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Permit „ i k,--Q i , 7� r� J , ' RPM - �q City of Tigard, Oregon o 13125 SW Hall Blvd. ® Tigard, OR 97223 Pa, .. 7�fjlr , 10 ' N 4 40 .C A R D; , August 26, 2008 z 1' . Specialty Heating & Cooling Inc. 7500 SW Tech Center Dr., Ste. 130 Tigard, OR 97223 Attn: Andrea Re: Permit No. MEC2008 -00394 Dear Andrea: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: Site Address: 11371 SW Sycamore Pl. Project Name: Gal Job No.: N/A Refund: ❑ Check # in the amount of $ . ® Credit card "return” receipt in the amount of $81.20. I Trust account "deposit" receipt in the amount of $ . Notes: Permit created in error as site plan was not approved for placement of an A/C unit in the common area easement. Refund 100% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, D Dianna Howse Building Division Services Coordinator Enc. 1: \ Building \Refunds \Administ ration \LtrRefund - CancelPermit.doc 01 / 16/07 Phone: 503.639.4171 0 Fax: 503.684.7297 o www.tigard- or.gov o TTY Relay: 503.684.2772 IAA L 77 cl `--UV TRANSMISSION VERIFICATION REPORT TIME : 08/11/2008 15:23 NAME . FAX . TEL . SEP.# : BROH7J590752 DATE,TIME 08/11 15:23 FAX NO. /NAME 5035980718 DURATION 00:00:30 PAGE(S) 02 RESULT OK MODE STANDARD ECM City City of Tigard 13125 SW Hall Blvd. y 3� J H Q Tigard, OR 97223 ; C '.7;:t Phone: 503 -639 -4171 F. TRANSMITTAL K Date 6 (�d Number of pages including cover sheet I� To: From: . ,/ - Co: _ p Co: City of Tigard Fax #: Fax #: 5_03.598.1960 Ph #: SUBJECT: . r' VV .GA tr Cil • MESSAGE: f IOW L�1 S.fU AUG /12 /2003 /TUE 03;19 M PA:x: No, r 001 ray �. City of Tigard r „ u , _d 11125 SW Hall Blvd. AP' r T'igatd, OR 97223 �M1 „ �¢ Phone: 503 639 -4171 Le C aA, -co 3 j � - , ` ..' FAX TRANSMITTAL `: � �„ Date d it d" Number of pages .including cover shcct Co: Co: Ciiv oSTkArd Fax #: 563 r ' 1 S 1 ""' V 70- Fax #: 5911960 Ph #: SUBJECT: .�i A VI e_ _ ..� MESSAGE: 1 ,-- / 0 I ." 1 / , ' / C4 7('" 77te (3 7E //apt/ I, A . t iI! l Y ,LI _ A. A - 1 4 aze._,41/05 ,‘ --f5v- 71.-iis ,kti t _A. , . / ,IkaV A a� _ A , . tit . 4 .. , C.Z. 1 e ' . uicks (Y pro 1 - u , 5i , - . i t- l i 1.' 11 0 L Alt_ S_ A - as • 4, ic--- t \Rvil ding \Form. \F Werrafaminal.P,doc 1/18/07 "- Lei:?/ 25 /2008 /FRI 08:25 AM FAX No. F. 002/005 Mechanical anica- ermit App ication �0 ► "- ° J , , T » t > i 4Ali r + yxFi�ROFF:ICF.�l15L / >I \i 1 ��� ! a "{ ,lw� �°, r `'I3 a� rtt�a.;u, r�wt >x �,st:3t r ' f t�ti �h 4,y � )' R eceived B y City of Ti gard •' ►- CEA! 1 /B — . k +7.�+ i k si p Date/By: ` / , � 7► 1 1 y ill I3125 SW Hall Blvd„ Tigard, 111, • .m— Plan Review `,; Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Pennir. s . Inspection Line; 503,639.4175 2 008 fart. p JU 2 5 DaltReadyBy. SeePaQe / ?