PFI2017-00023 VOIDED
PFI2017 - 00023
BCS
DEVELOPMENT
a
City of Tigard
April 4,2019
BCS Batiment LLC
19705 SW 65'Ave
Tualatin, OR 97062
Re:Permit No. PFI2017-00023
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: 13185 SW 115''Ave
Project Name: BCS Development
Job No.: N/A
Refund: ® Check#231671 in the amount of$3,997.00.
❑ Credit card"return"receipt in the amount of$
❑ Trust account"deposit"receipt in the amount of$
Notes: Refund remaining cash assurance deposit for one year maintenance bond.
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 9 503.639.4171
TTY Relay: 503.684.2772 a www.tigard-or.gov
City of Tigard
M 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 forPermitAction 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: BCS Batiment LLC DATE: 3/28/2019
19705 SW 65d Ave
Tualatin, OR 97062 REQUESTED By. Dianna Howse
BB
TRANSACTION INFORMATION:
Receipt#: 412507 Case#: PF12017-00023
Date: 8/24/2017 Address/Parcel: 13185 SW 1151h Ave.
Pay Method: Check Project Name: BCS Development
EXPLANATION: Refund remaining assurance deposit for one year maintenance bond.
Customer Deposit 640-0000-22000 $3,997.00
TOTAL REFUND: $3,997.00
APPROVALS: SIGNATURES E:
If under$5,000 Professional Staff
If under$12,500 Division Manager
If under$25,000 Department Manager
If under$100,000 City Manager
If over$50,000 Local Contract Review Board
Case Refund Processed: Date:. S By:
1:\Bading\Reftmds\RefundRequest.doc x 09/01/2010
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Request for Permit Action
13125 SW Hall Blvd. • Tigard. Oregon 97223 • 503-718-2439• www.ti,ard-or_�_,ov
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:
Check one ❑ Owner ❑ Applicant ❑Contractor ®City Staff
REFUND OR Name:
INVOICE TO: (Business or Indi%idual) `editlyll Kjenlpef"
Mailing Address: 19705 SW 65th Ave.
City/State/Zip: Tualatin,OR 97062
Phone No.: (541)337-8306
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (V):
EICANCEk/VOID PERMIT APPLICATION.
®REFUND P*RMIT FEES (attach copy of original receipt and provide explanation below).
._❑iNVOWT FOR FEES DUE (attach case fee schedule and provide explanation below).
❑REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit).
Permit#: PF12017-00023
Site Address or Parcel #: 13185 SW 115th Ave.
Tigard,OR 97223
Subdivision Name: 13185 SW 115th Ave. (BCS Development) Lot #:
EXPLANATION: Return customer remaining assurance deposit in the amount of 3,997.00.
This is the final remaining balance of customer one-year maintenance bond.
Signature: x-0-4 W e'&==== Date: 3/7/2019
Print Name: Brady R. Bullinger
Refund Policy
1. The city's Community DeN elopment 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.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
1. Please allow 3-4 weeks for processing refund requests.
*For Office Use Only*
Route to Sys Admin Date,T t p By: Route to Records ` By:
7 •v( 077
Refund Processed Dat 2Y By: Invoice Processed ate By:
Permit Canceled Date`!r 3- By',Co��C Parcel Tag Added Date By:
a
City of Tigard
November 20, 2017
BCS Batiment,LLC
Attn: Bruce Sinkey
19705 SW 65th Ave.
Tualatin, OR 97062
Re: Permit No. PFI2017-00023
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: 13185 SW 115th Ave.
Project Name: BCS Development
Job No.: N/A
Refund: ® Check#226725 in the amount of$30,000.00.
❑ Credit card "return"receipt in the amount of$
❑ Trust account"deposit" receipt in the amount of$
Notes: Refund partial release of bond in the amount of$30,000.00. Retain balance of bond
in the amount of$9,975.00 until conditional acceptance and maintenance bond is returned.
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
Community Development
WILL CALL/PICK UP
Fill out this form completely and attach it securely to the
document(s). Bring it to the WILL CALL/PICK UP
area at the Permit Center Counter and file alphabetically by
last name of individual or company name.
TO: 134A
COMPANY NAME:
DOCUMENT NAI\IE:
I
FROM: 05L—
DEPARTMENT:
DATE TO WILL CALL:
FEES DUE: .-16
ATTACH FEE INFORMATION(ACCOUNTS,PERMITS,COPIES,ETC.)
Document will be returned to the originator if not picked up
within 5 business days of e DA TO RLL CALL",
RECEIVED BY: J r
I
MUST BE SIGNED BY THE PERS •ED AB VE
RECEIVED DATE:
DATE RETURNED TO ORIGINATOR: ZD
1:\Building',Forms\KtcSlip-\I'i11Call.doc
_ 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: BCS Batiment,LLC DATE: 11/6/2017
19705 SW 65`h Ave.
Tualatin, OR 97062 REQUESTED BY: Dianna Howse
JG
TRANSACTION INFORMATION:
Receipt#: 412507 Case#: PFI2017-00023
Date: 8/24/2017 Address/Parcel: 13185 SW 115,h Ave.
Pay Method: Check Project Name: BCS Development
EXPLANATION: Refund partial release of bond in the amount of$30,000.00. Retain $9,975.00 until
conditional acceptance and maintenance bond is returned.
REFUND INFORMAMN: r �=
Fee Description From Receipt Revenue Account No. Refund
;xam le: .BtL1l~din Permit Fee Exam le: 2300000-43104 $Amount.
