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Permit y y CITY OF TIGARD MECHANICAL PERMIT 11111 s . = COMMUNITY DEVELOPMENT Permit #: MEC2013 -00371 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/09/2013 Parcel: 25111 BA06000 Jurisdiction: Tigard Site address: 14125 SW 97TH PL Project: Merrigan Subdivision: SOLARCREST Lot: 12 Project Description: Install a /c. Placement of unit must comply with manufacturer's clearance requirements. Contractor: COLUMBIA HEATING & COOLING INC Owner: MERRIGAN, MICHAEL B & JEAN M PO BOX 230397 14125 SW 97TH PL TIGARD, OR 97281 TIGARD, OR 97224 PHONE: 503 - 624 -2704 PHONE: 503 - 200 -7747 FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Air Conditioning 07/09/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 07/09/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/09/2013 $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 to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: C / 411/0 s i • Permittee Signature: c l 1e.a—L—) 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. @7/B5/2@13 1 1 : 15AM 5035%0270 COLUMBIA HEATING PAGE 02/02 • ,: ! : ! ' , Mechanical ermit BECEI VED • 1 .. : , • . 0 niit A Ilea 1 ()is 01 1 II. F I )) i M , I.1 ref: 7a/ 3 Cj) =IN 13125 S Ban elvd„ Tigard, OR 97223 JUL 8 2 013 Man Rdview " le; Phone: 5 3.718,2439 Fax: 503.598,1sa_ owasii: oth„ I Inspectio Line: 503.6 6 9.4175 la OF TIGARD Date Rjrady/13yi 11. 63 ' , . Page t fur Internet ligard-or.gov BUILDING DIVISION 14.0fk,vm.,, hod: Sutytatentp1 Intirmntion F: i.',tt : _w,`./4,?.... ... .P....),-.. ...E:t - -- Mechanical permit fees are bated on die value of the work 0 New construetion CtAdditionialterationtreplaeement I performed. Indicate Lho value (nintlea to thencarest dollar) of all 0 Demolition . 0 Other: l mechanical materials, equipment, Mb) overhead. end pro& Value: S wimusierzumizmwmarnammowszt -zz t Ege#1./W " fteuia• ' " ' ''' . ....2,,';„,„ /1- and 2-family d elling 0 Commercial/industrial 0 Accessory 'wilding 1 ' For spdalat kepranclear, Lsa dieekaL LI Multi 0 Master builder D Other Description I Qty. I ta. Total 7 ;' 4' - , ": i. (;,' :...;, !msm,, II L enolin:: • ... . ::,........-...& .., ... ,-.. _ _ . ,__-_,.. _ . a w---.7 f ,--.i57-‘z:7 8 Job ste • cmimonins i address: 1 46.75 46.75 1 =1.1M= 1 -- IrCIIICTEI Fr .. .--r 1111.11 Furnace 100.000 BTIEducts/vents) PurnaCe 100,000+ Bill OWN/vents). 54.91 SuiterbldgJapt. no.l 1 II . Project name; m err , , gam , Heat pump Otiquitta Bite OW shoWing plecerneritY 61.06 Closs street/directions o job site: : 1 Duct work 23.32 • A;. Hydnonie hot water-system I 2132 Residential boiler (radiator or it . • le 23.32 1 ' Unit heaters (fuel not eleqtric), in inAuct ittspended, etc. 46.75 __ . . SubditSinti: ' . I i,ot no:: Flue/van for any of above L_..... 23.32 2332 -- Other: . 23.32 Tax maP/Percel no.: Other fuel appliances: NEMEC :;.'ZipA Water header 23.32 ... 4 .), ,eie , _ i de Get lilt • law Flue vent for water heater or gas 3339 111111111 ftrcplaco 23.32 1111 to: Ii liter : s 23.32 WOod/pallet Stove . 