Permit Apr-21.2014 09 23 AM Tigard-Tualatin SD Operations 502-431-4019 V c ' C /y
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMEN r, V1/41
Request Permit Action A
T I c n u.f) 13125 Hall Blvd. • Tigard, Oregon 97223 • 503.718,2439 • www.tigartf or.gov U
TO: CITY OP TIGARD 'VOI-Q�
Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: El Owner ❑ Applicant 7 Contractor ❑ City Staff
(check one)
REFUND OR Name: Tigard-Tualatin School District
INVOICE TO: (Business or individual) Attn:Phil Wei""7-
Mailing Address: 6960 SW Sandburg St
City/State/Zip: Tigard,OR 97223
Phone No.: 503-431-4017
•
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED(✓):
❑ CANCEL/VOID PERMIT APPLICATION.
Z 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#: RER2013-00017
Site Address or Parcel#: 9500 SW Murdock,Tigard
Project Name: Templeton Roof
Subdivision Name: Lot#:
EXPLANATION: District determined roof project was outside available budget
Signature: / ' . A, Date: 4/21/2014
P 'p Wentz r /S�9,is /qo, 70 Print Name:
jr _ FQ x . ,v
liciaulaica
1. The Director or Building Official may authorize the refund of: /.2 7/• 3-2- f /S-a..S6 t/.2 • sa
a) any fee which was er roneously p aid 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b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. ` /YJ ,3p-
c) not more than 80%of the land use a plication 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. /Q��L!0115
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 2-4 weeks for processing refunds,
Rte to Sys A : Date b2i /14 By Rte to B g A ' : Date S e /y By 3/7. d'3
Refund Processed: Date ?s/// By Invoice Processed: Date By 3=
V�
Permit Canceled: Date y By Parcel Tag Added: Date By
Receipt# Date Method Amount S .3 SS,9 7
L•\Building\Forms\RegPemutAction.doc Rev 05/2512012
11111 •
TIGARD
City of Tigard
May 8, 2014
Tigard-Tualatin School District
Attn: Phil Wentz
6960 SW Sandburg St
Tigard, OR 97223
Re: Permit No. RER2013-00017
Dear Mr. Wentz:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 9500 SW Murdock
Project Name: Templeton Elementary - Reroof
Job No.: N/A
Refund Method: ❑ Check# in the amount of$ .
® Credit card "return" receipt in the amount of$1,423.88.
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit" receipt in the amount of$ .
Comment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
4f1: / 17--C----
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 permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Tigard-Tualatin School District DATE: 4/29/2014
Attn: Phil Wentz
6960 SW Sandburg St REQUESTED BY: Dianna Howse
Tigard, OR 97223
TRANSACTION INFORMATION:
Receipt#: 192445 Case#: RER2013-00017
Date: 7/30/2013 Address/Parcel: 9500 SW Murdock
Pay Method: CreditCard Project Name: Templeton Elementary
EXPLANATION: Per applicant's request as job was cancelled. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Building Permit 230-0000-43104 $1,271.32
12% State Surcharge 100-0000-24001 152.56
fe n / 234-AAAA-13135 12.50 56X4"--
TOTAL REFUND: --X1,4 3.6.38 '
APPROVALS: SIGN• _��'DATE:
�/a 3. ��
If under$5,000 Professional Staff , I 3Z--
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 AD INISTRATION USE ONLY
Case Refund Processed: Date: /y By:
l:\Building\Refunds\RefundRequest.doc x 09/01/2010
Building Permit Application o fi 0 0,A, 4w--
Rep.„or' R EIVED Received
City of Tigard 2013 eB : 7 ��/ Permit No.: Ea 0/3-coo/7
7111 • 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 2 Jr Plan R
ti Phone: 503.718.2439 Fax: 503.598.196QI Plan Review e: der Permit:
Inspection Line: 503.639.4175 11 OF Date Ready/By: .11........./ �,( lulls 63 See Page 2 for
TIC A h D Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: 3 Supplemental Information
w ■ y, /'v E0:14.0 AL
TYPE OF WORK REQUIRED t ATA:1-AND 2-FAMILY DWELLING
❑New construction ❑Demolition Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ®Other:School Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:Templeton Elementary School-9500 SW Murdock ST New dwelling area: square feet
City/State/ZIP:Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Templeton Roof Repair Covered porch area: square feet
Cross street/directions to job site:SW 96th Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: I Lot no.: Permit fees'are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Targeted repairs on 2 building roof areas -remove failed roof sections, Valuation: $$180,000.00
including insulation and replace with new materials Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name:Tigard-Tualatin School District Type of construction:
Address:6960 SW Sandburg Street Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: E
Phone:(503)403-4000 Fax:(503)431-4020 New:
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES'
Business name:Hubbard and Associates (Please
nlnmfuserlerark�
Structural plan review fee(or deposit):
Contact name:Nancy Hubbard
FI.S plan review fee(if applicable):
Address:P.O.Box 702
Total fees due upon application:
City/State/ZIP:Tualatin,OR 97062
Phone:(503)819-7505 I Fax::( ) Amount received: 49--
E-mail:hubbard.associates@frontier.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commerc". and residential prescriptiv• ' stallation of
CONTRACTOR roof-top mod: -d Photo Voltaic So Panel System.
Business name:TBD Submit two(2)s- of roof pl:• ith connection details
and fire department:. -ss .long with the 2010 Oregon
Address: Solar Installation Spec' ode checklist.
City/State/ZIP: Permit fee(' odes pl: view $180.00
• administrative
Phone:( ) Fax:( ) State sure':,ge(12%of permit fee):" $21.60
CCB lic.: �/ � Total fee due upon application: $201.60
Authorized.,CI., rtT� ���,�� 7 2j 13 This permit application expires if a permit is not obtained
_ f,; within 180 days after it has been accepted as complete.
Print name: David Moore Date: 113 * Fee methodology set by Tri-County Building Industry
Service Board.
et c-i r tkt-GQ .Lt]
Debbie Adamski
From: Debbie Adamski
Sent: Thursday, April 17, 2014 2:33 PM
To: 'Wentz, Philip'
Subject: RE: Templeton Roof Repair, RER2013-00017
Attachments: RegPermitAction_052512.doc; TempletonReceipt.pdf; PaymentAuthorization_
080113.doc
Phil,
Thanks for getting back to me so fast. Yes, you should be able to get 80%of your permit fee back. You will need to fill
out and submit the attached Request for Permit Action, stating that the project was cancelled. Since the fees were paid
by credit card,they will be refunded by credit card. If you also fill out and submit the Payment Authorization form with
the request form it will speed up the refund process.
Debbie Adamski
Senior Permit Technician
City of Tigard I Community Development
13125 SW Hall Blvd.,Tigard, OR 97223
503-718-2450
From: Wentz, Philip [mailto:pwentz @ttsd.k12.or.ys]
Sent: Thursday, April 17, 2014 2:09 PM
To: Debbie Adamski
Subject: Templeton Roof Repair, RER2013-00017
Hi Debbie,
Nancy forwarded your email about the Templeton roof to me. The project has been cancelled due to lack of funds. Is
there a refund due to the District?Thank you and I'm sorry for not taking care of this earlier. We've closed our contract
with Nancy as we wrap up the last of the projects. If something else pops up, please feel free to send it directly to me.
Phil
Philip Wentz,M.Ed.
Facilities Manager
Tigard-Tualatin School District
6960 5w Sandburg St.
Tigard,OR.97223
Office 503.431.4017 Fax 503.431.4020 Cell 971.563.1605
CONFIDENTIALITY NOTICE:
This email may contain confidential and privileged information.The information contained in this transmission
is intended for the addressee ONLY. If you are not the addressee of this email, please do not review,
disclose, copy or distribute any of the information enclosed. If you have received this transmission by
mistake, please telephone us immediately. Thank you!
1
Debbie Adamski
From: Debbie Adamski
Sent: Thursday, April 17, 2014 7:31 AM
To: 'hubbard.associates @frontier.com'
Subject: Templeton Roof Repair, RER2013-00017
Nancy,
We are checking on the permits that we have in our ready to issue file and this permit for the Templeton roof repair has
been ready to issue since 7/5/13. Please let me know if this project was cancelled or if we need to do a permit extension
on it.
If you want an extension, you will need to let us know the reason for the extension and an approximate timeframe when
the permit might be picked up. Thanks and let me know if you have any questions.
Debbie Ada mski
Senior Permit Technician
City of Tigard I Community Development
13125 SW Hall Blvd.,Tigard, OR 97223
503-718-2450
1