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PFI2016-00228 City of Tigard April 3, 2020 Tamas J Jako 21271 SW Rock Rd Aloha, OR 97003 Re:Permit No. PFI2016-00228 Dear Applicant: The City of Tigard has processed a refund for the deposit of fees on the above referenced permit for the following: Site Address: 12808, 12821, 12839 SW 132nd Ave Project Name: Csokas Partition Job No.: N/A Refund: ® Check#235134 in the amount of$22,790.00. ❑ Credit card "return"receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ Notes: Work completed,return balance of customer deposit. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Omelas Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 0 www.tigard-or.gov City of 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 PermitAction form (if applicable) must be attached to this request form. Refixed 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: Tamas J Jako DATE: 3/19/2020 21271 SW Rock Rd Aloha, OR 97003 REQUESTED BY: Dianna Ornelas KF TRANSACTION INFORMATION: Receipt#: 409005 Case #: PFI2016-00228 Date: 2/21/2017 Address/Parcel: 12808, 12821, 12839 SW 132^d Ave Pay Method: Check Project Name: Csokas Partition EXPLANATION: Work complete per Kenny Fisher. Return remaining customer deposit of$22,790.00 REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Customer Deposit 100-0000-22000 522,790.00 TOTAL REFUND: $22,790.00 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager If under$25,000 Department Manager SES Fp?f- ff�"/�jZp✓q L� If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: I Date: 2 B I:\Building\Refunds\RefundRequestdo x09/01/2010 CITY OF TIGARD RECEIPT s 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Project Name: Csokas Partition Site Address: 13230 SW WALNUT ST Receipt Number: 436235 - 09/03/2021 h CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12016-00228 $-22,790.00 Total: $-22,790.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 235134 DHOWSE 09/03/2021 $-22,790.00 Payor: Tamas J Jako Total Payments: $-22,790.00 Balance Due: $22,790.00 Page 1 of 1 CITY OF TIGARD RECEIPT ■ i 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Project Name: Csokas Partition Site Address: 13230 SW WALNUT ST 0 6 Receipt Number: 409005 - 02/21/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12016-00228 Customer Deposit 100-0000-22000 $22,279.00 Total: $22,279.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1014 BRUEF 02/21/2017 $222,790.00 Payor: Tamas J Jako Total Payments: $222,790.00 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD FEE AND PAYMENT HISTORY ■ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 PF12016-00228 - 13230 SW WALNUT ST, TIGARD, OR 97223 Csokas Partition Fee Description Revenue Fee Amount Invoiced Paid Date Paid Payment Receipt# Due Account Number Method Customer Deposit 100-0000-22000 $22,279.00 $22,279.00 $22,279.00 4/5/2019 Check 409005 $0.00 Eng/Maintenance 200-0000-43119 $1,188.00 $1,188.00 $1,188.00 2/21/2017 Check 409004 $0.00 Erosion Control Fee 100-0000-43134 $323.00 $323.00 $323.00 2/21/2017 Check 409004 $0.00 In Lieu Underground 411-0000-43124 $11,220.95 $11,220.95 $11,220.95 10/23/2017 Check 413464 $0.00 PFI Permit Fee 100-0000-43114 $300.00 $300.00 $300.00 10/13/2016 Check 406824 $0.00 PFI Permit Fee 100-0000-43114 $15,175.00 $15,175.00 $15,175.00 2/21/2017 Check 409004 $0.00 Public Works-Water 530-0000-43126 $206.00 $206.00 $206.00 2/21/2017 Check 409004 $0.00 Totals for Fees $50,691.95 $50,691.95 $50,691.95 $0.00 Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount 409005 Check 1014 Tamas J Jako 02/21/2017 $222,790.00 409004 Check 1013 Tamas J Jako 02/21/2017 $16,892.00 413464 Check 1179 HT Remodeling and 10/23/2017 $11,220.95 Design, LLC 422550 Check 229390 Tamas J Jako 04/05/2019 ($200,511.00) 406824 Check 1085 HT Remodeling & 10/13/2016 $300.00 Design LLC Total Payments: $50,691.95 Balance Due: $0.00 J�A-61 3/i9�2o .�� 7 U . �'Z� /�� 7S. dz) !I��u.v, � Q?o�,,�// 9v"�r r�gg-cam � v�.2�oZ 7`t • c� 9i �„c.s•r: - .57// cz) ��,a 7 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT . ' Request for Permit Action 13125 SW Hall Blvd. -Tigard,Oregon 97223 • 503-718-2439-www.tigard-or.lsov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPertnits@tigard-or.gov FROM:Check one ❑ Owner ❑ Applicant ❑ Contractor City Staff REFUND OR Name: INVOICE TO: (Businessorindividual) Tamas J Jako Mailing Address: 21271 SW Rock Rd. City/State/zip: Aloha, Oregon 97003 Phone No.: 503-887-8247 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (v): ❑ CANCEL/VOID PERMIT APPLICATION. ® REFUND PERMIT FEES(attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit#: PF12016-00228 Site Address or Parcel #: 12808, 12821, 12839 SW 132nd Ave. Tigard, Oregon 97223 Subdivision Name: Csokas Partition Lot #: 1, 2, 3 2d EXPLANATION: Return the customers 1 year final balance of their customer deposit. �,� Refund amount of$22.790.00 _ \1117 1 r Signature: ��(� - Date: Print Name: {"/1 EIJ jfA S A%*— Refund Policy 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. • 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 34 weeks for processing refund requests. *For Office Use Only* Route to Sys Admin I Date I BY: Route to Records Date B Refund Processed Date By: Invoice Processed Date By: Pennit Canceled Date By Parcel Ta Added Date By. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = Request for Permit Action 13125 SW Hall Blvd. •Tigard,Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SVP Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor X City Staff Check(✓)one REFUND OR Name: INVOICE TO: (Business or Indindual) Tamas J. Jako Mailing Address: 21271 SAX' Rock Rd. City/State/Zip: Aloha, Oregon 97003 Phone No.: 503 887 8247 PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (✓): ❑ CANCEL/VOID PERMIT APPLICATION. X REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit). Permit #: PFI2016-00228 Site Address or Parcel#: 12808, 12821, 12839 SW 132nd Ave. Tigard,Oregon 97223 Subdivision Name: Csokas Partition Lot#: 1, 2, 3 EXPLANATION: Return the customer assurance deposit in the amount of$222,790.00 minus 10% $22,790.00 for 1 year conditional maintenance.The P12�t1+ utrg amount to be released is $200,511.00. as,t t r,hs� tgnature: Date: Print Name: Refund dcy 1. The city Community Development Director,Building Official or City Engineer may authorize the refund of • Any fee which was erroneously paid or collected. • 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. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to Svs Admin: JDate I By Route to Records: Date Refund Processed: JDate B Invoice Processed: Date Be. Permit Canceled: Date By Parcel Tag.added: Date B 1:\Building\loo ms\RcgPcmatAcubn_t+()2314.doc CITY OF TIGARD RECEIPT 13125 SW Hall Blvd Tigard OR 97223 503.639 4171 Receipt Number: 409005 - 02/21/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12016-00228 Customer Deposit 100-0000-22000 $222,79000 Total: $222,790.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1014 BRUEF 02/2112017 $22279000 Payor. Tamas J Jako Total Payments: $222,79000 Balance Due: $000 Page 1 of 1 Dianna Ornelas From: Joe Wisniewski Sent: Tuesday, March 24, 2020 7:40 AM To: Dianna Ornelas Cc: Lori Faha Subject: RE: PFI2016-00228 - Refund Deposit Attachments: Joe Wisniewski P E .vcf Hi Dianna, Engineering is good with releasing the requested refund deposit. Thank You, Joe Wisniewski. P.E. City of Tigard Assistant City Engineer (971)271.4772 joew�tigard-or.gov 13125 SW Hall Blvd Tigard,OR 97223 From: Dianna Ornelas<Dianna@tigard-or.gov> Sent: Monday, March 23, 2020 6:30 PM To:Joe Wisniewski<joew@tigard-or.gov> Cc: Lori Faha<Lori F@tiga rd-or.gov> Subject: FW: PF12016-00228-Refund Deposit Importance: High Hi Joe, Were you able to approve this refund request? The customer is expecting the check to go out this week so I need to have this information to finance by no later than tomorrow(Tuesday) morning. Thank you! Dianna From: Dianna Ornelas Sent: Friday, March 20, 2020 5:20 PM To:Joe Wisniewski<joew@tigard-or.gov> Cc: Lori Faha<LoriFPtiRard-or.gov> Subject: FW: PF12016-00228-Refund Deposit Hi Joe, Please see attached and respond to let me know if you approve of the refund. Thank you. 1 Dianna L.Ornelas(Howse) Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Dianna Ornelas Sent: Friday, March 20, 2020 4:41 PM To: Lori Faha <LoriF@tigard-or.gov> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: PF12016-00228- Refund Deposit Importance: High Hello Lori, Please attached for request to refund the final balance of the customer deposit for this project PF12016-00228 for Csokas Partition. Please respond to this email to let me know you approve of the refund. Thank you. Dianna L. Ornelas(Howse) Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard,OR 97223 503-718-2430 Direct 1503-718-2439 Permits 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 VOIDED PFI2016 - 00228 CSOKAS PARTITION q City of Tigard August 9,2018 Tamas J.Jako 21271 SW Rock Rd. Aloha, OR 97003 Re: Permit No. PFI2016-00228 Dear Applicant: The City of Tigard has processed a refund for the deposit of fees on the above referenced permit for the following: Site Address: 13230 SW Walnut St Project Name: Csokas Partition Job No.. N/A Refund: ® Check#229390 in the amount of$200,511.00. ❑ Credit card"return"receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ Notes: Refund customer deposit,less 10%hold back for one year. 