33.39 Wind fircpiaccruiaert 23.32. IIMMEIWaL :, , :tr , r . z ii , •himmy/liner/Bug/vent . 23.32 Other. • 2332 0 2111/Mingat '. /1 Etiviionmental cx_ii auat and Velnii2 ., a: Address: f LH a yo If q 4 .1 Range hood/other kitchen I 1 _I , , equipment 3339 City/State/ZIP: :1) Aci At : a ,,,.." ° f Clothes dryer exhaust 33.39 1=M MIRMErrik am.2..., ..,17:11.1111.,E...,...s...Trm= StnEkkilla fthrIlliit thathmorat, toilet com .artmenti trait roma 23.32 IMEMMITIrrafr:3 Artieferawlsnacefbni . 23.32 W Business name: Cola i bis Heating and Ceding Inc_ . . ' Other Fuel pipin . . . 23.32 Contact name: Marletia Meedom S14.15 the first tOar: $4.03 , ascii fithlitittnal Address: PO Box 230 , 97 Furnace, etc. -: des heat pump City/State/ZIP: 972131 Wal Vsuepended/unit heater Phone: (503) 624-27 , I Fax: : (503) 598-0270 Water heater Fireplace _ E -mail' eotumbbee - eporteorn ! - - Rango Mlatmsv imizzEmilmmorgi Barbecue busin name: Caiumbla4icAtivig lad Cooling, Inc- Clothas dr (goo Other; , Address: N) Box 23 97 j- ‘? 4 '/1, 1 ' . ...i.:.. "' - -- :: : "&" 1 ' . 'gt,i7": . . City/Stale/ZIP: Tiger ..OR 97281 Subtotal : Minimum pemtit ($90.00) - Ye . a Phone: (51)3) 624.27 ' FOX: (503) 590 ; . - , marl review p5k oripermit ico 0.-- IMME11111 . . . State surely:mm.(12%1;rd fee) /a..qe TOTAL. PE T PEE I 700 • fee) Authorized siotatitee: J , , - e k. i , i e 1 The name split:mien expires if • pentat it. not obtaned wIthila 180 C;21 days attar It hal been zecepiad as campleta Print name: Marlene • Meedom Date: - -• _AI 4 Fee methodoleay spa by T6Coanty IsttOng ladnany semi.. Bawd . ua..........--i.soopr.p....0 ......4., nciA■010 441146 1 Yr i I or eniAnvsat 1 ! I 1111 - q FIGARD City of Tigard October 15, 2013 Columbia Heating& Cooling PO Box 230397 Tigard, OR 97281 Re: Permit No. MEC2013-00371 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 14125 SW 97`'' PI Project Name: Merrigan Job No.: 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 as job was cancelled. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov ill City of Tigard TGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request forPermit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Columbia Heating& Cooling DATE: 10/15/2013 PO Box 230397 Tigard, OR 97281 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 192145 Case #: MEC2013-00371 Date: 7/9/2013 Address/Parcel: 14125 SW 97th P1 Pay Method: CreditCard Project Name: Merrigan EXPLANATION: Per applicant's request as job was cancelled. Refund 80% of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Mechanical Permit 230-0000-43102 $72.00 12% State Surcharge 100-0000-24001 8.64 TOTAL REFUND: $80.64 APPROVALS: SIGNAT :ES DATE: If under S5,000 Professional Staff -VAT 7 e — If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMJNISTRATION USE ONL Case Refund Processed: Date: /V4.5. /_3 I By: ,J 1:\Building\Rcfiinds\RifundRcyucst.d,c x 0I9/I11/21111) 08/07/2013 01:26PM 5035980270 COLUMBIA HEATING PAGE 02/02 City of Tigard • COMMUNITY DEVELOPMENT DEPARTME T • Request Permit q Action . l6 