Permit Support Document (9) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1 D
saw
Request for Permit Action
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant E Contractor ity Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State/Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL/VOID PERMIT APPLICATION.
(...411.--- FC7�D PERMIT FEES (attach copy of original receipt and provide explanation below).
�e�(1�"„� INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: ��C. -o /GP—Ot l 12
Site Address or Parcel#: 7e6, 0 Sai /3.0 Z I 12_6
Project Name: 77 I % C
Subdivision Name: Lot#:
EXPLANATION: / i ,9-,✓T` e,,,,2 -71-7--- -)5 4-__;,5-3 ez__
/0&'72./49/r" &Jz_//v-s.,7_ /7VL kJ/7a /1_6--PZ}-L.r„Z i:ei/7-7-/-
N 6 C
/N6C c'/ — OO 9di5 Grog M£ , 1_, /
777- -si: --0 // ' / .
Signature: rYV767471 I, Date: /209/1e--
Print Name: /*/,/rv,9- /77r 'C---
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to Sys Admin: Date/27.ee / By ,,- Route to Records: Date/,2//� /„(....— t.
s.e,71 —1 m 1 rocessed: Date / fiI/ I, By , 0s Invoice Processed: Date By
i Permit Canceled: Date/Xi/ 7/ By '1•.' arcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_120518.d&
CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Penult#: MEC2018-00928
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 11/30/2018
TIGARD9
Parcel: 2S101AB02400
Jurisdiction: Tigard
Site address: 7060 SW BEVELAND RD
Project: Techheads Subdivision: BEVELAND Lot: 8
Project Description: Replace furnace
Contractor: D&R HEATING&AIR Owner:
12220 SW GRANT AVE 7060 SW BEVELAND RD
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: 503-678-2517 PHONE: 503-678-2517
FAX: 503-387-5827
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 11/30/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 11/30/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/30/2018 $43.25
Occupancy Grp:
Stories:
fur
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Nems 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 503.6394175 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.
Dianna Howse
From: Kayla Sheelar <Kayla@drheating.com>
Sent: Tuesday, December 18, 2018 10:14 AM
To: Dianna Howse
Subject: FW: Permit change
Attachments: Tech Heads Permit.pdf
Original Message
From: Kayla Sheelar
Sent:Tuesday, December 18, 2018 10:13 AM
To: Kayla Sheelar<Kayla@drheating.com>
Subject: RE: Permit change
Dianna,
Attached is the new permit app, I was told the funds from our original permit would be roller over for this one.
Please let me know what else I can gather to make this permit go through asap.
Best,
Kayla Sheelar
Install Coordinator
D&R Heating and Air
503-678-2517
Original Message
From: Kayla Sheelar
Sent: Monday, December 17, 2018 11:24 AM
To: 'Dianna@tigard-or.gov'<Dianna@tigard-or.gov>
Subject: FW: Permit change
Hello Dianna,
I have just been given the task of changing this permit over to commercial.You previously worked with Justin Sandness
on getting it switched so if you could let me now the next steps I need to take to get this figured out that would be great.
I attached a copy of the previous permit.
Best,
Kayla Sheelar
Install Coordinator
D&R Heating and Air
503-678-2517
Original Message
From: scanner@drheating.com<scanner@drheating.com>
Sent: Monday, December 17, 2018 11:24 AM
To: Kayla Sheelar<Kayla@drheating.com>
Subject:
1