Permit y,n CITY OF TIGARD SITE WORK PERMIT
7 ' = COMMUNITY DEVELOPMENT Permit: SIT2020-00008
TGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/28/2021
f.
Parcel: 2S102CB00100
Jurisdiction: Tigard
Site address: 12850 SW GRANT AVE
Project: Broadway Rose Theatre Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43
Project Description: Site work for East and West additions totaling 4,164 sq.ft.
Contractor: B&G BUILDERS Owner: TIGARD-TUALATIN SCHOOL
4213 NE ALBERTA ST DISTRICT 23J
PORTLAND, OR 97218 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-839-4030 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 04/28/2021 $2,901.76
Plan Review 04/28/2021 $1,886.14
Type of Use: COM 12%State Surcharge-Building 04/28/2021 $348.21
Class of Work: ALT Erosion Control w/Development 04/28/2021 $536.40
Info Process/Archiving-Lg$2.00(over 04/28/2021 $16.00
Project Valuation: $565,856.00 11x17)
Info Process/Archiving-Sm$0.50(up to 04/28/2021 $50.50
11x17) •
Site Specifics:
Excavation Volume: 100 cu.yd.
Fill Volume: 100 cu.yd.
Impervious Surface: 3500 sq.ft.
Engineered Fill: Yes Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: Yes
Storn Drains: Retaining Wall: No
Fire Underground: Accessible Parking: Yes
Fence:
Total $5,739.01
Required Items and Reports(Conditions)
1 Ersn Cntd 503-639-4175
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 OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Rally voun/De,weoePermittee Signature: OltiA a%_vt
f't'
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.
Building Permit Application
Site Work RECEI J III FOR OFFICE LSE ONLN
eived j �,}.�.��
City of Tigard Date/By: H 3/30 ,.P Pcmtit N°.: F--kx_..6106,1-55v1111
• 13125 S Hall Blvd.,Tigazd,OR 97223 NR 3 Q 202` P�ReV1el/ /Phone: 503.718.2439 Fax: 503.598.1960 Date By: ' )<J-2a 113 Other Permit: /:?-035/
t.1),_ ,,1,to Inspection Line: 503.639.4175 Date Ready/By: n��1- � �tari:i See Page 22 for W
Internet: www.tigard-or.gov CITY OF DIVISI ticedl ethod: /1.7 a' 'J/ /Ky Sepplemental Information
BUILDING DIVISIt �' V!J /�
;) _.
TYPE OF WORK y- .v ri" 2-FAMILYI}FKE1:....
❑New construction 0 Demolition Pe ' fees*are based on the value of the work performed.
Indica • e value(rounded to the nearest dollar)of all
I♦Addition/alteration/replacement ❑Other: equipmen • aterials,labor,overhead,and the profit for the
-� CATEGORY OF CONSTRUCTION work indicat on this application.
III 1-and 2-family dwellingValuation: $
Commercial/industrial
El Accessory building ] ❑ ulti-family Number of bedtoo .