sfi ��. . A R I) 13125 SW Hail Blvd. •Tigard, Oregon 97223 • 503.718.2439• www.tl ar -or. ov TO: CITY OF TIGARD 'cik Buil ' Division Services Supervisor 1 13 13125 SW Hall Blvd.,Tigard,OR 97223' II Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov ncTOG�SOV FROM: ❑ Owner El Applicant Contractor 0" G��� (check one) • REFUND OR Name: INVOICE TO: (Business or Individual) Co Iva lee `n + Cam,C Mailing Address: PO K 0391 City/State/Zip: Oi Phone No.: 030-( F PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): El CANCEL/VOID PERMIT APPLICATION. MREFUND PERMIT FEES (attach copy of original;receipt and provide explanation below). ElINVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: O C ?o iS Site Address or Parcel#: D a S) Ej(001 , Project Name: (Y)ef(I(,J CLn Subdivision Name: c s-f' Lot#: f,g EXPLANATION: \Q_ 66 11g+ i'1 PAPA `sit eerK.i{ ". Signature: Date: 7-4,-. o13 Print Name: -e&-1 1 f e' )tcfund Policy 1. The Director or Building Official may authorirc the refund of a) any fee which was erroneously paid or collected. b) not more than BO%of rho land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80%of the land use application fee for issued permits. d) not more than 80%of the building plan review fee when an application is cariceled before any plan review effort has been expended, c) not more than 8054 of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds. FOR OFFICE l SI ONLY Rte to 5.a.c'td:mitn: Date B Rte to Bldg Adr:ain: Date/0 ArarAill %- Refund Processed: Date/d®ACIII B e2 Invoice Processed; Dare B. Permit Canceled: Date /d MAI B 1:21,M Parcel Ta:Added: Date By Receipt# Date Method Amount$ I:\Building\Poems\Regpr jrilction.doc Rev 05/25/20112 QO ,'0,,Pd O 74- - . . .2-090 Fee "2.2.U7) 7--i,6v _ Po, (oy tlO 08/07/2013 08:55AM 5035980270 COLUMBIA HEATING PAGE 01/02 nhi HEATING & COOLING, INC. • P.O.BOX 230397•TIGARD,OR 97287 (503)624-2704 FAX COVER SHEET F XE TO: CITY OF TIGARD FAX: 503-598-1960 FROM: KAREN PH: 503-624-2704 FAX: 503-598-0270 d , PAGES INCLUDING COVER SHEE T:X 2 NOTES: PLEASE CANCEL PERMIT##MEC 2013-00371 REQUEST PERMIT ACTION,ORIGINAL PERMIT APPLICATION;AND ORIGINAL PAYMENT AUTHORIZATION FOLLOWING COVER SHEET. PLEASE CALL IF YOU NEED AN' THING ELSE.THANK YOU. 08/06/2013 08:58AM 5035980270 COLUMBIA HEATING PAGE 03/04 • -FiliiE) • Meg�,anicai Permit ApPlicat O IV FOR()I•l lt_:1';irSJ tJNl.'i — Received' City of Tigard : AU G 6 2013 oats Pelmit Na: 1 :.• 13125 SW Hall Blvd.,Tigard,OR 97223 flan Review' Phone: 503.71.82439 Fix: 503.598.19 9 DatalBy; Otha1,Permit i 1 i/t i) Inspection Lino: 503,639.4175 CITY OF TIGARD Data Roddy/By: emir. ' !:S$eePaga Z fw Internet: www,tigatd-or.gov GILDING DIVISION NO�ed/Methed• g imams al loformann, !::"`•t":.--,.