SDR2019-00005 1111 Ill:
TIGARD
City of Tigard
January 28,2020
Steadfast Properties & Development Inc.
18100 Von'Carman Ave., Suite 500
Irvine, CA 92612
Re:Permit No. SDR2019-00005
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: 9360 SW Oak St
Project Name: Steadfast Assisted Living/Memory Care
Job No.:
Refund: ® Check#234516 in the amount of$3,646.00.
0 Credit card"return"receipt in the amount of$ .
❑ Trust account"deposit" receipt in the amount of$ .
Notes: Applicant paid application fees for a Type III, however sensitive lands review
requires a Type I fee. Applicant submited a new check for the correct amount so refund
100%of application fees for Type III.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Coordinator
Enc.
lABuilding\RefunMA rti3Eigai 1' ' ti,Q§fgon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
III
e " 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: Steadfast Properties&Development DATE: 1/21/2019
Inc
18100 Von Kalman Ave., Suite 500
Irvine, CA 92612 REQUESTED BY: Dianna Howse
SC
TRANSACTION INFORMATION:
Receipt#: 426069 Case#: SDR2019-00005
Date: 9/26/2019 Address/Parcel: 9360 SW Oak St
Pay Method: Check Project Name: Steadfast Assisted
Living/Memory Care
EXPLANATION: Sensitive lands review for this project requires a Type I, however the applicant paid the
amount for a Type III. Refund 100%of application fees paid as applicant submitted
new check for the correct amount per Sam Copelan.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Sensitive Lands Review 100-0000-43116 $3,646.00
TOTAL REFUND: $3,646.00
APPROVALS: SIGNATURES/D E:
If under$5,000 Professional Staff <:( ,y.e
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
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
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—
CITY OF TIGARD RECEIPT
* 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIC AP.1)
Project Name: Steadfast Senior Living
Site Address: 9360 SW OAK ST
u AJA
Receipt Number: 436211 - 09/03/2021
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SDR2019-00005 $-3,646.00
Total: $•3,646.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 234516 DHOWSE 09/03/2021 $-3,646.00
Payor: Steadfast Properties & Development Inc.
Total Payments: $-3,646.00
Balance Due: $3,646.00
Page 1 of 1
CITY OF TIGARD RECEIPT
e 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIG.kI J)
Project Name: Steadfast Assisted Living/Memory Care
Site Address: 9360 SW OAK ST
10/2./6.("Air--
Receipt Number: 426069 - 09/26/2019
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SDR2019-00005 Development Adjustment(includes TMU 100-0000-43116 $1,586.36
Zone Adjustments)
SDR2019-00005 Sensitive Lands Review-Type II 100-0000-43116 /eV e?c, $3,646.00
SDR2019-00005 Site Development Review-Type II- 100-0000-43116 $21,542.64
$1,000,000 and Over
Total: $26,775.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 15879 SCOPELAN 09/26/2019 $26,775.00
Payor: Steadfast Properties&Development, Inc.
Total Payments: $26,775.00
Balance Due: $0.00
Page 1 of 1
1EL
DocuSign Envelope ID:8E7209DA-AF34-42B1-AE78-E3A5FC1913A2CITY ` ' '
ARD
JAN 1 6 2020
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
PLANNIF NG/ENGINEERING
■ Request for Permit Action
FIG A R t) 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: ❑ Owner g Applicant ❑ Contractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) Steadfast Companies
Mailing Address: 18100 Von Karman Ave.,Suite 500
City/State/Zip: Irvine.sA_92612
Phone No.: (9491518-2167(Contact Mark Sakioka)
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
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).
Permit#: swe. 2019-00003
Site Address or Parcel #: 9020-9360 SW Oak Street
Project Name: Steadfast Assisted Livina
Subdivision Name: N/A Lot#:
EXPLANATION: Sensitive Lands Review for this project is a Type I rather than the Type III the Payment covered,a
payment for a Type I review will be made to the City of Tigard's Planning Department as required to initiate the appropriate review.
2 Ail) /00 % rr- r—y F g Tre 1°47 ricre i-r tit 11 you
l i J 20 'zo Pten— Sin-► c r 'i .0----
/—uoeuspnea or
Signature: ,IJe.wt-S PtL1 - Date: 01/14/2020
Print Name: lfliK t9fe3E-Director of Real Estate Development
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 OFFICE I.JSE ONLY
Route to Sys Admin: Date By Route to Records: Date 9 ?. rL/ ' . / /
Refund Processed: Date //74 p;.e By ►. Invoice Processed: Date By
Permit Canceled: Date n/ f} B ,'!- arcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_1 518.doc
0 W W .
III
.
