Permit Support Document V 9) ,t
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City' of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT REJUNEIVED
CITY OF TIGARD
Request lest for Permit Action BUILDING DIVISION
t 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: Er Owner ❑ Applicant ❑ Contractor ❑ City Staff
Check(1)one
REFUND OR Name:
INVOICE TO: (3'2iaegs or'tndividuap .f7 i✓-b2 G`P 1 �iAd t j
Mailing Address: I A- 'o.7.. '°'V
City/State/Zip: I l 6rP1/-35 o d1 7 Z Z 4
Phone No.: (?_
PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (1):
CANCEL/VOID PERMIT APPLICATION.
11 REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: o 5 k1i ,o ?o f- iV/S 7
Site Address or Parcel#: GI`772 C1.774 '1n1 view �cRik C5 Tl6rpc'-,r- ‘71-1Z
Project Narne: i'Rol A-etTAGE} y4D cA
Subdivision Name: Lot#:
EXPLANATION: P L- -L.. 1c'P1 1 G ►o rt
f Q(Z -1-1-4 I S \ ' s G CT.
Signature: Date: - 2 2 -
Print Name: P ' 1 -Zi°ri
Behnd 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• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort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.
a 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.
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Refund Processed: Da l' By ainvoice Processed: Date By
Permit Canceled: Date /Ff2i By ,42e Parcel Tag Added: Date By
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Dianna Ornelas
From: #Building Permit Technicians
Sent: Tuesday, June 22, 2021 10:50 AM
To: Percy Traill
Cc: #CD PoD
Subject: Traill ADU - 9772 &9774 SW View Terrace - Void Permits
Hello Percy,
I am confirming that we received your request to cancel all land use and building permits for this project, and all plans
have been pulled to void the permits.
Since planning review was completed on the ADU,there will be no refund processed. For building permits, because plan
review had not been completed, there will be no invoice for fees due on the building permits and we will proceed to
void all permits.
We are sorry to hear that your project has been cancelled and we wish you all the best on your future projects.
Thank you and please let me know if you have any questions.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
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