>'I-t , 4i , i,oi , e:% Internet: www.tigard- or.gov Notified/Method: w` SuppiementIntormatioo TY OF TIGAR® TYPE $ ON COMMERCIAL *i. S CfREDULE U$E;C' C :IST I:1 ❑ New construction Mechanical permit fees* are based onthe value of the work Additionlalteration / replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, andprotiit CATEGORY OF CONSTRUCTION Value: $ ❑ 1- and 2- family dwelling 12 Commercial /industrial 111 Accessory building . RES f)EI EQTTI){�MEIV1 (, SXST E MSt FEES For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description Qty. I Ea, Total JOB BYTE INFORMATION AND LOCATION Heating/cooling Job site address 5 L ("0- PL. Air conditioning or heat pump � (requires site platy showing placement) J I4.00 /y W aa City /State/ZIP: q �� C1 -} Z 2, 7 Furnace 100,000 BTUJductsfvents) 14,00 — J / / Furnace 100,000+ BTU (ducts/vents) 17.90 Suite bldg. /apt. no.: Project name: ( Gas heat pump 14.00 Cross street/directions to job site: Duct work • 10.00 Hydronie hot water system 14.00 - Residential boiler (radiator or hZdrenic) 14.00_ Unit beaters (fuel -type. not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue/vent for any of above 6.80 Other. 10.00 E Tax map /parcel no,: Other fuel appliances . DESCRIPTION OF WO ' • Water heater 10.00 t .1 a 1 t LA) I c IA3 Ch bvt._s' Gas fireplace 10.00 - — Flue vent for water heater or gas 10.00 p - Log lighter (gases 10.00 _k a ,1\...) \f\-Q- n o� •. t- Wood/pellet stovo - 10.00 Wood fireplace /insert 10.00 Chimney/liner/flue/vent 10.00 ❑ PROPERTY OWNER El y , / Other: ; 10.00 Name: T � ? ('6u I Environmental exhaust and ventilation Address; Range hood /other kitchen equipment 10.00 City /State/ZIP; Clothes dryer exhaust 1 1 Single -duct exhaust (bathrooms, i Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Business name: Spee_Ltt�{ pi e ct Irk 4 6,6 /l.nLi . / � Fuel piping 1 10.00 — Contact name: "mil' 55,40 for first four; $1.00 for each additional Address: -Tip r ,r. 5-1 C 1 Furnace, etc, --� Gas heat pump L City/State /aP: I � a 0 . et '2�3 Wall/suspended/unit heater Phone: (5'63 ) � 6 .. 5. 6 J Fax: : ( 563 ) 5- q ? ' ( L e 1 p ter heater E -mail: ana -• • , ie _ 4 _. 4. • - e a / P , e I CONTRACTOR Barbecue i Business name: t £, �' . Clothes dryer (gas) i ��K t �� 1 n.G Other: Address: 71 t he) So 1 e i I- e r er, by . �J e op MECHANICAL PERMIT FEES" City/State/ZIP: r- 5-rd b g. 'I 7 .3 S ubt o tal 1 1 N, A) Phone: ( ) Fax: ( ) • Minimum permit foe ($72.50) d,� / Plan review (25% of permit fee) CCD lic.; v t 5 78 State surcharge (12% of permit fee) '',77 TOTAL PERMIT FEE ,ao Authorized signature: ',� , �^'� - "1 / Y t � This permit application expires if u Besot is nut ubtaioed within 180 days after It has been accepted as cumpkte. Print name; i,, % t (]p. L(mi l; ,a Date: / 1,4 ) C ' F ee methodology set by Tri-County Building Industry Service Board t:■0uildingWeimite \MEC- Parmi.App.doc 01/19/07 440 4617T(11./07/C(3JWEB) VtA C ZO 6 < tr . 00 „5y " City of Tigard TIGARD Tidemark Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refwnd form (if applicable) must be attached to this form. Refund requests are due to Tidemark System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Specialty Heating & Cooling, Inc. DATE: 8/26/08 7500 SW Tech Center Dr., Ste. 130 Tigard, OR 97223 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 2008 -2627 Case #: MEC2008 -00394 Date: 7/25/08 Address /Parcel: 11371 SW Sycamore PI. Pay Method: CreditCard Project Name: Gal EXPLANATION: Permit created in error as site plan was not approved for placement of an A/C unit in the common area easement. Refund 100% of permit fees. REFUND INFORMATION: . Fee Description From Receipt Revenue Account No. Refund Example: [BUILD] Permit Fee Example: 245 - 0000 - 432000 $ Amount [MECH] Permit Fee 245- 0000 - 431010 $72.50 [TAX] 12% State Surcharge 100- 0000 - 207020 8.70 TOTAL REFUND: $81.20 APPROVALS: If under $500 Professional Staff I f under $7,500 Division Manager — _ • _ .. If under $22,500 Department Manager ' �� e , -' � - = ,!,• If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: 1 et ,i ._' ?'° By: 1 . --- I:\ Building\ Refunds \RefundReguest.doc 05/23/07 AUG,(12 /2008 /TUE 03:19 PM FAX No, P. 0702 • ,,U /25 /'MUMVP!I Ud:ib AM FAX No, P. 002/0075 Mechanical P ermit i" -� .x }F4 �, „ pplxcatio s y s writ .: 7 i11 .L-f(J\ 1 1 ' r§ I s�� y /, �- `lu`L °. ua+ aw^w^.4, - "t s r..,y` x �.:41+�.'c �. {4� City of Tigard is ' G , &ea "ved � - i ',N. • r _ D> Y• tom''. t. �•�[�� ¢� a Phone: 303.639A171 Pic S015911960 aem Ftculaw r� a" na e etlonLne: 503,639.1175 Ronde Ronde : •, Tll::u'R4lo Ip Dot ;.r : internee wtrw.tigerd- or.gov JUL L 2 5 �Q O dy/sy: 7, S )rmen! (or NoliAaN,NtatDod: �1i, Swppleotatanl 'newsman •, .: RD TYPE T t d' ❑ N e w conecredea 0 A d d i t i o n / s i t el a t i o n l r e p l e c e r n e t l t onto portrilt.ffies' tea based gate v: ve oi' work performed. Indicate the value (rounded to to Watteau dallar) of alt ❑ Demolition 12 Other: mechanical materials, e • al. am labor Overlies and , . fi[. CATEGOIYY or cor sTRucr'xoN _ Witte: s Q 1 -told 2- :brnliY daue111ng ®CotaatmreSnUiad�tstrlad ©AaceS90ly btliiding � - �.. �., , �- - � T�...� .... . El Multi - family ❑ h�tar builder r. Cdr real irrforrrrotran sbnek!!rt © Other Dasciipt[ein Qty. Ea, Total JOB SITE INNDORIWATtON AND (LOCATION Head /cooling Job alto Addressl INE11111M C...-. 1 ,. r , PL. Air conditioning otho6t Away ., offer Pim - ea : • . •, , lacernaot 1 14.00 City /Statci21P: j to 9. 1-1- FutUsee10.000 BTU dae,A .ts IIM 14.0o MEI 8ttiteJbldglapt no.: '" Project tam Puny 100,000+BTU (daeuNaats) OM 17,4 r MI Its hint pump _ 14.00 Cross streaVdirectioos to job site: Duet work • 10,00 • dmnfe hoz water spawn 14.00 Residential boiler (radiator or hyydmnlc) 14.00 WI handers (fucMypc, not electric), tn•wa0 indueS su • elided cte, 14.00 Subdivision: Lot no.: F!1e/Ventfbr cI above 6,80 Other. 10.00 Tax taeplptyedl no,: Other fuel a , , llama — . Draciormv Q We I • wRter heater 10.00 y ` Gas 5mpiace ( 0,00 r •-- t �1 r C� ��� Flue vent far water hooter or gas � ` 1 -1-- _ ' - fire•tace 10-00 ' • "Q 6 0 La liTttmr :: MI i t.