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Permit
p CITY OF TIGARD MASTER PERMIT 11111 I - -- COMMUNITY DEVELOPMENT Permit#: MST2016-00012 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/08/2016 Parcel: 2S111AB02700 Jurisdiction: Tigard Site address: 9425 MOUNTAIN VIEW LN Subdivision: ELROSE TERRACE Lot: 23 Project: Freeman Project Description: Construct 488 sq ft detached shop/garage. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 5 Parking Spaces: 0 Height: 11 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 5 Detectors: No Total: 0 sf Value: $20,000.00 Rear: 5 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0-200 amp: 1 0-200 amp: 0 W/Svc or Fdr: 4 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other N Other Description: Ecompasing: Y BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ACS SF VB U 0 Owner: Contractor: FREEMAN.DANA H&CHARLES W JR OWNER Required Items and Reports(Conditions) 9425 SW MOUNTAIN VIEW LN TIGARD,OR 97224 PHONE: 503-453-6743 PHONE: FAX Total Fees: $917.92 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 ' acco .• ce 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. 'TTENTION a egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-'#1-0010 through O'' • 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 r 1.800.332.23 / �/ � Issu By: Permittee Signature: —J�- �/�- Call 503.639.4175 by 7:00 a.m.for the next available inspectio date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans aro required on the job site at the time of each inspection. A Building Permit Application A Residential FOR OFFICE I SE ONE) City of TigarRECEIVED Received / // r _/L Permit No.. 6r010/� as III 13125 SW Hall Blvd.,Tigard,OR 97223 PlDaan Review t0 � j'J " I Phone: 503.718.2439 Fax: 503.5I87L0 1 2016 Date/By: 2J 1 C .i Other Permit h i Inspection Line: 503.639.4175 Date Ready/By: _OA//,, runs: ® See Page 2 for Internet: www.tigard-or.gov CITY OF IG/ARD Notified/Method: o /tom / Supplemental Information Y i ( DO.nl1isio `(/4r� T OB REQUIRED DATA:;( AND 2-FAMILY DW�I►G New construction ID Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the >I TEGORY OF CO PWC',- TION`' work indicated on this application. ti �' Valuation: S 0 1-and 2-family dwelling ❑Commercial/industrial a d/ cd Accessory building ❑Multi-family Number of bedrooms: '-- 0 0 Master builder El Other: Number of bathrooms: U" JO SITE INFORMATION.AND LOCATION Total number of floors: Job site address: 9 y A c S,w. Yh pt7 KT f}I NO V 14y, 1^/j‘ , J New dwelling area: square feet C) City/State/ZIP: 11(pAQO O 2 97. 2V Garage/carport area: y 8E- square feet Suite/bldg./apt.no.: Project name: Covered porch area: square feet Co Cross street/directions to job site: 9 3 S A 4,C. Deck area: square feet 0 Other structure area: square feet Q REQUIRED DATA:COMMERCIAL-USE CI CK IST Subdivision: Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the DESCRIPTION OF WORK work indicated on this application. 400 Alf I ti e --�oflreAti0 Valuation: S /3 ow Existing building area: square feet New building area: square feet is PROPERTY OWNER 0 TENANT Number of stories: Name: ('#421„( cr,Et,'M A,•x, Type of construction: Address: 9 y,.s— S w_ widtJM'n9)rt, v/£w i—N, Occupancy groups: City/State/ZIP: 77 a oft qi7A2. 1 Existing: Phone:(s123 ) y 5-3 —{,793 Fax:( ) New: T APPLICANT p CONTACT PERSON BUILDING PERMIT FEES* (Please refer tafee schedule) Business name: Structural plan review fee(or deposit): Contact name: PRo ps,,, 00aNJ`(„r FLS plan review fee(if applicable): Address: Total fees due upon application: City/State/ZIP: Amount received: a iij Phone:( ) Fax: :( ) E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. Business name: Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: O lid Ni Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: n Total fee due upon application: $201.60 Authorized signature: li This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Date: *Fee methodology set by Tri-County Building Industry Print name: C//yo►l2 4 A,.eirs.,0-- // w 6 Service Board. 