Correspondence CITY OF TIGARD
Building Division
TIGARD 13125 SW Hall Blvd.,Tigard,OR 97223 503-639-4171
INVOICE
TO: Beacon Homes NW Customer ID: 151251
12703 SW 67th Ave. Invoice No.: INV2007-00007
Tigard, OR 97223 Invoice Date: 5/9/07
Attn: David Dalbey Date Due: Upon Receipt
Case No. Site Address Subdivision-Lot#or Project Name Amount Due
MST2006-00225 8809 SW Scheckla Dr. Lady Apple,Lot 29 $347.78
ICH 11.1
7, 71
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Invoice Total: $347.78
® Please see attached fee schedule for description of fees due.
(Detach and return this portion with payment.)
Case No.: MST2006-00225 Customer ID: 151251
Site Address: 8809 SW Scheckla Dr. Invoice No.: INV2007-00007
Project: Lady Apple,Lot 29 Invoice Date: 5/9/07
Date Due: Upon Receipt
Invoice Total: $347.78
Amount Paid: $ 3 97, 7,
Office Note: Remove parcel tag when invoice is paid.
Please mail payment to:
City of Tigard,Building Division
13125 SW Hall Blvd.
Tigard, OR 97223
Attn: Dianna Howse
I:\Building\Accounting\lnvoice.doc 04/06
CITY OF TIGARD 6/7/2007 ,
13125 SW Hall Blvd. 3:51:15PM
11 Tigard,OR 97223 503.639.4171
TI( \RD
Receipt #: 27200700000000002542
Date: 06/07/2007
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
MST2006-00225 [BUPPLN]Pln Rv Balance 245-0000-433000 239.58
MST2006-00225 [CDCPLN]CDC Pln Rev 100-0000-433060 45.00
MST2006-00225 [LRPF]LR Planning Surcharge 100-0000-438050 6.00
MST2006-00225 [ERPLN]Erosn Pln Rv CWS 100-0000-207308 28.60
MST2006-00225 [EROSN]Erosn Pln Rv COT 245-0000-433010 28.60
Line Item Total: $347.78
Payments:
Act./Check No. A
Method Payer User ID c Approval No. How Received Amount Paid
CreditCard BEACON HOMES NW-DAVID DEB 082973 In Person 347.78
DALBEY
Payment Total: $347.78
cReceipt.rpt Page 1 of 1
A
CITY OF TIGARD 5/9/2007
Fees Associated With 9:13:30AM
13125 SW Hall Blvd.
TIGARD Tigard,OR 97223 503.639.4171 Case #: MST2006-00225
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 8/16/2006 250.00 0.00
BPLD 1/1/1990 12/31/2020 [BUPPLN] Pln Rv Balance 245-0000-433000 LW 10/9/2006 239.58 239.58
CDCP 1/1/1990 12/31/2020 [CDCPLN] CDC Pln Rev 100-0000-433060 LW 10/9/2006 45.00 45.00
LRP1 12/28/2004 12/31/2020 [LRPF] LR Planning Surcharge 100-0000-438050 LW 10/9/2006 6.00 6.00
ERPU 1/1/1990 12/31/2020 [ERPLN] Erosn Pin Rv CWS 100-0000-207308 LW 10/9/2006 28.60 28.60
ERPC 1/1/1990 12/31/2020 [EROSN] Erosn Pln Rv COT 245-0000-433010 LW 10/9/2006 28.60 28.60
Total Due: $347.79
Page 1 of 1 CaseFees..rpt
Building Division :',
TIGARD Request for Permit Action - '°1
APR 1007
TO: CITY OF TIGARD
C1
Permit System Administrator g u ))�t1ro tu ()
13125 SW Hall Blvd.,Tigard, OR 97223
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) E,e�N —�ME- 1j\A/
V0 1 D Mailing Address: 1 Z7 O3, S w G1 ry A\`
/Ø7 ,iigl___City/State/Zip: TGPcQQ ( OIZ crl LZ 3
Phone No.: 933- 5-1O-
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
d CANCEL PERMIT APPLICATION.
I 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 #: QQ j ���2 : 006 --6e2/7,-
Site Address or Parcel#: o 609 5,0 ,Se_i4�C.l LA Z
Project Name: LAU1) A PP LE
Subdivision Name: Litz`; Pc(' Lot#: 29
EXPLANATION: NDT Fi T DOE Th A
Q_DT -c THEE E-c= 11S a?oo 7 — 0 0o,4)oz
w.eaoo7 -- do093
Signature: � Date: 'y I -7_3 -- 3
Print Name: h.N.11 A Li
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.
c) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) 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 Sys Adtnin: Date 5 07 e Rte to Bldg Admin: Date .579 D 7 By,((ri