PDR2008-00002 •
11 q
Community Development
TIGARD • Request for Permit Action
TO: CITY OF TIGARD •
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 ® City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
V a I D City /State /Zip:
9 -224(4 No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
•
® 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 # : PDR2008 -00002
Site Address or Parcel # :
•
Project Name: Tigard Retail Center
Subdivision Name: Lot # :
EXPLANATION: Please void case PDR2008 -00002 and transfer feesfrom PDR2008 -00002 to
PDR2008- 00001. Conceptual Plan Review & Detailed Plan Review should have been one case #
per Patty
Signature: Date: 9// /o,
Knstie Peerman
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b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.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 prior 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 Admin: Date B Rte to ; Date 94215,01- B
i mps .. ' 44siond Processed: Date /7 Q, B -y nvoice Processed: Date B
Permit Canceled: Date / , ' B : i1 arcel Ta; Added: Date B
Receipt # Of Date 9A Ave Method C' • Amount $
I:\ Building \Fomu \RegPermitAction.d R€v 07/26/07
PDR
2008 PLANNING DIVISION LAND USE APPLICATION DOCKET
Project Name,
Date *Land Use Case Type Applicant's Project Address Description Receipt No. Intake Person's
Received & Tidemark Case #'s Name /Address /Phone Map /Tax Lot #'s (# of LotsBldg. sq. ft.) & Fees Paid Initials
PDR2008 -00001 Pacific Realty Associates SW Dartmouth Rd west TIGARD RETAIL CENTER 20083071 KJP/
8/29/08 of SW 72nd Ave ` GP
15350 SW Sequoia Pkwy Development of an approx
Ste 300 1 S136CD- 04200, 137,90 sf Target building
Portland, OR 97224 25101 BA- 00100, and two 12,000 sf retail $7,412.00
503 - 624 -6300 2S101AB -01400 buildings - Conceptual
Plan Review
::2008- 00004' Pa is R- -lty Associates SW Dartmouth Rd west TIGARD RETAIL CENTER 20083071 KJP
8/29/08 of SW 72 s
15350 SW Se oia Pkwy Development • an approx
` 1 Ste 300 1 6CD- 04200, 137,90 sf :get building
� Portland, OR 97224 2S101BA- 00100, a • ««o 12,000 sf retail $15,9. .00
503 -624 -6300 2S101A6 -01400 buildings - Detailed Plan
Review
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(Ail', IJCA, DE 1", HOPI', MiS, DLLF, MAID, FOR, SUE, SDK, SLK, St-t5, SWL, lKh, 1"UF, VAR, LA, LON I: \CURPLN\ \fasters \DocketBook(PDRDocket08
• IN
,..T _ CITY OF T1GAR® 9/17/2008 •
� e 13125S II:33 :13AvI •
11' Hall Blvd.
m t; Tigard. OR 97223 5113.639.-1171
TiGARD
Receipt #: 27200800000000003270 /V `J
• Date: 09/17/2008
Line Items:
Case.No Trail Code Description Revenue Account No Amount Paid
PDR2008 -00001 [LANDUS] Detailed Plan Re I00- 0000 - 43800() 15,238.00
PDR2008 -0000I [LRPF] LR Planning Surcharge I00- 0000 - 438050 743.00
Line Item Total: $15,981.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check PACTRUST DLH 79213 In Person 15,981.00
•
Payment Total: $15,981.00
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CITY OF TIGARD 9/17/2008
13125 SW hail Itivd. I I :29:53ANI •
Tigard, OR 97223 503.639.4171
TIGARL1
Refund Receipt #: 27200800000000003269 /2,(7.71/
Date: 09/17/2008
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
PDR2008 -00002 Refund - [LANDUS] Detailed Pla 100- 0000 - 438000 (15,238.00)
•
PDR2008 -00002 Refund - [LRPF] LR Planning Su 100- 0000 - 438050 (743.00)
Line Item Total: ($1 5,981.00)
•
Refund:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check Refund PACTRUST 79213 In Person (15,981.00)
Refund Total: ($15,981.00)
•
•
•
•
movio.rri Pop: I of 1
CITY O TI.GAR 9/5/2005
,i> 13125 SW flail Blvd. 9:55:52AM •
• ' 1 Tigard, OR 97223 503.( 39.4171
Receipt #: 27200800000000003071 OAS /6 , <</49 �.--.--
Date: 09/02/2008
Line Items:
Case No Trait Code Description Revenue Account No A mount Paid
PD.R200S -00001 [LA N DUS] Conceptual Plan Revw 100-0000-438000 6.496.0(
PDR2008-00001 [LRPF] LR Planning Surcharge 100-0000-438050 916.00
PDR2008- 00002 [LANDUS] Detailed Plan Rcvw 100- 0000- 43$000 15.235.00
PDR2008-00002 [LR PF] LR Planning Surcharge 100-0000-438050 743.00
Line Item Total: $23,393.00
Payments:
:Method Payer User ID Acct. /Check No. Approval No. I-low Received Amount Paid
Check I'ACTRUST K.IP 79213 In Person 23,393.00
Payment Total: $23,393.00
I I