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Correspondence 663 City of Tigard, Oregon 13125 SW Hall Blvd. © Tigard, OR 97223 ' �,tr, ,o Vii � .` 1S 11 ij4 b. Y� U rikw I1 y • September 11, 2009 Tyler Combs 20908 SW Winema Ct. Tualatin, OR 97062 Re: Permit No. ELC2009- 00336, MEC2009- 00337, PLM2009 -00183 Dear Mr. Combs: The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the following: Site Address: 10990 SW 79t Ave. Project Name: Combs Job No.: N/A Refund: ® Check #100517 in the amount of $177.86. n Credit card "return" receipt in the amount of $ n Trust account "deposit" receipt in the amount of $ Notes: Per applicant's request as project was cancelled. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. I: \Buil ding\ Refunds\ Administration\ LtrRefund- CancelPermit.doc 01/16/07 Phone: 503.639.4171 0 Fax: 503.684.7297 . o www.tigard- or.gov 0 TTY Relay: 503.684.2772 City of Tigard s TIGARD Accela Refund III equest This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Tyler Combs DATE: 7/16/09 20908 SW Wmerna Ct. Tualatin, OR 97062 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt #: 174306, 174307, 174308 Case #: ELC2009- 00336, MEC2009 -00337 PLM2009 -00183 Date: 7/10/09 Address /Parcel: 10990 SW 79th .Ave. Pay Method: Check Project .Name: Combs EXPLANATION: Per applicant's request as project was cancelled. Refund 80% of permit fees. _'f 1 �7' S tt� a 7'�4j �, .3 .... t1� z.r �1 'u .�*F�&y� ' Y ' - s �� 3¢ h " s .. _ f �P �,3 � �� c µ, pi G� ® id0A 1 JO • ,3 "S� S ' r t,i �, 1.`.` 1 1 e xY - + ,'YG r 2 fi r,�x'iPtH�i +rt""e+ s f`. t '" ,' '�?3iYtE T.c�:kJkt "5. kup � tom .. �.. Y - � {�.',� "5 t cr3 ^t.„ °"1 t.�. "�,� s ��' � Y� � Jf� 'i'ma.7 k ro��f Y, � t ,,l � 4 a" �"�� '�•' i c lj t 1 rOVRecenpi 5;�; ift:0uenAccountNo aA f ' a ?� " Y , .n, " cµ1.. � k e.P k4 a NT'a v a y � y - d ,a e 1�� ] Perm t, ee ; .... l xample 245 Q000 432000 ,.. 5: 5` ° ®d t Electrical Permit Fee 2200000 -43103 $42.80 1.2% State Surcharge 1003100 -24001 5.14 Mechanical Permit Fee 2300000 -43102 58.00 12% State Surcharge 1003100 -24001 6.96 Plumbing Permit Fee 2300000 -43101 $58.00 12% State Surcharge 1003100 -24001 6.96 TOTAL REFUND: $177.86 APPROVALS: If under $500 Professional Staff If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board Rev' ,� ' FO'R ACCEtLA�SYSTEIVI ADMTNIS'1('RA`i'ION 7SE ONLY Refund Request iewed: / /e, <; By: F Case Refund Processed: Date ry ' By: :;; • I: \ Building \Refunds \ RefundRequest doc 04/13/09 CITY OF TIGARD RECEIPT 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 inG4B.P Receipt Number: 175175 - 09/11/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2009 -00336 $-47.94 Total: $ -47.94 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 100517 DHOWSE 09/11/2009 $ -47.94 Payor: Tyler Combs Total Payments: $ -47.94 Balance Due: $47.94 • Page 1 of 1 CITY OF TIGARD RECEIPT <, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Ttt ARL) Receipt Number: 174306 - 07/10/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2009 -00336 Branch Circuits wo /Purchase Service or 2200000 -43103 :,'. r' $53.50 Feeder ELC2009 -00336 12% State Surcharge - Electrical 1003100 -24001 —$ $6.42 Total: = `° $59.92 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1003 LSELLERS 07/10/2009 $59.92 Payor: Tyler Combs Total Payments: $59.92 Balance Due: $0.00 Page 1 of 1 • ing Community Development • TIGARD Request for Permit Action RECE IVED JUL 14 2009 TO: CITY OF TIGARD CITY OF TIGARD Building Division Services Coordinator BUILDING DIVISION 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: Owner Applicant ❑ Contractor n City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Ti few Co Mailing Address: 2.005 SW k/,I1t/tit„, Gf Cit /State /Zip: ! Vq A '706 2 Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): n 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 #: EL 200 ' 603 ` CC t t20 k • 0033 (0 Site Address or Parcel #: 15 136 C4 O 60 d /2 ? ?d fit) 79 /5 Project Name: Subdivision Name: Lot #: vV ► �� L Giot EXPLANATION: V2 0e 0l f . d �� - ne P Signature: 614/ 41'5 Date: ? o 1 Print Name: G/ ( p 45 Refund Policy 1. '1'he 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. Re- nds 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 B Rte to B1d: Admin: Date // 0 B a Refund Processed: Date 7 /1 d By (AT Invoice Processed: Date By Permit Canceled: Date // Q 9 By 7 r Parcel Tag Added: Date By Receipt # Date Method Amount $ I:\ Building \Forms \RcgPermitAction.doc Rev 07/26/07