Correspondence III q
TIGARD
City of Tigard
February 26, 2015
Climate Control Inc.
Attn: Roy Harris
16500 SW 72nd Ave.
Portland, OR 97224
Re: Permit No. MEC2015-00051
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: 15615 SW Alderbrook Dr
Project Name: Giles
Job No.: N/A
Refund: ® Check#216558 in the amount of$15.82.
❑ Credit card"return" receipt in the amount of$ .
❑ Trust account"deposit" receipt in the amount of$ .
Notes: Per applicant's request as customer removed furnace from scope of work. Refund
80% of the difference for amount over the minimum permit fee due.
If you have any questions please contact me at 503.718.2430.
Sincerely,
,
Dianna Howse
Building Division Services Coordinator
Enc.
I:\Building\RefundlsWiraScWon l ld-43 • Ti�ar i9ggon 97223 • 503.639.4171
TTY Relay: 507.684.2772 • www.tigard-or.gov
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 Request for 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: Climate Control Inc. DATE: 2/19/2015
Mtn: Roy Harris
16500 SW 72nd Ave REQUESTED BY: Dianna Howse
Portland, OR 97224
TRANSACTION INFORMATION:
Receipt#: 199208 Case#: MEC2015-00051
Date: 2/2/2015 Address/Parcel: 15615 SW Alderbrook Dr
Pay Method: CreditCard Project Name: Giles
EXPLANATION: Per applicant's request as customer removed furnace from scope of work. Refund 80%
o
of difference for amount over minimum permit fee due.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No Refund
Example::Building Permit Fee Example: 2300000-43104 $Amount
Mechanical permit fee 230-0000-43102 $1.1.12
12%o State surcharge 100-0000-24001 1.70
TOTAL REFUND: $15.82
APPROVALS: SIGNATT : D.TE:
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 ON Y
Case Refund Processed: Date: I /02. S By:
1:\Building\Refund,\RefundRequest.doc x 09/01/2010
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMEIRECEIVEP
114 ■ Request for Permit Action FEB 17 2015
1 f,,A I: i , 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •
I ( AO0
TO: CITY OF TIGARD BUILDING DIVISION
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner tgi Applicant I I Contractor ❑ City Staff
Check(1)one
REFUND OR Name:
INVOICE TO: (Business or Individual) e Li 44 /fit,rt4 L. i n c.
Mailing Address: (s,5 CO 31,-) 7 2„ ` ^- ^ —
City/State/Zip: Pa r-I-la..n 8.. c5-4- °-1 Z-z--V{
Phone No.: 503 4.5 3 -(-t (6 "CZ--
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
• -=-•"'w:4•,.VOID PERMIT APPLICATION.
E REFUND- 'ERMIT FEES (attach copy of original receipt and provide explanation below). p rut.4-L.
E ' •• i CE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: P14 L-"-C_20( - 000 .S/
Site Address or Parcel#: /c6/ 5 54") A4-66-4_.6 faaL pY
Project Name: 6/A3
Subdivision Name: Lot#:
EXPLANATION: evie►..-( /)EZe06- AA,7- 12) —5 'CZ+a
fLY/volC6 /00(2-1-1 /I-. D r .18_
Signature: Date: Z//Of
Print Name: bc, !7/
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. lta -0'AJ
2. All refunds will be returned to the original payer in the form of a check via US postal service. ./ff 0,NIA/ d'd ez A.,
3. Please allow 3-4 weeks for processing refund requests.
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Route to S s Admin: Date B Route to Records: Date 02m)23 i%�r - /`/ ./•2-
Refund Processed: Date �,l/� By •'V r Invoice Processed: Date By 9 3,5"3
Permit Canceled: Date B /,,2,... 'arcel Ta:Added: Date B /2 9ot
I:\Building\Forms\RegPexmitAction_0923 4.doc _ / 70
i
q
" CITY OF TIGARD W �� MECHANICAL PERMIT
IJi►.,
1111
• COMMUNITY DEVELOPMENT Permit#: MEC2015-00051
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/02/2015
TIGARD Parcel: 25111 DC04300
Jurisdiction: Tigard
Site address: 15615 SW ALDERBROOK DR
Project: Giles Subdivision: SUMMERFIELD NO.7 Lot: 358
Project Description: Replace furnace and AC,add gas line to BBQ. 2/17/2015: REPRINT permit to remove furnace.
Contractor: CLIMATE CONTROL INC Owner: LINNE, GLADYS E LIVING TRUST OF
16500 SW 72ND AVE BY LINNE, GLADYS E TR
TIGARD, OR 97224 15615 SW ALDERBROOK DR
TIGARD, OR 97224
PHONE: 503-453-4822 PHONE:
FAX: 503-968-7224
FEES
Specifics: Description Date Amount
Air Conditioning 02/02/2015 $46.75
Type of Use: SF Furnaces<100K BTU 02/02/2015 $46.75
Class of Work: ALT Type of Const: Fuel Piping 02/02/2015 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 02/02/2015 $12.92
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $120.57
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct question o OUN by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature: (;A/ //De>��e% �
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.