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Permit I 1 CITY OF TIGARD ©,� w PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2016-00232 T I K;,\iz n13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2016 Parcel: 1 S135BA00102 Jurisdiction: Tigard Site address: 10140 SW WASHINGTON SQUARE RD Project: Zoup! Subdivision: OAKBURG Lot: 9 Project Description: Interior plumbing for TI: Capping(2)sinks and(1)water closet;Adding(5)2"floor drains,(4)sinks,(2)food related sinks, (1)service sink,and(2)water closets; Installing(1)expansion tank,(1)ice maker,(1)grease trap,(4) primers,and(1)water heater. 5/11/2016: REPRINT permit to reduce total 2"floor drains from(8)to(5). .ter Contractor: RECON INC DBA MANZCO PLUMBING Owner: PPR SQUARE TOO LLC PO BOX 822964 PO BOX 847 VANCOUVER,WA 98682 CARLSBAD, CA 92018 PHONE: 360-772-8149 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Expansion Tank 05/02/2016 $12.51 Specifics: 3 ea Fixture/Sewer Cap 05/02/2016 $75.06 8 ea Floor Drain/Floor Sink/Hub 05/02/2016 $200.16 Type of Use: COM 1 ea Ice Maker 05/02/2016 $12.51 Class of Work: ALT 1 ea Interceptor/Grease Trap 05/02/2016 $25.02 Type of Const: 4 ea Primer 05/02/2016 $50.04 Occupancy Grp: 7 ea Sink 05/02/2016 $175.14 Stories: 2 ea Water Closet 05/02/2016 $50.04 1 ea Water Heater 05/02/2016 $37.52 1 12%State Surcharge- 05/02/2016 $76.56 Plumbing Total $714.56 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. A Issued By: /��, Permittee Signature: i 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. CITY OF TIGARD PLUMBING PERMIT • COMMUNITY DEVELOPMENT Permit#: PLM2016-00232 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2016 I i`'A I`l g Parcel: 1 S 135BA00102 Jurisdiction: Tigard Site address: 10140 SW WASHINGTON SQUARE RD Project: Zoup! Subdivision: OAKBURG Lot: 9 Project Description: Interior plumbing for TI: Capping(2)sinks and(1)water closet;Adding(8)2"floor drains,(4)sinks,(2)food related sinks,(1)service sink,and(2)water closets; Installing(1)expansion tank,(1)ice maker,(1)grease trap,(4) primers,and(1)water heater. Contractor: RECON INC DBA MANZCO PLUMBING Owner: PPR SQUARE TOO LLC PO BOX 822964 PO BOX 847 VANCOUVER,WA 98682 CARLSBAD, CA 92018 PHONE: 360-772-8149 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Expansion Tank 05/02/2016 $12.51 Specifics: 3 ea Fixture/Sewer Cap 05/02/2016 $75.06 8 ea Floor Drain/Floor Sink/Hub 05/02/2016 $200.16 Type of Use: COM 1 ea Ice Maker 05/02/2016 $12.51 Class of Work: ALT 1 ea Interceptor/Grease Trap 05/02/2016 $25.02 Type of Const: 4 ea Primer 05/02/2016 $50.04 Occupancy Grp: 7 ea Sink 05/02/2016 $175.14 Stories: 2 ea Water Closet 05/02/2016 $50.04 1 ea Water Heater 05/02/2016 $37.52 1 12%State Surcharge- 05/02/2016 $76.56 Plumbing Total $714.56 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit , ill e sire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requir>. yo to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 001 6090. You may obtain a copy of the rules or direct questio s_o OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: A..._)GPermittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspects i date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application 1 5&4,..looL a ,`,_ . • , Building Fixtures �� IC) FOR 01 FI( h: t SF O' I.l City Of Tigard ` Q\6 Date/By: ',Agri, /ilv j j Permit No.: 141 i 01 /, a Iii III 13125 SW Hall Blvd.,Ti 9722 �- �'y Plan Review �1 / I Phone: 503.718.2439 F x: 503R561j 0 t19`�' Date/By: Other Permit No.:fi ,ato`f,_.,cxj/ I I t :�I:a Inspection Line: 503.639.4175 1N �'``'�`�t�C�,`o Date Ready!: . / orris: la See PPaaggee'2 fortr Internet: www.tigard-or.gov 0 s\ Notified/Me rod: • f 1 ' /" T Supplemental Information e .q Nf, r .x, ad},,ri:, h$ § 'p,x k "` 6 x. ,yB:: ,4k, "r xpy� " t'L 3.+ yt' T, If*P'+y�'.s '; - is .e,y,+; :�. Rt . t - �s € Baru ,v 0.� r 6 ..4 ,r te, .: 0 New construction SZ51111 Demolition For special information use checklist _ Description Qty. Ea. I Total IIDAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) '. ,. _ ".,, Et . - 0 .i n ' ..-:.:4W...41,'''..',-*,R=>- SFR(I)bath 312.70 0 1-and 2-family dwelling 1 'ommercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 FIVS"- r''''::”t 44 , evm k a�I uwr VSite utilities. `. , .. s, , -,, Job site address: t (:),1 t j Cj S(,,.