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Permit A - (A CITY OF TIGARD MECHANICAL PERMIT l A DEVELOPMENT SERVICES PERMIT #: MEC2004 -00791 -I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/3/2004 PARCEL: 2S104AC -01400 SITE ADDRESS: 13090 SW WALNUT ST SUBDIVISION: ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Replacement of heat pump & air handler. Owner: FEES WHITE, ELLEN E Description Date Amount 13090 SW WALNUT [MECH] Permit Fee 12/3/200 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchari 12/3/200 $5.80 Phone: Total $78.30 Contractor: • SUNSET FUEL CO PO BOX 42289 2944 SE POWELL BLVD REQUIRED INSPECTIONS PORTLAND, OR 97242 Heating Unt lnsp Phone: 503 234 - 0611 Cooling Unt Insp Reg #: LIC 161085 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. • Issued By: Permittee Signature: _ LP S) \;. Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bsiness day 12/03/2004 15:26 0000000 ABAB:AAAAAA AA PAGE 02 Mecha ica1 Permit ® , ,1 „ t 1 , ,, 1 , , ,) , , City of Tigard _3- a (../ Permit No. \ 4. X441 " / 171 13125 SW hall Blvd., Tigard, OR 97223 I A1116 Rao Review ' Phone: 503.639.4171 Fax 503.598.19 -- L C 0 - - otharl�mit Inspection Line: 503.639.4175 t. . 'I I' Date Ready/By: 81 See Page 2 for Internet: www.ci tigerd onus GIN Of T,GARp - - - Notified/Method: Supplemental Information g10N El New construction I. ddition/altetation/replacetnent Mechanical permit fees* are based on the value of the work ❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit. ,. :I .,: - •,. Value: $ . .......... . i;/ 1 and 2 family dwelling ❑ Cotnmercial/industrial ❑ Accessory building For special information use checklist ❑ Multi ❑ Master builder ❑ Other: DeScriptiOn I Qty. I Ea_ I Total y} y {t'I 'l r 7t t ,`"is ? li ) o 1 �r r Ileatln /cowling 1 ,, / 1., y (! Air conditioning or heat pump Job site address: 1 Sw fill (requires site plan showing placement) 1 14,00 1UI -1) City / State/ZIP: "r j . 012.. 0122.-3 Furnace 100,000 BTU (ducts/vents) I 14.00 1 O t) 1 a 2 Furnace 100,000+ BTU ( ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: le )ij 0 Gas heat pump 14.00 Cross strect/directtons to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydrvnic) 14,00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00_ Flue/vent for any of above 10.00 Subdivision: Lot no.; - Other: 10.00 Tax y map /parcel no.: Other fuel appliances � , ' - �, 1 i z' , 2 �' 7 e l i � t U \ , i 4 c ., 1 ,, Water heater 10.00 IA Gas fireplace 10.00 Flue vent for water heater or gas fireplace - _ .. 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 10.00 nr n r,t t Chitttttey/liner /fluelvent SF . ,Iis •4 • [ { t t ( I I ({� i ..o ` .,, K„ r , , • .�.er � ,,. I. 7 .�i, .., y �Y'1 .,, ..'.'•::' 1 i � t . • ,..,..h.la:r, 't... t.� ,d �r. r�� \ ^•�� other 1U 00 Name: I� 1 �'�� r, Environmental exhaust and ventilation Address: I 1 _ 1A)a lh t.d Range hood/other kitchen iti equipment 10.00 City/ State/ZIP: - '1 — i t ,, g ' 7a Clothes dryer exhaust 10.00 - Single -duct exhaust (bathrooms, Phone: (S63) 4 Fax ( ) ' toilet compartments, utility rooms) 6.80 _ i� y . T'd 1 ..,',..11';',' !t R < l 1 i ( � r f 4r . r j Alttic/crawlspace fans 10.00 Y 7 ta ` r S r a 9r l y i ?l r :. t c .... -,.. , + . ? . �' ..... .. .h.'. � ... ' ; - - Business name:' 10.00 Fuel pipinfs Contact name: 55.40 for Grst four: $1.00 for each additional Address; Furnace, etc. Gas heat pump City /State /Z1P: Wall/suspended/unit heater Phone: ( ) Fax: ; ( ) .water heater Fireplace E -mail: Range ";?Y .1''44 '33'.' � RAlft„X`y� a t y M g37 w mtcr ty ra) ���tuc et 11 i �}(r 7 y ; l t i �c l F it h �` ) ' r ` a y�- h • If _ , w,.9 ,, &.% 11 t.tittc6 y �s`r'xo is *1,4 1.r , ,- , tr e : (r `tL S a14',. : :•+;.