Correspondence 1
'`,.
TIGARD
City of Tigard
September 30, 2011
Garner Electric
Attn: Melanie
2920 SE Brookwood Ave.
Hillsboro, OR 97123
Re: Permit No. ELC2011 -00518
Dear Melanie:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
• Site Address: 11360 SW 92 " Ave.
Project Name: Ervin
Job No.: N/A
Refund Method: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $169.77.
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 scope of work changed and was completed
under MST2011- 00144. Original fees paid = $295.61; amount transferred to MST =
$125.84; refund balance of $169.77.
If you have any questions please contact me at 503.718.2430.
Sincerely,
'4
Dianna Howse
Building Division Services Supervisor
Enc.
\ Building \Refunds ala2r5sSaWn iliallfiB car aiEl r on 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
111111 . City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: Garner Electric DATE: 9/30/2011
2920 SE Brookwood Ave.
Hillsboro, OR 97123 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt #: 183980 Case #: ELC2011 -00518
Date: 9/21/2011 Address /Parcel: 11360 SW 92nd Ave.
Pay Method: CreditCard Project Name: Ervin
EXPLANATION: Transfer scope of work and payment to MST2011 -00144 and refund balance to
applicant.
.� _ P. - _,. _ ,p, , � -. • �� =t. _ ,- �:RevefiiiejAcco.uriYNo,�. '._ �,�- 'a�;�Refupd
t�'' 'A•Tt;'1 1 �Blllldlll - ?•l ermit "Fee = ._•,:��.; `'` ..4; -.. t`;; ;;.: u : -�s . ` 2 .T- • •:' - -> _ :��;:: _ .. r.s.. -_ .. o.:,;
Electrical Permit Fee 220 - 0000 -43103 $151.58
12% State Surcharge 100- 0000 -24001 18.19
TOTAL REFUND: $169.77
APPROVALS:
If under $5,000 Professional Staff
If under $12,500 Division Manager
If under $25,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
�' "�t.� t'.;;�i•�'��•�`:� ' �' '^` FO R_; T' IDEMA�KSl' ST' E1VI' �ADIVII_NI_STR``AT'ION >USE�: r "`��� "�:�r��;':`
Y _.. -- .. - - , ONLY 'u: - �•r.,
Case Refund Processed: I Date: I X /j I By: I
I \Budding \ Refunds \RefundRequest doc x 09/01/2010
I PIII e Community Development ED
Request for Permit Action SEP 30 2 011
TIGARD
. CITY OF BUI D NG 4R D
.TO: CITY OF TIGARD S ION
Building Division Services Coordinator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor ,f City Staff
(check onc) ,
REFUND OR Name:
INVOICE TO: (Business or Individual) C I- C
6 e. 6 3 go e Ee- IR 1 C
Mailing Address: p9.9 ao 5i, ► JQDO k Lode 7 c401....
City /State /Zip: N -i r,LJ PDo4o 02- 97 1) , 5
Phone No.: '503 ^ ( /'-
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL PERMIT APPLICATION. l 0 0 I m REFUND PERM FEES (attach receipt, if available). V.
I FOR FEES DUE (a case fee schedule and explain below). p,5d ///
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
1
Permit #: eJC A0/ / - 00 5/
Site Address or Parcel #: / 13 69 (-0 q a` 6,_di '' f—
Project Name: (2_t), i3
Subdivision Name: D woa'h —0 -__t - Dci,, e_ Lot #: / 3
EXPLANATION: I ge ,�4-: c...(2., A n ) li I . S , 6� - 6 M S1 ao I i - oo i L/ Li
To Tizi ,y5p 2 °t 6-1D1) - ra ec. -E.eT2, c„_L. eir3 PE of t- 0021<, o,..) Msra0i/ -oo /4 .
. go10 EL , •ii -•• 51`g q- R €i „0 $ r 11.25.
Signature: , _: _ , . /� I I' Date: 9/49//
Print Name: ( P L- /4 - D01- /L(S /&/
Refund Policy •
1. The 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 pnor to any inspection requests.
2. Refunds 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 ' ;n ®ENIA_, Rte to Bld. Admin: Date - ,
_Refund Processed: Date jj�� /t. B , C " Invoice Processed: Date By
Permit Canceled: Date 9/j6/1/ By , • - Parcel Tag Added: Date By
Receipt # /J'39,f=d Date � // Method cc__ Amount $ 4.2Y..5 4.,/
I: \Building \Forms \RegPemritAction o R 07/26/07
•