� W c\ )tn\,,,S g 4 L3�,,, � Catch basin or area drain 18.76 City/State/ZIP: G•� Drywe11,leach line,or trench drain 18.76 1Footing drain(no.linear ft.:_) Page 2 _ Suite/bldg./apt.no.: Project name: _ r Zi Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Stone sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 r :" 91ti'TiON OF '",v� "`'� r�f .: Backwater valve 12.51 ;LA�. ,. - - t- c' c .:.:.'... ,--L---- .�..,.. s . __�.._- -� ^^� r <,. .., � * "` "'"'-` Clothes washer 25.02 � � ij& ' ) Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 § vm r " ' Expansion tank A 12.51 !�-S1 Fixture/sewer cap /...-'-'79. 25.02 .7 S ci ti: Name. - Floor drain/floor sink/hub ,/ L{ 25.02 ?e,t �V Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice makera, ( ( 12.51 ( *oNrAc1 i` k Interceptor/grease trap I 25.02 ,2..(OX Business name: ;elm et S L, _,I � Medical gas(value:$ ) Page 2 O� Primer 14 12.51 5),o L,, Contact name: Roof drain(commercial) 12.51 Address: _ Sink/basin/lavatory ,/' 7 25.02 /'5-f y City/State/ZIP: Solar units(potable water) 62.54 r Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 circ x �� �mrw3) r * t q a + 'y ); k Water closet ./r-2_ 25.02 s--0..0q "��' °� , � � °'o �` `7,-,:''t.,-14 Water heater ( 37.52 f 2 S'„1., Business name: Pv-‘,\/\7.=CRD ) L4 i, 1 Water piping/DWV 56.29 Address: :-/-?(.)_/JCiX e2Z ci tp`i Other: 25.02 City/State/ZIP: Uco✓kcApc.rvQ-J- Wts 9,$,Cc - - Subtotal 637 Phone:(S 6Q ")7Zy a It-4 61 Fax:(‘;(,O) 85 ei LIS- I.1 Minimum permit fee: $72.50 93 1 3 I I1 P Plumbing Lic.no.: ?g5'73 7 //7 Plan review (25%ofpernit fee) CCB Lic.: / r )�� State surcharge(12%of permit fee) Authorized signature: _ TOTAL PERMIT FEE' )/41 JZ This permit application expires if a permit is not obtained within 180 days Print name:X.41>� � „.11„.4,,,,,,_ Date:z,(..//-2,.7/e, after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I.Building Permits,PLMIJ-PermitApp.doe 10 01 09 440-4616T(10,02 COM,WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: r�. Residential Fire Suppression S stems: Footing drain-1" 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service- 1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 ".."4"r" '�f aha z , Storm&Rain Drain-1st 100' 62.54 �4° ".K. '. � $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for e € ,; each additional$100.00 or fraction thereof,to ,�. _... �; : , ,-,�. ,�b'-�,� ,.z"'- _ K and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fees 90.00/hr and including$50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minimum charge 1/2 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. tr (�Xgg #+pqg Y Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font 0 Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive as defined in OAR9 1 8-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 8 ` _ /� �- ns�a ,t �,, l LKOil 4 ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) 7�'y/ t//b �{ ky;�, w/ Rec.Vehicle Dump Station l Shower: -Gang J � a k -Stall . QU 111w4 o'St.�c..do 3p' a Sink: -Lav/Bar non-food related • 4 O -Bradley -Coni/Sery/Util food related 2 ,/ -Service 't / *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet 'W 1 2- plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Pennits\PLMF_PermitApp.doc 08/04/2011 2 Debbie Adamski From: Debbie Adamski Sent: Thursday, April 28, 2016 1:33 PM To: Tom Whitaker<twhitaker@zoup.com> (twhitaker@zoup.com) Cc: #Building Permit Technicians Subject: FW: Tigard SDC fees waived email Attachments: Zoup! Sewer SDC's.pdf Tom, Your plumber, Mike with Manzco Plumbing, was in and changed the size of the floor drains from 3" to 2". This greatly reduced the Sewer System Development Charges from $17,850.00 to $10,506.00. Please see the attached revised Sewer Tally Worksheet. Again, this fee must be paid before the plumbing permit can be issued. Let me know if you have any questions on it. Debbie Adamski Senior Building Permit Technician City of Tigard I Community Development 13125 SW Hall Blvd.,Tigard, OR 97223 503-718-2450 From: Debbie Adamski Sent: Thursday, April 28, 2016 7:54 AM To: Tom Whitaker' Cc: #Building Permit Technicians Subject: RE: Tigard SDC fees waived email Tom, Below are the types of System Development Charges (SDC) that are assessed on commercial projects. Washington County Transportation Development Tax (this is Washington County tax) Tigard Parks Development Charge (this is a City of Tigard tax) Sewer System Development Charge (this is Clean Water Services charge, they oversee/maintain the sewer& storm systems in Washington County) Per Albert Shield's previous correspondence: "Since the building is over 20 years old there is a 75%discount on the Transportation Development