Customer Deposit 100-0000-22000 $30,000.00
TOTAL REFUND: $30,000.00
APPROVALS: SIGNATURES/DATE:
If under$5,000 Professional Staff
If under$12,500 Division Manager 0
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTE MINISTRATION USE ONLY
Case Refund Processed: Date: B
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
CITY OF TIGARD RECEIPT
It 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
Project Name: BCS Development
Site Address: 13185 SW 115TH AVE
Receipt Number: 416583 - 04/06/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PF12017-00023 $-30,000.00
Total: $-30,000.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 226725 DHOWSE 04/06/2018 $-30,000.00
Payor: BCS Batiment, LLC
Total Payments: $-30,000.00
Balance Due: $30,000.00
Page 1 of 1
\ 1
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
Project Name: BCS Development
Site Address: 13185 SW 115TH AVE 62
k16/ L / n L—
Receipt Number: 412507 - 08/24/2017
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
PF12017-00023 Customer Deposit 100-0000-22000 $39,975.00
Total: $39,975.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 4005 SWARREN 08/24/2017 $39,975.00
Payor: BCS Batiment LLC
Total Payments: $39,975.00
Balance Due: $0.00
Page 1 of 1
City of Tigard • COMMUNITS' DEVELOPMENT DEPARTMENT
Request for Permit Action
13125 Six' Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • \;,,w\%,.tigato -d or.gov
TO: CITY OF TIGARD
Building Division
13125 Six'Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor kf City Staff
Check(V')one
REFUND OR Name:
INVOICE TO: (Business or Individual) 13C-5
Mailing Address: �R 7�?!�' 5t-j 6t�
City/State/Zip: Q Wx , 64 q-704r
Phone No.: 0—G3—(4
19- 7070
PLEASE TAKE ACTION FOR THE ITEMS) CHECKED (✓):
❑ ANCEL/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#: Pl:�I a2O 1-7- 6002 3
Site Address or Parcel #: 1 a 1 gs- sw Ils-
Tillawd, 09
Subdivision Name: /3/f5- St-3 llst- Avg` 3-Lo7- PZA Lot#:
EXPLANATION: boo Paf1:a 1 ke Ira's e. 6t -1 3o,000.00.
&aa 7s.o o �d>~�. 1\elot ear t-
c KC e aka 4i 4KCt 98 KJ iS re A,enrol
Signature: Date: Job 1 // 7
Print Name:
Rcfund Policv
1. The city's Community Development Director,Budding Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80`O 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. ]'lease allow 3-4 weeks for processing;refund requests.
Route to Sties Admin: Date B• Route to Records: Date �� B
Refund Processed: Date Bt' Invoice Processed: Date B),
Permit Canceled: Date Bx —Parcel Tag.added: Date lav
I:\Building\I;orms\RegPcrmit-iction_I1)2314.doc
VOIDED
PFI2017 - 00023
BCS
DEVELOPMENT
q
City of Tigard
March 1, 2018
BCS Batiment
19705 SW 65'Ave.
Tualatin, OR 97062
Re: Permit No. PFI2017-00023
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: 13185 SW 115`"Ave.
Project Name: BCS Development
Job No.: N/A
Refund: ® Check#227683 in the amount of$5,978.00.
❑ Credit card "return"receipt in the amount of$
❑ Trust account"deposit"receipt in the amount of$
Notes: Refund deposit for work completed for public improvements;project moving into
maintenance period;retain $3,997.00 as 10%maintenance assurance.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Kil;l
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
i
c of 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 ReguertforPermit 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: BCS Batiment DATE: 2/23/2018
19705 SW 65 b Ave.
Tualatin, OR 97062 REQUESTED BY: Dianna Howse
TRANSACTION INFORMATION:
Receipt#: 412507 Case#: PFI2017-00023
Date: 8/24/2017 Address/Parcel: 13185 SW 115th Ave.
Pay Method: Check Project Name: BCS Development
EXPLANATION: Applicant completed construction of public improvments and project is moving into
maintenance period. Refund$5,978&retain$3,997 as 10%maintenance assurance.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Customer De osit 100-0000-22000 $5,978.00
TOTAL REFUND: $5,978.00
APPROVALS: SIGNATU 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
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM AD INISTRATION USE ONLY..
Case Refund Processed: I Date:
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
City of Tigard • COMMUNITY DEVELOP-HENT DEPARTMENT
Request for Permit Action
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • x%.A,-%v.tigard-or.gcv
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 Applicant ❑ Contractor Ci Staff
❑ ❑ PP t3'
Check(,/)cmc
REFUND OR Name:
INVOICE TO: (Business or Individual) i3es Q aj� w ev%,4--
Mailing Address: I'110 S L3 G g
City/State/Zip: '7uQ 14�,L�.. D Q?o(,c
Phone No.: 503- 4 M - 7070
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (�):
PERMIT APPLICATION.
KANCEL/VOID
EFUND 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#: W/c2o) 7-000 2 3
Site Address or Parcel #: 131 V5 SQ //3 t; 4.,rG.
Subdivision Name: +c- 3-6 Lot#:
EXPLANATION: Awlxa&,. kotS 14 Coyis ki uc ko o F PhbI%C-
n vtt'nt r# e c i m4.'n f P m KCe.. Plege regLk
3 ? .vo !o%, ;Jer4kc-e !4S yurtc
Signature: Date:
Print Name:
Refund Policy
1. "I'he city's Community Development Director,Building Official or City l;ngineer 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.
ItmajostummmW
Route to S Ts admin: Date By Route to Records: Date B
Refund Processed: Date a a- /f-- By y Invoice Processed: Date By
Permit Canceled: Date /(//`,f B Parcel Tag added: Date B
1:\Building\I orms\i:c-ql"cnTit:kction_(192314.doc