Correspondence CITY OF TIGARD RECEIVED
Buildin g Division
I I(i,\R I) 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171 JUN 1 2 2007
CITYOF TIGARD
INVOICE
BUILDING DIVISION
TO: Don Morissette Homes, Inc. Customer ID: 12
4230 SW Galewood St., #100 Invoice No.: I Tr/J.17-00011
Lake Oswego, OR 97035 Invoice Date: 5/30/07
Attn: Andy Thomas Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
MST2006-00252 11068 SW North Dakota St. Dakota Glen,Lot 2 $975.52
S
o2ov� - 99
Invoice Total: $975.52
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2006-00252 Customer ID: 162512
Site Address: 11068 SW North Dakota St. Invoice No.: INV2007-00011
Project: Dakota Glen,Lot 2 Invoice Date: 5/30/07
Date Due: Upon Receipt
Invoice Total: $975.52
Amount Paid: $975, .5,2_,
t/
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:\Building\Accounting\lnvoice.doc 04/06
CITY OF TIGARD 6/12/2007
14 ■ " 13125 SW Hall Blvd. 8:45:26AM
Tigard,OR 97223 503.639.4171
TIGARD
Receipt #: 27200700000000002599
Date: 06/12/2007
Line Items:
Case No Iran Code Description Revenue Account No Amount Paid
MST2006-00252 [CDCPLN]CDC Pln Rev 100-0000-433060 45.00
MST2006-00252 [LRPF]LR Planning Surcharge 100-0000-438050 6.00
MST2006-00252 [BUPPLN]Pln Rv Balance 245-0000-433000 789.22
MST2006-00252 [BUPPLN]Pln Rv Extra Set 245-0000-433000 62.50
MST2006-00252 [ERPLN]Erosn Pln Rv CWS 100-0000-207308 36.40
MST2006-00252 [EROSN]Erosn Pln Rv COT 245-0000-433010 36.40
Line Item Total: $975.52
Payments:
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check DON MORISSETTE HOMES INC DLH 54048 By Mail 975.52
Payment Total: $975.52
cReceipt.rpt Page 1 of 1
5/30/2007
1111 CITY OF TIGARD Fees Associated With 7:23:40AM - -
13125 SW Nall Blvd.
TIGARD
Tigard,OR 97223 503.639.4171 Case #: MST2006-00252
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 10/17/2006 250.00 0.00
CDCP 1/1/1990 12/31/2020 [CDCPLN]CDC Pln Rev 100-0000-433060 MAV 11/8/2006 45.00 45.00
LRPI 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 MAV 11/8/2006 6.00 6.00
BPLD 1/1/1990 12/31/2020 [BUPPLN]Pln Rv Balance 245-0000-433000 MAV 11/8/2006 789.22 789.22
PLCK 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Extra Set 245-0000-433000 MAV 11/8/2006 62.50 62.50
ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100-0000-207308 MAV 11/8/2006 36.40 36.40
ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245-0000-433010 MAV 11/8/2006 36.40 36.40
Total Due: $975.5,
Pagc 1 of I CaseFees..rpt
• : Building Division
TIGARD Request for Permit Action Rct
h',-,‘f 1007
TO: CITY OF TIGARD C`Y' `' ' L., CORD
Permit System Administrator Bllll.0""�L l �`lQ '
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:
INVOICE TO: (Business or Individual) gr1 V '-t ;; 14.
VOIDMailing Address: 4)---3 (-4 . ( �
_ _
�'3C� 7 City/State/Zip: �1�� C�i ( E 7;93
/ Phone No.: a 3 -- `�L� 3) e7 s 3 g
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
11 CANCEL PERMIT APPLICATION.
II 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#: `lra/604- 00 ASP, /Soo
Site Address or Parcel#: 1/ (,, S ,
Project Name: /
Subdivision Name: �l ci r*a—. 6 ( C --- . Lot#:
EXPLANATION: ► c- (moo -�. p c-- ,,� d/09k (C'
V'g I ) -5"6"--E- / 57 2,00 7 `Dno7-5
srdoq o2o07 d0/.2X
Signature: 14 (- Date:
Print Name: lf—.ti
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°'0 of the land use application fee for issued permits.
c) not more than 80%0 of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) 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 By Rte to Bldg Admin: Date -5-.0e) By 4'7'4'
Refund Processed: Date N ' B Invoice Processed: Date B
Permit Canceled: Date ,S,30 C 7 B 1,,7 Parcel Tag Added: Date e p 7 By =v
Receipt# Date Method Amount
I:\Building\Forms\RegPermitAction.doc Rev 05/24/06