Correspondence (11) III I
• CITY OF TIGARD
Building Division
TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Timber Projects LLC Customer ID: 164939
8407 SW 58th Invoice No.: INV2008-00020
Portland, OR 97219 Invoice Date: 10/24/08
Attn: Mark Seaman Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
MST2007-00134 9322 SW North Dakota St. Hellwege Partition $110.02
vv1ST2007-00133) 9254 SW North Dakota St. Hellwege Partition $110.02
Invoice Total: $220.04
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2007-00I34/MST2007-00133 Customer ID: 164939
Site Address: Various Invoice No.: INV2008-00020
Project: Hellwege Parition,Lots 1 & 2 Invoice Date: 10/24/08
Date Due: Upon Receipt
Invoice Total: $220.04
Amount Paid: $
Office Note: Please forward copy of receipt to Dianna Howse.
Please mail payment to:
City of Tigard,Building Division
13125 SW Hall Blvd.
Tigard, OR 97223
Atm: Dianna Howse
I:\Building\Accounting\Invoice.doc 04/06
CITY OF TIGARD 10/21/2008
• Fees Associated With 7:26:25AM
C 13125 SW Hall Blvd.
:1/4
TIGARD Tigard,OR 97223 503.639.4171 Case #: MST2007-00133 9,z 5 Y 5!t) 'V'A.?fi` ` 'T19 L o7 a
Fee Start End Revenue Created
Type Date Date Dept Description Account Number By Date Amount Due
BPLC 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Deposit 245-0000-433000 BLD 7/18/2007 750.00 0.00
CDCP 1/1/1990 12/31/2020 [CDCPLN]CDC Pln Rev 100-0000-433060 MAV 8/13/2007 46.00 46.00 ; -
LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 MAV 8/13/2007 6.00 6.00 ✓
BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245-0000-433000 MAV 8/13/2007 16.42 16.42 , -
BPRT 1/1/1990 12/31/2020 [BUILD] Bldg Permit 245-0000-432000 MAV 8/13/2007 1,179.11 1,179.11
B5PC 1/1/1990 12/31/2020 [TAX] Build 8%State Surchrg 100-0000-207020 MAV 8/13/2007 94.33 94.33
MCET 7/1/2006 12/31/2020 [METCET] Metro Const Excise Tx 245-0000-229202 MAV 8/13/2007 223.86 223.86
MPRT 1/1/1990 12/31/2020 [MECH] MEC Permit 245-0000-431010 MAV 8/13/2007 83.70 83.70
M5PC 1/1/1990 12/31/2020 [TAX] MEC 8%State Surcharge 100-0000-207020 MAV 8/13/2007 6.70 6.70
PL3B 1/1/1990 12/31/2020 [PLUMB] PLM Prmt 3Bth 245-0000-431000 MAV 8/13/2007 399.00 399.00
P5PC 1/1/1990 12/31/2020 [TAX] PLM 8%State Surcharge 100-0000-207020 MAV 8/13/2007 31.92 31.92
ELCF 1/1/1990 12/31/2020 [ELPRMT] ELC Permit 220-0000-431510 MAV 8/13/2007 245.35 245.35
ELC5 1/1/1990 12/31/2020 [TAX] ELC 8%State Surcharge 100-0000-207020 MAV 8/13/2007 19.63 19.63
ELRP 1/1/1990 12/31/2020 [ELPRMT] ELR Permit 220-0000-431510 MAV 8/13/2007 75.00 75.00
ELR5 1/1/1990 12/31/2020 [TAX]ELR 8%State Surcharge 100-0000-207020 MAV 8/13/2007 6.00 6.00
PRK6 7/1/2005 12/31/2020 [PKSDC] SF Park SDC 270-0000-450000 MAV 8/13/2007 4,812.00 4,812.00
TIFM 7/1/2002 12/31/2020 [TIF-MT] TIF Mass Tr 210-0000-448005 MAV 8/13/2007 240.00 240.00
EROS 1/1/1990 12/31/2020 [ERPRMT] Erosion Control 100-0000-207307 MAV 8/13/2007 64.00 64.00
ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pln Rv CWS 100-0000-207308 MAV 8/13/2007 20.80 20.80 '�
ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245-0000-433010 MAV 8/13/2007 20.80 20.80 ,-
WQUL 7/1/2001 12/31/2020 [WQUAL] Water Quality 520-0000-445002 MAV 8/13/2007 225.00 225.00
WQAT 7/1/2001 12/31/2020 [WQUANT] Water Quantity 520-0000-445001 MAV 8/13/2007 275.00 275.00
TIFR 7/1/2002 12/31/2020 [TIF-R]TIF Resident 210-0000-448001 BLD 6/5/2008 2,960.00 2,960.00
Total Due: $11,050.62
TT1�L /'r4-N / vc) ; S//e . o.L
Page 1 of 1 CaseFees..rpt
NCommunity Development
TIGARD Request for Permit Action
TO: CITY OF TIGARD
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 IN City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) 1-7=M b La., j,(Lby‘LT g Li - /M„.,� 5"M Ai✓
Mailing Address: ,�L.Io 7 <w SST'-' At
City/State/Zip: TO/L-7-L.6,./ I 0,e_., 9 . 7 l cJ
Phone No.: -c 3-) ')-id G - cj 15 U
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
❑ CANCEL PERMIT APPLICATION.
Fu�N:Q, ERMIT FEES (attach receipt,if available).
a INVOICE FEES DUE (attach case fee schedule and explain below).
CONTRACTOR FROM PERMIT (do not cancel permit).
Permit#: /kg--,,cv-7 - 0(9/ 3 3
Site Address or Parcel#: (/).5-/I 5 Lou juo(2_7-ul ',DA k r,TA-
Project Name: ).16 l_LA.A.)9 0 itv2. -.7`T-1 ciJJ
Subdivision Name: S A,/,,, Lot #:
EXPLANATION: lido 2 x A- B Jr Q..v c.,.A .6 / I ...�/t-i-D ?)°c' 1....a-m a--7.-.47-2�A✓
Li a FLAN P L 11-z i-Z /'i t-A )c.-6 t,‘&
Signature: 614,v3\ r•.,, ,,,,,` Q Date: i d/?/o
Print Name: /I\A 2 cL VA ki b C✓`'1 t rt/
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%o 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 Sys Admin: Date By Rte to Bldg Admin: Date I V p,fr By •
Refund Processed: Date By Invoice Processed: Date jp/�//Cr--- By '"!i°`.
Permit Canceled: _ Date By Parcel Tag Added: Date / By
Receipt# Date Method Amount$
I:\Building\Forms\RegPermitAction.doc Rev 07/26/07