1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) Electrical Permit Applicatitir , -� n 1 ,l1,12 tl,( ► t `1 t..► , 1 City Tigard Ti d 't �' Received. d„ / lie allEENCOMEMI ofverde ' 13125 SW Hall Blvd.,Tigard,ORPlan Review 8 1 Phone: 503,718.2439 Fax: 503.5%140 1 2016 Date/B Related Permit#: Inspection Line: 503.639.4175,.�-r Ready Date/By: ;um 0 See Page 2 for 1 I'' ' I., Internet: www.tigard-or.gov . I Y o� t- ; f 9,:„z'\f t[.) Notified/Method: Supplemental Information TYI'L`((��`` ''r , ©j DIVISION PLAN REVIEW Ja New construction 0 Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling 0 Commercial/industrial Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: y YDS B,L . PAGV NTAf4 Vif ifiLl! 10OHP or more. 0"A","E","1-2","1-3" City/State/ZIP: �n n ❑Six or more residential units. Recreational occupancy. ty tip�l� t:.rtG. 77a' ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: F/LR4,-Mr,,.. GAggrog- ['Hazardous locations. ❑Supply voltage for more than 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to job site: 93 4 "lam FEE SCHEDULE Description I Qtr. I EachI Total I • I I.JC. W 1 T , i 7bor'�� New residential single-or multi-family dwelling unit. Subdivision: Lot 4: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'!500 sq.ft.or portion 33.92 t DESCRIPTION OF WORK Limited energy,residential ` (with above sq.ft.) 75.00 2 N W iJ Afi£ Limited energy,multi-family residential(with above sq.ft.) 75.00 2 cif • Renewable Energy ❑ See Page 2 PROPERTY OWNER f ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: C IMA 1.ss P71Emj9.) 200 amps or less 'ti'." ;.;--.'...12;!';'J'..f',7:::'!'''''''..2 Address: 9 St's'- a,W. rot O U 0J7-19/iv tM 1t) 401/1201 amps to 400 amps 133.56 2 City/State/ZIP: .�7` wn� q 401 amps to 600 amps 200.34 2 t3 //e�iQ ( ♦ ), 601 amps to 1,000 amps 301.04 2 Phone:(ye:3 ) 983 4,7.8 Fax:( ) Over 1,000 amps or volts 552.26 2 b i�1 S Temporary services or feeders installation,alteration,and/or Email: y (ppt relocation Owner installation:T1iis instdflation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT Q,CONTACT PERSON Branch circuits—new,alteration,or extension r panel A_Fee for branch circuits with Business name: above service or feeder fee, 4 -..e:.4",,: ;ap'. 2 each branch circuit Contact name: (AM LS/ gvziewA,..." B.Fee for branch circuits without Address: 7 sc2,, service or feeder fee,first 56.18 2 S.{,J, rK(�Vyt j�9/W'JI`j� Ails branch circuit City/State/ZIP: 77 4,A40 pk, g'y/ Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(c ) y/J3 67 V Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: b il l .s ip G illi 00 .1 Cn Reconnect only 67.84 2 (/ CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Andersen Electric Inc. Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address:9390 SE Hide-A-Way Ct. panel,alteration,or extension. City/State/ZIP:Damascus,Or.97089 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)665-4327 Fax:(NA) Investigation(1 hr min) 90.00/hr Email:Dave@AndersenElectric.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 9000/hr CCB Lie.: 173153 !/'2l4oElectrical Lie.: C362 1 i /1 Suprv.Lic.: 4826S iO/i//(c specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: _A_-- .-/- Subtotal: 130.38 Print nnmc: Dave Andersen Date: 1-28-16 0 Plan Review Required(25%of permit fee): _ State surcharge(12%of permit fee): 15.65 Authorized signaturea , ,.10- TOTAL PERMIT FEE: 146.03 fff a This permit application expires if a permit is not obtained witbin 180 Print name: /LLtJ O', Fft� Date: 25/) Lid/to days after it has been accepted as complete. • Number of inspections allowed per permit. iiBuiidingWamits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(I I/05/COM/WEB l City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT • T I G n R D Building Permit Review — Residential Building Permit #: H STc2©It,' - Do() I a Site Address: 9 4,. 