PFI2016-00062 a
City of Tigard
July 29, 2016
Venture Properties, Inc.
4230 Galewood St., Suite 100
Lake Oswego, OR 97035
Re: Permit No. PFI2016-00062
Dear Applicant:
The City of Tigard has processed a refund for the deposit of fees on the above referenced
permit for the following:
Site Address: 15435 SW Hall Blvd.
Project Name: Heritage Crossing
Job No.: N/A
Refund: ® Check#221896 in the amount of$54,347.00.
❑ Credit card "return" receipt in the amount of$
❑ Trust account"deposit" receipt in the amount of$
Notes: Refund customer deposit after grading permits issued.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 0 www.tigard-or.gov
M1 City of 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: Venture Properties, Inc. DATE: 7/22/2016
4230 Galewood St., Suite 100
Lake Oswego, OR 97035 REQUESTED BY: Dianna Howse
AD
TRANSACTION INFORMATION:
Receipt#: 404528 Case#: PFI2016-00062
Date: 6/16/2016 Address/Parcel: 15435 SW Hall Blvd
Pay Method: Check Project Name: Heritage Crossing
EXPLANATION: Refund customer deposits after grading permits issued.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Customer Deposit 100-0000-22000 $27,475.00
Customer Deposit 100-0000-22000 $26,872.00
TOTAL REFUND: $54,347.00
APPROVALS: SIGNATURES/DATE:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager 7•.2S-Zo f(-
If over$50,000 Local Contract Review Board /✓��'
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: ,6 B y7.
l:\Building\Refunds\RefundRequest.doc x 09/01/2010
City of Tigard • COMMUN4TY DEVELOPMENT DEPARTMENT
r
Request for Permit Action
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 TigardBuildingPern-tits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor City Staff
Check(✓)one + �•
REFUND OR Name:
INVOICE TO: (Business or Individual)
Mailing Address:
City/State/Zip: _ � Qr 'r
Phone No.: •� � '�� 7
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
CANCEL/VOID PERMIT APPLICATION.
REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #:
Site Address or Parcel#:
Subdivision Name: Lot #:
E P ION:
Signature: Date: °�..�i ✓f�j
Print Name:
Refund Policy
1. The city's Community Development Director,Building Official or City Ungineer 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.
Route to Sys Adntin: Date By Route to Records: Date'//---'9,11k., I B
Refund Processed: Date' a / By voice Processed: Date B
Permit Canceled: Date B Parcel Tag ridded: Date B
I:\Building\Forms\RcgllcrmitAction_l -314.doc