❑ aster builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Ail Total number of floors:
Job site address: 12850 SW GRANT AVE New dwelling area: quare feet
City/State/ZIP: TIGARD/OR/97222850 SW GRANT AVE Garage/carport area: sq .. 'feet
Suite/bldg./apt.no.: Project name:BROADWAY ROSE THEATRE ADDITION Covered porch area: square
Cross street/directions to job site: Deck area: square feet
HWY 99W/PACIFIC HWY TO SW WALNUT ST Other structure area square tcct
TO SW GRANT
REQUIRED DATA:COMMERCL4L-USE CHECKLIST
Subdivision: Lot no.:8700 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: WCTM 2S102C800100 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
EAST AND WEST ADDITIONS TO THE EXISTING THEATRE:1923SF EAST ADDITION Valuation: $ 565,856
ADDS A REHEARSAL STUDIO AND MARKETING OFFICE,2241 SF WEST ADDITION xisting building area: 10,981 square feet
RIGHT-SI7FS THEIR SCFNF AND SFT SHOP AND ADDS COSTI IME STORAGE AND
COSTUME SHOP New building area: 4,164 square feet
❑ PROPERTY OWNER U TENANT 11 Number of stories: 1
Name: BROADWAY ROSE THEATRE,ATTN:SHARON MARONEY& DAN MURPHY Type of construction: VA
Address: 12850 SW GRANT AVE Occupancy groups:
City/State/ZIP: TIGARD/OR/97223 xisting: A-1,B, E
Phone:( 503 ) 603-9862 Fax:( 503 1 670-8512 New A-1, F-1 B
■ APPLICANT 0 CONTACT PERSON NOTICE
Business Business name:SCOTT EDWARDS ARCHITECTURE All contractors and subcontractors are required to be
Contact name: MELISSE KUHN licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2525 E BURNSIDE ST jurisdiction in which work is being performed.If the
City/State/ZIP: PORTLAND/OR/97214 applicant is exempt from licensing,the following reasons
apply:
Phone:( 503)226-3617 Fax: :( )
-mail: mkuhn@seallp.com
Business name:B&G BUILDERS,ATTN:GREG CAPEN BUILDING PERMIT FEES*
Address: 4213 NE ALBERTA ST
r ,,...
City/State/ZIP: PORTLAND/OR/97218 Structural plan review fee(or deposit):
1
Phone:( 503) 839-4030 Fax:( ) FLS plan review fee(if applicable):
CCB lie.: 197519 Total fees due upon application / - _ l L/
Amount received: l(7 f
Authorized signature: This permit application expires if a permit is not obtained
Print name: MELISS UHN Date: 3.30.20 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
,1104.
I:'Buildineermits\SIT-PermitApp.doc 08/02/2016 440-4613T(11/02/CO / B)
•
City of Tigard: Site Work Permit Checklist
Page 2-Supplemental Information
Commercial,Multi-Family and One-and Two-Family Dwellings:
No permit is required if fill is less than 50 yards(5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain,drainage way,or wetland,the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: 500 more or less cu. yds.
Grading Volume:
(Soils report required for>5,000 cu.yds.) 200 more or less cu.yds.
Fill Volume:
(Fill exceeding 12"in depth shall be compacted to
90% of maximum density) 35 more or less cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all buildings, redeveloped=5,790sf
sidewalks, and .avin_: New=4,235sf Si. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application-Plan Submittal Requirements"attached.
The following must accompany this application:
❑ Site Plan with Vicinity Map showing ADA ❑ *Parking(including ADA) and Lighting
compliance Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report(if required)
❑ Retaining Structures
*Does not apply to One-and Two-family dwellings.
Plan Submittal: Permit Fee:
TYPE OF SUBMITTAL #of Plans
(New,Additions or Required at $.00 to$500.00 $51.09 minimum permit fee
Alterations) Submittal $500.01 to$2,000.00 $51.09 for the first$500.00 and
$2.69 for each additional$100 or fraction
Commercial 3 thereof,to and including$2,000.00.
$2,000.01 to$25,000.00 $91.44 for the first$2,000.00 and
Multi-Family R-1 Occupancy 3 $10.76 for each additional$1,000 or
fraction thereof,to and including
$25,000.00.
One-&Two-Family Dwelling 3 $25,000.01 to$50,000.00 $338.92 for the first$25,000.00 and
$8.06 for each additional$1,000.00 or
fraction thereof,to and including
$50,000.00.
$50,001.00 to$100,000.00 $540.42 for the first$50,000.00 and
$5.38 for each additional$1,000.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and over $809.42 for the first$100,000.00 and
$4.49 for each additional$1,000.00 or
fraction thereof.
L "..
1'\l3ui4 \Permits\SIT-PermitApp.doc 08/02/2016 2
I Ill
111 City of Tigard
COMMUNITY DEVF.T OPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - With Land Use
Building Permit #: .77 p j _ -or
Site Address: t 2g50 SvJ &rani- Ave. Suite/Bldg#:
Project Name: gl'ixicf tniA\1 Rene Th .
