Correspondence
J2/03/2009 10:44 FAX ( 001
~l c 2zoet -C_J0(3 v
e Community Development
~ Request for Permit Action
C~
TO: CITY OF TIGARD GF'C1GV ON
Building Division Services Coordinator NG1~
13125 SW Hall Blvd., Tigard, OR 97223 ~t}1L~1
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner Applicant ® Contractor ❑ City Staff
(check one)
REFUND OR Name: STONER ELECTRIC, INC.
INVOICE TO: (Business or Individual)
Mailing Address: 1904 SE OCHOCO
City/State/Zip: MILWAUKIE, OR 97222
Phone No.: 503-462-6500
PLEASE TARE ACTION FOR THE ITEM(S) CHECKED
® CANCEL PERMIT APPLICATION.
® REFUND PERMIT FEES (attach receipt, if available).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit ELC2009-00043
Site Address or Parcel _S"v'
r
Project Name: ETHICS POINT
Subdivision Name: Lot
EXPLANATION: PROJECT MANAGER FURNISHED INCORRECT SITE ADDRESS,
ACTUAL SITE WAS IN THE CITY OF BEAVERTON (132009-0288)
Signature: Date: 2/3/09
DENNIS WHITCOMB
Print Name:
Rcfynd Policy
L The Director or Building Official may authorvx the refund of-.
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 800/6 of the budding plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2 Refunds will be returned to the ongimal Payer in the same method in which payment was received. Please allow 1-2 weeks for processing refunds.
Rte to S Admin: Date 91
pr Rte to Bldg Admin: Date / B
Refund Processed: Date 7 p B Invoice Processed: Date B
Permit Canceled: Date - 1 Z/0-9 y B Parcel Tag Added: Date B
Receipt # Date Method ArnoLmt S
City of T`~igaral, Oregon ~ 13125 SW 1w1l Blvd. C, Tigard, OR 972
~r 4_A
August 27, 2009
Stoner Electric Inc.
1904 SE Ochoco
NHwaukie, OR 97222
Attn: Dennis Whitcomb
Re: Permit No. ELC2009-00043
Dear Mr. Whitcomb:
The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the
following:
Site Address: 13221 SW 68`h Pkwy, Ste. 120
Project Name: Ethics Point
Job No.:
Refund: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $59.86.
❑ Trust account "deposit" receipt in the amount of $
Notes: Per applicant's request as job site address was incorrect. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supen-isor
Enc.
1:ABuilding\Refunds\Adenim,trition\LtrRefund-CancelYernut.duc 01/16/07
Phone: 503.639.4171 e Fax: 503.684.7297 ® www.tigard-or.gov o TTY Relay: 503.684.2772
Erg City of Tigard
Accela Refund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Permit,1ction or Refund form (if applicable) must be
attached to this form. Refund requests are due to Accela System Administrator by Friday at
5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela
System Administrator for distribution. Please allow 1-2 weeks for processing.
PAYABLE TO: Stoner Electric Inc. DATE: 8/20/09
1904 SE Ochoco
Milwaukie, OR 97222 REQUESTED BY: Dianna Howse
Attn: Dennis Whitcomb
TRANSACTION INFORMATION:
Receipt 2009-224 Case ELC2009-00043
Date: 1/29/09 Address/Parcel: 13221 SW 681h Pk-,x-v, Ste. 120
Pay Method: CreditCard Project Name: Ethics Point
EXPLANATION: Per applicant's request as address was incorrect. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Exam le: [BUILD] Permit Fee Example: 245-0000-432000 $ Amount
LPRM'I ELC Permit 220-0000-431510 $53.44
AX 12°'o State Surcharge 100-0000-207020 6.42
TOTAL REFUND: $59.86
APPROVALS:
If under $500 Professional Staff
If under $7,500 Division Manager
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR ACCELA SYSTEM ADMINISTRATION USE ONLY
Refund Request Reviewed: Date: B -
Case Refund Processed: Date: By:
1:ABuilding\ReCUllds\RefundRequesc.doc Oa/1i; 09