HOP2012-00038 c 0 1 p,
1-- y
: . "
"A ;
TIGARD
City of Tigard
October 18, 2012
1
Mike Kamerer
12170 SW Kelly Ln.
Tigard, OR 97223
Re: Permit No. HOP2012 -00038
Dear Mr. Kamerer:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 12170 SW Kelly Ln.
Project Name: Mike's Custom Fencing
Job No.: N/A
Refund Method: ❑ Check # in the amount of $ .
❑ 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. See attached copy of Request Permit Action
form submitted by city staff and copy of Merchant Chargeback Advice form where city
" agrees" with cardholder's claim for refund of 100 %.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
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
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: Mike Kamerer DATE: 10/2/2012
12170 SW helly Ln
Tigard, OR 97223 REQUESTED BY: Dianna Howse
Hap
TRANSACTION INFORMATION:
. Receipt #: 188303 Case #: HOP2012 -00038
Date: 9/10/2012 Address /Parcel: 12170 SW helly Ln
Pay Method: CreditCard Project Name: Mike's Custom Fencing
EXPLANATION: Per applicant's request. Refund 100% of application fee per Tom McGuire.
REFUND
= `TFee >DescriptionPFrom
Etample: Buildm Peimit_Fee,,, _' E ample 4310=.1 „ , ,_,- ,._ $'Amount
Home Occupation Permit - Type II 100- 0000 -43116 $546.00
Home Occupation Permit - Type II - LRP 100- 0000 -43117 81.00
TOTAL REFUND: $627.00
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
FORsTI ,REMARK_SY_STEM_ADMIIVISTRATION USE LY � ;;; . � . ANgg�;�`r,��na
Case Refund Processed: Date: /0/414,2____ By :�?�N
I: \Building \Refunds \Rcfundltegucst.dnc s 09/01/21111)
0C/
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
l i ■
• Request Permit Action
1 i , , ,\ r 1) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor 'Cit Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) M, 4 4-
Mailing Address: / 0. / 70 w 4 t 'i
City /State /Zip: ( / Mj/ (9/ (?'7Z
Phone No.: 41111rip —/ DC q
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL /VOID PERMIT APPLICATION.
►i REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: 1' P
, o{ O /� . �S ' �Q6
Site Address or Parcel #: fa i '70 S W kM" 4-1 47 /t t l7O
Project Name: _ i / � ' / !, ,• / ,J , 1 mgrs. cusn't f F6-746A/6-
Subdivision Name: /�h I/ Aj4 Lot #: -3 1
EXPLANATION: (9V 1/ 7tep 7 6 cie 414/ / lfr
/00 a0 ,��i z ' " �� �
�Ij / / -/Z
Signature: ��, vl���i�A`�l�ti . te:
Print Name: - 7)1// r wQ y,t;/,S
/
Policy
1 The 4/
1. The Director or Building Official may authorize the refund of: �P/4)---
a) any fee which was erroneously paid or collected. - C,
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. V LS
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. �QD 0 j
e not more than 80% • .uil. • . - 't fee for issued . e 9' .: or to an • ins .ection - . 1.3 �1�rC
2. Refun. s w I .e returned to the orip . al Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds. , . 1 ti �
FOR OFFICE USE ONLY 0_ � ^
Rte to Sys Admin: Date By Rte to Admin: Date4, ! / By Air"' v ,e r
Refund Processed: Date / 1 / By ,. • Invoice Processed: Date By f C
Permit Canceled: Date `D/GZ By !'!•- ' Parcel Tag Added: Date By
Receipt # Date Method Amount $
I: \Building \Forms \RegPermitAction.doc Rev 05/25/2012
September 15, 2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
Attention: Hap Watkins
I am withdrawing my home occupation two permit application due to the cost. I will load all tools myself
and take to the job site or meet my employee outside of my neighborhood to load tools into their
vehicle.
Mike Kamerer
12170 SW Kelly Lane
Tigard, OR 97223
•
•
■
1 : 1 0111
City of Tigard
Land Use Permit Application PRE -APP. HELD BY:
TIGARD
File # I I Other Case # I
Date I I By I I Receipt # I I Fee I I Date Complete I
TYPE OF PERMIT YOU ARE APPLYING FOR
❑ Adjustment /Variance (II) ❑ Historic Overlay (II or III) ❑ Site Development Review (II)
❑ Comprehensive Plan Amendment (IV) ' Home Occupation (II) ❑ Subdivision (II or III)
❑ Conditional Use (III) ❑ Land Partition (II) ❑ Zone Change (III)
❑ Development Code Amendment (IV) ❑ Planned Development (III) ❑ Zone Change Annexation (IV)
❑ Downtown Design Review (II, III) ❑ Sensitive Lands Review (H or III)
NOTE: FOR REQUIRED SUBMITTAL ELEMENTS, PLEASE REFER TO YOUR PRE - APPLICATION CONFERENCE NOTES
LOCATION WHERE PROPOSED ACTIVITY WILL OCCUR (Address if available)
/2/70 1.14 Xe. 11y 4A.4 e..