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 0 www.tigard-or.gov City of 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 ReqiiestforPermit 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: Tamas J.Jako DATE: 8/3/2018 21271 SW Rock Rd Aloha, OR 97003 REQUESTED BY. Dianna Howse KF TRANSACTION INFORMATION: Receipt#: 409005 Case#: PF12016-00228 Date: 2/21/2017 Address/Parcel: 13230 SW Walnut St. Pay Method: Check Project Name: Csokas Partition EXPLANATION: Return customer assurance deposit,less 10% for 1-year conditional maintenance, $222,790 less $200,511;10)per Kenn Fis and approved by Khoi Le. Customer eposit 000 $200,511.00 TOTAL REFUND: $200,511.00 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff 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 Case Refund Processed: Date: By: 1:\Building\Refunds\ReftmdRequestdoc x 09/01/2010 City Of Tigard • CONEMUNITY DEVELOPMENT DEPARTMENT r = Request for Permit Action 13125 SXX'Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SAX'Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor X City Staff (:heck(✓)one REFUND OR Name: INVOICE TO: (Business or Indixidual) Tatnas J. Jako Mailing Address: 21271 SXX' Rock Rd. City/State/Zip: Aloha, Oregon 97003 Phone No.: 503 887 8247 PLEASE TAKE ACTION FOR THE ITEMS)CHECKED (✓): ❑ CANCEL/VOID PERMIT APPLICATION. X REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: PFI2016-00228 Site Address or Parcel #: 12808, 12821, 12839 SXX' 132nd Ave. Tigard,Oregon 97223 Subdivision Name: Csokas Partition Lot #: 1. 2, 3 EXPLANATION: Return the customer assurance deposit in the amount of$222,790.00 2 77 minus 10% for 1 year conditional maintenance. The amount to be released is $200,511.00. Signature: i` .... Date: `? / , IC•Q•L. Print Name: Refund Policy 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. • 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. 3. Please allow 3-4 weeks for processing refund requests. FOR OYFICE LSE ONLN Route to Sys admin: Date By I Route to Records: Date -511_<11I B - Refund Processed: Date B1 Invoice Processed: Date Br Permit Canceled: Date B)- Parcel TagAdded: Date B L\Building\I�orms\Req PemutAeuon_092314.doc CITY OF TIGARD RECEIPT s 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Receipt Number: 409005 - 02/21/2017 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12016-00228 Customer Deposit 100-0000-22000 $222,790.00 Total: $222,790.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1014 BRUEF 02121/2017 $222,790.00 Payor: Tamas J Jako Total Payments: $222,790.00 Balance Due: $0.00 Page 1 of 1 ■ City of Tigard 7/9/2018 HT Remodeling and Design,LLC 21271 SW Rock Rd. Aloha,Oregon 97003 RE: Csokas Partition—MLP2016-00002/PFI2016-00228 The City of Tigard is prepared to place this project into its one-year conditional acceptance period. In the matter of the Two Hundred Twenty Two Thousand and Seven Hundred Ninety Dollars($222,790.00)cash assurance, involving HT Remodeling,LLC and the City of Tigard,Oregon,this is to serve as official notice to allow City of Tigard to release to HT Remodeling and Design,LLC a portion of the deposit entrusted to the City of Tigard. The amount hereby authorized to be released is($200.511.00). The amount to remain entrusted to the City of Tigard as a cash performance bond to assure the City that all remaining requirements are completed at the end of the one-year maintenance period shall be Twenty Two Thousand and Two hundred Seventy Nine Dollars. ($22,279.00). This notice shall not be construed to nu➢ify or alter the terms of the aforesaid.Agreement with the City of Tigard in any way; it is merely an authorization to release a portion of the entrusted monies. If you have any questions regarding this matter,please contact Kenny Fisher,Senior Engineering Tech,at 503-718-2602 Sincerely, Khoi Le Principle Engineer City of Tigard,Oregon 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 0 www.tigard-or.gov C City of Tigard July 10, 2018 HT Remodeling and Design,LLC 21271 SW Rock Rd. Aloha,Oregon 97003 RE: Csokas Partition—PFI 2016-00228 / Conditional Acceptance This is to acknowledge that as of 7/9/2018 the minor land partition improvement project known as Csokas Partition has been conditionally accepted by the City,placing it onto its one-year guarantee period, subject to the following: ❑ Completion of incomplete performance items,namely: ❑ Correction of known defects,namely: ® Continuation of developer's maintenance responsibility and correction of any deficiencies,which may arise during the guarantee period(s). To assure the aforesaid,until such time as the project is fully accepted by the City for operation and maintenance purposes,the City has taken the following action(s): ❑ Authorized release of the original performance bond . ❑ Authorized continuation of the original performance assurance in full force and effect. ® Authorized a reduction of the original performance assurance (Customer Deposit$222,790.00) and is holding 10% ($22,279.00) as a Cash assurance. ❑ Accepted a performance assurance bond# ❑ Accepted a assurance bond# ❑ Other: Should you have any questions regarding any of the above,please contact me at 503.718.2602 Sincerely, 6--�__4� Kenny Fisher Senior Engineering Tech 13125 SW Hall Blvd. Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov