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Permit (126) 1111 q S TIGARD City of Tigard January 28, 2020 Rudnick Electric Signs 1400 SE Township Rd Canby, OR 97073 Re: Permit No. BUP2019-00238 Dear Applicant: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 15700 SW Upper Boones Ferry Rd Project Name: Best Western Plus Job No.: N/A Refund Method: ® Check#234514 in the amount of$120.54. ❑ Credit card "return"receipt in the amount of$ 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 IN o 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: Rudnick Electric Signs DATE: 1/17/2020 1400 SE Township Rd Canby, OR 97073 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 425669 Case#: BUP2019-00238 Date: 9/5/2019 Address/Parcel: 15700 SW Upper Boones Ferry Pay Method: CreditCard Project Name: Best Western Plus EXPLANATION: Per applicant's request as customer cancelled job. Refund 80%of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Building Permit 230-0000-43104 $107.63 12%State Surcharge 100-0000-24001 12.91 TOTAL REFUND: $120.54 APPROVALS: SIGNATU ES/DATE: 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 FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: 9/3/21 By: 4/e I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT ". 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Best Western Plus Site Address: 15700 SW UPPER BOONES FERRY RD Receipt Number: 436198 - 09/03/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID BUP2019-00238 $-120.54 Total: $-120.54 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 234514 DHOWSE 09/03(2021 $-120.54 Payor: Rudnick Electric Signs Total Payments: $-120.54 Balance Due: $120.54 Page 1 of 1 . 11114 CITY OFfIG ,RD RECEIPT r 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGAPD Project Name: Best Western Plus Site Address: 15700 SW UPPER BOONES FERRY RD 0g-(CAA/ Receipt Number: 425669 - 09/05/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID BUP2019-00238 Permit Fee-Additions,Alterations, 230-0000-43104 gt' ` $134.54 Demolition BUP2019-00238 12%State Surcharge-Building 100-0000-24001 cP.''i1 $16.14 .� BUP2019-00238 Info Process/Archiving-Sm$0.50(up to 230-0000-43135 $3.00 11x17) Total: $153.68 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 5527075 PUBLICUSERO 09/05/2019 $153.68 Payor: Total Payments: $153.68 Balance Due: $0.00 Page 1 of 1 REOMVFO City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENIOV '1 9 2019 RIt , ,,!Piequest for Permit Action BUILDING' UIVI ION TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD \/ 1) I [ Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 ///0/20 ZO Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ,❑pplicant ontractor ❑ City Staff Check(✓)one REFUND OR Name: C INVOICE TO: (Business or Individual) �,�rO,C ,` �+1 C 4.-Vv:e.. S R Ir..`b Mailing Address: let S€ - ov. 'Z�._ City/State/Zip: Cam, e 3 Phone No.: _ 7i., —.-(o� p 1�� PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): Q' 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 nation below). Permit#: 4W20 1(31-o0 2-14)° P---t-eafLit--e Site Address or Parcel#: rtC�3 Project Name: 12es L5.c\. 7kOS Subdivision Name: Lot#: EXPLANATION: btdV1e c e2 - s\ NS.nc\�t\ea ¶c - Signature: Date: iOnt — A- Ze Print Name: .� Refund Policy 1. The city's Community Development 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. 3. Please allow 3-4 weeks for processing refund requests. _ •9/ /3e/S% - !d�� 9 _ • .3. ia.3 . FOR OFFICE USIA ONLY Route to Sys Admin: Date By Route to Records: Date V// y/ / By .f Refund Processed: Date f 1 2.0 By ' / Invoice Processed: Date By Permit Canceled: Date / to 2420 B. / Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction 2051 .doc CITY OF TIGARD BUILDING PERMIT • COMMUNITY DEVELOPMENT Permit#: BUP2019-00238 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/05/2019 'FIG A I.L7 g Parcel: 2S112DD01000 Jurisdiction: Tigard Site address: 15700 SW UPPER BOONES FERRY RD Project: Best Western Plus Subdivision: None Lot: None Project Description: A 69 sq.ft.illuminated sign on north-facing wall. Contractor: RUDNICK ELECTRIC SIGNS LLC Owner: BHGAH TIGARD LLC 1400 S TOWNSHIP RD 5895 JEAN RD STE 100 CANBY,OR 97013 LAKE OSWEGO, OR 97035 PHONE: 503-263-3600 PHONE: FAX: 503-263-4617 Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 09/05/2019 $134.54 Demolition Occupancy Grp: R-2 Occupancy Load: 0 12%State Surcharge-Building 09/05/2019 $16.14 Dwelling Units: Plan Review 08/28/2019 $87.45 Stories: Height: ft Info Process/Archiving-Sm$0.50(up to 09/05/2019 $3.00 Bedrooms: Bathrooms: 11x17) Value: $4,000 Floor Areas: Total Area: Accessory Struct: Basement: Carport: Covered Porch: Deck: Garage: Mezzanine: Total $241.13 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: ATarm: trrool Smoke Detectors: Manual Pull Stations: Accessible Parking: 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 OAR952 01-0090. You may obtain a copy of the rules or direct questions to OUNC by callin. • 232.1987 or Issued By: /`4d4a P• ittee Signature: Ain Call 503.639.4175 by 7:00 a.m.for the next available insp ction date:•. This permit card shall be kept in a conspicuous place on the job site until • pletion)of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application Commercial 1014OFFi("I:l SF,()NI.l City of Tigard eived City g I By: �j' Permit No.: �t 0 Lt+ 3 'e r 13125 SW Hall Blvd.,Tigard,OR 97223 E �l r/ /1 r I am{ �" C(3). L _ ¢ an Reviewp J Related Permit: j,,,. u Phone: 503-718-2439 Fax: 503-598-1960 DateBy: _17 S' �(.t44a0i 1- 1gi5 I .. ,�7 Inspection Line: 503-639-4175 9010 Date Ready/By: Juris: B See Page 2 for Internet: www.tigard-or.gov AUG 2 8 Noti : Method: 1, Supplemental Information _ ma aRD ��. —.. Ili_ r ,. TYPE OF WORK r U►1©1NG twist() REQUIRED DATA. =AND 2-FAMILY DWELLING New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 0 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 0 1-and 2-family dwelling m Commercial/industrial ❑Accessory building ❑Multi-family Number of bedrooms: ❑Master builder 0 Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: ,�j New dwelling area: square feet Job site address: le-5-3c .:, t...:4_,,-__\_, ���� (� 1 jCx,rLP`� _ City/State/ZIP: ;` 0 cs-f`ca C, j" -S Garage/carport area: square feet Suite/bldg./apt.#: Project name: K , ?,‘,3V o oc,,C Covered porch area: square feet Cross street/directions to job site: Deck area: square feet .... - _ - - -- r, e Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot#: Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all Tax map/parcel#: equipment,materials,labor,overhead,and the profit for the r ``DESCRIPTION.OF"WORK " work indicated on this application. ,1`qc -r \t ,rt r�\jt cJ N 'LI-L..< ,n4A c,, y ,0_L Sf� Valuation: $ �Ci �1Cla �/ ` X 12'c.‘, ., /I., �C'1.s L►- Existing building area: square feet New building area: square feet "PROPER Y , , " 1 ENAI(1T Number of stories: Name: V\t �'c C,,C' Type of construction: Address: 1S-4i�`" , C , k(- 004.-\_e`- Occupancy groups: v City/State/ZIP: "�•c .� 2 ( 9.1.(25- !1.0 `J Existing: Phone:( ) Fax:( ) New: APPLICANT : :. J CONTACT PERSON BUILDING PERMIT FEES* refertofeesched ) Business name: `�� �� ���?*� c k PC-, �ns Lc.C- Structural plan review fee(or deposit): Contact name: C Av 1 A- N-kC E FLS plan review fee(if applicable): Address: 1`-A0,c) �E__ \,5„,1g4.`,v �� Total fees due upon application: / I •Li City/State/ZIP: CA i. .( C) 'q•b t Amount received: _.Phone:(�'3) --- - Email c y - PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* �.C v Ci`t �i t�E'LSC`K c r - ,Cc, 7_, Commercial and residential prescriptive installation of _ ,,.-, RACTOR ". roof-top mounted PhotoVoltaic Solar Panel System. with connection details Submit two(2)sets of roof plan Business name: 2L- A C 1,-.. `r r, �.�,s� [ and fire department access,along with the 2010 Oregon Address: 1 Lkck, ‹.-,:,:c ---co,,,-,,L, `, Solar Installation Specialty Code checklist. 1 Ca�Z-1 o '� Permit fee(includes plan review City/State/ZIP: $180.00 and administrative fees): Phone:(,-- C,,2,_ ) - 2e, � Fax:( . 5) -?L 5•- 4L,11 State surcharge(12%of permit fee): $21.60 CCB Lic.: 1`e.) , CS�cb Total fee due upon application: $201.60 f — Authorized signature: F"—r-----"--r" � This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: o.kh E'�E✓C,Z Pa e: IV . 2 _ 7,(c\ * Fee methodology set by Tri-County Building Industry Service Board. d 441 e.---4.s'.,- .1 I:\Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2011d440-4613T(11/02/COM/WEB) City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT q Accessibility: Barrier Removal Improvement Plan Commercial & Multi-Family - Additions or Alterations TIC'ARD 13125 SW flail Blvd. •Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov REQUIREMENT: OREGON REVISED STATUTE (ORS)447.241. (1) Every project for renovation,alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five percent(25%). VALUATION: Total of all renovation,alteration or modification being done, excluding painting and wallpapering: [1] $ MULTIPLIER(25%barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains:and, $ (g) When possible,additional accessible elements such as storage and alarms: $ TOTAL(shall equal line [2] of Valuation Computation): $ I:\Building\Pemuts\BUP_COM_PermitApp.doc Rev.03/05/2019