Correspondence (31) 1111 • CITY OF TIGARD
a Building Division
TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Timber Projects LLC Customer ID: 164939
8407 SW 58`h Invoice No.: INV2008-00020
Portland, OR 97219 Invoice Date: 10/24/08
Attn: Mark Seaman Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
i2007-00134) 9322 SW North Dakota St. Hellwege Partition $110.02
MST2007-00133 9254 SW North Dakota St. Hellwege Partition $110.02
Invoice Total: $220.04
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2007-00134/MST2007-00133 Customer ID: 164939
Site Address: Various Invoice No.: INV2008-00020
Project: Hellwege Parition,Lots 1 & 2 Invoice Date: 10/24/08
Date Due: Upon Receipt
Invoice Total: $220.04
Amount Paid: $
Office Note: Please forward 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
CITY OF TIGARD 10/21/2008
Fees Associated With 7:26:11AM
13125 SW Nall Blvd.
T I CARD Tigard,OR 97223 503.639.4171 Case#: MST2007-00134 y.��a .5& we .d kc7 - Z..0 T /
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BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245-0000-433000 BLD 7/18/2007 750.00 0.00
CDCP 1/1/1990 12/31/2020 [CDCPLN]CDC Pln Rev 100-0000-433060 MAV 8/13/2007 46.00 46.00 ✓
LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 MAV 8/13/2007 6.00 6.00 ✓
BPLD 1/1/1990 12/31/2020 [BUPPLN]Pin Rv Balance 245-0000-433000 MAV 8/13/2007 16.42 16.42 •
BPRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245-0000-432000 MAV 8/13/2007 1,179.11 1,179.11
B5PC 1/1/1990 12/31/2020 [TAX] Build 8%State Surchrg 100-0000-207020 MAV 8/13/2007 94.33 94.33
MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245-0000-229202 MAV 8/13/2007 223.86 223.86
MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245-0000-431010 MAV 8/13/2007 83.70 83.70
M5PC 1/1/1990 12/31/2020 [TAX]MEC 8%State Surcharge 100-0000-207020 MAV 8/13/2007 6.70 6.70
PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245-0000-431000 MAV 8/13/2007 399.00 399.00
P5PC 1/1/1990 12/31/2020 [TAX] PLM 8%State Surcharge 100-0000-207020 MAV 8/13/2007 31.92 31.92
ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220-0000-431510 MAV 8/13/2007 245.35 245.35
ELCS 1/1/1990 12/31/2020 [TAX] ELC 8%State Surcharge 100-0000-207020 MAV 8/13/2007 19.63 19.63
ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220-0000-431510 MAV 8/13/2007 75.00 75.00
ELR5 1/1/1990 12/31/2020 [TAX] ELR 8%State Surcharge 100-0000-207020 MAV 8/13/2007 6.00 6.00
TIFM 7/1/2002 12/31/2020 [TIF-MT] TIF Mass Tr 210-0000-448005 MAV 8/13/2007 240.00 240.00
EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100-0000-207307 MAV 8/13/2007 64.00 64.00
ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100-0000-207308 MAV 8/13/2007 20.80 20.80 '✓
ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245-0000-433010 MAV 8/13/2007 20.80 20.80 ✓
WQUL 7/1/2001 12/31/2020 [WQUAL] Water Quality 520-0000-445002 MAV 8/13/2007 225.00 225.00
WQAT 7/1/2001 12/31/2020 [WQUANT] Water Quantity 520-0000-445001 MAV 8/13/2007 275.00 275.00
PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270-0000-450000 MAV 8/13/2007 4,812.00 4,812.00
TIFR 7/1/2002 12/31/2020 [TIF-R]TIF Resident 210-0000-448001 BLD 6/5/2008 2,960.00 2,960.00
Total Due: $11,050.62
77?/1.- "."1-/n//aCj4/;' 1' /461. 0„ ,
Page 1 of I CaseFees..rpt
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• 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 g. City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) --r� 4 QRa 6,GT"S LLC� MAA'c S k4i.-v g
Mailing Address: 41 0 7 5,,J 5 A\�
City/State/Zip: ?0.2 i LAr.1 1 C)2 _ C1 7)-1c/
Phone No.: (3o 3) a y b .i cj
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL PERMIT APPLICATION.
- - • 11 P ' IT FEES (attach receipt,if available).
INVOIC -•R FEES DUE (attach case fee schedule and explain below).
• MOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: MST ?CK,7 —OO 1 3/
Site Address or Parcel#: qi 3aa 5 uo No"---71-1 DA k&TA
Project Name: zu-,1/
Subdivision Name: SAM,_ Lot#:
EXPLANATION: uksrzrs A 5 0 N,E 9 f�x��2F.- 8
Av.) gk v 6 ) big t t .
Signature: Date: Jo — / ?—UPS
Print Name: /,A R k \ N 4 k -LA./
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 Sys Admin: Date By Rte to Bldg Admin: Date /C/Z,ee- By
Refund Processed: Date By Invoice Processed: Date/��4/e f By
Permit Canceled: Date By Parcel Tag Added: Date By
Receipt# Date Method Amount$
I:\Building\Forms\RegPermitAction.doc Rev 07/26/07