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PDR2016-00013
VOIDED PDR2O16 -. 00013 RIVER TERRACE ESAST NO . 3 n TIGARD City of Tigard April 4, 2019 Polygon WLH,LLC 703 Broadway St., Suite 510 Vancouver,WA 98660 Re: Permit No. PDR2016-00013 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 2S 106DB24300 Project Name: River Terrace East No. 3 Job No.: Refund: ® Check#231713 in the amount of$17,100.00. ❑ Credit card"return" receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ Notes: Overpayment of address fee. Paid $19,000 when the amount due was $1,900.00; refunded the difference. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I:\Building\Refunds d'rrums argr,a l AllY6 e•aTi c464regon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov ifill City of Tigard T(G A R D 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: Polygon WLH, LLC DATE: 3/28/2019 703 Broadway St., Suite 510 Vancouver, WA 98660 REQUESTED BY: Dianna Howse JG TRANSACTION INFORMATION: Receipt#: 420570 Case #: PDR2016-00013 Date: 12/3/2018 Address/Parcel: 2S106DB24300 Pay Method: Check Project Name: River Terrace East No. 3 EXPLANATION: Overpayment of address fee. Paid $19,000 instead of$1,900;refund difference. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Address Fee ,600-0000-43113 $17,100.00 TOTAL REFUND: $17,100.00 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY _ Case Refund Processed: Date: f'fl 7 By: I:\Building\Refunds\RefundRequest.doc x 09/01/2010 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT iii II . . - Request for Permit Action TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov 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: Check one ❑ Owner ❑ Applicant 0 Contractor ©City Staff REFUND OR Name: INVOICE TO: (Busincs,or Individual) PO j,,,...,0, L,..,L.t4 L L C `7 0, ,a/2vrb cca,4 y s% _I'ez i!-c S/ 0 Mailing Address: 1- - _ City/State/Zip: Uqh Cot&v e e-, W A 4 V4 G Q Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (v): ❑CANCELL,VOID PERMIT APPLICATION. rigREFUND_ORMIT FEES (attach copy of original receipt and provide explanation below). �7lla VOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Pen-nit#: P Ok 2O 1G - 00013 Site Address or Parcel #: 2 S i0(9 0 13 a q3 O O Subdivision Name: R 1 u q? Teri-44e t a$4-- Abe . 3 Lot #: EXPLANATION: AdUresS frt. t„. ..S 411,100 .00 10,.,..4-- app u C - p..4 4 ici dOo.d 6 . C‘n.ek-14., a c Aao 1 li 36 Signature: Date: i f!14/1 q Print Name: �»ny 6ia h_ Refund Policy — /1 '9 r , C7) 1. The city's Community Development Director, Building Official or City Engineer may authorize the refund of: ,_ • Any fee which was erroneously paid or collected. /7/ /eV , 0-6 - 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. All refunds will be returned to the original payer in the form of a check via US postal service. 1. Please allow 3-4 weeks for processing refund requests. *For Office Use Only* Route to Sys Admin Date By: Route to Records Dater/she? By: 4: Refund Processed Date/iell By: Invoice Processed Date By: Permit Canceled Date By Parcel Tag Added Date By: