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Permit 1,„ ,� CITY OF TIGA MECHANICAL PERMIT ..._ - COMMUNITY DEVELOPMENT Permit #: MEC2012 00281 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2012 Parcel: 2S109ACO2900 Jurisdiction: Tigard Site address: 13407 SW ANGUS CT . Project: Saravanan Subdivision: WILSON RIDGE Lot: 3 Project Description: Installation of A/C Must meet minimum 5' side yard setback and approved rear yard setback Contractor: ROTH HEATING & COOLING Owner: SARAVANAN, VIDHYA PO BOX 1265 13407 SW ANGUS CT CANBY, OR 97013 TIGARD, OR 97224 PHONE: 503 - 266 -1249 PHONE: 503 - 206 -1418 FAX: 503 - 266 -3478 FEES Specifics: Description Date Amount Air Conditioning 05/31/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 05/31/2012 $10.80 Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/31/2012 $43.25 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 ttoo by calling 503.232.1987 or 1.800.332.2344. _ // Issued By: i1�1 / Permittee Signature: 'A/ /5 /C11 ` – C 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. S May 21 2012 10:50AM ROTH HEATING 5032632513 p.1 Mechanical Permit Application l'Ult 4 ) uric_ E rsi:i)NL\ City of Tigard Received Pen .11 nft _ • 13125 SW Hall Blvd., Tigard, OR 972 "3...ECEIV lan ED Date/By: . ji i _ P R- • - II Phone: 503 718.2439 Fax: 503.598.1 Date/By: Other Pernik: ) Inspection Line: 503.639.4175 I Ili A I: I MAY 29 2012 Date Ready/By: Eall RI See Page 2 for don Internet WWW.tigard-or.gov Notifted/Method; ,f, f.- ilrisidiArj. 4 - 1 7 :2 , j':P7P , 4176 : M77;271 : A 4,1•IS • L_S 1 ,..... l i'P Z., )72-1 3f 6 5 11.1"."' ''' '''' '': ' l'' ' - - Mechanical penstiilees" are ' on the Vidue wo U New construction (81 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ i,g: ............ :.• :.• • : ' . . CAI*000.0 Itt MI. 7 : 4 : 1 2 41 _ , Y:is - ri ;; " 7 . 7 4 -- - • za'.....: gl 1- an62-family dwelling D Commercial/industrial 0 Accessory building For :pedal ittformafkm we checklist. 0 Multi-family 0 Master builder 0 Other . Description 1 Qty. 1 Ea. I Total Tot kat H 774-. ,71:44ichittlio-oh.7,:, 7:1-1: ealing/cooling: fi. .• ,,,, : • ---- - • ---72 n - ---... Job site address: 13407 SW Angus Ct. (requires site plan showing placement) 1 46.75 46.75 Furnace 100,000 BTU (deetetvem) 46.75 City/State/ZIP: Tigard, Oregon 97224 Furnace 100,000f BTU (duets/vents) 5491 Suite/bldg./apt. no.: ! Project nqaravannOyi4ddr Heat pump (requires site elan showing placemern) , 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or bydronic) 23.32 .„ Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue/vent for any of above 23.32 Other: 23.32 Tax map/parcel no.: , Other fuel applianeea: ''''', -.', ,,-,.:•:,, i :' : " , . - - Ett,tritlioilt ' I*401*-4t "-; 7,..: 2132 ' : -:: .' _ : : :" :....,,,,,.-',... .....„*A::•,- ---,,i:r-FV- :,:::::',. rsr...; :: • Water hcater ' Gas firephtedinsen 33.39 INSTALLATION OF AN AIR CONDITIONER - Flue vent for water heater or gas - fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplacermsert 23.32 . . , • 2332 00 : g . . eiviii txv:...a; Chimney/liner/flue/vent er: _ 23.32 Name: VIDHYA ITEM Environmental exhaust and vendladon: Range hood/other kitchen Address: 13407 SW ANGUS CT. . equipment 33.39 • City/State/ZIP: TIGARD, OREGON 97224 Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: (503)206-1418 Fax: ( ) toilet compartments, utility rooms) 23.32 12 '•7:1;;?:;; ;- :6: 7 g . ' - ' - ::: ":_.. • :' • I':; APPLICANT .: - AttidcrevilsOace fans 2332 t , Business name: ROTH HEATING AND COOLING Other: 2332 Fuel piping: Contact name: STEVE MERRILL $14.15 for find four; $4.03 for each additional Address: PO BOX 1265 Furnace, etc Gas heat pump City/State/ZIP: CANBY, OREGON 97013 Wall/asspendedAmit heater Phone: (503) 266-1249 1 Fax: : (503) 266-3478 , Water heater - Fireplace E-mail: STEVEM@ROTH-HEAT.COM Range -i• .:I . 1 . ' ,:' • ; 0 4(47 - 0 1 V 7 1; : Albrgig : 74:4,:ag ' Barbecue Business name: ROTH HEATING AND COOLING Clothes dryer (gas) Other: Address: PO BOX 1265 re..14,-...,?:7/kai .77.77X.,71171r7.1Mir•anifl,:''*:-Ir City/State/ZIP: CANBY, OREGON 97013 Subtotal ' Minimum permit fee ($90.00) 90.00 one: (503) 266-1249 CCB tic.: 14008 I Fax: (503) 266-3478 1 Plan review (25% of permit fee) State surcharge (12% of permit fee) laso TOTAL PERMIT FEE .., 100.80 This permit applicati expires ire permit la net obtained within 180 Authorized signature permit on ys after it has been accephsd as complete. I Print name: STEVE MERRILL I Date: 542/12 0 Fee methodology sot by Tri-County Building industry Service Board IABuildloi0PermiteMEC-PermilApp.doe 03/07/12 617T (l uovromminB) JUN -06 - 2012 WED 09:05 AM ROTH HEATING FAX NO. 5032663478 P. 01 RECEIVED G JUN 06 2012 06/05/2012 17:63 5035981968 CITY OF TIGARD PAGE 01/81 CITY OF TIGARD BUILDING DIVISION City of Tigard ' COMMUNITY DEVELOPMENT 11 1 i Request Permit Action , , „., , 13 123 SW Hall Blvd, • Tigard, Oregon 97223.503.71$.2439 • !