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Permit //P77I RErcIVED *I" City of Tigard a COMMUNITY DEVELOPMENT DEPARTMENT U Cl19 2017 Request for Permit Action CITY OF TIGARD BUILDING DIVISION 13125 SW Hall Blvd. •Tigard, Oregon 97223• 503-718-2439 •:sv TIGARD TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: Ei Owner El Applicant ID Contractor City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) R.A. Warner Plumbing Co. Inc. Mailing Address: PO Box 493 City/State/Zip: Camas,WA 98607 Phone No.: (360) 772-2490 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED(1): CANCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). O INVOICE FOR FEES DUE(attach case fee schedule and provide explanation below). 0 REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: SWR2017-00242 Site Address or Parcel#: 9504 SW WASHINGTON SQUARE RD Parcel#1S1260000300 Project Name: TUMI-Revision 1 Subdivision Name: Lot#: EXPLANATION: As a result of the plumbing fixture changes, and sewer EDU credit, the sewer connection permit SWR2017-00242 is no longer required and must be voided. 00'4, If- S /417 Signature: Date: 10/19/2017 Print Name: ' onda Boehm Refund Policy I. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. O Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended.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. Al]refunds will be returned to the original paver in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFLCE USE ONLy Route to Sys Admia: Date By Route to Records: Date Y 6 re- •••77-f Refund Processed: Date ,7' By •`••• Invoice Processed: Date By Permit Canceled: Date /7 By :,,r444-'Parcel Tag Added: Date By l:\Budding\Fonns\Reqpejthcflqty34.doc 1111111 Ill TI GARD November 20,2017 City of Tigard R.A. Warner Plumbing Co., Inc. Attn: Rhonda Boehm PO Box 493 Camas,WA 98607 Re: Permit No. SWR2017-00242 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 9504 SW Washington Square Rd Project Name: Tumi Job No.: N/A Refund Method: ® Check#226783 in the amount of$3,465.00. ❑ Credit card "return"receipt in the amount of$ 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$ . Comment(s): Change in scope of work for plumbing fixtures and prior sewer system development credits applied from capped fixtures resulted in no sewer fees due. If you have any questions please contact me at 503.718.2430. Sincerely, f VA 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 It NI 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: R.A.Warner Plumbing Co. Inc. DATE: 11/8/2017 Attn: Rhonda Boehm PO Box 493 REQUESTED BY: Dianna Howse Camas,WA 98607 TRANSACTION INFORMATION: Receipt#: 412056 Case#: SWR2017-00242 Date: 7/31/2017 Address/Parcel: 9504 SW Washington Sq Rd Pay Method: Check Project Name: Tunis EXPLANATION: Per applicant's request as change in plumbing fixture scope of work and credits applied from prior capped fixtures,resulted in no sewer EDU fees due. yc `sd"7�3 a d `'_, q .:3 �A.r,,,''' 3 J.*n 4.5 ,p� � 1 Sewer Connection Fee 500-0000-25500 $3,465.00 TOTAL REFUND: $3,465.00 APPROVALS: SI S/DATE: If under$5,000 Professional Staff � Irk/ If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board :. FORTIDE MARK,SYSTEM ADMINIS'TRATION X7$E Case Refund Processed: I Date: I y 6 /, I.\Building\Refunds\RefundRequest.doc x 09/01/2010 1111 CITY OF TIGARD RECEIPT i 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Tumi Site Address: 9504 SW WASHINGTON SQUARE RD J02 /4—A4 fi/v I Receipt Number: 416570 - 04/06/2018 I CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID S WR2017-00242 $-3,465.00 Total: $3,465.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 226783 DHOWSE Payor: R.A.Warner Plumbing Co., Inc. 04/06/2018 $-3,465.00 Total Payments: $-3,465.00 Balance Due: $3,465.00 Page 1 of 1 CITY OF TIGARD • RECEIPT g13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Tumi Site Address: 9504 SW WASHINGTON SQUARE RD J02 Receipt Number: 412056 - 07/31/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SWR2017-00242 Sewer Connection Fee 500-0000-25500 $3,465.00 k- Total: $3,465.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID Check CASHIER ID RECEIPT DATE RECEIPT AMT 1060 Payor: Jerime Maloney/R.A. Warner Plumbing Co. BTAGGART 07/31/2017 $3,465.00 Total Payments: $3,465.00 Balance Due: $0.00 Page 1 of 1 Accumulative Sewer Tally _ Tenant Name: TUMI-Revision 1 Site Address: 9504 SW WASHINGTON SQUARE RD SWR# 2017-00242 REVISED T I G A R D PLM# 2017-00313 Parcel#: 1 S 1260000300 Fixture Value Previous Previous Credits Capped Fixture Fixture ew New # value count capped#s value count added# added value total#s total values Baptisery/Font 4 0 0 0 0 0 Bath: -Tub/Shower 4 0 0 0 0 0 -Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash: -Each Stall 6 0 0 0 0 0 -Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher: -Commercial 4 0 0 0 0 0 -Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 Eye Wash 1 0 0 0 0 0 0 0 1 2 Floor Drain/Sink: -2 inch 2 000 -3 inch 5 0 0 1 2 1 2 0 0 0 0 -4inch 6 0 0 -Car Wash 6 0 0 0 0 0 0 0 0 Garbage Disposal: -Domestic(to 3/4 HP) 16 0 0 0 0 0 -Commercial(to 5 HP) 32 0 0 0 0 0 -Industrial(over 5 HP) 42 0 0 0 0 0 Ice Machine/Refrigerator Drain 1 0 Living Unit 16 0 0 0 0 0 0 0 0 0 Oil Sep(Gas Station) 6 0 0 0 0 0 Rec.Vehicle Dump station 16 0 0 0 0 0 Shower: -Gang(per head) 1 0 -Stall 2 0 0 0 0 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 0 -Bradley 5 0 0 1 2 2 0 0 0 0 0 -Com/Sery/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 10 0 Water Closet-Toilet 6 0 Urinal 6 0 0 1 6 1 6 0 0 0 0 Previous EDU Count 0 Capped EDU Credit 0.88 0 TOTALS 0 0 14.08 0 0 3 10 3 -4.08 Current Fixture Value -4.08 divided by 16= -0.255 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change -4.08 divided by 16= -0.255 over (under) $ (1,430.00) Enter EDU Change Here -0.260 * *Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01. Notes: 9/6/17,.88 sewer credits from PLM2017-00248 applied,.26 credit balance remaining. Dadamski Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 9/6/2017 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\Building\Sewer Tally\SewerTallySheet_5500_070117.xlsx Dianna Howse ,-7/E ) `✓/&f,/.6EAj From: Dianna Howse Sent: Thursday, October 19, 2017 1:53 PM To: 'Rhonda Boehm' Cc: Albert Shields;#Building Permit Technicians Subject: RE:Case#SWR2017-00242 - 9504 SW Washington Square Rd - Tumi g q Az6 Attachments: Req PermitAction_092314.pdf; SWR2017-00242_REV1.pdf C:sr Ail Hello Rhonda, There was a sewer connection credit of.88 EDU calculated due to the capped sewer fixtures under plumbing permit PLM2017-00248. Under our policy,the property owner is responsible for retaining the original sewer EDU credit document that can be submitted for credits when obtaining future plumbing permits. When the interior plumbing permit PLM2017-00313 was applied for,the sewer EDU credit document was not submitted, and page 2 of the plumbing permit application completed by the plumbing contractor R A Warner Plumbing indicated that all plumbing fixtures were "added"to this space resulting in new and additional EDU charges for sewer. After the$3,465.00 sewer EDU fees were paid, it appears that this information was corrected under the interior plumbing permit PLM2017-00313, where the original sewer EDU credits of.88 was applied to the newly added fixtures, resulting still in a remaining sewer EDU credit of.26 for this address. A revised sewer EDU tally was generated (see attached)and this document is the responsibility of the property owner for future plumbing permit submittals. As a result of the plumbing fixture changes, and sewer EDU credit,the sewer connection permit SWR2017-00242 is no longer required and must be voided. Please complete the attached Request For Permit Action form and email it back to me so that I can void the sewer connection permit and process a refund in the amount of$3,465.00. Please allow 3-4 weeks for a refund check to be mailed to your company. Thank you and please let me know if you have any questions. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct I 503-718-2439 Permits From: Albert Shields Sent: Wednesday, October 18, 2017 12:10 PM To: Dianna Howse Cc: 'Rhonda Boehm' Subject: RE: Case #SWR2017-00242 Dianna, do you know anything about this sewer connection fee being waived? Thanks,Albert. From: Rhonda Boehm [mailto:rhoodles@gmail.com] Sent:Wednesday,October 18, 2017 12:05 PM To:Albert Shields<albert@tigard-or.gov> Subject:Case#SWR2017-00242 1 Good afternoon, We (R.A. Warner Plumbing Co. Inc.) performed services as a subcontractor for Dugan Building Company several weeks ago.We applied for and received a permit for the Sewer Connection Fee for work done at 9504 Washington Square- Space#J02 Portland, OR 97223. We have since billed this cost to the General Contractor(Dugan) and have been notified by Dugan that the permit fees were waived by the City of Tigard and that we should have received a reimbursement. There was an original building permit issued for this project. I have attached a copy. I have also attached a copy of the receipt for the Sewer Connection Fee,and included our contact information in the body of this email. I would appreciate any help in getting this reimbursement processed. R.A. Warner Plumbing Co. Inc. Jerime Maloney—Owner PO Box 493 Camas, WA 98607 Phone: (360) 772-2490 Email: rawarnerplumbing@gmail.com Thank you again for any assistance you can provide. Please let me know if any additional information is needed. Enjoy the rest of your day. Rhonda Boehm Office Manager R.A. Warner Plumbing Co. Inc. (360) 261-3157 mobile DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law, E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule.` 2 CITY OF TIGARD SEWER CONNECTION PERMIT :14 .. COMMUNITY DEVELOPMENT Permit*: SWR2017-00242 T MARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/31/2017 Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9504 SW WASHINGTON SQUARE RD J02 Project: Tumi Subdivision: None Project Description: .63 EDU increase. Lot: None Contractor: Owner: PPR WASHINGTON SQUARE LLC PO BOX 847 CARLSBAD, CA 92018 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Sewer Connection Fee 07/31/2017 $3,465.00 Type of Use: COM Class of Work: ALT Install Type: Building Sewer Fixture Units: Number of Dwelling Units: .63 Total $3,465.00 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 .. .in a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800. . ''--„„ Issued By: ermittee Signature: 1111 L Call 503.639. y 7:00 a.m.for the next available inspection .a•nte This permit card shall be kept in a conspicuous place on the job site until co .I. on of the pr. ect. Approved plans are required on the job site at the time of each i section.