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Permit Support Document 4/11/2022 American Heating 5035 SE 24th Ave Portland OR 97202 Re: Permit No.: ELC2021-00717 Site Address: 10260 SW Greenburg Rd 550 Project Name: KPD Suite 550 Dear Applicant: The City of Tigard has received your request to cancel the above referenced permit. The status of this permit indicates that inspections were already completed prior to the request to cancel. In accordance with our policy,we are unable to grant a refund of your payment that covers work already performed. If you have any questions,please contact me at 503.718.2470. Sincerely, Holly Van De Wege Program Development Specialist City of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT 111 " 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 n Contractor ❑ City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) 1 `i t1 lrt. \.,t Mailing Address: 5 Q 3 5 S E, c q 4*\** v-e, City/State/Zip: ?AA-1 e:414 Q • '1 "2 ZA Z Phone No.: SJ" a 5 -,Q 3 q u n C} PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (V): el CANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). al INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit #: QLC, Cal 1 -- d 0 3 t 1 Site Address or Parcel#: 10.2 ER CI 654.4 Gyb.Atztv.es Rd • J5 ti Project Name: I'd) J S V.. i-k. 550 Subdivision Name: •Mt3C- „p,(,r d �'} Lot #: q EXPLANATION: 0 t-sstck y i xse, l y'e i Signature: --L„ Date: 1 ~v 7• Print Name: 'C„+54- 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 • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended.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 By Route to Records: Date By Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By I:\Boilding\Forms\ReyPermitAction_120518.doc