Permit ' til'W.= CITY OF TIGARD
SEWER CONNECTION PERMIT
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1:;I;=: COMMUNITY DEVELOPMENT Permit#: SWR2015 00123
1 "f t14,', 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439 Date Issued: 11/02/2015
TIGARD Parcel: 1 S136AA00201
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Jurisdiction: Tigard
Site address: 10208 SW 69TH AVE
Project: Oak Street Estates, Lot 2 Subdivision: 2007-031 PARTITION PLAT Lot: 2
Project Description: Sewer connection for new SF
Contractor: Owner LENNAR NORTHWEST INC
11870 NE 99TH ST, STE 1170
VANCOUVER,WA 98682
PHONE PHONE
FAX
FEES
Description Date Amount
Specifics: Sewer Connection Fee 11/02/2015 $5,100 00
Sewer Inspection-Residential 11/02/2015 $35 00
Type of Use: SF
Class of Work: NEW
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $5,135 00
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 dir questions
to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By: Permittee fa�
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Call 5d .- '.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
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TIGARD
City of Tigard
March 9, 2016
Lennar Northwest Inc.
Attn: Juls Call
11807 NE 99th St., Suite 1170
Vancouver,WA 98682
Re: Permit No. Various New SF Residential Permits - See Attached Li st
Dear Applicant:
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: Various
Project Name: Oak Street Estates - Lots 1-23 and 25-31
Job No.:
Refund: ® Check #220393 in the amount of$338,059.00.
j Credit card "return"receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
n Trust account "deposit"receipt in the amount of$
Comments: Refund for SDC fees paid prior to available credits applied from demolition
permit BUP2015-00091 for armory building and SF residential building. See attached
spreadsheet for SDC credit balance and list of permits that credits were applied to.
If you have any questions please contact me at 503.718.2430.
Sincerely,
#6.5/)/e7c77-e..._,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
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City of Tigard
TIGAR j Accela Refund Reques t
This form is used for refund requests of land use, development engineeri.rig and building permit
application fees. Receipts, documentation and the Request forPermit Actio,, 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 distz-ibution to applicant.
PAYABLE TO: Lennar Northwest Inc. DATE:
Attn: Juls Call 3/7/2016
11807 NE 99`h St., Suite 1170 REQUESTED BY: Dianna Howse
Vancouver, WA 98682
TRANSACTION INFORMATION:
Receipt#: Various Case#:
Date: Various Various
Pay Method: CreditCard Address/Parcel: Various
Project Name: Oak Street Estates
EXPLANATION: Refund for transportation development and parks system development fees paid prior
to demolition credits for armory structures and (1)residential structure. Received final
inspection for BUP2015-00091 on 2/10/2016 so credits care be applied and all SDC
fees paid by developer shall be refunded.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account N .
Exam sle: Buildin: Permit Fee Exam.1e: 2300000-43204 Refund
Washin•ton Coun Trans sortation Develo.ment Tax 405-0000-43320 $Amount
Parks SDC Im.rovement
425-0000-43300 $237,723.00
Parks SDC-Reimbursement 425-0000-43301 20,203.00
Sewer Connection
500-0000-25500 3,633.00
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TOTAL REFUND: .$333; 9701
APPROVALS: SIGNAT S DATE: -3 3?JOS-Y.re)
If under $5,000 Professional Staff ePejWir
If under$12,500 Division Manager j�,/��
If under$25,500 Department Manager /
If under$50,000 City Manager i -
If over$50,000 Local Contract Review Board ,L.4E-5 PVo r- ,
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: ,g /G`
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