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Permit • City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223 • I1 T I GARD August 20, 2009 Jennifer Nguyen 1457 45 PI SE • Salem, OR 97317 Re: Permit No.: BUP2009 -00030 Site Address: 9751 SW Washington Square Rd. Project Name: Signature Day Spa Dear Ms. Nguyen: The City of Tigard has received your request to cancel the above referenced permit. The status of this permit indicates that plan review has already been completed on your building plans submitted for this project. Therefore, the Building Official has determined that the initial plan check deposit of $385.04 will be retained to cover plan review and administrative costs. Thank you for your notification to cancel the permit. If you have any questions you may contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor 1: \Building\ Refunds \ Administration \LtrNoRefund- CancclPcrmit.doc 01/16/07 Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772 ..:1 Community Development '' CEIVED T l C, n It Request for Permit Action OCT 16 2009 CITY OF TIGARD TO: CITY OF TIGARD BUILDING DIVISION Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor [,k City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State /Zip: Phone No.: PLEASE TAKE 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 #: r t 1 aoc 9- ono 3o Site Address or Parcel #: - 916/ Loo / ,o'Tp,0 • Project Name: eJ✓tTutti_ t P(4- Subdivision Name: Lot #: EXPLANATION: `DA 0 1■ ►J Un , 'J -(i 5 PEA t r (ADAS ado F- ooO(o5. o , 1 - L N_-A 1�) 0 tAD • ► € Pt c m � P�e� + Cr. Signature: :� 6 �^1 ( �� 1 Date: /0//6 /D 9 Print Name: ) p 2 } M g k 1 Refund Policy 1. The Director or Building Official may authorize 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 b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.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 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. c) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. Rte to S s Admin: Date 1 o TEE O � own Rte to Biid. Admin: Date /' y'AS= B Refund Processed: Date N /9- By d ; , Al Invoice Processed: Date By Permit Canceled: Date 6/2 a/tt 9 By LS Parcel Tag Added: Date By Receipt # Date Method Amount $ I:\ Building \Forms \ReiPermitAction.doc Rev 07/26/07 Building Permit REpp Commercial ry - l ECF ' y''� - . 1 . r r . r 3 ; -s.a k7� ..FOR , OFF:ICE_USE'ONLY s , .7.z . `� 3 � 4 City of 'Tigard MAR 0 2 2009 Plan Date/ RB x iew 3 2 0 � C ..›. ) :1 0 . 4 Permit No.: - 30 g 13125 SW Hall Blvd., Ti ard, OR 97223 ev � II 1 . 4 Phone: 503.639.4171 Fax: 503.598.196 CITY OF TIGARD Date/By: Other Permit: �'' i t' ' I nspection Line: 503.639.4175 ® See Page 2 for k l tG ^R, V ISION Date Ready /By: kris. - rG Supplemental t Internet: Line g 503.639.4175 BUILDING DIVISION Notitied/Meth S u lementallnformadon Ci - ,Ic Z �1 4c3 - TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application ❑ 1- and 2- family dwelling ❑ Commercial /industrial • Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑_Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: q 'j 5I c 5 L. 0 �1+ i0Y'o _ P L New dwelling area: square feet City /State /ZIP: — al, , o2 9 7 (9-a 5 *),- Garage /carport area: square feet Suite/bldg. /apt. no.: ` U/ Project name: 1 , ., ,,)4 - f&_� -D4 Y Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. /'•d ) CO I �T Valuation: $ - �y :eJv u P.A. .tiw (A e_ ! — Existing building area: square feet New building area: square feet ❑, PROPERTY OWNER ❑ TENANT Number of stories: Name: t 1 Q [,‘; L o C 9 t - Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON " NOTICE Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. lithe City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: - CONTRACTOR . Business name: i 1 Ce i 1 4 T - t-e- X' VL BUILDING PERMIT FEES* Address: / O 7 6 N)/t) • L- lJ _ -t �f (Please rej w fee schedule / Structural plan review fee (or deposit): 'S$ . City /State /ZIP: I or- 1- 101 ,,e f 02_ g 7 2 '2- & Phone: (i7,3 ) a_0 Fax: ( ) FLS plan review fee (if applicable): ft/4, If 8' u2� — �7 /-p / / I �7 S 7 ,2/ Total fees due upon application: CCB lic.: Amount received: 3 b 5 .6 1 Authorized signature: ."-C(S ---)TR .k f1 Ft4 ,' )F O This permit application expires if a permit is not obtained �' within 180 days after it has b een accepted as complete. Print name: P �,,,,, (j r6k �=t� /� Date: (5j/ p 9/ ©Lj . * Fee methodology set by Tri- C ounty Building Industry --'' Service Board. l:\Building \Permits \BUP -COM Pe itApp.doc 2/23/07 440- 4613T(11 /02 /COM/WEB) , • • • n, ., ._... ._. M ..,. 