Permit CITY OF TIGARD MECHANICAL PERMIT
_.� COMMUNITY DEVELOPMENT Permit#: MEC201300504
T[G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2013
Parcel: 2S104AC00700
Jurisdiction: Tigard
Site address: 12975 SW 132ND AVE
Project: WRIGHT Subdivision: MORNING HILL NO.1 Lot: G
Project Description: Pellet stove insert.
Contractor: LUDEMANS INC Owner: WRIGHT, LARRY
12675 SW BEAVERDAM RD 12975 SW 132ND AVE
BEAVERTON, OR 97005 TIGARD,OR 97223
PHONE: 503-646-6409 PHONE: 503-318-4059
FAX: 503-646-8034
FEES
Specifics: Description Date Amount
Wood/Pellet Stove 09/04/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 09/04/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/04/2013 $56.61
Occupancy Grp:
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 503.232.1987 or 1.800.332.2344.
Issued By: _'.Permittee Signature:
—
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.
09/03/2013 14:30 503 64668034 LUDEMANS #5589 P. 002/003
Mechanical Permit Applicati 1.(R OFFRc i•: t sr.O.1.1
City of Tigard Received
13t25SW Hall Blvd.,Ti :,�• q rL0'��J Received ./ Permit No.- vC�, O(3-0p 0 :i
Plan Review
I Phone: 503,639.4171 Fax 60 %
r :.. ..pe_ction Line: 503.639.41..•. . .._."- 1 � \c. \...i..-u.Ds . ;..
s.._+luvau�...•:('.,.tOther
Permit
Internet: www.agatd�r.gov SO n`�\G SDate Ready/By: RI SSec Page 2 for
`V` 7 Noated/Metbod . SnPDlwwatal Information
,,�,J tp � zr i7 + Y . , l rn^'' 1 I ' -.W ;t m ,r1.! s• .'.
,-.N a
■.wbi... . _-....-. ._ . 4,;`.;;,',t\�s e. . -'-kkx \, 9 .y w-,!;.. r {{ vtJ "_:",'!: .2 .. ! .., 4,' JI ' e 3„,,i 5 � t.7 G R'4,+
`>
❑Ncw construction Additiondalt= on/replaccment Meehanieal perntit fees'are based on the value of the w4prk
❑Demolition -.Other. performed_Indicate the value(rounded to the nearest dollar)of all
mechanical materials equipment,labor,overhead,and profit
A-y ,c, n yw .\Wk4' a t.: ''' Z w� - , 1f t:r.s..: rn P.n Value $� P F.79-r- .4.i.,uyyraxLa,:,. ,fi.. 1 yt).+y .u.1: :.. �,..±. _.:A.. .5 ...._,..2. ;" 'n, n. t .:c.
, ' r '
I-and 2-family dwelling ❑.Commercial/industrial ❑Accessory building M-;;s..k.z•.:� •'...2..;e ' .. .•..:.._.t.us . 4_. :,. : ,a.,.'`Ld.'s:-2
F
❑Multi-family ❑Master builder ❑Other.
For special
information um chaddist
.=n
Description
I Qty. I Ea. Total
a rZY t `r r ri. .i �4 .e T +r Z ';v
Viak.L.a4L.�>... .x& ,,ur.s � y ;a.x_�G.. . _� � e.;_.. ,.. �M1 ° -:. � 3eatiwIcooliAg
Job sitc address: /e2 9 7 /3 /�ta �../..?--
Air conditioning
(requites situ plan showing plseensent) 46.75
City/State/ZIP: '77 ,er oI OR 9 7 a g-.• Furnace 100.000 BTU(ducts/vents) 46.75
Suitc/bldgJapt no.: Project name: ../C9 A Furnace 100,000+BTU(aactrrveats) 54.91
Heat pump 61:06
Cross street/directions to job site: Duct work 2132
— Flydraic hot water system , 2332
Residential boiler(radiator or
hYdronic) 23.32
Unit heaters(fuel-type,not electric),'
in-wan,in-duct,suspended,etc. 46.7$
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other - 23.32
Tax map/parcel no.: Other fuel appliances r ]
: :4` ?F {V-..n .r/J- ?4::; F. C.Y:':").;„';,,,-: + r r . -1,N..' """4 .k r Water heat r I 1 1
2332
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 2332
Log 1ihter(gas) 23.32
Wood/pellet stove 1 3339 33.X(,
Wood 5replace/msert Jk//e f'
a.a.-.� r+ t fif ri e ,a M r r ,„r.! x M n i o 5._. S . F'r7.,e, "'
ChimaeY/iiner/flue/vent 1 23.32 033-
e: yr.i_s r,u,�_v .,y.,c r i ;..,h w {om.; °2::.:.. .. v y,wr:_.,_ ; .t_� u��,
Other. 23.32
Name: J g£ 2/6 h Environmental exhaust and ventilation
Range hood/other ldtchCtr
Address: „, fit V, i2J /3 1)-4) C2!/-' equipment 3339
IA'iE6riagM— /Coot" cl a R- 910.:2- Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:(z 3) ,3/Q- '/0$9 Fax:( ) .toilet compartments,utilty rooms!w 23.32 ,
,>r' e r rr , f + r;; : ', r te' , r %r Anicc awIspace fans 2332
$t. � ,b>,1'.,u ,.. r..7,:n:,nom..' ,Zit:"`ttf2 _q:'12,: .' i r 4 fi..ii _ v _. !:.:?la
Other: 2332
Business name: ` *.• -,-4, 5 Fuel piping
Contact name: 411.AZENg21ff $14.15 for first four;$4.03 for each additional
Furnace,_etc. L
Address'/ Ca 7 ,4E....., . • A e• Gas heat pump
City/State/ZIP: `,_v . 02 - 700 _ walvsuspended/unit heater
Phone:Bp 24,, - O• Fax::(, 3 a, , _ „,'0 / Water heater
Fireplace
E-mail: on c ) /C/Cr/e 9i -,n1 Range
l rr 2 7 f 7:7'p ii x 1r ` y rfs w y •a'.{e b�m a.�A' •f 1,-:.,<': Barbecue
z�.aFx,+ L:';{. °. P.0,i;I:ts.,,I ;i:'lir..r2va.::u.,w ,:r4 kiS .�.«: ;..:.1.u'.i a7w -,::._,.n,f4,,1i,d.S.M::.
Clothes dryerjgas)
• Other
Address: R., ir-.iC ! , ,,ca? l..,: .4 ti,,,,,- z,-;-.I P .,,r . y',,..
Subtotal
City/State/ZIP:
"e f,5/
M cz
Phone:( ) Fax:( ) ini permit fee($90.00) 90.
Plan review(25%of permit fee)
CCB tic.: r / 6,9 State surcharge(12%of puma fee) /O.at)
TOTAL PERMIT FEE /nd1!'�
Authorized signature:
?--Z91%; T6ls Dermlr appxcaHoa e u a permtt to nut obtained,riehin t80
days after it has been accepted es complete.
IPrint name: �`19.r i c S ..f" I Date: 9? • Fee methodology set by'hi-County Building Industry Service Board