Permit 4 -•1
CITY OF TIGARD MECHANICAL PERMIT
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°. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00216
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/20/2009
Parcel: 25111 CA11100
Jurisdiction: Tigard
Site address: 9564 SW SATTLER ST
Subdivision: Lot: 0
Project: Mathews
Project Description: Install wood insert.
Owner: FEES
MATHEWS, STEPHEN F /JANET C Description Date Amount
9564 SW SATTLER ST Wood Fireplace /Insert 05/20/2009 $10.00
TIGARD, OR 97224 Chimney /Liner /FlueNent 05/20/2009 $10.00
PHONE: 12% State Surcharge - Mechanical 05/20/2009 $8.70
Minimum Fee Adjustment - Mechanical 05/20/2009 $52.50
Contractor:
LUDEMANS INC
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005
PHONE: 503 - 646 -6409
FAX: 503 - 646 -8034
Type of Use: SF
Class of Work: ALT Type of Const:
•
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue
•
•
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Issued By: Permittee Signature: 0A/ frAD4i /ON
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion,of the project.
Approved plans are required on the job site at the time of each inspection.
4 - t'+ 1'e�Y . 12.2009 9: 38AM � D 0.008 -.2/3
Mechanical Permit Anplica _ 1 OFFICE I XSE ONLY
City of Tigard 2009 Received �.
M 1 Datr/$y. S • • • l� • O�{ .�L._ ' 411.411/1 f to
74 v 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review -
'' Phone: 503.639.4171 Fax: 503.598.1960 F TIGARD n.roBy: Other Patron:
T I GA Inspection Line: 503.639.4175 CII V S 10N Date Ready /By: reds: 53 See Paget far
!Mum; www.tigard- or.gov BUILDING DWI Notified/Method: supplemental Information
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0 Ncw construction 1:1 Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
O Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
xrPtn "dA t �`a',n1 aP 1 n' Ir�tir r n It t � of Jlh�. FT' I .ra� v Value: $
�,II 15 y Oil [q lu 1 + atf "l
Ies ul t lu.�'e'.:,,IEE.tial , �'h�n71 wg g ir rt1.tiA. - t i t ti9l fiW , P -sr�l:lppk'01 t v t 1o� I�tl���Q��i!�r��ffmC�li. R t:F grzar.�.tsi S 4 mt7�'��°isp�
c if I. and 2- family dwelling ❑ Colntnercial/industrial ❑ Accessory building F snee • J information use chrcldicr.
❑ Multi- family 0 Master builder 0 Other: Description ' Qty. Ea I Total
I �p(uar I¢ j�al Lnnl t 'i { U 5tii" uT El W' uC ; i1 , " I M1 p
vt i:. 1 1 :, �il;j.,.�5 .. Heating/cooling _..
/ Air conditioning or heat pump
Job site address:
q56 , GJ 4 / / e..,C ., f, (madras s ate plan showing placement) 1 4.00
City/State/ZIP: J23.eir• 0 fe 9 QQ.:71/ Fumaee 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BM (ducts/vents) 17,90
Suite/bldg. /apt.no.: Project name. ma.. B S Das heat .um. 14.00
Cross street/direcdons to job site: Duct work 10.00
- - Hydronic hot water system 14.00
Residential boiler (radiator or
h onic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14,00
Subdivision: Lot no.: Flue/vent for any of above 6.30
_Other: L. 10.00
Tax map /parcel no.: Other fuel appliances _
�����yy Os! t wiF- rasa: rs {r,1. ru, x „1r:;�� ryr f � f a t'' I � � '�: 9'► t r,� R . p1Y9i . 6 y 3 , 'l Water heater 10.00
lEESM h� l i � ` MM1t Nit1 :JG.�h w/LLf1 r. u. WfW1/ i �
Gas fireplace 10.00
-: :V ca 0 / 7 -.r L Flue vent for water heater or gas
fireplace 10.00
- Log lighter (gas) 10.00
Wood/pellet stove - 10.00
_ Wood_fireplace/insert , L 10.00 Ld eV
{! �cr rs.e ,, 2'� fl ,3 �r � �I , Chimney/liner /fiue/vent / i0.00 ,�
r c�i sgrE VJ 1 ' r 1 1..__ rr ..1 , : 7 , i ' � ti t
vsr tie n r t Ir sN . n �. Other: 10,00
Name: ' J. P ,. f e S environmental eztmeet and ventilation
c Range hood/other kitchen
Address
9- . 05 41 iSQ 71 kc . e S7< equipment (0.00
Cit /State/ZIP: 77 or 0 / a d 5 7 a Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (54) 6a0- A5 O Fax: ( ) • toilet compartments, utility rooms) 6.80
a li ` {3�i ` t l �r t t�� > a.Ftr t � '` ( � �” I E� t r rt- F , u s S inttt a t , u l trti'r� e , kttideraw ace fans 10.00
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Business name: / Other: _10.00
iG. G1 Q�e J I'� S _ Fuel piping
Contact name:, j /�,/A C le R $5.40 for first four: $1.00 for each additional
Address; J - _Furace,etc, I
- L. . 4 U r • 4 G as h eatputt�t
City/State /7.1P: !. a4 O O - 74c3,5 Wall/suspended/unit heater
Phone: 0 aWLP • 690 ? Fax:: (5423 (94. ea3, Water heater
• - f Fireplace
E -mail: on h Z - Cron S . • Range
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i' 4 1 . in ,1 . s . ..'. I . ; .. 1 1 t , ,..r1. ... 1• i . i a , , i
' ,,.' . -. ,•,, 'L,W1i!F�i e , , t� � � � .Ir � , ., ���:�¢r{�4 � Barbecue
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Business name: Clothes dryer (gas)
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Other:
Address:
''.0_11111M t, uhf r :t MEP' 1;;.1x, • Y,- .
City /State/ZIP: Subtotal _ Q del
Minimum permit fee ($72.50) 7,1..50
Phone: ( ) F ax: ( ) Plan review (25% of permit fee) 1
CCB lic.: .5/96, - State surcharge (12% of permit foe) J 70
TOTAL PERMIT FEE „' /, 6
Authorized signature This permit application eapirec If a permit to flat ahtalncd within Ise
days after It lies peen accepted as complete.
Print name: '/ 4 e Date: - /a _ c2 9 . Pee methodology set by Tri.County Building Industry Service Board
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