TAX MAPS do TAX LOT NOS.
2 6/6 3 C4'08 700
TOTAL SITE SIZE ZONING CLASSIFICATION
ctcr� R-1 5
APPLICANT*
I'*
/G-e /earviice/
MAILING ADDRESS /CITY /STATE /ZIP
,Z/ 7t' lj1I . ke /// Las
PHONE NO. FAX NO.
5 -f67 0597
PRIMARY CONTACT PERSON PHONE NO.
.14.17A.12 5 41
E-MAIL
r "
mat /ur eus ew, 4,7e //I ,ecom.
AM
PROPERTY OWNER /DEED HOLDER (Attach list if more tAan one)
C (Gl /S �
MAILING ADIS / CITY "i A T
TE /ZIP
PHONE NO. FAX NO.
*When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with written
authorization from the owner or an agent of the owner. The owners must sign this application in the space provided on the back of this form
or submit a written authorization with this application.
PROPOgAL SUMMARY (Please be specific) /
/ a/14 app Mt) `er Gx Aorkw r?efu Cc %04 fjP�/L1� Co4elktG -li n9
rz i e,iJ/a) cons /a ,'J, ,n A,.) oho r�u/Iey.ee »i /l r / zrk i dtivPa,Ja or e:a - S
k`vlilloyee hod/ bP /" %oaf Try iti .n £ ar dro ; .', oFf �rl /S % y l>'�;
� P � � / Pl'
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 718 -2421 I www.tivard- or.nov I Pave 1 nf2
THE APPLICANT SHALL CERTIFY THAT:
• If the application is granted, the applicant shall exercise the rights granted in accordance with the terms and
subject to all the conditions and limitations of the approval.
♦ All the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are
true; and the applicants so acknowledge that any permit issued, based on this application, map be revoked if it is
found that any such statements are false.
• The applicant has read the entire contents of the application, including the policies and criteria, and understands
the requirements for approving or denying the application(s).
SIGNATURES OF EACH OWNER OF THE SUBJECT PROPERTY ARE REQUIRED.
9/i v/
Own s SigtYature Date
Owner's Signature Date
Owner's Signature Date
Owner's Signature Date
Owner's Signature Date
Applicant /Agent /Representative's Signature Date
Applicant /Agent /Representative's Signature Date
City of Ti-ard I 11125 SW Hall Blvd. Tioarrl OR 07771 I 5f11_71 R_7171 I ..,.Ins, r;,,.,«,a_,..- I n,,,..a '7 ..t
glib
,• ID
i Vl
61-DA C 'i LL h O nkc 6,64- ! ► �n'1n 1 T
C.o uc4-1 h re.S id .i4 'a1 Go n 5 r tate_4► an one eriv l e yGe
wtj earl in driveel or ert &_ frin4ariIy 45111 be- prc.ic A. by or droprin
of -took n�6541
oFf o S
A' f KMVer
•
A .tJoV-
caw a
is r�
. f i ,
■ ;_ t
1
1 T) r ' ,
3. •
ti N
•
a
IV" 7i
I' ,' r
JI I1 1
All ..... .
ifi * ' . .
12170 y
TWO ' ,, r c
li
q.
•
•
) . %..-.
,�
.►.. . i ,.
Feet .
a
0 31
�'
PRE 2-0 - 00
Pre— applicoc}-ion co4ereAce, -fvr NOP .
�,- r7 ij
'N : . " ( i � ., ii
U
TIGARD
City of Tigard
October 18, 2012
Mike Kamerer
12170 SW Kelly Ln.
Tigard, OR 97223
Re: Permit No. PRE2012 -00026
Dear Mr. Kamerer:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 12170 SW Kelly Ln.
Project Name: Mike's Custom Fencing
Job No.: N/A
Refund Method: ❑ Check # in the amount of $ .
® Credit card "return" receipt in the amount of $501.60.
Note: Please allow 2 -5 days for this refund transaction to be
credited to your account by the company that issued your card.
n Trust account "deposit" receipt in the amount of $ .
Comment(s): Per applicant's request. Refund 80% of application fee. See attached
receipt, copy of Request Permit Action form submitted by city staff and copy of Merchant
Chargeback Advice form where city "disagrees" with cardholder's claim for refund of 100 %.
If you have any questions please contact me at 503.718.2430.
