (1F`! i< t l til u 1
" :> 'of 40141 •T, VE® Permit No.i4 s r ,, �i'e -
oatem �
: 25 SW all Blvd., Tigard, OR 97223 � Moo Review Caber Permit
l i , ne: 503. .39.41 Fax: 503.598.1960 Cep 1 3 2OOe n'i�� + y � i �� ti I � Dnte/BY:
l3 i (o i
g • coon ne: 503.639.4175 6 D U 1 11 I tote ReadyBY: ® Sce Page 2 for
�,` Notified/Method: Supplemental Information t met: cr.tigard.or.u9 INI
CITY OF TIGARD _
fillitRifqiiiffiS IGN COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
„ � Mechanical pennitfees* are based on the value of the work
�� New struction ►i Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
I Demol ion ❑ Other; mechanical materials, equipment, labor, overhead, and profit. _
I CATEGORY OF CONSTRUCTION Value; $
I RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
- and •- family dwelling 0 Commercial/industrial 0 Aeeessb building
■ For ,special i,tornratlon use checklrsr.
i ce, Multi -i slily 0 Master builder 0 Other: Description _ Qty. 1 Ea. 1 Total
I J'O1t SITE INFORMATION AND LOCATION 1 _ , Heuting/ceolist� .
1 ' Air conditioning or heat pump
o. site ad. ss: /Q � - 4 , e J 4 /.cJ I . - i'..Aty ;- (requires site plan showing placement) 14.00 _ -
itylSta IP l . ' O/Z 9 '0 2 40 • i W I Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100.000+ BTU (duets/vents) 17.90
• te/bldg. apt, p0,: I Project name: Gas heat pump 14.00
ors stye- directions to job site: Duct work _ 14,00
1-lydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00 _
Unit heaters (fuel -type, not electric),
in•wall, in -duct, suspended, etc. 10.00 .
Fluc/vent for any of above 10,00
bdivisio : Lot no.: ,I Other: _ T 1 10.00 F
1R, I . e map /p reel no.: Other fuel appliances f
D)rSCRIP I ION OF WORK Gas Water heat
ter 1 10.00
� v 7 1 P ___J 10.00
I A S 74P /1 ` 7 6 •�C ')-�+ e 7 Flue vent for water heater or gas
1 fireplace - 10.00
Log lightrrrgas) 10.00
j Wood/pellet Stove 10.00 .
+ _
Wood theplace /1 C. / 10.00 /a Q4
' Chimney/Una/MM./Van [742.040 Vant _ / 10:00
I . 7. PROPERTY OWNER ❑ TE Other: 10.00
II s e: giver /. l.,d t e , f-A e /e Environmental exhaust and ventilation
^ Range hood /other kitchen
I .djess: OAPQ A) 13 /r% O/Qms 42 4 ■ equipment 10,00
ty/stn • ' IT: t'PQP es.e 0 9 71 Clothes dryer exhaust 10.00
i Single - duct exhaust (bethrooma,
3 9 - [D FO Fax: ( ) toilet compartments. utility rooms) 6,80
' � one: i , Q ._
7. APPLICANT 0 CONTA ERSON Aaic/crawlspace fans 10.00
/� I • Other: 10.00
lacers s kcYC M #7 Fuel piping ,
intact/1;i .. Q r „( J Ade A 55.40 for post filar; $1.00 for each eddlttona
x�( y Furnace c.
, et
7S ize<) �e ,overA+vi R Sce. ct jd drtrss:
ily /Stat r i' 14 t'1:7 e'er 74 an ?70a *7 Wall/sus_pended/unitlteater
one: (- Q3 CP 5/60 - e•WO p Fax; . ( 5 ) Co 5/4a', - cpCL3. Water l heater
I mail; =:,:L ! Range CON CONTRACTOR B
r usiness ame: Clothes dryer (Ras)
�af M Other,
P ddress: MECHANICAL PERMIT vas-
Subtotal ± .) h/4
a ity/5ta Z�: Minimum permit fee (572.50)
•:. Ise. ( ) Fax: ( ) Pisa review (75% of permit the)
a CB Tic.: , ) es — a 8, 49- State surcharge (8% of permit fee) ..
• TOTAL PERMIT FEE 7j 3 r) I
T his permit a pplication expires if a permit is not obtafoed within 180
• uthoriz . signature. " days after it bas been accepted as complete.
' rint rum •• r r -,(e C / e rg _ Date: � At ��/ i Foe methodology set by Ili County Duildime Industry Sin Board
CITY OF TIGARD 0 ,.
BUILDING DIVISION PERMIT #: P+ f=s;20060( )87
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1312006
Phone: (503) 639 -4171 Ipa ii g�i 13120 -
( i�uNi a �l
,
Inspection Requests (24 Hrs.): (503) 639 -4175 q9-3
INSPECTION WORKSHEET FOR DATE: 212.112006 TIME: 7:02AM PAGE: 94
SITE ADDRESS: 10120 SW BLACK DIAMOND WAY CLASS OF WORK:
SUBDIVISION: BLACK BULL PARK LOT #: 017 TYPE OF USE:
PROJECT NAME: LUTHER
DESCRIPTION: Gas fireplace insert and outlet..
OWNER: LUTHER, LINDA PHONE #: 51')3 6
CONTRACTOR: LUDEMAN'S FIREPLACE & PATIO PHONE #: 5 64409
Inspection Request Scheduled For: Date: 1i2G(• . Pour Time:
Code # Inspection Description Confirm # Contact # Message
X99 Mechanical final 027'190 -01 503-639-0690 N
Corrections /Comments / /II structions:
04/ ------ o 415 6---y
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7 S f /0 v 7 /2e ` 1 .
/
f
„.. ,.
4100
C fr i 16 ' ; ' 4 4111 I . rA
r4I PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ve 1. Date Phone #: (503) 718-