Correspondence 11111 • CITY OF TIGARD
■ Building Division
T I G A R D 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Wilshire Homes LLC Customer ID: 15720
10110 SW Nunbus Ave., Ste.B-1 Invoice No.: INV2007-00006
Tigard,OR 97223 Invoice Date: 5/1/07
Attn: Aaron Fuller Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot# or Project Name Amount Due
MST2006-00057 14710 SW 149th Ten French Prairie Vineyards,Lot 7 $303.60
(MST2006-00059 ) 14730 SW 149th Ten French Prairie Vineyards,Lot 8 $808.19
MST200-6700093 14896 SW Pennie Ln French Prairie Vineyards,Lot 11 $878.26
I 1
5 ,11w
0"
Invoice Total: $1,990.05
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: Various Customer ID: 15720
Site Address: Various Invoice No.: INV2007-00006
Project: French Prairie Vineyards Invoice Date: 5/1/07
Date Due: Upon Receipt
Invoice Total: $1,990.05
Amount Paid: $
Office Note: Cases are in URB area.
Please mail payment to:
City of Tigard,Building Division
13125 SW Hall Blvd.
Tigard,OR 97223
Attn: Dianna Howse
I:\Bull ding\Accounting\Invoice.doc 04/06
CITY OF TIGARD 10:11 /6AM
INI
Fees Associated With
a 13125 SW Hall Blvd.
Tigard,OR 97223 503.639.4171 Case #: MST2006-00059 L 0 T 9
TIGARD >;
Fee Start End Revenue Created
Type Date Date Dept Description Account Number By Date Amount Due
BPL3 1/1/1990 12/31/2020 [UBUPLN] Pln Rv Deposit 255-0000-433000 BB 2/23/2006 250.00 0.00
CDRU 1/1/1990 12/31/2020 [UCDC] CDC Review URB 255-0000-433060 MAV 4/10/2006 43.00 43.00
LRP2 12/28/2004 12/31/2020 [ULRPF] LR Planning Surcharge 255-0000-438050 MAV 4/10/2006 6.00 6.00
BP2D 1/1/1990 12/31/2020 [UBUPLN] Pln Rv Balance 255-0000-433000 MAV 4/10/2006 759.19 759.19
Total Due: $808.19
Page 1 of 1 CaseFees..rpt
MI .CITY OF TIGARD JI 1.11 LVV l
2:33:41 PM
13125 SW Hall Blvd.
Tigard,OR 97223 503.639.4171
TIGARD
Receipt #: 27200700000000002116
Date: 05/14/2007
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
MST2006-00059 [UCDC] CDC Review URB 255-0000-433060 43.00
MST2006-00059 [ULRPF]LR Planning Surcharge 255-0000-438050 6.00
MST2006-00059 [UBUPLN] Pln Rv Balance 255-0000-433000 759.19
Line Item Total: $808.19
Payments:
Method Payer User ID Acct./Check No. Approval No. How Received Amount Paid
Check WILSHIRE HOMES LLC DLH 2146 By Mail 808.19
Payment Total: $808.19
cReceipt.rpt Page 1 of 1
v Building Division
Request for Permit Action
TIGARD ;r ;
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: Owner f`l Applicant
Contractor ❑ City Staff
(check one)
REFUND OR Name: ��
INVOICE TO: (Business or Individual) (�t hbL'tV�� .��.{�(' /{ L►C-G..
V0 • Mailing Address: I n n o `3 r.f) A.1 1 tAA sA 2-i ,041.►4-- S "ES
_5/0 7 City/State/Zip: --rt�a.�d OIL. 77.23
Phone No.: 5c53 ( Z-4 -- !c.�
PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (✓):
CANCEL PERMIT APPLICATION.
/,f d pr RE PERMIT FEES (attach receipt,if available).
(' VOICE OR FEES DUE(attach case fee schedule and explain below).
❑ CONTRACTOR FROM PERMIT(do not cancel permit).
Permit#: /1 aDO 0O�` ,
Site Address or Parcel#: P1730 st.i /fop"-
Project Name: pYo v — - �t lot.A.1 Goss CL—CP
Lot#: _ �_
Subdivision Name:
EXPLANATION: {slyu.. Pia" CAek awcs.L•.
Date: 5/5/o -
- Signature: _ -
Print Name:
Refund Policy
1. The Director or Building Official may authorize the refund of
a) any fcc which was erroneously paid or collected is withdrawn or cancticd before any review effort has been expended.b) not more than 80°.�e of the land use application ffee ee for issued pcsmits•
c) not more than 80%of the land use g application�ew fee when an application is canceled before any plan review effort has been expended.
d
c))not more than 80%of the buldin plan fce for issued permits poor to any inspection eta.
d) not more than 80%of the original Payer in Please allow 1-2 weeks for processing refunds.
2 Refunds will be returned to the otig}rnl Payer rn the same method in which pigment was received.
FOR OFFICE USE ONLY Date B "�t� .• Admut.. B c�
Rte to S� rldrttiri: Da ����p Invoice Processed: Date .:i 0� B• �� -
Refund Processed. Date '� B B
Parcel T :Added: Date
Permit Canceled: Date •�� Method Amount�
Recei•t# Date