Permit CITY OF TIGARD SITE WORK PERMIT
1. COMMUNITY DEVELOPMENT Permit#: SIT2021-00004
TtGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/21/2021
Parcel: 2S111ACO2901
Jurisdiction: Tigard
Site address: 9550 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: Site work for a 80 sq.ft.addition to the core building.
Contractor: TRIPLETT WELLMAN INC Owner: TIGARD-TUALATIN SCHOOL
PO BOX 160 DISTRICT 23J
WOODBURN, OR 97071 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-982-4188 PHONE:
FAX: 503-982-0390
FEES
Description Date Amount
Specifics: Permit Fee-Site Work 04/21/2021 $1,285.36
Plan Review 02/23/2021 $835.48
Type of Use: COM 12%State Surcharge-Building 04/21/2021 $154.24
Class of Work: ALT Misc Administration Fee 04/21/2021 $11.25
Project Valuation: Info Process/Archiving-Lg$2.00(over 04/21/2021 $70.00
$205,398.00 11x17)
Info Process/Archiving-Sm$0.50(up to 04/21/2021 $49.00
11x17)
Site Specifics: Erosion Control w/Development 04/21/2021 $311.40
Excavation Volume: cu.yd.
Fill Volume: 145 cu.yd.
Impervious Surface: 10800 sq.ft.
Engineered Fill: No Soil Report Required: Yes
Paving: Yes Grading: Yes
Landscaping: Yes Site Prep: No
Storn Drains: Retaining Wall: No
Fire Underground: No Accessible Parking: Yes
Fence: Yes
Total $2,716.73I
Required Items and Reports(Conditions)
1 Ersn Cntrl 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 1.80 ';39? 44.
Issued By: Permittee Signature: �� 1
Call 03.639.4175 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.
1
Building Permit Application „ — 4.
,' Sife Work RECEIVED FOIZ OFFI('h,USE ONLY
City of Tigard Date/B d .667..... Permit No.: t"n+.��/�e.X U lie.
g 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 10 IOU Plan Review."' ! �L! `
' Phone: 503.718.2439 Fax: 503.598.1960 t Date/By: 3'a3^Z) Other Permit: ,[Q,,�, _a,
TIGARI3 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: / / runs Id See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:Ffj /O i�r. Supplemental information
TYPE ON WORK RE °IDATA; 1-AND 2-FA?11LYDWELLING
❑New construction ❑Demolition - Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ I-and 2-family dwelling ® Conunercial/industrial .
❑Accessory building ❑Multi-family Ntlmber.ofbedrooms:
❑Master builder ❑ Other: Number of bathrooms:
rllil; . r- + JOB SITE INFORMATION AND LOCATION Total number of floors_
Job site addres SW Murdock Street (Old Elementary School New dwelling area: square feet
City/State/ZIP:Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: P K Conference °, Covered porch area: square feet
Cross street/directions to job site:96th & Murdock Deck area: square feet
Other structure area: square feet
REQUIRED DATA:C0 Ft1I UCIAI-US ,GIlECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
l DESCRIPTION OF WORK work indicated on this application.
Valuation: $ ''�
Renovation of old elementary school in to a Pre-K Center, District O�OS �95.
Existingbuildingarea: square feet
Training Center and District Resource Center. 45,529 q
�- 4. ,, r:. , �i7 ,,, �/ y New building area: n/a square feet
' ❑ PROPERTY OWNER ❑ lIENANT' Number of stories: 1
Name:Tigard-Tualatin School District Type of construction: III-B &V-B
t,N Address:6960 SW Sandburg Street Occupancy groups:
ssslCity/State/ZIP:Tigard, OR 97223 Existing: E
Phone:( ) 503-431-4000 Fax:( ) New: E & A-3
0 APii.,.R T (,, ` - ❑ CON'I1C7 PERSON NOTICE
' Business name:Day CPM/Otak All contractors and subcontractors arc required to be
Contact name:Shawn Christensen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:14650 SW 97th Street jurisdiction in which work is being performed. If the
City/State/ZIP:Tigard, OR 97224 applicant is exempt from licensing,the following reasons
apply:
Phone:( )971-727-4168 Fax: :( )
E-mail:shawn.christensen@otak.com
','i';I tl ';t till ' ', ii k" rRACTOR
Business name: Triplett Wellman Contractors outp F.;PERMIT FCES*'
(Pfroa€referlat fee schedule)
Address:1717 Mt Jefferson Ave Structural plan review fee(or deposit):
City/State/ZIP:Woodburn, OR 97071
Phone:( ) 503-J82_418$ ( ) FLS plan review fee(if applicable):
Fax:
Total fees due upon application:
CCB Ile.:43496
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Shawn Christensen Date:01/06/2021 1 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\SIT-PemiltApp.doc 08/02/2016 440-4613T(11/02/COM/WEB)
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: (NET oFFNAUL) 0 cu. yds.
