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Permit
FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT i II _ Transmittal Letter T I C A F. n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Branden Taggart DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FROM: Artur Grochowski SEP ? 2020 CITY OF TIGARD COMPANY: SERA Architects BUILDING DIVISION PHONE: 503.445.7362 By: -It., RE: 11974 72nd Ave -Stalisei)26-E3Bef15.&PLM 2020-00142 (Site Address) (Permit Number) 72nd&Dartmouth (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: _ Description: Additional set(s) of plans. 5 Revisions: Updated sheets for both permits Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Sewer Tie-In location updated per on-site conditions.This change has been reviewed and updated by engineering in the PFI and they asked that we update this in the Site&Plumbing permits just to keep everything tidy.3 sets of sheets C300&C310 are included for the SIT permit and 2 sets of sheets C300&C310 are included for the PLM permit. FOR OFFICE USE ONLY Routed to Permit Techni ian: Date: 11-/3-„ o2v Initials: Fees Due: [ Yes No Fee Description: Amount Due: () $ $ $ $ Special Instructions: Reprint Permit(per PE): ❑ Yes ❑ No ❑ Done Applicant Notified: 4�- Date: ///1 y/ Initials:/j T, I:1Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 t CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00142 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/1/2020 Parcel: 1 S136DC04300 Jurisdiction: Tigard Site address: 11974 SW 72ND AVE Project: Dartmouth Apartments Subdivision: DARTMOUTH APARTMENTS Lot: 31 Project Description: Plumbing site utilities for a 219 unit mixed-use multi-family building and an underground parking garage. Contractor: ESSEX GENERAL CONSTRUCTION INC Owner: DARTMOUTH PROJECT LLC 4284 W 7TH AVE 222 SW COLUMBIA ST, STE 700 EUGENE, OR 97402 PORTLAND, OR 97201 PHONE: 541-342-4509 PHONE: FAX: FEES Quantity Description Date Amount 900 If Footing Drain 09/01/2020 $350.19 Specifics: 10 If Sanitary Sewer 09/01/2020 $62.54 2 If Storm Sewer 09/01/2020 $62.54 Type of Use: MF q If Water Service 09/01/2020 $62.54 Class of Work: NEW 1 Plan Review 09/01/2020 $134.45 Type of Const: o 1 12%State Surcharge- 09/01/2020 $64.54 Occupancy Grp: Plumbing Stories: Total $736.80 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 OUNCCbbyr`calling 503.232.1987 or 1.800.332.2344. Issued By / ' J% /he. � Permittee Signature: //V 6 77e.J 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. Plumbing Permit Application I Site-Utilities FOR OFFICE USE ONLY City of Tigard E C E I y {-:terBya V 3 7-0 s 1, Permit NoPL f 2a O -00//2., I • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review q i Phone: 503.718.2439 Fax: 503.598.1960 FEB 2 4 2020 Date/Be: S-S`-aot>W Other Permit No.: TIGARD Inspection Line: 503.639.4175 _ Date Ready/BY .Tuns- WI See Page 2 for Internet: WWw.tlgard-or goy CtT' ?lotitcdAnclhod'. ( ar 4 Supplemental Information TYPE OF WORK ";i.i !ING,DIV[S 7N4,it.:, ,, ; :4t.: r... FEE* SCHEDULE 0 Ncw construction ❑Demolition For special infornur ion use checklist Description I Qty. Ea. Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) r- "s . T if SFR(1)bath 312.70 -, "g i3O` d �... EGORY or CQ = iii ❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building x❑Multi-family Each additional bath kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION ,AND LOCA'I ION Site utilities: Catch basin or area drain 18.76 Job site address:11974 SW 72nd Ave Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97223 9r..4 Footing drain(no.linear ft.: Page 2 �7 Suite/bldg./apt.no.: I Project name: DARTMOUTH APARTMENTS Manufactured home utilities 50.03 Cross street/directions to job site:NE corner of 72nd & Dartmouth Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:Jn ) 1 Page 2 62.54 Storm sewer(no.linear fl.: 2 ) 1 Page 2 dipi s1( Water service(no.linear ft.: 1.1 ) 1 Page 2 62.54 Subdivision: FRUITLAND ACRES AND ISSACS SUBDIVISION Lot no.: Fixture or item: Tax map/parcel no.:1 Si 36DC04000 Backflow preventer 31.27 -- - Backwater valve 12.51 DESCRIPTION OF WORK Clothes washer 25.02 219 unit mixed-use multi-family building, underground parking garage, Dishwasher 25.02 at grade parking,sanitary sewer services,water and fire services, Drinking fountain 25.02 and landscaping Ejectors/sump 25.02 .