Sincerely,
r .cfg - 214. 76) .... 1 ._ e _
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
October 18, 2012 TIGARD
City of Tigard
Dispute Resolution Department
7300 Chapman Highway
Knoxville, TN 37920 -6612
Re: Case No. 1015052752
Permit No. PRE2012 -00026
In accordance with Card Association Regulations, the City of Tigard:
Disagrees with the cardholder's claim per the attached Merchant Chargeback Advice and
provides the following rebuttal:
1. Cardholder was informed of the refund process on 9/11/2012 by planning staff, Hap
Watkins, and cardholder submitted written request to cancel permit and request refund on
9/15/2012 (see attached letter from cardholder).
2. City staff, Hap Watkins, submitted written request on 9/18/2012 to cancel permit and
request refund to accounting staff within the 2 -4 week refund policy (see attached
Request Permit Action).
3. Per city refund policy, cardholder was only entitled to a 80% refund of application fees
(see attached Request Permit Action).
4. A credit card refund transaction in the amount of $501.60 was issued on 10/16/2012 (see
attached refund receipt).
The cardholder requested the city to refund his application fees on 9/15/2012. On 10/4/2012,
just 18 days later, the city's account was debited $627.00 for this disputed transaction. The
city's refund policy is 2 -4 weeks, or 14 -28 days to process a refund. Therefore, the cardholder's
request to dispute the transaction was in violation of the city's written refund policy. In addition,
the cardholder requested a refund of 100% of the application fee, which also was a violation of
the city's refund policy to refund only 80% of application fees when an application is withdrawn.
Per the above findings, the city requests that a credit in the amount of $501.60 be returned as
soon as possible to our merchant account number 8003130658.
Sincerel
G? en-e
Dianna L. Howse
City of Tigard
Building Division Services Supervisor
503- 718 -2430
Cc: Michael W Kamerer
Encs.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
•
� I
Ili '
City of Tigard
TicARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request Permit Action form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: Mike Kamerer DATE: 10/2/2012
12170 SW Kelly Ln
Tigard, OR 97223 REQUESTED BY: Dianna Howse
Hap
TRANSACTION INFORMATION:
Receipt #: 188304 Case #: PRE2012 -00026
Date: 9/10/2012 Address /Parcel: 12170 SW Kelly Ln
Pay Method: CreditCard Project Name: Mike's Custom Fencing
EXPLANATION: Per applicant's request. Refund 80% of application fee. 0 1)
>REFIJND INFORI%' ATIOIV: , :
Fee:= Desc don From Receiptr `Revenue Account;N "o,. Refund (2
�Etiample: Building Permit Fee:.,;.`, x a . : ° ',,._ y ; - Esam le: 2300000, 43;101 , -, _ ; 3$_Amount . 11
Pre - Application Conference 100- 0000 -43116 00 04. g'
Pre - Application Conference - LRP 100 - 0000 -43117 81.00
TOTAL REFUND: $6' . 0 5i" .
APPROVALS: Air
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
'" "` "'` "' ` A1t FOR:TIDEMARK SYSTEM= ADNIINISTRATIQN,USE ONLY �
Case Refund Processed: Date: I /D7f /j.- By:
I:\ Building \RefundARefundRc9ucst.duc s 09 /111 /2' II)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
11111 a Request Permit Action
I I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor X City Staff
(check one)
REFUND OR Name: 4'l 1 / ` Q INVOICE TO: (Business or Individual) K k e...r a r
Mailing Address: / a 7 l7 G) / C -e`i tt
/
City/State /Zip: '1 5t/ 012 4 7 y
a ‘ 2.3
Phone No.: ? 3 L/0 7 0 5 9 7
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (
CANCEL /VOID PERMIT APPLICATION.
c REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: P 2 L 0/A-000 of
Site Address or Parcel #: ` / 7C ' ) 1,- L-!.,1 �-4i 03G CO57()
Project Name : /// Mixers & wrJtl •lCin
Subdivision Name: v / 7 t 14/k Lot #: .3 L%
EXPLANATION: p pei4 77) l'1062 -1
/.. R Ar, CFO % /"& ,9y° 4M-7 / &j5
Signature: 1 ' y Date:
9 '/2 /2-
r , /'
Print Name: ,4y`t C? / Ci4 '
rk ^/
4 Refund Policy A.. et 1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected. 0 t
c Q�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. /��l '_ 111"\
c) not more than 80% of the land use application fee for issued permits. Q' n l/ ,""
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. 1 1 01
- - - - - - ... :.1° , of the buildin..ermit f e e f o r issued .emits .rio ... '. . - .. - C
2 Refunds will be returned to the origin. 'ayer in t e same method in which payment was received. Please allow 2 -4 weeks for processing refunds. PO -
FOR OFFICE USE ONLY
Rte to Sys Admin: Date 13 Rte to : �
Admin: Date /i M jj��
Refund Processed: Date , Invoice Processed: Date By
Permit Canceled: Date /p / . /_ By - 4 - _ Parcel Tag Added: Date By
Receipt # Date Method Amount $
I: \ Building \ Forms \RegPennitAction.doc Rev 05/25/2012
September 15, 2012
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
Attention: Hap Watkins
I am withdrawing my home occupation two permit application due to the cost. I will load all tools myself
and take to the job site or meet my employee outside of my neighborhood to load tools into their
vehicle.