Grading Volume: (CUT/FILL oxsxT&)
(Soils report required for>5,000 cu. yds.) 145 cu. yds.
Fill Volume: (IMPORT)
(Fill exceeding 12"in depth shall be compacted to
90% of maximum density) 145 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
I I Other: Area is replaced
*Total new impervious area including all buildings, impervious.Net
sidewalks, and paving: 10,800 Sc ft. impervious area
reduced.
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
❑X Grading Plan and details ❑ *Landscaping Plan
X❑ 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 Valuation: Permit Fee:
(New, Additions or Required at $.00 to S500.00 $51.09 minis uin 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.
1:\Building\Permits\SIT-PermitApp.doc 08/02/2016 2
City of Tigard
1" COMMUNITY DEVELOPMENT DEPARTMENT
IN
TtGARD Building Permit Review — Commercial - With Land Use
Building Permit #: S„z-j-�21./_d,fo
Site Address: 9550 SW Murdock St Suite/Bldg#:
Project Name: Templeton/ Twality PreK Conference and Services
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Renovation of old elementary school in to a Pre-K Center, District Training Center and
District Resource Uenter.
® Verify site address/suite#exists and active in permit system.
❑ River Terrace Neighborhood: N Yes ❑ No
® Land Use Case#: MMD2020-00029. PDR2017-00002
® Plans Match Approved Land Use:
a Site Plan N Landscape Plan ❑ Other:
❑ Urban Forestry Plan N Elevation Plan
EX Building Height: Maximum Height N/A Actual Height
® Conditions Met: 0 Prior to Submittal N Prior to Permit Issuance
IN/Ausiness License:
Exists: ❑ Yes 0 No,applicant was provided a business license application
® Public Facilities Improvement (PFI)Permit:
Required: 0 Yes, applicant was notified ❑ No Applied For: E Yes ❑ No,stop intake
Notes:
Approved by Planning: MB Date: 2/18/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: D Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: p'-//p/01./
Site Plans: #
Building Plans:
Building Permit#: _P.,,�nes�er building permitit#above.
Workflow Routing: B—Planning i�gineering lal-15 it Coordinator B—wilding
Workflow Sign-off: 4]/5` off for Planning(include notes from planning review)
Route Application Documents: 4i Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: -�' Date: a�?dpi
.--44: 7
I:\B u i I din g\Forms\B Id gPe rm itRv w_COM_W ithLandUse_111819.d ocx
Engineering Review
Slope at building pad:
❑ PFI Permit#: 7-021 -DQ0
[Conditions"Met"prior to issuance of building permit
1`.asements (encroachments)per engineering conditions of approval and plat (not typical on SDR/CUP)
\R/ater Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: D Yes L�No
Assess Water Quantity Fee in-lieu: ❑ Yes Rr- o
LIDA Facility on lot: 1f" 'es E No
❑ NOT Approved by Engineering: Date
Notes:
Approved by Engineering: R Date: `/-/Z-2 z,/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
jzr Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: 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: Or Yes ziZr N/A--7
Tigard Trans SDC: kie Yes N/A
L 4112- 47-1
Parks SDC: ye Yes 4 N/A
OK to Issue Permit Approved by Permit Coordinator: 4g - Date: 41/24tO21
I:1Building\Fonns\BldgPermitRvw COM_WithLandUse_111819.docx
Branden Taggart
From: Branden Taggart
Sent: Tuesday, April 20, 2021 6:53 PM
To: Debbie Pearson
Cc: Shawn Christensen; Beth Cantrell; Sarah Mehrabzadeh
Subject: Templeton Elementary Permits: BUP2021-00050 &SIT2021-00004 - 9550 SW Murdock
St.
Attachments: Templeton Core Permit Invoice.pdf;Templeton Site Work Permit Invoice.pdf
Debbie,
The Templeton Elementary School Building and Site Work permits are ready to issue now. I have attached invoices
above for you, and the fees due are as follows:
Templeton Elementary School Permits
Permit U Fees Due
BUP2021-00050 $ 37,071.42
S1T2021-00004 $ 1,881.25
Total: $ 38,952.67
Please note that the current Trust Account balance will not cover the Site Work permit. As always,the above fees can
be paid online now at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number
under the Building tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee. Also, I can
meet you for a check delivery.
If paid online, please email the Permit Technicians at TigardBuildingPermits(a@tigard-or.gov so that we may issue this
permit and make it available for pick up.
Thank you,
ErBranden Taggart
City of Tigard
Senior Permit Technician
Community Development
13125 SW Halo Blvd
Tigard,OR 97223
(503)718-2449
brandent@tigard-or.gov
1