TIGARD
City of Tigard
11/19/21
CB Two Architects
500 liberty St SE Suite 100
Salem, OR 97301
Re: Permit No. SDR2019-00005
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 or Parcel No.: 9360 SW Oak
Project Name: Steadfast Senior Living
Refund Check: #241322 in the amount of$37.64.
Comment(s): Refund overpayment after application fee adjustment.
If you have any questions,please contact me at 503.718.2470.
Sincerely,
MID --L ---
Holly Van De Wege
Program Development Specialist
is\Building\Refunds s5Nnkifild51361 ayagu Pregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
IIIII
TIGARD
City of Tigard
11/19/21
CB Two Architects
500 Liberty St SE Suite 100
Salem, OR 97301
Re: Permit No. SDR2019-00005
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 or Parcel No.: 9360 SW Oak
Project Name: Steadfast Senior Living
Refund Check: #241322 in the amount of$37.64.
Comment(s): Refund overpayment after application fee adjustment.
If you have any questions,please contact me at 503.718.2470.
Sincerely,
Holly Van De Wege
Program Development Specialist
I:\Building\Refunds{tY s5aWnkl fdrilvderi ay l al6)regon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
111
. " 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: CB Two Architects DATE: 11/14/2021
500 liberty St SE, Suite 100
Salem, OR 97301 REQUESTED BY: Dianna Ornelas
AL
TRANSACTION INFORMATION:
Receipt#: 426070 Case#: SDR2019-00005
Date: 9/26/2019 Address/Parcel: 9360 SW Oak St
Pay Method: CreditCard Project Name: Steadfast Senior Living
EXPLANATION: Refund overpayment after application fee adjustment.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Cash Over 100-0000-48001 $37.64
TOTAL REFUND: $37.64
APPROVALS: SIGNATURES/DATE:
If under$5,000 Professional Staff
If under$12,500 Division Manager i
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: 11 VAck,Zk By: I1/4)
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
CITY OF TIGARD RECEIPT
IIII 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
T WAR D
Project Name: Steadfast Senior Living
Site Address: 9360 SW OAK ST
19/2021
Receipt Number: 437653 - 11/19/2021
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SDR2019-00005 $-37.64
Total: $-37.64
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 241322 HVANDEWEGE 11/19/2021 $-37.64
Payor: CB Two Architects
Total Payments: $-37.64
Balance Due: $37.64
Page 1 of 1
CITY OF TIGARD RECEIPT
■ • 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
I I G A iz.L7
Project Name: Steadfast Senior Living
Site Address: 9360 SW OAK ST 6 4`ltC/A/
Receipt Number: 426070 - 09/26/2019
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SDR2019-00005 Cash Over 100-0000-48001 $37.64+-
Total: $37.64
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 5599540 SCOPELAN 09/26/2019 $37.64
Payor: Gretchen Stone
Total Payments: $37.64
Balance Due: $0.00
Page 1 of 1
Dianna Ornelas
From: Dianna Ornelas
Sent: Sunday, November 14, 2021 12:38 PM
To: Agnes Lindor
Subject: RE: SDR2019-00005 - Steadfast Senior Living
Hi Agnes,
I reviewed the case record and due to a prior adjustment it resulted in an overpayment and we are processing a refund
for$37.64 to Gretchen Stone at CB Two Architects. The check will go out in the mail by November 18tn
Thank you.
Dianna L. Ornelas
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:Agnes Lindor<agnesl@tigard-or.gov>
Sent: Monday, November 1, 2021 5:11 PM
To: Dianna Ornelas<Dianna@tigard-or.gov>
Subject: RE:SDR2019-00005
No worries, not a rush at all! 0
From: Dianna Ornelas<Dianna@tigard-or.gov>
Sent: Monday, November 1, 2021 5:10 PM
To: Agnes Lindor<agnesl@tigard-or.gov>
Subject: RE: SDR2019-00005
Hi Agnes,
I will take a look at this tomorrow. I don't have access to the refund documents here at home, so if I have to go to the
office to figure it out it might be next week before I get back to you.
Thanks.
Dianna
From:Agnes Lindor<agnesl@tigard-or.gov>
Sent: Monday, November 1, 2021 4:51 PM
To: Dianna Ornelas<Dianna@tigard-or.gov>
Subject:SDR2019-00005
Hi Dianna-
Can you take a look at what is going on with the negative balance? Do we need to refund them this amount?Thanks,
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
1