Correspondence CITY OF TIGARD
Building Division
1 i A i [) 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Don Morissette Homes, Inc. Customer ID: 162512
4230 Galewood St., #100 Invoice No.: INV2007-00001
Lake Oswego, OR 97035 Invoice Date: 2/28/07
Attn: Andy Thomas Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
MST2006-00219 14687 SW Angus Pl. Wilson Ridge,Lot 10 $854.82
Invoice Total: $854.82
Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2006-00219 Customer ID: 162512
Site Address: 14687 SW Angus P1. Invoice No.: INV2007-00001
Project: Wilson Ridge,Lot 10 Invoice Date: 2/28/07
Date Due: Upon Receipt
Invoice Total: $854.82
Amount Paid: $
Office Note: Remove parcel'hold' tag upon receipt of payment.
Please mail payment to:
City of Tigard, Building Division
13125 SW Hall Blvd.
Tigard, OR 97223
Attn: Dianna Howse
I:\Boil ding\Accounting\Invoice.doc 04/06
IN CITY OF TIGARD 3/6/2007
r 13125 SW Hall Blvd. 9:16:07AM
Tigard,OR 97223 503.639.4171
TIGARD
Receipt #: 27200700000000000969
Date: 03/06/2007
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
MST2006-00219 [CDCPLN]CDC Pln Rev 100-0000-433060 45.00
MST2006-00219 [LRPF]LR Planning Surcharge 100-0000-438050 6.00
MST2006-00219 [ERPLN] Erosn Pln Rv CWS 100-0000-207308 28.60
MST2006-00219 [EROSN]Erosn Pln Rv COT 245-0000-433010 28.60
MST2006-00219 [BUPPLN]Pln Rv Extra Set 245-0000-433000 62.50
MST2006-00219 [BUPPLN]Pln Rv Balance 245-0000-433000 684.12
Line Item Total: $854.82
Payments:
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check DON MORISSETTE HOMES INC. BB 54007 In Person 854.82
Payment Total: $854.82
1cc, aatL /443
cReceipt.rpt Page 1 of 1
„ CITY OF TIGARD ?,L8,2007 Fees Associated With 8:04:31AM
11111 2 13125 SW Hall Blvd.
Tigard,OR 97223 503.639.4171 Case #: MST2006-00219
TIGARD g
Fee Start End Revenue Created
Type Date Date Dept Description Account Number By Date Amount Due
BPLC 1/1/1990 12/31/2020 [BUPPLN]Pln Rv Deposit 245-0000-433000 BLD 8/15/2006 250.00 0.00
CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100-0000-433060 LW 8/29/2006 45.00 45.00
LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 LW 8/29/2006 6.00 6.00
ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100-0000-207308 LW 8/29/2006 28.60 28.60
ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245-0000-433010 LW 8/29/2006 28.60 28.60
PLCK 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Extra Set 245-0000-433000 LW 8/29/2006 62.50 62.50
BPLD 1/1/1990 12/31/2020 [BUPPLN]Pln Rv Balance 245-0000-433000 LW 8/29/2006 684.12 684.12
Total Due: $8541
Page 1 of 1 CaseFees..rpt
•
Building Division
Request for Permit Action
TIGARD
TO: CITY OF TIGARD
Permit System Administrator
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: El Owner El Applicant Contractor ❑ City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) C: CA /7o2/5S&--77—E---- IoM&-S
O o Mailing Address:
City/State/Zip: d/A.30 'q c- C)O O d T, 7r )
L g/c E- QSKJEG D/e 9 7D.
s
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Phone No.: ,50 - JP 7
7513 pf.
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
jsi 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#: tV t " a-00 — oo 1 q c. a)g.20.0 too --DO/73
Site Address or Parcel#: ) y(e7:2 1 SL) vtc �Q 1 19 -
Project Name:
Subdivision Name: /'
Ll) l K--Dd. )'\. TLGQ.?je- Lot#: le)
EXPLANATION: CAGY.�'e_cA, l� •�•� o z r' S evt•.C�
f(G� /1 4 S ci /`?.7a C G 7 -Lr�% G�9 41 40D OOO `5'
Signature: ( 1 Date: 272-l/o 7
Print Name: ‘4_ 7 (C^� ` 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°o 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.
c) not more than 80°'o of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) 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 ()1.1.1(:1 1 tile. ()NJ 1
Rte to S s Admin: Dat- EIMII= B „._L Rte to Bl.:Admin: Date a- Pe a B. f��'
Refund Processed: Date B Invoice Processed: Date,2A,'re.- B ref%ani
Permit Canceled: Date c,? `,y' B. gaill Parcel Ta:Added: Date v7 1. ®�j+P�%fj7_
Receipt*tag, Date Method Amount$
I:\Building\Forms\RegPermitgction.doc Rev 05/24/06