•,,.1 .',:.L- en1 •, r%att-te--.42f. 1 4"' '1= u�..Y. :w , :itr es;Urc ` n i, work McCh9nir�1 p ermit fl!t:4*ore based on t' vatic of the vvorl; ❑New construction KAddition/alterolaotvrepladement performed.Indicate the value(rounde■to the newest dollar)of all ❑i3emolition 0 Other: _mechanical materials,equipment,lobo overhead,and profit g ., Value.5 1:4' °�., r e'.:- , , •- ri•yt ZE r;s 2 "'i:-'? -: ,... S= . s '. - . L:'„Tool w t VI-and 2-family dwelling ❑Commerciltt/industrial In Accessory building "For speciialltifornmllen rise checklist ©Multi-family ; p.?4aster builder 0 Other: _Description 1 IQty. I Ea. ' Total t ry r,c ,�qn+ it coil heeling ti,'•�+''",";�.,�'i''ii''rt�'�.s�`" :�_,a•. i'e•�« "i�' y11�+++a�'a,.„�/i''�,. :�'.�� ',,�r.*�.�, �,�� �Air cotlditloning Job site address: 1�! T '�� f unt2,100,000 BTU(ductalvente) { 46.75 City/SnuoIZlP: i i_f. /, 0". _ _ Furnace 100.000+13TU(Cum/vents), I 54.91 Suite/bldg./apt,no.: d Project name: errs'ate Y% Heat pump V�q+`-"� (oegalip4 site plea shelving placement}' 61.06 Cross street/directions to job site: Duel work 23.32 • Hydronie h ot:water-system 2332 Residential boiler(radiator or ltyd eaiie) • . 2332 Unit heaters(flrel-type,noteleCtrtc). in-well,induct,suspended,.etc. 46.75 _ Sabdivition: [Lot no:: Fluc/vcnt for an of above I 23.32 -. -- Other. - 2132 Tax map/payee!no. Other Heel appliances: _i•,i i " ': a +"g,'...1: ai:;i-' i 0:1072 7 'z aya+:'. W ..�.� �iL r i Water treater ! 2332 / ,Gas fireplace 33.39 ' Lad 19_ '1 _ Flue vent for Wafer hearer or gas fireplace 23.32 ' tog lighter(gags) , 23.32 Wood/pellet stove {. .33.39 . Wood f'ireplacefmsell .. 23.3.1. } ; ,, DD y .�,,��! ,!�7� �L yt f� ChimniryAinaNftuaFreru. 2-3.32 1 � .,: + 'iz ti< .`r._-i cinfo iimotartit A• i% Other. Name: — �— 23.32 �/ 11 �• Environmental exhaust and vertilai' a: Address: f 7!a`y'� q �/. �- Rangc hood/other kitchen equipment 1 33.39 City/Stnte/ZIP: ij or. i rd 6 - g7aa4 r Clothes d erexha,�nt 33.39 ( tdi at comp rt ents luOthmr rooms) Phone: ) _ « (� Fax iii r''• ) roster compartments,utility rooms) :-.-i,..;;-_c_7.44z,.,. a; ie u 4 IPA n 2 .ace fans ..._.,.i •'•�1. �.. K' ., c_`c{'4�_ci�• ��'°.1". Attie/crawl:._. - �iL�ArR87r.ni�i Business namt Columbia Heating and Cooling;ine.' �'� - 23.32 Fool piping Contact name:Maslen Meedom y s1'4.15 fdi•first root;54.03 fo each odditlonat Address:PO Box 730397 Fiunace,etc. - - .Gas heat pump City/State/ZIP:97281 . wall/suspended/un(theoter Phone:(503)024.2704 Fax::(503)598-0270 Water hearer ' Fireplace &mail eolumbhc(.telaport.cnm Range V4'r"•�dx y ;a•%rT�y:si4 k n,i r,, ilitgl/ '�w ,) ;+it ,._-,, a n �• raw,.�r:Erci�•.,7ru4��i�7��"i"„t�•�j rq'-,,..�:�'t�4pst+nI:i�:'t+ltl u� ���t' y; Harbeeue business name:Columbia Heating and Cooling.Inc Clothes dryer(gen) Other: Address:PO Bnx.230397 j;.1,73,-,-.,...___,_p h a ,a " "7_,,p! ". .-, 1 City/State/ZIP:Tigard,OR 97281 subtotal Minimum;atilt ike(590.00) Phone:(S0 )624-2704 fax.(503)598-0270 plot review(2 OA ofltettnit lee) CCB lac.:76359 Stare surcharge(12%ofkycrmit foe)r TOTAL P> 11T FZZ Anthorined t a t u r e: ' This permit applieation expires if s ire r i9 not obtained within 180 daysattertrhastoeo'arcep as compere. Print name:Marlena.R Meedom Oita: '7—s._13 - fee mclilatol igy ore by TrnConmy tied g Industry 5nrvlce Bow .nu-:i.w..a-.,,.-.,-..r.v;w..+a.,.A•.w,orris, • reo-thirr(11,n,;rOM.w si