� IDPROPER'l Y OWNER ❑,TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: DartmouthDevulopmentPartners Floor drain/floor sink/hub 25.02 V Address: 222 SW Columbia 5t,Suite 700 _ Garbage disposal 25.02 City/State/ZIP: Portland,OR 97209 Hose bib 25.02 Phone: ( N/A) Fax: (N/A ) Ice maker 12.51 © APPLICAN F: ❑ CONTACT' PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$_) Page2 SERA Design &Architecture, Inc. Primer 12.51 iliContact name:Artur Grochowski Roof drain(commercial) 12.51 Address: . Sink/basin/lavatory 25.02 City/State/ZIP:338 PortlandNWSthSt,OR 97209 Solar units(potable water) 62.54 Phone:( 503)445,7362 Fax: :( N/A) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: arturg@serapdx.com Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Essex General Construction, Inc. Water piping/DWV 56.29 Address: 17400 SW 65th Avenue,Suite 100 Other: 25.02 City/State/ZIP: Lake Oswego,OR 97035 Subtotal ,...4§6'�lfr,g Minimum permit fee: $72.50 __// Phone:( 503)747.0092 Fax:( N/A) Plan review (25%ofpermit fee) _""rv.1a( CCB Lic.: OR 54531 Plumbing Lic.no.: State surcharge(12%of permit fee) a4Ta(ol,5i Authorized signature: Art,,.G TOTAL PERMIT FEE ,$2 '27!$ Date: 2020.02.24 This permit application expires if a permit is not obtained within 180 days Print name: Artur Grochowski after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:UBuilding\ermits'PLMU-PennitApp.doc 10/01/09 440-4616T(10/021COWWEB) pi uniting Permit Application - City of Tigard Page. - Supplemental Information to Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain- I" 100' 1 50.03 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' p 7.' 37.52 ��q 0 14 2,001 to 3,600 $169.69 O �i 3,601 to 7,200 $233.20 Sewer-1st 100' 1 62.54 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 162.54 Valuation: Permit Fee: 42 S''l shoo 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 Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to p 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: 10.5 537.IV 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Repl°" Plan review is required for any of the following. Work Performed:... Capped Added Relocate Baptistry/Font Please check all that apply. ElAny new commercial building with water service 2"and Bath -Tub/Shower Jacuzzi Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities, -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. 3„ Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above, -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Permits\PLMU_PermitApp.doc 2 Plumbing Permit Application Site Utilities FOR OFFICE USE ONLY City of Tigard Received )))) . Date/BY, /3I� ,D.() Permit No.: PtM 20a©YlLJI7„L ■ 13125 SW Hall Blvd.,Tigard,OR 97223 K / Phone: 503.718.2439 Fax: 503.598.1960 Plan Review .,./ .b r S--�.C3d,C) Other Permit No.: Inspection Line: 503.639.4175 ® See Page 2 for T I U A R D Date Ready/By: Juris Internet: www.tigard-or.gov Notified/Method: /[,A) e - Supplemental Information TYPE OF WORK ,sal4 • '.... L�l r FEE* SCHEDULE XNew construction 0 Demolition For special information use checklist Description I Qty. I Ea. 1 Total ❑Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building AMulti-family SFR(3)bath 500.32 ❑Master builder Each additional bath/kitchen 25.02 ❑Other Fire sprinkler( sq.ft.) , Page 2 JOB SITE INFORMATION AM) LOCATION Site utilities: Job site address: +l�7� S wt A t Catch basin or area drain 18.76 City/State/ZIP: J. Drywell,leas ine,or trench drain 18.76 Ttaelrtl 1 oA.. (492n Footing o.linear ft.:CI Page 2 350, 14 Suite/bldg./apt.no.: I Project name:iacl+rt ilolktk Apr-41 *S Manu ed ome utiliti-: 50.03 Cross street/directions to job site: Manh 18.76 Ra' ' connect, 18.76 ,/3 sewer t o.linear ft.: ICU) IPage 2 41,54 Sto sew,. 