�'> f 4% A �4t Woo• •cllotetovo 1000 Mill 10.00 Wood flmplaee/dleert III 10.00 [n P>;t0>yEii,'I'Y OWNER 0 TENANT Mama finer /fluahrcnt 10.00 Other 1.111 10.00 MIN omtnrol " • 1' v ' lotion AMMO: sa ttoodltrlh4r ld(ahen 091dllitte)lt III 10. CiEy/State/ZTP: Cie , • - d er es t 10.00 Phone: ( ) gad. ( - ) slirdttct exhaust (bathrooms, APPLICANT jpilatoampvtmcalo.utillty ns) 6.e0 ❑ COnACT PERSON Atticicrawlspeee fens 10.00 Business name: 1 ; 1 , A L ' • / Other 10.00_ — b ► 1.11fi 1 Fool trip Canted name: • _ 35.40 far Brat four $1.00 for a th Additional ,r, 54e i O F nisccto, d Cies heat urop City/Statal2�; "� � ' O e - 1 l; IN 4Val r UsuapaadedArtut Phone: (SD wane natter ,. e. . o a -, a e0 I Ran CONTRACTOR Barbecue _ ME = 13tL4trtess aunt: - cln eA , -1 Other, ( 1f 1 Te II City /StatelZlp. [ •f p1- _ _ i�C!'[AlY1CAL PJr tthQT " , , dubtot ( Phone: ( ) Pax: ( ) M {slalom • emelt lee 71.30) M , CM u:.: G L 57 Flan review case of . emit Ale) state surcharge (12% of permit tt:e) W Cy� () �� ^ ' „ TOTAL PER 1 i I FF ; ,Ap Tbk AUtheri2ed SiojSANeC; � Va,1 Cy""% p ermit a ppliea6on e kpa -m It • p to is so obtained witiiia IN Print wend z U r days atterlr het bid, accepted oo Wxnpleh, �'ti ' GC/ Date: an r r be eowufottology set hy Tr 9 • Caunty Building Industry Serviee rlpvadlnntiem,ffetMECdtrml•Alm.doc OVUM, t40.4617T(II /fCUMirW84 AUG /12 /2008 /TUE 03:19 PM 'FAX No. P.003 • -e 2;= a 3 , \ i\ a\. 6 1 SITE PLAN t r a p ( /1) 5 • PL PL • l 2 ( eat iyeA e-60(5 / y/ / 7 g PL _ STREET • • NOTE — Please show the following on the site plan: • Location of Indoor Unit and Outdoor Unit • Indicate how the flue will be run (thru the roof - out the sidewall - etc) ▪ Indicate with dotted line how the lineset will be run and approx. distance Indicate how the condensate will be run Str 7500 SW Tech Center Drive Suite 0130 SPECIALTY Tigard, OR. 97223 HEATING (503) 620 -5643 Fax (503) 681 -0793 C O O L I N I G www.5Decialitvheacine.cotn w City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • • • • T I GARD August 26, 2008 Specialty Heating & Cooling Inc. 7500 SW Tech Center Dr., Ste. 130 Tigard, OR 97223 Attn: Andrea Re: Permit No. MEC2008 -00394 Dear Andrea: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: Site Address: 11371 SW Sycamore P1. Project Name: Gal Job No.: N/A Refund: ❑ Check # in the amount of $ ® Credit card "return" receipt in the amount of $81.20. ❑ Trust account "deposit" receipt in the amount of $ Notes: Permit created in error as site plan was not approved for placement of an A/C unit in the common area easement. Refund 100% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, 4g4 teZe--- Dianna Howse Building Division Services Coordinator Enc. I: \ Building\ Refunds\ Administration \LtrRefund- CancelPennitdoc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 a#f"gii CITY OF TIGARD 8/26/2008 . 