Mike Kamerer
12170 SW Kelly Lane
Tigard, OR 97223
. !Pi City of Tigard
TIGARD Pre- Application Conference Request
GENERAL INFORMATION
FOR STAFF USE ONLY
Applicant:
Q tt ` r AI/ 1 �G�-� !` FirP r Case No.:
,
Address: /2 /7C 5 tJ. ke- /( // Phon(S63)4C7 -C�J 77 Receipt No.:
�� / 3 Application Accepted By:
City: P °� 7ZZ-
Date:
Contact Person: Phone:
DATE OF PRE - APP.:
Property Owner /Deed Holder(s): 54 e TIME OF PRE - APP.:
m inlig,cii547444friet A W A_
l _ PRE -APP. HELD WITH:
�
l
Rev. 7 /1/11
is \curpin \ masters \land use applications \Pre -App Request App.doc
Address: Phone:
City: Zip:
Property Address /Location(s): genii e.
REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
without the required submittal elements)
Tax Map & Tax Lot #(s): / ) j ❑ ✓Pre- Application Conf. Request Form
6 COPIES EACH OF THE FOLLOWING:
Zoning: r �/� ❑
1/13rief Description of the Proposal and any
Site Size: t / L/ (it site - specific questions /issues that you would
like to have staff research prior to the
meeting.
PRE - APPLICATION CONFERENCE INFORMATION ❑ VSite Plan. The site plan must show the
proposed lots and /or building layouts drawn
All of the information identified on this form are required to be submitted by to scale. Also, show the location of the
the applicant and received by the Planning Division a minimum of one (1) week subject property in relation to the nearest
prior to officially scheduling a pre- application conference date /time to allow streets; and the locations of driveways on the
staff ample time to prepare for the meeting. subject property and across the street.
A pre - application conference can usually be scheduled within 1 -2 weeks of the ❑ Vicinity Map.
Planning Division's receipt of the request for either Tuesday or Thursday ❑ Vile Proposed Uses.
mornings. Pre - application conferences are one (1) hour long and are typically
held between the hours of 9:00 -11:00 AM. ❑ Topographic Information. Include Contour
p ines if Possible.
PRE - APPLICATION CONFERENCES MUST BE SCHEDULED IN ❑ Filing Fee $627.00
PERSON AT THE COMMUNITY DEVELOPMENT COUNTER
FROM 8:00- 4:00 /MONDAY- FRIDAY.
IF MORE THAN 4 PEOPLE ARE EXPECTED TO ATTEND THE
PRE - APPLICATION CONFERENCE IN YOUR GROUP, PLEASE
INFORM THE CITY IN ADVANCE SO THAT ALTERNATE ROOM
ARRANGEMENTS CAN BE MADE TO ACCOMMODATE THE
GROUP.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 718 -2421 I www.tigard- or.gov Page 1 oft
CITY OF TIGARD RECEIPT
r � 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 188304 - 09/10/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PRE2012 -00026 Pre- Application Conference - LRP 100 - 0000 -43117 $81.00
PRE2012 -00026 Pre- Application Conference 100- 0000 -43116 $546.00
Total: $627.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 06288G HWATKINS 09/10/2012 $627.00
Payor: Mike.Kamerer
Total Payments: $627.00
Balance Due: $0.00
•
•
•
Page 1 of 1
~ '
U
// _7
( /��
MIA p1. rtei rikc, .64,4g
} �
--- �-- -'C ---^~� r-c'-~~~-- ``^°^^.i �� Le;Lyx~�e. -___.
"
lie51 . par_~__ _~
__
. . '-- __m 6 5414
•
44 _~'___y-_ -__
.��
_ ___'
_ _
ii LN -
9 . 4r.
. , .
. .
i ATP
, .
• • .1. 1 . .
it . '*- ' t 71 1. ..,-'
AO 7 - ------ ... 11,
q 41) .
_ , .
_ r -...."
t ,
..... .!, 4 i a • i
.. L.
I t ----,------- , i
k.
.. ._ _ .
:, ....
I 4 _.
,,..4, uIIIPIuu
. i
i f
Taq , 1
(. 12170 b
iin . .. ..
.„..0 „.
II .
..,
. ,
1 1
; • .1°4'44; 1 .
i
1
_ _ ___
i .
, .e.e.! .
0 31 a . ger
- ' -%' ' ' ''' .'• '-ii''' oe '