Correspondence .
TIGARD
City of Tigard
February 26, 2015
Lennar NW Inc.
Attn: Charles Webb
11807 NE 9961 St., Ste. 1170
Vancouver,WA 98682
Re: Permit No. MST2014-00104
Dear Applicant:
The City of Tigard has processed a refund for overpayment of permit fees on the above
referenced permit for the following:
Site Address: 13226 SW Hazelcrest Way
Project Name: Sequoia Heights,Lot 13
Job No.: N/A
Refund: ® Check#216577 in the amount of$6.28.
❑ Credit card"return" receipt in the amount of$
❑ Trust account"deposit"receipt in the amount of$
Notes: Refund overpayment of state surcharge.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Coordinator
Enc.
13125 SW Hall 31vd. • T ar Oregon 97223 • 503.639.4171
I:\Building\Refunds\Adminisu e_ay: 503. 4.Z///2 7• www.tigard-or.gov
R
• City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Requestfor Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Lennar NW Inc. DATE: 2/19/2015
Attn: Charles Webb
11807 NE 99th St.,Ste 1170 REQUESTED BY: Dianna Howse
Vancouver,WA 98682
TRANSACTION INFORMATION:
Receipt#: 198984 Case#: MST201-1-00104
Date: 1/14/2015 Address/Parcel: 13226 SW Hazelcrest Way
Pay Method: CreditCard Project Name: Sequoia Heights,Lot 13
EXPLANATION: Refund overpayment of state surcharge
REFUND INFORMATION:
Fee Description From:Receipt Revenue Account No Refund
Example: Building Permit Fee Example: 2300000-43104 '$Amount
12%State Surchage 100-0000-24001 $6.28
TOTAL REFUND: $6.28
APPROVALS: SIGNAT ' - DA E:
If under$5,000 Professional Staff ► ,
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
-FOR TIDEMARK SYSTEM ADMINISTRATION USE ONJ ;
Case Refund Processed: Date: .2`o26/4Ci By: ,� —
I:\Building\Refunds\RefundRequest.dx x 09/01/2(110
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
IPIII = r Request for Permit Action
, , i i , 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor vi City Staff
Check(✓)one
REFUND R Name: q
INVOICE TO: (Business or individual) C�HA.a,,,CJ �.JL,s tU - �60 41.0, / /i
Mailing Address: /1 go? N E. 99' 6l . re.... 1l7 CI
City/State/Zip: VAN CauJ€i .F L 9(a1vt;i
Phone No.: ta0-),Sg- 7 900
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
N - ' -_-- VOID PERMIT APPLICATION.
dig REFUND ' RMIT FEES (attach copy of original receipt and provide explanation below).
• • • E FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT'(do not cancel permit).
Permit#: ,H57 - 00 /04
Site Address or Parcel#: 13??.(p 51.0 /4 4 7-...E t.eL ST L..),4\11
Project Name: LAL)t et 1-44 t a/17',
Subdivision Name: I I ft Lot#: /3
EXPLANATION: ID T)o1 ( .&i e (-{ f1T 0.0#--t 0 urea- kb-I) E-73
A-1-51>1-7-100 L R T f_ 1 a L m e.C.1-f A I 2 L >AMo[_i )T D ii (Q. g,
PLE._4 5 r�� 100°y
Signature: Date: 111 s'1/S
Print Name: 1 C�,a-1 rc ifb 111/4-t S 1
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONI.1
Route to S s Admin: Date !minim— Route to Records: Date .�QI B e-4 �
Refund Processed: Date_WWII (%702 Invoice Processed: Date B'
Permit Canceled: Date A/ ' By •1;4 111"7i 'arcel Tag Added: Date By
I:\Building\Forms\R eg Permi to ction_1192.14.d oc