`- . ?., . L. dirbI 1: + J 4 t,1it114, Barbecue Business name: Sunset Heating and Cooling Clothes dryer (gas) Other: Address: PO Box 42289 •,..y ❑ r ug, �ttqq.. � .. ,+^ i :� a N . `c fcr ii�t�r�we..2i�iF. � ruTi�f,G+r ,� � Lt'1' 1T7 �: " v •., - City /State/ZIP: Portland, Oft 97242 Subtotal 2.00 Phone: (503) 234 - 0611 Fax; (503) 234 -0439 Minimum permit fee (S72.S0) /2 •S t7 Plan review ( 25% of permit f ee) CCB lic.: 161085 - State surcharge (8% of permit fee) S � A TOTAL PERMIT FEE 'jg. 30 Authorized signature: V Y`Ql This permit application expires if a permit is not obtained within Lao 1 days otter It has been accepted as complete. Print name; Shauna D'Arnbrosie Da07 te: l ?� /� • Fee methodology set by 7rL Counry Building Industry Sernce Board .'\ EluildiniAPemtionn sC- PecmNAoodot 12103 adn4s,-mr,.mrnvnveon 02/03/2005 03:43 0000000 ABAB:AAAAAA AA PAGE 01/01 S' 02'03'200> 15:35 FAX 6035981960 CITY OF TIGARD . JU1) , I / Building Division C � � • z�' 'f it Applicant R for Permit Acti i , g C ' o �^ .... � ��� 3 PRO � of Tigard . 0 GC" C O \ v \S\ eve TO: CITY OF TIGARD, BUILDING OFFICIAL _ 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 FROM: Applicant Name: S set . l . t Address: � . ,T .7A/Ar6 Mailing � ddr P o I�b q ZZ�� _ . �-- �//S/0_5 4174— City/State/Zip: P t-Y1 j -&v` © 12_- C( '"1"2J-1.:2.. �. VOID Phone No.: (503) 234' - CCo L_ -- - —_— Fax No,: 03 04361 1 ASE TAKE ACTION CHECKED (✓) FOR THE FOLLOWING PERMI l : K CANCEL PERMIT APPLICATION. . REFUND PERMIT FEES. Permit No.: KA ec7o04 - ooico . • Type of Permit: M OACIA Sit Address : ` ,' r` fP W ?t •',71 '1" 0 g.c7Z'Z 3 Sub division: Lot No.: EXPLANATION: .. ) ' ,e ' / 11. -- -- S i nature: C Date; 4516 g Print Name: l A � /-'0 I ! 1 FOR OFFICE USE ONLY - � .oute to Admin.: Date: A c ; y: ri%__ III Permit Canceled: Date: :.. 7:.e fund Processed: Date: By: C ashier Receipt: Date: /v./-9 /0'/ #: AapV — So23/ Amt: $ 71'T d ` Payment Type: - -.. ' . Per: .a,..a./.- 4 _TA ,;' �iiding1F'or ns∎RcgPem)rAction 0 1 - / 8 27- 04.doc 4 t4 2/15/04 Hap, I have refunded 80% of permit fees and voided this permit per request by Sunset Heating & Cooling because they said that the customer cancelled the job and hired another contractor. I noticed that the case had a final inspection so it must be for work done by the phantom contractor without paying for a permit. I contacted Shauna at Sunset today and she confirmed that the customer hired someone else. I will leave this with you to handle. Thanks. Dianna Tidemark Advantage [Dianna Howse - DIN] Fde Edt Options Wndow Help Co al ca..2imel New Op. Teel, Lrt WC 013 I N &DX AS alw. View Add Ddate Sign On PrW Dem.er. '40 charucal!WI1$I 1p 3;, igJ J Name WHITE, ELLEN E Updated. 12/3/2004 DER Ccnoral Address 13098 SW WALNUT ST Jur IG Description. Master #.kv1EC2004 -00791 Project WHITE Fuel 'Replacement of heat pump & air handler No of Appliances Class of Work. OTR No of pliances Type of Use SF Dates Ap Occupancy Group: R3 Received 12/32004 Stories r Target Issued 11213/2004 Expired 3/12005 • Activity for MEC2004- 00791; Menu Code I Description Date1 Date2 Oete3 Disp Done By Notes - -EIZEM® ®- ` A008 Create Perna 121312004 DONE DER 13080 (F) Issue pared 12132004 DONE DER A725 Heating UM Insp 12/7/2004 PASS FEY A730 Cooing Urd Insp 121712004 PASS HEY A799 Final Inspection 121712004 PASS FEY A800 Case Fineled 112E2005 DONE JMT 4 I I J _ . Tidemark Advantage [Dianna Howse - DM] Fde Edit Options Window Help [sit N. Op. Tack Usk OBE 01S © X ! a Close Vi. Add Delete Primary prat ®!2 '.+1' trati Name WHITE, ELLEN E Updated 12/12004 DER General Address 13090 SW WALNUT ST Jur IG Description Master ft IMEC2004 -00791 Project WHITE Fuel (Replacement of heat pump & air handler No. of 1_ People Associated with MEC2004 -00791 Role Name Address 13 GJVNER WHITE, ELLEN E 130911 SL ^JNdR.LNUT TIGARD OF 97223 MECHANICAL SUNSET FUEL CO PO BOX 42289 2944 SE POWELL BLVD PORTLAND OR 97242 12/03/2004 15:26 0000000 ABAB:AAAAAA AA PAGE 03 NC & H/P SUNSET. Site Plan Fuel Company Name & Address: DIRECTION 1 W vtiu_ i .. fi 5cu-k Erie coa2-3 .. HOUSE 1 C4 0 5. w , vJ A err