PRE2020-00043 q
1111
TIGARD
City of Tigard
March 9,2021
AKS Engineering&Forestry LLC
12965 SW Herman Rd, Suite 100
Tualatin, OR 97062
Re: Permit No. PRE2020-00043
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following.
Site Address: 2S110BC01300
Project Name: Froude Subdivision
Job No.: N/A
Refund Method: ® Check#238496 in the amount of$344.00.
❑ Credit card"return"receipt in the amount of$
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): Duplicate permit created of original PRE2020-00042. Refund 100%of
application fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
62
Dianna Ornelas
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
_ 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 forPermitAction 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: AKS Engineering&Forestry LLC DATE: 3/1/2021
12965 SW Herman Rd, Suite 100
Tualatin, OR 97062 REQUESTED BY: Dianna Ornelas
AL
TRANSACTION INFORMATION:
Receipt#: 431064 Case#: PRE2020-00043
Date: 9/22/2020 Address/Parcel: 2S110BC01300
Pay Method: Check Project Name: Fronde Subdivision
EXPLANATION: Per Agnes Lindor as this was a duplicate application, see PRE2020-00042. Refund
100% of application fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Application Fee 100-0000-43116 $344.00
TOTAL REFUND: $344.00
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: 9/�f�-1 By:
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: Froude Subdivision
Site Address: LE: r2"Lb
Receipt Number: 436253 - 09/04/2021
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PRE2020-00043 $-344.00
Total: $-344.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 238496 DHOWSE 09/04/2021 $-344.00
Payor: AKS Engineering & Forestry LLC
Total Payments: $-344.00
Balance Due: $344.00
Page 1 of 1
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Project Name: Froude Subdivision
Site Address:
I2 (6 C/✓et._
Receipt Number: 431064 - 09/22/2020
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PRE2020-00043 Application Fee 1 00-0000-431 1 6 $344.00 -
Total: $344.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 35361 ALINDOR 09/22/2020 $344.00
Payor: AKS Engineering & Forestry LLC
Total Payments: $344.00
Balance Due: $0.00
Page 1 of 1
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT jd / tS
Request for Permit Action 3 %/2 <0 6
T I G A R l 1 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 ❑ Applicant ❑ Contractor ® City Staff
Check(✓)one
REFUND OR Name: 6-Mc?' ` , z—y1
INVOICE TO: (Business or Individual) AKS AV c/.-/ 77ty
Mailing Address: /- J AS Ski / E ,'i J .cU i7 fOZ)
City/State/Zip: 7 4-1-41- N 7-/
Phone No.: SO3 -56.3 -6 (5/
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
E CANCEL/VOID PERMIT APPLICATION.
El REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).- 100%
0 INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: PRE2020-00043
Site Address or Parcel#: 2S110BC01300
Project Name: Froude Subdivision
Subdivision Name: Lot#:
EXPLANATION: Duplicate case created of PRE2020-00042/
Signature: ( t. Date: 9/22/20
Print Name: Ag s Lindor
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 USE ONLY
Route to Sys Admin: Date By Route to Records: Date Cy 2., By ,/
Refund Processed: Date 77, B� Invoice Processed: Date By
Permit Canceled: Date / By, Q Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_ c
illCITY OF TIGARD RECEIPT
• •• 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Project Name: Froude Subdivision
Site Address:
Receipt Number: 431064 - 09/22/2020
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PRE2020-00043 Application Fee 100-0000-43116 $344.00
Total: $344.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 35361 ALINDOR 09/22/2020 $344.00
Payor AKS Engineering&Forestry LLC
Total Payments: $344.00
Balance Due: $0.00
Page 1 of 1