Tax(TDT) bringing that charge down to $4,624. There will be no Parks SDC charge because the estimated number of employees will decrease.", you were charged, and paid,the $4,624 for the Washington County Transportation Development Tax. There were no charges for the Tigard Parks Development Charge. These fees were collected with the permit fees on the building permit. The Sewer System Development Charges are assessed and collected with the plumbing permit. This charge is determined by the impact a new, additional plumbing fixture has on the sanitary sewer system. Each plumbing fixture has a value point, determined by the impact it has on the sewer system. When the plumbing permit is applied for we create a sewer tally worksheet to calculate the Sewer System Development Fee for the work being permitted. I have attached a revised Sewer Tally Worksheet where I was able to remove the 3-compartment sink as it drains into a floor sink. Clean Water Services does not charge for the 3-compartment sink when it drains indirectly into another fixture. So 1 that made a minor change. If there is any way you can reduce the number of fixtures or sizes of the floor drains that would reduce your SDC fee. Let me know if you have any questions. Debbie Adamski Senior Building Permit Technician City of Tigard I Community Development 13125 SW Hall Blvd.,Tigard, OR 97223 503-718-2450 From: Tom Whitaker [mailto:twhitaker(azoup.com] Sent: Thursday, April 28, 2016 6:12 AM To: Debbie Adamski Subject: Fwd: Tigard SDC fees waived email Hi Debbie See below. This is one of the communications that the architect had with the city which led to me only budgeting for the $4634 for impact fees. Would it be possible to confirm that I am not already paid in full for all my permit fees/impact fees? All the best, Tom Whitaker FranchiseOwner ofAWARD-WINNING SOUP,SALAD AND SANDWICHES 10140 S.W.Washington Square Rd.Tigard,OR 97223 503.505.2400 direct twhitakert zoup.com ,'J � TOVN ,R N Mlff7 a , Forwarded message From: Dan Barney<dan a,arkinetics.com> Date: Thu, Apr 28, 2016 at 5:59 AM Subject: Tigard SDC fees waived email To: Tom Whitaker<twhitaker@zoup.com>, Jim Silvis<jim.silvis(aalegisconstruction.corn> Cc: Darell Nelson <dnelson@arkinetics.com>, "Robert Kirma(robert(a,zoupco.com)" <robert(&,zoupco.com>, Maria Green <maria@zoupco.com> All, See attached email from the city that indicates the SDC fees are being waived. Dan Dan Barney, AIA principal I architect 2 director of design arkinetics architects + urbanists 3723 Pearl Road Cleveland, OH 44109 216-749-7800 phone 216-749-1300 fax www.arkinetics.com We're looking for Good People to join our team! Learn more Please click here for our confidentiality note and electronic message terms. Forwarded message From: Darell Nelson<dnelson@arkinetics.com> To: Robert Kirma<robert(aizoupco.com>, Tom Whitaker<twhitaker@zoup.com> Cc: Dan Barney<dan@arkinetics.com>, Vince Boccardi <vboccardi@arkinetics.com> Date: Thu, 19 Nov 2015 14:19:15 +0000 Subject: FW: Tap and Impact Fees Good morning Tom/Robert, See attached and below comments from theermit coordinator about the impact fees for Zoup! Tigard. p P p g With regards, Darell Darell Nelson, NOMA architectural designer arkinetics architects + urbanists 3723 Pearl Road Cleveland, OH 44109 216-749-7800 phone 216-749-1300 fax www.arkinetics.com We're looking for Good People to join our team! Learn more Confidentiality Note: This message is generated by Arkinetics, Inc. This message and any files transmitted with this message are confidential and intended for use only by the individual or entity to which it is addressed. If you are not the named recipient of this message (1) please immediately notify Arkinetics, Inc., Attn: Darell Nelson at(216)749-7800, and (2) you may not copy, duplicate or otherwise make this message or any files transmitted with it available to anyone without the written consent of Arkinetics, Inc. Electronic Material Note: Because Arkinetics cannot control the procedures used in connection with the retrieval or possible modification of the data contained in the electronic files transmitted with this message, Arkinetics does not guarantee the accuracy or completeness of such data. Any attached files are being supplied to you for informational purposes only, and in the case of architectural design files, layouts, or plans (collectively, "Design Documents"), are not intended to replace the printed versions of such Design Documents transmitted to the recipient by means