+.tea ar.goi TO; CITY OF TIGARD Building Division Services Supervisor 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Pax: 501598.1960 wu,w.tigatd or.gov FROM: ❑ Owner ❑ Applicant X Contractor [l City Staff (Chock one) REFUND OR Natrie: INVOICE TO: alto rhms 'Jr imilvkduar) g 0 0+°. A-k.PJ 1 CyO I i Mailing Address: y. O , QO x i 74.r City /State /Zip: CP.w►6 ©IQ— C1 l 3 Phone No.: (9b3) 2-tio tz — t 2 99 PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (V): . CANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attacks copy of original receipt and provide explanation below). INVOICE FOR FEES DUE (attach ease fee schedule and provide explanation below). REMOVE/REW.ACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: INN G 1~ 2,o l "L. -- DO 2- a l Site Address or Parcel #: l 3 S �{ S G� • �� • +�e - Project Name: via IA A• 3c•.,rG.Jr"-✓1 ow% , Subdivision Name: G47; (So ,n gy -e. Lot #: . PLANATION: CS IV rvi.e r 69,0f e, l it ci ins 1-e-../144,13 h axe Signature: 4.1111 AlltaMI.AMMiL. Date: --- Print Name: S ✓t e 'W' 1 (f - 1. The Piroctor or 13uilding cNralal may authorize the refund of a) any feu which wait c,xoneauely paid et collected, b) not morn Phan KM of the land me application fee when xn npplicotion IF w,irhdnawn or [anmled be fan any review afflict hna been eapendcd. e) not mene than ftfI% of the land uae application fee for boned permits, plan rv� eau Wart has been comae_ d) not mom than BO% of the huild)g plan review the when en application is canceled before any p rp c) not more than yf % of the htsecTmgpermit fix for issued permit' plot to any itwpeetien wgtlmate. 2 Refunds will be gg null ad to the nrigjutal Payer in the came method in which payment was received. Mow annul 24 weclte fret p:aeeaeieg rcfunda. I +cIIi ()I'I 1 Oi\JI.Y Rtc eo S , a Admin: Date LIMN Rte to El. - Admin: Data , - 127AEMI B • _+ifii' Refund Proeeesed: Date ® By —Orr invoico Proccaaed: t)ate By Permit Canceled: Date ,' . �Z.N *reel Tag .Added; Date B • Receipt ##1 l 9 Date 3/ / Z Method (' CT Amount $ rn,ThuUdlnR \>'onnAllegPcmrftnctIon.•oc ' eveS /24/2o12 City of Tigard TIGARD Accela Refund Request . .. .. ......... . This form is used for refund requests of land use, development engineering and building application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request. Refund requests are due to Accela System Administrator by Wednesday at 5:00 PM for processing by the following Wednesday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing. PAYABLE TO: Roth Heating & Cooling DATE: 07/26/2012 Attn: Steve Merrill PO Box 1265 REQUESTED BY: Dianna Howse Canby, OR 97013 TRANSACTION INFORMATION: Receipt #: 186966 Case #: MEC2012 -00281 Date: 05/31/2012 Address /Parcel: 13407 SW Angus Ct. Pay Method: CreditCard Project Name: Saravanan EXPLANATION: Refund 80% per applicant's request as job was canceled. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000 -43104 $ Amount Permit Fee 230- 0000 -43102 $72.00 it' lf) 12% State Surcharge 100 - 0000 -24001 8.64 -2 16 ' TOTAL REFUND: $80.64 APPROVALS: If under $5,000 Professional Staff If under $12,500 Division Manager 1t. ,t • . If under $25,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: d By: ✓ L \Buil din \Refunds \RefundRequcst.doc x 09/01/2010 V TIGARD City of Tigard August 22, 2012 Roth Heating & Cooling Attn: Steve Merrill PO Box 1265 Canby, OR 97013 Re: Permit No. MEC2012 -00281 Dear Mr. Merrill: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 13407 SW Angus Ct. Project Name: Saravanan Job No.: N/A Refund Method: ❑ Check # in the amount of $ . ® Credit card "return" receipt in the amount of $80.64. Note: Please allow 2 -5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account "deposit" receipt in the amount of $ . Comment(s): Per applicant's request refund 80% of permit fees as job was canceled. If you have any questions please contact me at 503.718.2430. Sincerely, I s , Dianna Howse Building Division Services Supervisor Enc. 1:\ Building \ Re fund:1412 syin ale13 ,coW b 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard- or.gov May 21 2012 10:50AM ROTH HEATING 5032632513 p.2 Outdoor Unit Site Plan s i House Street Address: 13 `l 0 } 5w A GvS CT' City, State Zip: I NG,adzO , o quay Front Street