Correspondence tl
CITY OF TIGARD
"!
_ Building Division
I G A R D 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Ryan Kerner Construction Customer ID: 143282
20140 SW York St. Invoice No.: INV2007-00013
Aloha, OR 97006 Invoice Date: 8/21/07
Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
MST2006-00077 13123 SW Wellington PI Riggs addition $49.00
S 1 A.
svo
Invoice Total: $49.00
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2006-00077 Customer ID: 143282
Site Address: 13123 SW Wellington P1. Invoice No.: INV2007-00013
Project: Riggs Invoice Date: 8/21/07
Date Due: Upon Receipt
Invoice Total: $49.00
Amount Paid: $
Office Note: Fees due as project was cancelled after plan review was complete.
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
III CITY OF TIGARD 10/30/2007 • {
_ 13125 SW HaII Blvd. 9:52:22AM '
Tigard,OR 97223 503.639.4171
TIGARD
Receipt #: 27200700000000004821
Date: 10/30/2007
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
MST2006-00077 [CDCPLN] CDC Pln Rev 100-0000-433060 43.00
MST2006-00077 [LRPF] LR Planning Surcharge 100-0000-438050 6.00
Line Item Total: $49.00
Payments: .
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check RYAN KERNER DLH 0308 By Mail 49.00
CONSTRUCTION
Payment Total: $49.00
•
.
_s
cReceipt.rpt Page 1 of
8/21/2007
lig CITY OF TIGARD Fees Associated With 9:44:02AM g 13125 SW Hall Blvd. .
Tigard,OR 97223 503.639.4171 Case#: MST2006-00077
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 4/10/2006 232.90 0.00
CDCP 1/1/1990 12/31/2020 [CDCPLN]CDC Pln Rev 100-0000-433060 MAV 5/8/2006 43.00 43.00
LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 MAV 5/8/2006 6.00 6.00
Total Due: 549.00
Page 1 of 1 CaseFees..rpt
•' " 1
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 f] Contractor g City Staff
(check one
REFUND OR Name:
INVOICE TO: (Business or Individual)
V o j o Mailing Address:
Vc2//10 City/State/Zip:
7 Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCE PERMIT APPLICATION.
REF i S PERMIT FEES (attach receipt,if available).
INVOIC :OR FEES DUE (attach case fee schedule and explain below).
• • 1 CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: }`-( 9406 - 000 77
Site Address or Parcel #: 1 Ix a3 o t7 LAD�tLr nJ(o7-3r3 P�
Project Name: -Xi 66 5
Subdivision Name: • /19- Lot#: ,J//t-
EXPLANATION: N_AN` l)I 5Cv`to S ry tJ W I T1f 1/4 le-)i I�►� 2 l��p[.(ei x-Yr-
` ut_ Cos? k1-c.ue6upiitis Nio- i C�
�ilr2ou41+ Lo rat- ',ioJ
Signature: C 1 k:( Date: 7 lO 7
Print Name: `7Di f Ai 4.-}1•4 5 k J
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%o 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 7 By Rte to Bldg Admin: Date e/2/ cy By 4'
Refund Processed: Date r By Invoice Processed: Date � _e o 2 By 4L
Permit Canceled: Date/ R/Q 7 By Parcel Tag Added: Date _ By
Receipt# —/557 Date j�/p 4, Method �'C_ Amount$
I:\Building\Forms\RegPermitAction.doc//Rev 07/26/07