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SLR2015-00005 11111 II i TIGARD City of Tigard September 2,2021 Capstone Partners LLC 2175 NW Raleigh St, Ste 104 Portland, OR 97210 Re: Permit No. SLR2015-00005 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 12780 SW Ash Ave Project Name: Burnham&Ash Apartments • Job No.: N/A Refund Method: ® Check#240396 in the amount of$2,460.80. ❑ Credit card"return"receipt in the amount of$ . Note: Please allow 2-5 days for this refund transaction to be credited to your account by the company that issued your card: El Trust account"deposit"receipt in the amount of$ . Comment(s): Determined that sensitive lands permits was not required after lot line adjustments. Refund 80%of application fees for review completed prior to cancellation of permit. If you have any questions please contact me at 503.718.2430. Sincerely, d l /-(1:2.V421--z Dianna Omelas 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 -IGAKD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Requestfor 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: Capstone Partners LLC DATE: 8/27/2021 2175 NW Raleigh St, Ste 104 Portland, OR 97210 REQUESTED BY: Dianna Ornelas GP TRANSACTION INFORMATION: Receipt#: 200493 Case#: SLR2015-00005 Date: 4/28/2015 Address/Parcel: 12780 SW Ash Ave Pay Method: Check Project Name: Burnham&Ash Apartments EXPLANATION: Determined that sensitive lands permit was not required after lot line adjustments. Refund 80%of application fees for review completed prior to cancellation of permit per Gary Pagenstecher. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Application Fee 100-0000-43116 $2,460.80 TOTAL REFUND: $2,460.80 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff If under$12,500 Division Manager 41 sal.,{>,f 444--� 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: /y/L—> By: /S. C- I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT i` 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 T EGAPL) Project Name: Burnham &Ash Apartments Site Address: 12780 SW ASH AVE /f � �� flt Receipt Number: 436273 - 09/04/2021 ,w CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SLR2015-00005 $-2,460.80 Total: $-2,460.80 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 240396 DHOWSE 09/04/2021 $-2,460.80 Payor: Capstone Partners LLC Total Payments: $-2,460.80 Balance Due: $2,460.80 Page 1 of 1 INCITY OF TIGARD RECEIPT I `•_ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIC ;\R1.3 Project Name: Burnham&Ash Apartments Site Address: 12780 SW ASH AVE Oaf 6'w-fl-z_-- Receipt Number: 200493 - 04/28/2015 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SLR2015-00005 Application-Type II 100-0000-43116 $2,680.00 SLR2015-00005 Application-Type II-LRP 100-0000-43117 $396.00 A4' [off K 6)°1 Total: $3,076.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 1672 LSMITH 04/28/2015 $3,076.00 Payor: Capstone Partners LLC Total Payments: $3,076.00 Balance Due: $0.00 Page 1 of 1 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMEN' , 0 / r j ■III Request for Permit Action ,/ro/z, xib 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: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) STa AT C xJ 7 r5./b- c L/L7.C_ Mailing Address: ai/ -7 S /Lt1 -7-71��1 G/ -Cr- 1/rS /0 y 7 City/State/Zip: /3i ri. it / 0 /L g 7-2/ 0 Phone No.: 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). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: SLR2015-00005 Site Address or Parcel #: 12780 SW Ash Ave,Tigard, OR 97223;2S102AD02800 Subdivision Name: Burnham and Ash Apartments Lot #: EXPLANATION: At the time of application,the subject site included three lots,TLs 2800,2900,and 3000.TL 3000 included wetlands,slopes of 25%,the floodplain for Fanno Creek,and the majority of the development site.After the lot line adjustment,TL 2900 was expanded to become the development site, and TL 3000 was reduced to just contain all of the sensitive lands roughly corresponding to the 100 year floodplain boundary. Still, TL 2900 contains approximately 1,400 square feet of the CWS designated vegetated corridor which will be encroached on by the proposed a artment building.NO SLR required. / Ef iVL.) e0 ald /6--x 6"907 •— SEE 417/-9 e6' Relz, Date: 6-2-21 Signature: Print Name: Gary Pagenstecher 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 SO%of the application or permit fee for issued permits prior to any inspection requests. 4Fet_f) sO 2. All refunds will be returned to the original payer in the form of a check via US postal service. 30 `'7 ^02�G 0 F�, /�k. a 3. Please allow 3-4 weeks for processing refund requests. � r 1915. U FOR OFFICE USE ONLY Route to Sys Admin: Date By Route to Records: Date ' to ye' By 4/ Refund Processed: Date i7;107yj By 0' Invoice Processed: Date By Permit Canceled: Date r'/irhyl By Parcel Tag Added: Date By I:\Building\Forms\RcgPenmitAction_O�f231 .doc Dianna Ornelas From: Gary Pagenstecher Sent: Wednesday, August 11, 2021 3:36 PM To: #Building Permit Technicians Cc: Dianna Ornelas Subject: RE: SLR2015-00005 - 12780 SW Ash Ave - Burnham &Ash Apartments Follow Up Flag: Follow up Flag Status: Completed Categories: Dianna Please send the refund to: Capstone Partners, LLC, 2175 NW Raleigh St,Suite 104, Portland Or, 97210 Thank you. Gary From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Sent:Tuesday,August 10, 2021 4:27 PM To: Gary Pagenstecher<Garyp@tigard-or.gov> Subject: RE:SLR2015-00005- 12780 SW Ash Ave- Burnham &Ash Apartments Thanks for the update Gary! From:Gary Pagenstecher<Garvp@tigard-or.gov> Sent:Tuesday,August 10, 2021 3:58 PM To: Dianna Ornelas<Dianna@tigard-or.gov> Cc: #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: SLR2015-00005 - 12780 SW Ash Ave - Burnham &Ash Apartments Dianna, I spoke with Lauren Jones at Capstone Partners who said it may take a few days to determine who should receive the refund because the LLC that wrote the check may have been dissolved. Stay tuned. Gary From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Sent:Tuesday, August 10, 2021 11:33 AM To: Gary Pagenstecher<Garvp@tigard-or.gov> Subject: RE: SLR2015-00005- 12780 SW Ash Ave- Burnham &Ash Apartments Importance: High Hi Gary, Thank you for the refund amount. The request to void permit was blank on where to send the refund to. Capstone Partners LLC was the named payor, however I need a current address to send the check. Can you please provide that today so that we can get this check out? Thank you. 1 Dianna From: Gary Pagenstecher<Garvp@tigard-or.gov> Sent: Friday,August 6, 2021 5:06 PM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: Re: SLR2015-00005- 12780 SW Ash Ave- Burnham &Ash Apartments 80% per policy: not erroneously collected, but voided before review was done. Get Outlook for iOS From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Sent: Friday,August 6, 2021 4:19:36 PM To:Gary Pagenstecher<Garyp@tigard-or.gov> Subject:SLR2015-00005 - 12780 SW Ash Ave- Burnham &Ash Apartments Hi Gary, I am trying to process the request you submitted (see attached) but it does not indicate how much of a refund to return. Please let me know and I can route this for processing. 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 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