Correspondence Er CITY OF TIGARD
Building Division
TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Broadway Electric Customer ID: 72942
626 SE Main St. Invoice No.: INV2008-00019
Portland, OR 97214 Invoice Date: 10/24/08
Attn: Jeff Holmes Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
ELC2008-00548 12785 SW Pacific Hwy Burgerville $447.65
$ 1 ..
Invoice Total: $447.65
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: ELC2008-00548 Customer ID: 72942
Site Address: 12785 SW Pacific Hwy Invoice No.: INV2008-00019
Project: Burgerville Invoice Date: 10/24/08
Date Due: Upon Receipt
Invoice Total: $447.65
Amount Paid: $
Office Note: Please fonvard copy of receipt to Dianna Howse.
Please mail payment to:
City of Tigard, Building Division
13125 SW Hall Blvd.
Tigard, OR 97223
Attn: Dianna Howse
I:\Building\Accounting\Invoice.doc 04/06
!111 CITY OF TIGARD 11/19/2008 '
13125 SW Hall Blvd. 1:49:04PM
Tigard,OR 97223 503.639.4171
TIGARD
Receipt #: 27200800000000003906
Date: 11/19/2008
Line Items:
Case No Tran (ode Description Revenue Account No Amount Paid
ELC2008-00548 [ELPLCK] ELC Pln Rev 220-0000-433040 447.65
Line Item Total: $447.65
Payments:
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check BROADWAY ELECTRIC DLH 9479 By Mail 447.65
Payment Total: $447.65
4
cReceipt.rpt Page 1 of 1
CITY OF TIGARD 10/24/2008
Fees Associated With 9:24:34AM
Er, 13125 SW Hall Blvd.
TIGARD Tigard,OR 97223 503.639.4171 Case #: ELC2008-00548 - •
Fee Start End Revenue Created
Type Date Date Dept Description Account Number By Date Amount Due
PRMT 1/1/1990 12/31/2020 [ELPRMT.]ELC Permit 220-0000-431510 GN 10/24/2008 1,790.60 1,790.60
PLCK 1/1/1990 12/31/2020 ([ELPLCKI ELC Pin Rev 220-0000-433040 GN 10/24/2008 447.65 447.65_
SUR1 12/31/2007 12/31/2020 [TAX] 12%State Surcharge 100-0000-207020 GN 10/24/2008 214.87 214.87
Total Due: $2,453.12
Page 1 of 1 CaseFees..rpt
Broadway Electric
624 SE Main Street
Portland, OR 97214
ATTN: Jeff Holmes
Date: Oct. 3, 2008
Project: Burgerville
12785 SW Pacific Hwy.
Tigard, OR
Dear Jeff,
The plan review for the above mentioned project was started on Sept. 30, 2008.
Correct information is required for the completion of the plan review.
Please submit the information requested below as soon as possible to facilitate the plan
review.
1. The information submitted on Sheet E-500 is inaccurate and/or incomplete.
Feeders are mislabeled.
2. The information submitted on sheet E-800 is inaccurate and/or incomplete.
Load calculations for Panels K1 and K3 are inaccurate.
Signed,
Gary Noble
Electrical Plans Examiner
City of Tigard, OR
•
Phone: 503.718.2446 ►\AA
Fax: 503.624.3681
1 ( 04(6
7111 ■ ' Community Development
Request for Permit Action
TIGARD
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: r
OICE T (Business or Individual) awilavy 4 6-/-1--i 6--
Mailing Address: Co `j&:- M1/1/4 / 71
City/State/Zip: I/4Jj" (9/2 7;; ,
�
Phone No.: 4)23 " 34/- i 'if
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach receipt, if available).
l
INVOICE FOR FEES DUE (attach case fee schedule and explain below). Le-M/4-5- i :,'7'''''"?..'
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: L�'C- Z7,9'M 1;Y.
Site Address or Parcel #: M 7 g 5 ,.(�' A /
Project Name: 9i,,,,,eyv,/z2
Subdivision Name: / Lot #:h?ii, -)414 r?el ,
EXPLANATION: 'L%L'I ct 4g '7 A-gepi 1 if/ 1.4--1 1 rt 111 /1:9 /
j o4 4 /� im Aa. -
Signature: 4.41#4444-1° Date: / 0/. 2_�G g
Print Name: Cza6. uja-,c_,v, •.k
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.
e 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.
Rte to Sys Admin: Date By Rte to Bldg Admin: Date By
Refund Processed: Date By Invoice Processed: Date /t1`lih a` c T`
Permit Canceled: Date By Parcel Tag Added: Date By
Receipt# " Date Method Amount$
I:\Building\Forms\RegPermitAction.doc Rev 07/26/07