Permit ,■;1 14x:
.r' CITY OF TIGARD SEWER CONNECTION PERMIT
c g COMMUNITY DEVELOPMENT Permit#: SWR2015-00122•
TI 4 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Date Issued: 11/02/2015
G RD
Parcel. 1S136AA00201
Jurisdiction: Tigard
Site address: 10236 SW 69TH AVE
Project Oak Street Estates,Lot 1 Subdivision. 2007-031 PARTITION PLAT Lot: 2
Project Description: Sewer connection for new SF
Contractor: Owner: LENNAR NORTHWEST INC
11870 NE 99TH ST, STE 1170
VANCOUVER,WA 98682
PHONE PHONE.
FAX
FEES
Description Date Amount
Specifics: Sewer Connection Fee 11/02/2015 $5,100 00
Sewer Inspection-Residential 11/02/2015 $35 00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units
Number of Dwelling Units: 1
Total $5,135 00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable
law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if
work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification
Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules or direct questions
to OUNC by calling 503 232 1987 or 1 800 332 2344 . /
t
/
Issued By: i � Permittee Signature:
7'
Call .4175 by 7 00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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TIGARD
City of Tigard
March 9, 2016
Lennar Northwest Inc.
Attn: Juls Call
11807 NE 99th St., Suite 1170
Vancouver,WA 98682
Re: Permit No. Various New SF Residential Permits - See Attached List
Dear Applicant:
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: Various
Project Name: Oak Street Estates - Lots 1-23 and 25-31
Job No.:
Refund: ® Check #220393 in the amount of$338,059.00.
n Credit card "return"receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
(1 Trust account "deposit"receipt in the amount of$ .
Comments: Refund for SDC fees paid prior to available credits applied from demolition
permit BUP2015-00091 for armory building and SF residential building. See attached
spreadsheet for SDC credit balance and list of permits that credits were applied to.
If you have any questions please contact me at 503.718.2430.
Sincerely,
<62,71 --er7(.21-c_ J
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. 4 Tigard, Oregon 97223 • 503.639.4171
g
City of Tigard
TIGAR Accela Refund Reques t
This form is used for refund requests of land use, development engineerimag and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable)must
be attached to this request form. Refund requests are due to Accela '
S-ystem Administrator
by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Lennar Northwest Inc. DATE:
Attn: Juls Call 3/7/2016
11807 NE 99th St., Suite 1170 REQUESTED BY: Dianna Howse
Vancouver,WA 98682
TRANSACTION INFORMATION:
Receipt#: Various Case #: Various
Date: Various Address/Parcel: Various
Pay Method: CreditCard Project Name: Oak Street Estates
EXPLANATION: Refund for transportation development and parks system d'eve1opment fees paid prior
to demolition credits for armory structures and (1)residential structure. Received final
inspection for BUP2015-00091 on 2/10/2016 so credits can be applied and all SDC
fees paid by developer shall be refunded.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No.
Exam sic: Building Permit Fee Refund
Example: 2300000-431 04 $Amount
Washington County Transportation Development Tax 405-0000-43320
Parks SDC-Improvement $237,723.00
P 425-0000-43300 20,203.00
Parks SDC-Reimbursement 425-0000-43301
Sewer Connection 3,633.00
500-0000-25500 .71,899700
TOTAL REFUND: 4.333;449.1 I
APPROVALS: SIGN T S/DATE: -3 ,fi lrD
If under$5,000 Professional Staff i f
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
/L/ `1
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: 3 AV/62 By ,,;F:r