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Permit Support Document VO I t City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT a/;?/` 4 �v Request for Permit Action OV 13125 SW Hall Blvd. •Tigard,Oregon 97223. 503-718-2439• www.ti +r�iy TO: CITY OF TIGARD of 1\ Building Division G\'(`( c��0 13125 SW Hall Blvd.,Tigard,OR 97223 ,LpiNG pM Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPennits@tig -or.gov FROM: ❑ Owner ® Applicant ❑ Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) Oregon Heating and AC LLC Mailing Address: 6950 SW 111th Ave City/State/Zip: Beaverton, OR 97008 Phone No.: 503-691-9699 PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (1): EA CANCEL/VOID PERMIT APPLICATION. ® 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#: ELC2021-00122 Site Address or Parcel#: 9020 SW Washington Square Rd.Tigard, OR 97223 S7€ j Project Name: EMBASSY TOWER 3RD FLOOR Subdivision Name: Lot#: EXPLANATION: Permit was pulled by mistake. Signature: Date: 05/19/2021 Print Name: Amy McDonald 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 • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended.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. l 3. Please allow 3-4 weeks for processing refund requests. e / t� /— e 'Jr �C � 7. 4 Rd Route to Sys Admin: Date By Route to Records: Date Ljt y '2�' By 4/2 Refund Processed: Datetp ,.1/ Byig Invoice Processed: Date By Permit Canceled: Date � t7�a, Bye Parcel Tag Added: Date By I:\Building\Forms\RegPemutAction_120518.d6c q C TIGARD City of Tigard September 2, 2021 Oregon Heating&Air Conditioning 6950 SW 111th Ave Beaverton, OR 97008 Re: Permit No. ELC2021-00122 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 9020 SW Washington Square Rd, Suite 301 Project Name: Embassy Tower- 3`d Floor Job No.: N/A Refund Method: ® Check#240431 in the amount of$67.20. ❑ Credit card "return"receipt in the amount of$ 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 permit was obtained in error. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Ornelas Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov CITY OF TIGARD RECEIPT .gt • 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T I C A R.I Project Name: EMBASSY TOWER 3RD FLOOR Site Address: 9020 SW WASHINGTON SQUARE RD, STE 301 A /1 6- Receipt Number: 433308 - 03/15/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2021-00122 Signal circuit or Limited Energy Panel 220-0000-43103 $75.00 ELC2021-00122 12% State Surcharge-Electrical 100-0000-24001 $9.00 Total: $84.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 7482881 PUBLICUSER282 03/15/2021 $84.00 Payor: Total Payments: $84.00 Balance Due: $0.00 Pace 1 of 1 III ' City of Tigard TIGARD 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 for Permit 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: Oregon Heating&Air Conditioning DATE: 8/27/2021 6950 SW 111th Ave Beaverton, OR 97008 REQUESTED BY: Dianna Ornelas TRANSACTION INFORMATION: Receipt#: 433308 Case#: ELC2021-00122 Date: 3/15/2021 Address/Parcel: 9020 SW Washington Square Rd,Ste 301 Pay Method: CreditCard Project Name: Embassy Tower- 3rd Floor EXPLANATION: Per applicant's request as permit was obtain in error. Refund 80% of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account N. Refund Example Building Permit Fee Enple: 2300000-43104 $Amount Permit Fee 220-0000-43103 $60.00 12%State Surchage 100-0000-24001 7.20 TOTAL REFUND: $67.20 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager 'e--- If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board Case Refund Processed: Date: `ly 2` By: 7 I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT a 13125 SW Hall Blvd.,Tigard OR 97223 IN 503.639.4171 TIGARD Project Name: EMBASSY TOWER 3RD FLOOR Site Address: 9020 SW WASHINGTON SQUARE RD, STE 301 Ai-J , Receipt Number: 436284 - 09/04/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID E LC2021-00122 $-67.20 Total: $-67.20 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 240431 DHOWSE 09/04/2021 $-67.20 Payor: Oregon Heating &Air Conditioning Total Payments: $-67.20 Balance Due: $67.20 Page 1 of 1 Julie Drinkwater From: Amy McDonald <amcdonald@oregonheating.com> Sent: Wednesday, May 19, 2021 12:38 PM To: #Building Permit Technicians Cc: Jeff Sanchez;Andy Beckman Subject: Request for Permit Action: ELC202 1-001 22 Attachments: Embassy 3rd Floor_re EP_Tigard_RegPermitAction_05.19.21.pdf Follow Up Flag: Follow up Flag Status: Completed Categories: Julie Warning!This message was sent from outside your organization and we are unable to verify the sender. Good afternoon, Permit action request form is attached regarding the subject permit number; fee receipt and copy of permit are included. Please let us know next steps at your soonest opportunity, and if you have any questions. Thank you, Amy McDonald Commercial Admin Oregon Heating &Air Conditioning 503-691-9699 www.oregonheating.com 1 Dianna Ornelas From: Julie Drinkwater Sent: Wednesday, July 21, 2021 9:26 AM To: Dianna Ornelas Subject: FW: Request for Permit Action: ELC2021-00122 Hello Dianna Amy McDonald, from Oregon Heating &Air Conditioning, wanted to check the status of the refund request that she submitted on May 19. I can respond to her if it is helpful. Thank you Julie Drinkwater Permit Technician City of Tigard I Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2804 Due to an increased demand for services, please expect longer wait times for responses to emails,voice messages and building inspections. Requests for permit status may not be responded to until the permit is ready to issue. Other requests deemed non- essential,such as fee estimates, may take longer to respond. In the meantime, please view this quick guide on how to submit common service requests. From:Amy McDonald <amcdonald@oregonheating.com> Sent: Wednesday,July 21, 2021 8:26 AM To:Julie Drinkwater<JulieD@tigard-or.gov> Subject: RE: Request for Permit Action: ELC2021-00122 Warning!This message was sent from outside your organization and we are unable to verify the sender. Allow sender I Block sender z i Good morning Julie, Could you please provide an update about the status of this refund? Thank you! Amy McDonald Commercial Admin 111111 Oregon Heating&Mr Conditions g 503-691-9699 www.oregonheating.com 1