Permit CITY OF TIGARD MECHANICAL PERMIT
11 1 w COMMUNITY DEVELOPMENT Permit #: MEC2012 -00655
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/12/2012
Parcel: 2S 110BCO2200
Jurisdiction: Tigard
Site address: 12012 SW ASPEN RIDGE DR
Project: Kaeding Subdivision: ASPEN RIDGE Lot: 34
Project Description: Install gas insert, flue vent and gas piping.
Contractor: LUDEMANS INC Owner: KAEDING, GEORGE E & ELLEN E
12675 SW BEAVERDAM RD 12012 SW ASPEN RIDGE DR
BEAVERTON, OR 97005 TIGARD, OR 97224
PHONE: 503 - 646 -6409 PHONE 503 - 740 -1549
FAX: 503 - 646 -8034
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 12/12/2012 $23 32
Type of Use: SF Chimney /Liner /Flue/Vent 12/12/2012 $23.32
Class of Work: ALT Type of Const: Fuel Piping 12/12/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 12/12/2012 $10.80
Stories: Minimum Fee Adjustment - Mechanical 12/12/2012 $29.21
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: Permittee Signature: � / 9_ 7 0 / 0 4d eg 77 . 0 ,1
,(( I
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.
12/11/2012 17.57 503 64668034 LUDEMANS #3935 P.002/003
Mechanical Permit AppliC • i' t l l CEIV ED
l c>li tyrr• l c l t s1: <I\ i.\
City of Tigard EC 12 2012 D: €/2 /a /61— A PermitNo: � 0/ - e9O(5•5 vTSgar, OR 972 „, �tlxr Permit
503.639.4171 Fax: 503 -598- TinARD Date/Br I
Inspection line: 503.639.4175 1 11.11 ` � n + Date neaayBy:
Internet: www.ngatd•or.g0v ILD�G DIVISION NotiSed/Mett.od: I VA II
1.1 s T "w� c . ,'w_.s vf::,j �M.>. ;_ _. '-;. 4. +; 5 ` n . '' , :;'..4. , _....�W � ;.. ..x Cc.:, •i f +1 —_ .. . .. . . .. .1-1:7: / .. �. ees• arc ...._ .L ,- _ .? f _ .:.c:...,,
Mechanical permit r, r 1A ( J ✓ C , ✓
mv based on the value o the work
❑ New consmicdon litt Addition/alteration/replacement d ;te e value (rounded to the nearest donor) of all
Demolition ❑Other mechanical trh.terials, equipment, labor, overhead, andyrofit
F 7 r , e,. .' -r r 6 , x 7 T r] I Value
?. I - and 2- family dwelling Q Commercial/i dustrial 0 Accessory building Par special injormado►t use checklist
Q Multi- family 0 Master build ❑ Other. Description I Qty. Ea Total
n 437t. w `r .� V".. . - ti r s :r t c ?.
'in,r~o F�4r `x' T ry . t r �_..,.. ....� --•= ' ! �..- .'4. - ..t He Ungf
V...u! ..l. .t? ak�rY..c...��._._.�. ...�•.J'-:-,3::; , ...,emu - -
Air conditioning
Job site address: / r 0/ 0 _ d - . f • --.. (requires sitephin showing placement) 46.75
City/State/ZIP: / �a I F Furnace 100,000 BTU (duets/vents) 4635
Furnace 100,000+ BTU (dacts/vents) 54.91
Suite/bldgJapt.no.: Project name: a .. - • G Heat pus) I 61.06
Cross stroet/directions to job site: I - Duct work I 23.32
H •• onic hot inter .• 2332
Residential boiler (radiator or
hydronic) 1 2332
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended. etc. 4635
Lot Flue/vent for any of above 23.32
Subdivision: Other: I 2332
Tax map/parcel no.: I Other fuel appliances
”' m ^ } :., cr 2 r, Cllr 1 ,, , :.. .. X) I`, f L , `i S .- r ' r;: Water heater I 23.32
i ?,:.. : : :::2 ;x . �� n,a�.:;.F,,. . :;
:_. -..` .....t..:.t u
,.. ,i _ r
. .r...l. . _. _. . . .r ,•. . .. -�.. Gas fire . lace1 3339
A - Air- / : 6. .y h � .,4 G Flue vent for (water heater or gas
fireplace I 23.32
rrq n I 9.2 // /7 -e. . Log lighter (Ras) 2332
Wood/pellet stove 33-39
wood freplacc/msert )26- / . 2332 . 3..3 -
Chirtmey/1in�r /fluelverre j 23.32 , �� -
4:4' tk ' ( , ,, . : o t h er: I 2332
Name: E/lrh / e ge. C )2 Envirvuntenial exhaust and ventilation
Range hood/other kitchen
Address: /.. O/C - . , / . /o f I f ui• ment I 3339
City/State/ZIP: /��r �/ ply - ' Clothes . exhaust NW 33.39
Single -duct eikhaust (bathrooms,
Phone (523) 7e/ 1 y9 .ax: ( ) toilet ems, utility rooms) 23.32
ri, , ] : I y ": ` „ w w ; ' ‘1'.4',..n....',.:,.
< ,� Attiderawlspaoe fans 23.32
" ..M ..M..<1.. 7 ` _... 4 ........ ` ' ! .., t ,....._ ,%., ' Wier 1 23.32
Business name: 41 ! 5 Fuel pipin
Contact name: /"1 I . 514415 for first four; 54.03 for each additional
1/ ∎, 4' _ Furnace, etc
Address: /a Cv 7_ ct,_‘_ ! " Y i v Q� � Pr 47 Ar a Gas heat •u • City/State/ZIP : Wall/ • aed/unit
9dCr 7 o2 yap .
(5 4 '� �/ _ water heater; _
Phone: 6 „ CO � .. Fax: . - i 3` Ran le I
E-mail: c n a /41 de 4j.." • r'1 .
,) 19 , { 5 Barbecue I
s �ti.�al;:,.., l ....r - -..rl .r._. , .., m. - �.., ...., . ,.�": 4 .A F ._ 'w_ ?:,... . r ,! .
Clothes dryer as)
Business name: 5 other
Address Jv'! -e_... 6 ' .- _ .. . ,, ! y ' , _. _ _w .
City /StaterLIP: I _ . I Subtotal LiO.7/
I Minimum permit foe ($90.00)
P .:ne: ( ) Fax: ( ) j Plan review (25% of permit fee)
j State surcharge (12% ofpemutfee) /Q.(O
I CCBlie_: — / (p/ f0 30 /
I ' / I TOTAL PERMIT FEE /go- �Cl
e 'lids permit 'application expires if a permit is not obtained within 180
Authorized signature: � J ail i Idaya Orr it has been accepted as coprpletc
Print name: ��in i - CG he. _ f AW.- I I Date : /a .// /eP - ' Fee met a:two f set byTri- County Buddies lndnstry Service Board
12/11/2012 17 57 503 64668034 LUDEMANS #3935 P.001/003
r , 6464409
i ‘ / A B�AV ERTOI� , OR 97005
, Aim 1.80888683
FAX SB34464O34
FACSIMILE TRANSMITTAL
o / Qic7/Zr3a Date: /p�- //--/ a"L
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To: �'i f �'
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From: Joni Hacker .
CUSTOMER SERVICE Pages in;1uding this.
Ph: 503- 646f6409
Fax: 503- 646 -8034
jonih@l _corn
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