5 6 'J ED6208Q. 1`4,, - U i t t,-) Ln - Project Name: iF„-c e,y-I,a el Lot #: (New dwelling=subdivision name;Addition or Alteration=last name of owner) Planning Review Proposal: JJ.e,,3 ci e 4—c+C e.c4 Gt GC e iJ U rti b L i l CI i rt° , k Verify site address/suite# exists and active in permit system. .River Terrace Neighborhood: ❑ Yes No Site Plan Elements: . Three(3) copies of site plan XExisting structures on site lnite plan must be on 8-1/2"x 11"or 11 x 17"paper footprint of new structure(including decks)with finished .'brawn to scale(standard architect or engineer scale) ��floor elevations orth arrow eLJ lJtility locations (required for new,may apply for additions) dt j, bite address,project or subdivision name and lot number 0 ocation of wells/septic systems pplicant information(name and phone number) NErosion control(including drainage-way protection, silt fence f y ` Lot dimensions and building setback dimensions design,location of catch basin,etc.) .n. CS/tot area,building coverage area,percentage of coverage and lkttreet names impervious area(applicable if R-7,R-12,R-25&R-40) / treet tree size,type and location j -0Property corner elevations (2 foot contour lines if more than J.' xisting trees to be retained with drip line,and tree 4 foot differential) protection measures J'Clean Water Services—Service Provider Letter (lot platted prior to 9/10/1995): Required: Yes,applicant was notified ❑ No Received: E Yes ❑ No Public Facilities Improvement (PFI) Permit: Required: ❑ Yes,applicant was notified Pt No Applied For: ❑ Yes ❑ No,stop intake .kr Land Use Case#: litl krZoning: H , 5 cc?"Setbacks: Front Rear 6 Side 5 Street Side — Garage — I(�t Landscape Requirement: 0/0 (� �`ttLot Coverage Maximum: Building Height: Maximum Height IS Actual Height --S . IJI? Visual Clearance ( Easements (%J fr I Sensitive Lands: ❑ Yes No Type ,1 Urban Forestry Plan Nil "Met"prior to issuance of building permit Notes: d -- Approved By Planning: 0,64_ Q , Cccvvc� Date: a—( - (a Revisions (after Building Submittal only)__ Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 1:\Bui Iding\Fonns\BldgPermitRvw_RES_070915.docx Building Permit Submittal Original Submittal Date: 4/, /it Site Plans: # 3 Building Plans: # 3 Building Permit#: 0"Enter building permit#above. �/ Workflow Routing: Planning e [k 1.' ngineering ermit Coordinator - Building Workflow Sign-off: a-Sign-off for Planning(include notes from planning review) Route Application Documents: [Engineering: (1) copy of permit application, (1) site plan, (1) building plan and original plan review routing form. Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: Date: Engineering Review dope at building pad: 2�� <y)onditions "Met"prior to issuance of building permit asements (encroachments) per engineering conditions of approval and plat Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes ❑ No Assess Water Quantity Fee in lieu: ❑ Yes No LIDA Facility on lot: ❑ Yes No ❑ NOT Approved by Engineering: Date: Notes: Approved by Engineering: / G 1.z)_ Date: _221.Z"--l Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Permit Coordinator Review ❑ Conditions "Met"prior to issuance of building permit ❑ Approved,NOT Released: Date: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Applicant: Revision Notice 3: Date Sent to Applicant: le SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes p'N/A Tigard'Trans SDC: ❑ Yes ?'N/A Parks SDC: ❑ Yes )2' N/A OK to Issue Permit Approved by Permit Coordinator: / Date: 'Z 4 1:\Building\Fonns\BldgPennitRvw_R ES_070915.docx Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325(2)) This statement is required for residential building, electrical,mechanical,and plumbing per mits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. or