74 , a ® Building Division Wk Accessibility: Barrier Removal Improvement Plan • .: REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty -five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ I:\ Building \Permits \BUP -COM PermitApp.doc 10/30/07 03/31/2009 16:41 412 -- 650 -9801 FEDEX KINKO'S 0532 PAGE 01 • 1KT7 I . ! ±`' • MAR A a -, �. 1 : Community Development , TIGARD Request for. Permit Action � � Oy >i ti ; 13111IL ?aIi� G TVISIOil TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Mall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503 - 598.1960 wwv.tigard- or.gov FROM: m Owner. Applicant (check one) s 0 ❑ Contractor ❑ City Staff �.� REFUND OR Namc: INVOICE TO: (Business or Individual) *.z ursit 4 v. id Mailing Address: w L.g, B �� r — City /State /Zip: ru 1. Iv?, v 1 ---- P ------------ hone No.: lGu 5 56 1 9 __ d � PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): tie 3v / N A � El CANCEL PERMIT APPLICATION. � P / .,,, t � i t/I 0 REFUND PERMIT FEES (attach receipt if available). P / ' e — r 1 0 INVOICE FOR FEES DUE (attach case fee schedule and explain below).` 13 ` , , 0 REMOV) CONTRACTOR FROM PE I n (do not cancel permit). �, � A �� l a ✓ 4 � 1' Permit #: i} V ; 16 zc o.9 - g4a3� k Site Address or Parcel #: 1 1151 5 >_._, L _ a ,,, S Project Name: _S9r,• > Subdivision Name: Was��s� M =�� �1aCr.�,t�1 _ Lot #: . EXPLANATION: u� nr� Exec . _Fillem„_13,,,-r_. glon � C11 Signature: A Date: 3/30 /zcoq Print Name: t,,z, _ p 1 61r>Jl_o 191u•2 `- 1"6'5 /Z►5• $y1e•2.9t,1 CG-�1) 1. The Director or Building Official may authorize the refund of: a) any fee which was crmnaously paid or collected, b) not mom than Lk( of the land use application fcc when an application is withdrawn or canceled before any review effort has been expended. c) not more than 1111% of the land use application fee For issued permits, (l) nor m than FM of the building plan review fcc when an application is canceled before any plan review effort has been expended a) not more than 811% of the building permit fee for issued permin prior ua any inapecrinn rcquuxr:. 2, Rc1 ,nds will be returned to the original Payer in the sane method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rtc to S a .Admin: Date B RcfiuTd Processed: Date Rte to Bld: Adlnin: Date B B Invoice Processed: D B Perrriit Canceled: Date B Parcel T1 • Added: Date Rccei•t # Date Method 1: \Kaldinp \Farms \RegPc:rmitAcx;∎an.d Rev (17 /2(/x17 Amount 1( • • ' , . • • • CITY OF TIGARD RECEIPT . 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 2009 -00506 - 03/02/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID BUP2009 -00030 Plan Review 245 - 0000 - 433000 $238.36 BUP2009 -00030 Plan Review - Fire Life Safety 245 - 0000 - 433020 $146.68 Total: $385.04 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 067622 DADAMSKI 03/02/2009 $385.04 Payor: Huy Tran , d 7721:-/ ,... / p' Total Payments: $385.04 CC" ...._L rte-. e _O'�G Balance Due: $410.70 • Page 1 of 1 City of Tigard 13125 SW Hall Blvd. ... o ve, Tigard, OR 97223 *,.1-- ." -- J __ , � i+ r 44 F: ",,..y - wnuy BOWES rA 02 1M . $ 00.44° • i 0004227235 G20 2009 •''. - tt MAILED FROM-=a41 DE 97223 G i al Jennifer Nguyen 1457 45th Pl. SE • ,: oP Salem, OR 97'"' NIXIE 973 SE I GO 08/22/00 RETURN TO SENDER NOT DELIVERABLE AS ADDRESSED UNABLE TO FORWARD BC: 97223616799 X1629 13164 -20 -40 q77 97223©81E7 I II1l. ili11I) 1J1li1ililliI1l. 1l1I „ll1lit,ititlltinliliil,tlii • ;� o Community Development • RE I ED TIGARD Request for Permit Action OCT 1 6 2009 CITY OF TIGARD TO: CITY OF TIGARD BUILDING DIVISION Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov • FROM: ❑ Owner ❑ Applicant ❑ Contractor [ City Staff (check one) REFUND OR Name: INVOICE TO: (Business or Individual) Mailing Address: City/State /Zip: . Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED ( In i 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 #: u P aoo 9- 060 ?JD . Site Address or Parcel #: 915/ L{�f} /,, 70,4) 1.. • Project Name: ( 13y9- j„L -1 }Y C4,4-. Subdivision Name: Lot #: EXPLANATION: - IDA 13 jJ f,Z O tJ , 06 l7 174,6 Pf it M I T 4-s /T LO A6 L. N. CLb - 3y I goo I- oodo5'. C' (b, }c_ PLA Signature: , • Date: /O/ ( 4 9 J Print Name: 4 - 7 1 7 ) . _ C M ) / 1 ? - , Ab41 - g k 1 Refund Policy 1. The Director or Building Official may authorize 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 80% of the building 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 original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY Rte to S s Admin: Date /O MO IIETIMPA Rte to Bid: Admin: Date 4 YAM" B 4 it Refund Processed: Date d' B I� By a , AI Invoice Processed: Date By Permit Canceled: Date .5/2 �2 / �t d By 4,s' Parcel Tag Added: Date By Receipt # Date Method _ Amount $ I:\ Building \Forms \RegPermitAction.doc Rev 07/26/07