PDR2016-00017 1111 -.
TIGARD
City of Tigard
February 25,2021
The Spanos Corporation
10220 SW Greenburg Rd
Tigard, OR 97223
Re: Permit No. PDR2016-00017
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: 8900 SW Oak St
Project Name: Oak Street Apartments
Job No.: N/A
Refund: ® Check#238457 in the amount of$17,775.00.
❑ Credit card"return"receipt in the amount of$
❑ Trust account"deposit"receipt in the amount of$ .
Notes: Refund customer cash assurance for work completed.
If you have any questions please contact me at 503.718.2430.
Sincerely,
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
1111
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: The Spanos Corporation DATE: 2/23/2021
10220 SW Greenburg Rd
Tigard, OR 97223 REQUESTED BY: Dianna Omelas
TRANSACTION INFORMATION:
Receipt#: 426634 Case#: PDR2016-00017
Date: 10/24/2019 Address/Parcel: 8900 SW Oak St
Pay Method: Check Project Name: Oak Street Apartments
EXPLANATION: Per applicant's request refund $17,775 customer cash assurance deposit.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Customer Deposit 100-0000-22000 $17,775.00
TOTAL REFUND: $17,775.00
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: VZ3/ 2/ By:
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
CITY OF TIGARD RECEIPT
IIIF 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Project Name: Oak Street Apartments
Site Address: 8900 SW OAK ST 11-/V�
Receipt Number: 436248 - 09/03/2021
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PDR2016-00017 $-17,775.00
Total: $-17,775.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 238457 DHOWSE 09/03/2021 $-17,775.00
Payor: The Spanos Corporation
Total Payments: $-17,775.00
Balance Due: $17,775.00
Page 1 of 1
IliCITY OF TIGARD RECEIPT
2 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Project Name: Oak Street Apartments
Site Address: 8900 SW OAK ST , /J Vic(.Al�-
Receipt Number: 426634 - 10/24/2019 /`
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PDR2016-00017 Customer Deposit 100-0000-22000 $17,775.00
Total: $17,775.00
PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 2326 LSMITH 10/24/2019 $17,775.00
Payor: Oak Street AGS
Total Payments: $17,775.00
Balance Due: $0.00
Page 1 of 1
RECEIVED
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT JAN 2 Q
111 III2021
_ Request for Permit Action 6(CITYOFTIGAAD
;L;A H I I 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.PING DIVISION
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: The Spanos Corporation
INVOICE TO: (Business or Individual)
Mailing Address: 10220 SW Greensburg Rd.
City/State/Zip: Tigard, OR 97223
Phone No.: 209-478-7954
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#: PDR2016-00017
Site Address or Parcel #: 9010 SW Oak St.
Subdivision Name: Oak Street Apartments (Aka,Astikos Apts) Lot#:
EXPLANATION: Refund permit fees of$17,775 for cash assurance refund
Christopher Bo .a,m
Signature:
Date: 1/20/21
Print Name: Chris Boring
Refund Polity
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 9 3 `3-/ By •.ty-�
Refund Processed: Date eZ 3 �/ By Invoice Processed: Date By 6/
Permit Canceled: Date N/� B , , Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_09 314.doc