i/ I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this hom eowner statement is true and accurate. c / LC /c��e:WA - Print Name of Permit Applicant ,62‘ 2-/8 Signature of Permit Applicant Date Permit#: 1`-15T-9-0 1Lo-CC) ( 2- Address: /tto'LS .5-13 4:4,210 p.J I-1` Tcoito, co_ °t7 2.9- ;:.t:,,` Issued bate: 2/8 tt.isi •r This Copy for Permit Offices City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ■ 4 III Request for Permit Action ,I- (;A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW I fall Blvd.,Tigard, OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ::1 Owner ❑ Applicant ❑ Contractor n City Staff (;heck(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) e ./4-/' L ES ,2E-g/`7,qA/ Mailing Address: / w2.5- J 2 /7o 1t Ai 77,517l✓ 0 E-G'J City/State/Zip: 77 9-,f L / Dr , 9 9 Q 2 " Phone No.: --5-,3- / - w 71/3 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): Is VOID PERMIT APPLICATION. A► ERMI'I'FEES (attach copy of original receipt and provide explanation below). ,, FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: /17-57.2o/ - bo0/2d Site Address or Parcel#: 99.23' S fo tioRj/Tff//ll //E& 1-/J Subdivision Name: Lot #: EX LANATION: /�E/t€ALb ,e, �LEC7�. eiz... 7�, "Et7.% ��S ceo`?o ,5--- S 6-749 l'49-7-E- EZ --- .772.,Cy L, /6-7/7/r i etc /W c L z �. 6-c-G'n2o% --e9G 9V /S/ ZA 'ee i7OA[S .4so.i , Signature: 1,_-- Date: -12,tcyd Print Name: Ciy24t f Ar&rn 4--- Refund —Refund Policy 1. The city's(:onanumity Development Director,Building()fficial or City Iingineer may authorize the refund of: • .Any fee which was erroneously paid or collected. • Not more than 800'0 of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80' of the application or permit fee for issued permits prior to any inspection requests. 2. .All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. /130, 3 /Q y, ,,© i, pL • 0 /s , 6S -- _ i-2 . .�a . . /3 /y6 , o3 .,--- // 6, J7-2- ,P9' AI Route to Sys Admin: _ Date By Route to Records: Date 4 1 4, B Refund Processed: Date 4/3 /(o By Invoice Processed: Date By Permit Canceled: Date /t/ Parcel Tag.Added: Date By I:ABudding\Forms\RegIcmaiLAction_11923I4.doc 111111 TI GARD City of Tigard June 3, 2016 Charles W. Freeman Jr. 9425 SW Mountain View Ln Tigard, OR 97224 Re: Permit No. MST2016-00012 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 9425 SW Mountain View Ln Project Name: Freeman Job No.: N/A Refund: ® Check#221190 in the amount of$116.82. ❑ Credit card"return" receipt in the amount of$ Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account"deposit" receipt in the amount of$ Comments: Electrical work removed from this permit as contractor took out separate permit and inspections were performed under ELC2016-00294. Refund 80% of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov II i I City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering 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 System 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: Charles W. Freeman Jr. DATE: 5/26/2016 9425 SW Mountain View Ln Tigard, OR 97224 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 401936 Case#: MST2016-00012 Date: 2/8/2016 Address/Parcel: 9425 SW Mountain View Ln Pay Method: CreditCard Project Name: Freeman EXPLANATION: Refund 80%of permit fees paid for electrical work on this MST permit as a separate permit ELC2016-00294 was pulled by electrical contractor and inspections were done. REP31STA.11414OR TION : ' . ' k=,, . g Fee liesdrnp tlob'From"Re,t;eiipt% - ReVenue ACcoii tN'o. Ex, atop Permit Fee, Example: 23'00000=43104 � 1 4 it.'1e.,;Buri Electrical permit 220-0000-43103 $104.30 12%State Surcharge 100-0000-24001 12.52 TOTAL REFUND: $116.82 APPROVALS: SIGNATU DATE: If under$5,000 Professional Staff ,(-C If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: ,6/3//fa By: ..<1595:01----- I: I:\Building\Refunds\RefundRequest.doc x 09/01/2010