Permit Support Document (32) ,
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City of Tigard f, COMMUNITY DEN'EL()PMENT DEPARTMENT
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Request for Permit Action
TIGARD 13125 SW Hall Blvd. ° Tigard,Oregon 97223 ° 503-718-2439 ° \
TO: CITY OF TIGARD V fl 1 D
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223 ///7//e
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPertnits@tigard-origov
FROM: gr Owner D Applicant Ej Contractor D City Staff
Check(1)one
REFUND OR Name:
INVOICE To: (finainei,i;or Individual) D.R. Horton, Inc. - Portland
Mailing Address: 4380 SW Macadam Ave, Suite 100
City/State/Zip: Portland, OR 97239
Phone No.: 503-222-4151
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (V'):
C.ANCFI./V011) tIRNI IT \PPlJCAi ION,
REFFINI) PI IR NI IT I r] (attach copy of receipt and provitic explanation below).
INV<)1cl I.:I.:1,1s 1)1 I'. (attach case flee schen:Jule and provide explanation below).
R I.N40 TI/R['PLACE 'ONI ON PliIRNIFF (do not caned permit).
Permit: 4:
Site Address or Pared if:l'i 1m. :77, t,-.2 pt",24irova-
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EX P LANAT ON: Ws Hirsan onuct instalit129 ritlation cal itis lot rind 15 irriqstion removed from
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Refund Processed: Datn7"g3 4,,F- By -,—"Invoice Processed: Date By
Permit Canceled: Date//f B -f;.• arcel Tag Added: Date By
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TIGARD
City of Tigard
March 1,2018
D.R. Horton, Inc.
Attn: Mark Grismer
4380 SW Macadam Ave.,Suite 100
Portland, OR 97239
Re: Permit No. PLM2016-0052' > C
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 15547 SW Applewood Ln.
Project Name: Heritage Crossing,Lot 48
Job No.: N/A
Refund Method: ® Check#227702 in the amount of$64.96.
0 Credit card"return"receipt in the amount of$
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$
Comment(s): Per applicant's request as job was cancelled. Refund 80%of permit fees.
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 • www.tigard-or.gov