131z5 sw ilau Blvd. k 4 :16: I2PM f �. Tigard, OR 97223 503.639.4171 ' IMAM I AM Refund Receipt #: 27200800000000003018 /� C. 5.:.1-:.._ Date: 08/26/2008 Line Items: Case No Tran Code Description Revenue Account No Amount Paid MEC2008 00394 Reversal - [MECH] Permit Fee 245- 0000- 4310I0 (72.50) MEC2008 -00394 Reversal - [TAX] 12% State Sur 100- 0000 - 207020 (8.70) Line Item Total: ($81.20) Refund: Method Payer User I D Acct. /Check No. Approval No. H ow Received Amount Paid Credit Reversal SPECIALTY HEATING 8:. 030849 Fax (81.20) COOLING INC Refund Total: ($81.20) • • - 4 rt Q G a 0 ° v .a O -° .c ° . .x w q r' . ` i w 4 J ' ; •d iii O, 2 0 ea a , 0 o v -z vo b � ° a v O L's u ^ > C ii C l) a . " C v Q a v 0 7d w ` 'C ttl -0 w Q ' 0 Wx U ° WY x t i a .�' 8 F A 44 �O a �`'� Q w o a. 0 u �\ S . DC ' U Q H w g a 11)1 I CITY OF TIGARD 7/25/2O08 • " 13125 SW Ilan Blvd. 2:25:071'iM • • • 9 ' ' 'Tigard, 012 97223 503.639.4171 TIGARD • Receipt #: 27200800000000002627 Date: 07/25/2008 Line Items: Case No Trait Code Description Revenue Account No Amount Paid MEC2008 -00394 [MECH] Permit Fee 245- 0000 - 431010 72.50 MEC2008 -00394 [TAX] 12% State Surcharge 100- 0000- 207020 8.70 Line Item Total: $81.20 Payments: Method Payer User ID Acct. /Check No. Approval No. Ho w Received Amount Paid CreditCard SPECIALTY HEATING / SHERI BTT 030849 Fax 81 20 MATH EIS Payment Total: $81.20 • • .Rrcr0.1.0 I'at'L I or I • Community Development TIGARD Request for Permit Action TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard -or. v FROM: ❑ Owner ❑ Applicant ❑ Contractor City Staff (check one) REFUND OR Name: jpo�. � �(/ V ! INVOICE TO: (Business or Individual) "C.C�,/ qi/ �r���/J /r V 6.76 `i C' (� Mailing Address: 7 5UO N d )- ie-c CPA�71 er Q Sic t•_ / , 3 V OI 0 4/0? City/State /Zip: ?a Phone No.: �Q 3v — s6 �r PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓): RI CANCEL PERMIT APPLICATION. REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). • ❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). • Permit #: .'La(,ej — t�U3cj y Site Address or Parcel #: L3/ . � O(.3 -r //s7/ Project Name: Subdivision Name: £A /I5 Ferry 64 -fin, iNit,ytcS Lot #: 41' EXPLANATION: /grill d Cleat : N er(U y rf &v / ay ke f i )vSte7/ fN co/rmoil areei dice 7`0 �cErei t/l` Signature: _ Date: -7�vr Print Name: grrAN) rs/ Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the 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 canceled before any plan review effort has been expended. e) not more than 80% 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 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to S s Admin: Date AwA�;, B Rte to Bld: Admin: WM, 6 d. B • 7g'. Refund Processed: Date ,� B �T Invoice Processed: Date B • Permit Canceled: Date 6 zG i B 'l� Parcel Ta: Added: Date B Recei.t # 4 - A Date i , Method £ Amount $ I:\ Building\ Forms \RegPemmitAction..oc • v 07/26/07