Plans 6 I C2010 -. 0 067c
City of Tigard, Oregon ® 13125 SW Hall Blvd. ® Tigard, OR 97223
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December 1, 2010 l tlJ
Cochran, Inc.
7550 SW Tech Center Dr., Ste. 220
Tigard, OR 97223
Attn: Bo Singleton
Re: Permit No. ELC2010 -00604
Dear Mr. Singleton:
The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the
following:
Site Address: 10220 SW Greenburg Rd., Ste. 601
. Project Name: Matrix Absence
Job No.: N/A
Refund: ® Check #96.88 in the amount of $ i. ill Credit card "return" receipt in the amount of $ .
111 Trust account "deposit" receipt in the amount of $ .
Notes: Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Since rely,
Dianna Howse
Building Division Services Supervisor
Enc.
I: \Building\ Refunds\ Administration \LtrRefund- CancelPemtit.doc 01/16/07
Phone: 503.639.4171 ® Fax: 503.684.7297 ® www.tigard- or.gov ® TTY Relay: 503.684.2772
71
, :
, , : . . City of Tigard
T1cARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: Cochran, Inc. DATE: 11 /23/2010
7550 SW Tech Center Dr., Ste. 220
Tigard, OR 97223 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt #: 180155 Case #: ELC2010 -00604
Date: 10/28/2010 Address /Parcel: 10220 SW Greenburg, Ste 601
Pay Method: Check Project Name: Matrix Absence
EXPLANATION: Per applicant's request as job was cancelled. Refund 80% of permit fees.
REFUND.INFORMATION ' ,
Fee Description'From: Receipt Revenue , A c count No ' . Refund
Example :.. BuildingPermit Fee, Example 2300000 43104 $ ;' tY punt
Electrical Permit 2200000 -43103 $86.50
12% State Surcharge 1003100 -24001 10.38
TOTAL REFUND: $96.88
APPROVALS:
If under $5,000 Professional Staff
If under $12,500 Division Manager
If under $25,500 Department Manager I Ii
I f under $50,000 City Manager �/
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM AE MINISTRATION; USEONLI' a , 4
Case Refund Processed: I Date: ,4,2/ I By: 1 i t',-,-/---/
I:\ Buildin \Refunds \RcfundRc N 09/01 /2010
OCT /29 /2010 /FRI 10:49 AM COCHRAN TECHNOLOGIES FAX No, 971 205 4268 P. 001
RECEIVED Community Development
Request for Permit Action OCT 2 9 Z010
T I GA R D.
TO: CITY OF TIGA.RD 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: Cochran, Inc.
INVOICE TO (Business or individual)
.
Mailing Address: 7550 SW Tech Center Drive Suite 220
City /State /Zip: Ti:d, OR 97223
Phone No.: 971-205-4242
PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (✓): V 0 1
® CANCEL PERMIT APPLICATION.
El REFUND PERMIT FEES (attach receipt, if available). /5Z/V/
❑
INVOICE FOR FEES DUE (attach case fee schedule and explain below). �j,
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). r
Pe.t nit #: ELC2010 -00604
Site Address of Parcel #: 10220 SW Greenburg Rd. Suite 601
Project Name: Matrix Absence
Subdivision Name: Lot #:
EXPLANATION: The job is cancelled for: us. Some other eiecttical contractor will be
awarded the contract.
Signature: /f Date: 10 -29 -10
o Singleton
Print Name:
Wind 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 803/4 of the land use application fee when an application is widideewn or canceled before any review effort has been expended.
c) not more than 80" o 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 peunit 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 B Rte to Bld; Admin: Date j / 2 By 1gj�
Refund Processed: Date /...2 AB 52. Invoice Processed: Date By
Permit Canceled: Date ,2 33 - rIPAI Parcel T, ; Added: Date By
Receipt # /F-G /SS Date / / - /ia Method Amount $
l:\ Building \Fomu`RcgpcumtAction.doc Rev 67/26/07