'no.linear ft.: .) ( Page 2 (y,'L,.Se? Subdivision: Water ice(no.linear ft.: L{ ) / Page 2 d r 551� o•: \i Fix eoritem: Tax map/parcel no.: ^` : ckflow preventer 31.27 DESCRIPTION OF WOR I `1 Backwater valve 12.51 K t N'1. ,j a_ . f.i• Clothes washer 25.02 Sitt1lk:'ii tit?' Mlt{ llii+ )t` ( 11 Dishwasher 25.02 -Paw.;+y ,Ejtk: 0.(Ni Drinking fountain 25.02 0 / Ejectors/sump 25.02 0 PROPERTY OWNER ENANTY Expansion tank 12,51 Name: I 1 / FixtutrJsewer cap 25.02 Address: v Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax: ) Ice maker 12.51 ❑ APPLICANT ■ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$_) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 537 81 Minimum permit fee: $72.50 Phone:( ) Fax:( ) CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) (3q.its State surcharge(12%of permit fee) 6 y,5j Authorized signature: TOTAL PERMIT FEE 1 36.80 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. L\BuildingTetmhs\PLMU-PermitApp.doc 10/O1/09 440-0616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: Footing drain-1"100' I 50.03 50,63 0 to 2,000 $121.90 Footing drain-each additional 100' p 37.52 300,16 2,001 to 3,600 $169.69 p 3,601 to 7,200 $233.20 Sewer-1st 100' r 62.54 0.54 54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' / 62.54 6o1,S4 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 162.54 62.,51f $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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or Fees 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: 537.8( 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/Work Performed: Capped Added Relocate Plan review is required for any of the following. Please check all that apply. Baptistry/Font ElAny new commercial building with water service 2"and Bath -Tub/Shower -Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refiig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 1:\Building\Permits\PLMU PermitApp.doc 2 FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 111 Transmittal Letter 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Branden Taggart DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED APR 3 0 2020 FROM• Artur Grochowski CITY OF TIGARD COMPANY: SERA Architects BUILDING DIVISION PHONE: 503.445.7362 By: RE: 11974 72nd Ave PLM 2020-00142 (Site Address) (Permit Number) 72nd &Dartmouth (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 2 Revisions: Checksheet response to city comments Cross section(s)and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: In response to emails with Don,attached plans provide context sheets from sister site works permit. FOR OFFICE USE ONLY Routed to Permit Technician: Date: Initials: Fees Due: ❑ Yes ❑ No Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No I I Done Applicant Notified: Date: Initials: I:1Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012 .& WILLAMETTE Willamette Print& Blueprint (503)223-5011 PRINT & BLUEPRINT 3461 NW Yeon Avenue info@wpbinc.com 111 COMPANY, INC. Portland, Oregon 97210 https://wpbinc.com DIGITAL IMAGING Client-Driven Service Since 1975 RECEIVED Packing Slip APR 3 0 2020 CITY OF TIGARD BUILDING DIVISION Bill To: Ship To: SERA Architects, Inc. City of Tigard - Permit Center 338 NW 5th Avenue 13125 SW Hall Blvd. Portland, OR 97209 Tigard, OR 97223 ATTN: Brandon Taggert (503) 718-2449 Invoice# Order Date Invoice Date Project Name 1008504 Apr 29 2020 Apr 30 2020 Dartmouth PLM Checksheet Comments Account# Terms Shipping Type Purchase Order/Job Number 100763 Net 10th EOM Local Delivery Sets Units Quantity Job Description 1 Sets of 12 Large Format B&W Plot onto 20#Bond -36"x 48" Edge Binding 1 Sets of 12 Large Format B&W Copy onto 20#Bond-36"x 48" Edge Binding 1 Sets of 2 Small Format Color Print on 28#Bond-8.5"x 11"(without bleed) 1 1 Delivery Charge Received by(print): Date: Signature: