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VAR2010-00008 .11 1111 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: Joan and Dan Goodrich INVOICE TO: (Business or Individual) Mailing Address: 13285 SW Essex Dr ,(l y City /State /Zip: Tigard, OR 97223 v � �� � 5 � Phone No.: 503 - 705 -3030 G \ i 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 # : VAR2010 -00008 Site Address or Parcel # : 13285 SW Essex Dr Project Name: Goodrich Subdivision Name: Lot # : EXPLANATION: Application was created in error. Variance not needed. Please cancel and efund full amount of $294.00 Signature: Date: 10/12/10 ,John Floyd Print Name: 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 b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.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 au; Admin: Date B iJ Refund Processed: Date /41. m, By Invoice Processed: Date By Permit Canceled: Date /, / B ,liaan Parcel Ta: Added: Date B Receipt # .5'f Date' 7 /d Method . , Amount $ I:\ Building \Forms \RegPermitAction.d -,c • v 07/26/07 Dianna Howse From: Angela McCoy Sent: Tuesday, December 28, 2010 11:14 AM To: Dianna Howse Subject: RE: VAR2010- 00008, Refund Request Dianna: Check #67381 for $294.00 was cut on 10/20/2010. © From: Dianna Howse Sent: Tuesday, December 28, 2010 10:51 AM • To: Angela McCoy • Subject: VAR2010- 00008, Refund Request Hello Angela, I am checking my files to see if there was a check refund request processed in the amount of $294.00 to Dan & Joan Goodrich between 10/15 and 10/22/2010. I have a copy of a request, but I don't show that I sent out a check. Can you please look this up and see if a check was cut? Thank you. • Dianna Howse Building Division Services Supervisor City of Tigard 503.718.2430 DISCLAIMER: E -mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E -mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1 Er _ City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land usc, 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: Dan & Joan Goodrich DATE: 10/14/2010 13285 SW Essex Dr. Tigard, OR 97223 REQUESTED BY: Dianna Howse John Floyd TRANSACTION INFORMATION: Receipt #: 178631 Case #: VAR2010 -00008 Date: 07/09/2010 Address /Parcel: 13285 SW Essex Dr. Pay Method: Check Project Name: Goodrich EXPLANATION: Variance was not required; refund 100% of application fee. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000 -43104 $ Amount Development Adjust 1003100 -43116 $256.00 Development Adjust - LRP 1003100 -43117 38.00 TOTAL REFUND: $294.00 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 FOR TIDEMARK SYSTEM ADMINISTRATION USE ON Y Case Refund Processed: I Date: I /0/4,//d I By: I 1: \Building \ Refunds \RefundRequest.doc x 09/01/2010 . • CITY OF TIGARD RECEIPT II 1312 SW Hall Blvd., TigaM OR 97223 503.639.4171 TIGARD /QC A11. Receipt Number: 180833 - 12/28/2010 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID • VAR2010 -00008 $- 294.00 Total: $- 294.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 67381 DHOWSE 12/28/2010 $- 294.00 Payor: Dan & Joan Goodrich Total Payments: $ - 294.00 Balance Due: $294.00 / y co I Tidemark S ystem Administration Finance Department Request Date: /v' /XP/�O To: Liz Lutz Angela McCoy From: Dianna Howse/ Re: Receipt #: / t6 3/ /PO d 3 3 Please process this request as follows: Journal Entry (route copy of JE to . Dianna Howse). Reversal (fees have been reversed on Revenue Account Report). Credit Card Return (fees have been reversed on Revenue Account Report). :� Other /Explanation: /if 5/ /. /A((- Gfice,e. 4 .1- 777 Th ies yo u L . '" e /E G - "Cl //✓ - C S. AZ c/Vo itar.',C I:\ Building \Fottns \RteSlip - FinanceReq.doc /, L A. 75 Page 1 of 1 CITY OF TIGARD RECEIPT II III 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD • Receipt Number: 178631 - 07/09/2010 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID VAR2010 =00008 Development Adjust - LRP 1003100 -43117 $38.00 VAR2010 -00008 Development Adjust 1003100 -43116 $256.00 Total: $294.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1068 STREAT 07/09/2010 $294.00 Payor: Joan Goodrich Dan Goodrich • Total Payments: $294.00 Balance Due: $0.00 • • • Page 1 of 1