other than electronic mail. In the case of any use or reuse of such Design Documents by the recipient of this message, agents of the recipient, consultants or agents of consultants or other parties without the review and written approval of Arkinetics, (1)such use shall be at the sole risk of the user, and (2) such user, by using such Design Documents will be deemed to have agreed to defend, indemnify, and hold Arkinetics harmless from all claims, injuries, damages, loses, expenses, and attorney's fees incurred by Arkinetics as a result of such use. 3 From: Albert Shields [mailto:albert@tigard-or.gov] Sent: Wednesday, November 18, 2015 9:30 PM To: Darell Nelson <dnelson@arkinetics.com> Cc: #Building Permit Technicians <TigardBuildingPermits@tigard-or.gov> Subject: RE: Tap and Impact Fees In that case I believe that the correct address should be 10140 SW Washington Square Rd. with the previous tenant being "Color Me Mine." Since the building is over 20 years old there is a 75% discount on the Transportation Development Tax (TDT) bringing that charge down to $4,624. There will be no Parks SDC charge because the estimated number of employees will decrease. I've attached a copy of my worksheets. Please let me know if you have any other questions. Albert Shields Permit Coordinator DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 4 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT III r Request for Permit Action -I-I(i A R 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 111 Applicant PA. 'ontractor ❑ City Staff Check(V)one REFUND OR Name: INVOICE TO: (Business or Individual) \Nc.)Qn V\ .rT\ c Mailing Address: P D• ‘ :: V,04-4 City/State/Zip: .! A , q S---- Phone No.: oO - a 1`ig PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): • _A k, ,L/VOID PERMIT APPLICATION. Si, REFU ' ERMIT FEES (attach copy of original receipt and provide explanation below). mi IN I TOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: PL,( oqO/ .7 —MA 302. Cid.2ogrj/6 .ae/a,5- Site Address or Parcel #: 70/V0 S ) 1 ,'/,VC7// s&. /2.6 Subdivision Name: Lot #: EXPLANATION: /e ms Qi /. 6.o-7/e, ..J/1�} /`✓S L.. 00td Signature: Cj. )�l.Q-rV&,a-kit Date: 67////ct, Print Name: 1 e(]3(')) f- 2-. CA40 -i !<,I Refund Policy I. The city's Community Development Director,Building()fficial or City I Ingineer may authorize the refund of • ,Any tee 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. i /(e _ 7c, o , ,' y /a r . 07 / 9`71 • bs Route to Sys Admin: Date By Route to Records: Date ‘ 3 /k, By- Refund Processed: Date a, By Invoice Processed: Date By Permit Canceled: Date Ai `f Parcel Tag Added: Date By I:ABuilding\I4orms\RegIermtt Action_(92314.doc 14 li TIGARD City of Tigard June 3, 2016 Manzco Plumbing PO Box 822964 Vancouver,WA 98682 Re: Permit No. PLM2016-00232 Dear Applicant: The City of Tigard has processed a refund for fees on the above referenced permit(s) as follows: Site Address: 10140 SW Washington Square Rd Project Name: Zoup Job No.: N/A Refund: ® Check#221203 in the amount of$84.07. ❑ Credit card"return" receipt in the amount of$ . 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: Plumbing fixtures reduced from 8 to 5 2-inch floor drains resulting in a refund. If you have any questions please contact me at 503.718.2430. Sincerely, ,,&,S1 )71,7,0 .C___> Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov 1111 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: Manzco Plumbing DATE: 5/26/2016 PO Box 822964 Vancouver,WA 98682 REQUESTED BY: Dianna Howse DA TRANSACTION INFORMATION: Receipt#: 403583 Case#: PLM2016-00232 Date: 5/2/2016 Address/Parcel: 10140 SW Washington Sq Rd Pay Method: CreditCard Project Name: Zoup EXPLANATION: Refund difference after reduction in the number of plumbing fixtures from 8 to 5 2" floor drains. REFUND:INFORMATION: Fee Description"From Receipt Revenue'Account No. lkftikd Example: Building Permit Fee Example: 2300000-43104 Plumbing Permit Fees 230-0000-43101 $75.06 12%State Surcharge 100-0000-24001 9.01 TOTAL REFUND: $84.07 APPROVALS: SIGN TU S D• TE: If under$5,000 Professional Staff �o ft 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 ONLY Case Refund Processed: Date: /_ ,/f/G By: .42/2Y----- 1 41: \Building\Refunds\RefundRequestdoc x 09/01/2010 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10140 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Commercial - Plumbing 399 Plumbing final PASS - No C of O PLM2016-00232 Don Sylvester Violation Summary: Inspector Contractor