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: S 1 c.V or-r-
% Verify site address/suite#exists and active in permit system.
L RiverTerraceNeighborhood: ❑ Yes 1& No
.Land Use Case #: PkNtD2.D19-00O2G1
XPlans Match Approved Land Use:
121 Site Plan !d Landscape Plan 0 Other:
Urban Forestry Plan !L' levation Plan
Building Height: Maximum Height A al Height
Conditions Met: -Prior to Submittal ❑ riot to Permit Issuance
usiness License:
Exists: 0 Yes 0 No, applicant was provided a business license application
Ig-Public Facilities Improvement(PFI) Permit:
Required: Yes, applicant was notified 0 No Applied For: Yes 0 No, stop intake
Notes: Do roil- ISSue ur\-h1 eta t&-.S rY.Q,+.
Approved by Planning: Date: 4 12- 2.0
Revisions (after Building Submittal only) Reviewer Date
Revision I: 0 Approved 0 Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date:
/
Site Plans: #
Building Plans: #
Building Permit#: nter b ' ' g permit#above.
Workflow Routing: armingLd'Engineering �'Pe_rnut Coordinator Y-'Building
Workflow Sign-off: ff for Planning(include notes from planning review)
Route Application Documents: [ dung: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: „� ecrDate• Lf l
0/0
I:\Building\Forms\BldgPermitRvw_COM_WithLandUse_l 11819.docx
Engineering Review
J Slope at building pad: 3
PFI Permit#: pF 1 2,010 — OO 12 2
Conditions "Met"prior to issuance of building permit
i Easements (encroachments)per engineering conditions of approval and plat(not typical on SDR/CUP)
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes /RI No
Assess Water Quantity Fee in-lieu: ❑ Yes VI No
LIDA Facility on lot: Igr Yes ❑ No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: ci rally Date: 4 •ZI• Z02c-
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: 0 Approved ❑ Not Approved
�rP�ermit Coordinator Review
JQ)Conditions "Met"prior to issuance of building permit
❑/ Approved,NOT Released: 4a/Ut — 1IOt 1.X) Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes V. N/A
Parks SDC: ❑ Yes N/A
70K to Issue Permit Ll') Pc y'eS
Approved by Permit Coordinator:
Date: 412012D 21
I:\Building\Forms\BldgPermitRvw_COM_W ithtandUse_l 11819.docx
Branden Taggart
From: Branden Taggart
Sent: Tuesday, April 27, 2021 6:33 PM
To: Melisse Kuhn
Cc: Brandon Dole
Subject: Broadway Rose Site Work Permit: SIT2020-00008 - 12850 SW Grant Ave.
Attachments: Invoice.pdf
Hi Melisse,
The Site Work permit for Broadway Rose Theatre is ready to issue now. The balance due is$5,739.01, and I have
attached an invoice above for you to reference. The fees can be paid online now at https://aca-
prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number SIT2020-00008 under the Building
tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee.
Once paid, please email the Permit Technicians at TigardBuildingPermits@tgard-or.gov so that we may issue this
permit and make it available for pick up.
Thanks,
lirBranden of Tigard
Taggart
City of Tigard
Senior Permit Technician
Community Development
Oki g.Aktart;III
13125 SW Halt Blvd
Tigard, OR 97223
(503)718-2449
bra ndenttfatigard-or.gov
1
Agnes Lindor
From: Agnes Lindor
Sent: Thursday, October 15, 2020 9:59 AM •
To: Melisse Kuhn
Cc: Brady Bullinger; #Building Permit Technicians; Albert Shields
Subject: SIT2020-00008
Attachments: 10-15-20 Conditions.pdf
Hi Melisse-
The site work permit has been approved but is placed on hold until all conditions of approval have been met. See
attached.
Brady-
If there are any engineering conditions that have been met, can you please sign those off?
Thanks,
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email: AgnesL@tgard-or.gov
1