Permit CITY OF TIGARD SEWER CONNECTION PERMIT
1111 a • • COMMUNITY DEVELOPMENT Permit#: SWR2015-00125
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/09/2015
Parcel: 1 S 136AA00201
Jurisdiction: Tigard
Site address: 10162 SW 69TH AVE
Project: Oak Street Estates,Lot 4 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 11/04/2015 $5.100.00
Sewer Inspection-Residential 11/04/2015 $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 direct questions
to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call O3.; •.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 List
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: /1 Check #220393 in the amount of$338,059.00.
n Credit card "return"receipt in the amount of$
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ 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,
<67 411
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. 4 Tigard, Oregon 97223 s 503.639.4171
City of Tigard
TIGARD Accela Refund Reques t
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: 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 No.
und
Exam.le: Buildin: Permit Fee Exam.le: 2300000-43104 Rmou
Washin•ton Coun Trans.ortation 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
_21,890-00 •
6 aid .e414--
111.111111.111111.1111111111111111111111
mimmmommENEENEENE
TOTAL REFUND: .$333; 91
APPROVALS: SIGNAT S DATE: .fi 03"-Y•Iry
If under$5,000 Professional Staff . �� _ - qe1X-/—
If under$12,500 Division Manager + j9/��
If under$25,500 Department Manager /
If under$50,000 City Manager i
If over$50,000 Local Contract Review Board wo
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: ltWA