Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00088
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013
Parcel: 2S104AA08700
Jurisdiction: Tigard
Site address: 12140 SW 127TH AVE
Project: Jenner Subdivision: BELLWOOD NO.2 Lot: 98
Project Description: (1) wood fireplace /insert and (1) flue /vent
Contractor: LUDEMANS INC Owner: JENNER, CHARLES
12675 SW BEAVERDAM RD 12140 SW 127TH AVE
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503 - 646 -6409 PHONE: 503 - 367 -1190
FAX: 503 - 646 -8034
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 02/12/2013 $23.32
Type of Use: SF Chimney /Liner /FlueNent 02/12/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/12/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 02/12/2013 $43.36
Stories:
Fuel
Fuel Types:
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 ��iCCCJJJ��� �°►►► 503.232.1987 or 1.800.332.2344. /�
Issued By: ^ °) "` / /1 Permittee Signature: Dij 4 PPL/ 4-y7 U �I
Call 503.639.4175 0 --- 3.639.4175 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.
02/11/2013 11:10 503 64666034 LUOEMANS #4402 P.002/003
RECEIV Mechanical Permit Application rt)I, i)r• rlt t 51:
City of Tigard FEB 1 1 2013 R i> � // a- r 3 k �° cc, avi
I3I25 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639 -4171 Fax 503-98.1960 • pig . O�erPvmit
:\ ;, :, inoc
sption Irate: so3.639.4175 CITY OF TIG ' ' I • R��: (a See Pale 2 for
Internet: www. °gala- ar•gov BUILDING DIVISI 1 d h ; /�
❑ New construction �Additivn/aheratipn/teplacement Mcchamcal Ipemtit fees• arc based oa the value of the work
❑ bcmolition Q pthier performed. indicate the value (rounded to the nearest dollar) of all
mechanical 'materials, equipment, labor, overhead, and pro5t
L 1 r i i t ..: i VS1RC
j r)
I- and 2- family dwelling ❑ Commercial/industrial (J Accessory building
_ -_
For special information use checklfsL
❑ Multi family ❑ Master builder ❑ Other
�t � Descnp � Qry. Fa. Total
Job site address: + /? Q / 1 e - Air cot►o�
(m4� s>to+vmRplaceraai) 46.75
City/Statc/ZIP: i • o = 7 a _ wee 1 0 0 00O BTU (manta 46.75
Furnace I00t000 +BTU (du_ersha) 54.91
Suncdbldgiapt.no -: Project name: - 1eatpump I 61:06
Cross su eet/directions tq job site: I Ductwork 23.32
lydttmic hot water system 23.32
Residential ljoiler (radiator or
hy*ynic) 23.32
Unit heaters �fue1.type, not electric),
in -wall, in- dint, suspended, etc. 46.75
Flue/vent foe ey of above 23.32
Subdivision: Lot tto.:
Other. 2332
Tax map/par cl no .: ocher fud rit>D�uees
water heater 2332
Gras fireplace 33.39
L ie� / s i O • . ' / C Flue vent for water heater or gas . ■
-Mace I 2332
Lo: li ter (::: 23.32
wood/pcUetlstovc 33.39
wood fieplaoclinscrt 23.32 07„3 3 _
r .'_ . T ' Chinn /liner /flue/vent f :'-
_.._.. >..k..... .,._....., L_.._... Other I 1 23.32
Namc � _ _ - Environmertstl eztiaust and ventilation
Range hoo other kitchen
Address: / ` - ' - - • , „ . I 33 39
City/State/ZlP: ` . r a' Q ,z 9 7 _ ex
Clothes dryer exhaust 3339
Singlt: duct haust (bathrooms, _
Phone: (5 3 - Fax ( ) toilet couq�artrrrnta, utility rooms) 2332
T r Attic /crawlspaoe fees 23.32
_.. �. Other I 23.32
Business name: �, . 3 Fuel plpbigl
Contact name: _ — .. G K _ $14115 for Cast four; $403 for each additional
Furnace, �I
Address: � e� Co 7 . - _ • 4 - — • 4 r Gras heat pump
City/Staw/ZIP: ��_ , Yi 7 Wa1l/suspcn cd/umtheater
Phone: j 3 , O + Fax:: (5 , .. �' water heater
. / Fueplacc i
E-mail: Oh o �l.�[rP 4� • /''1 RaaRe
Barbecue
5......_.: u: ...,.. '+ !tee
Business name: • S' C
tt d ry I )
Address- -... -� —. -. ._ . _ .,.
I
City /StatdZlP: _ Subtotal
Phone Mininwin permit fee 7J
($90.00) gO.0
( ) p er: ( )
j Plan review (25% of permit fee)
State sutrbarge (12% of pent fa) / p: s pry
` TOTAL PERNIIT FEE /OG. FO
A uthorized si titre: TIIt$ permt �ppfecaecn esphea if a permit ts not obtatffid wlhhr 180
t !dm after tt has been accepted as complete.
Print nam ,-..'�. I Date: a _ / J — /,3 ' Pee meibodology SCi by TrlCowtty Banding )adnmy Service Bond
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12140 SW 127TH AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
02/21/2013 00:00
MEC2013-00088
PASS - No C of O
Violation Summary:
Inspector Contractor