Permit CITY OF TIGARD PLUMBING PERMIT
■ COMMUNITY DEVELOPMENT Permit#: PLM2021-00254
Date Issued: 12/2/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108CC00100
Jurisdiction: Tigard
Site address: 15600 SW RIVER TERRACE BLVD
Project: Art Rutkin Elementary School Subdivision: None Lot: None
Project Description: Interior plumbing for a new two-story elementary school.
Contractor: HYDRO TEMP MECHANICAL INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
28465 SW BOBERG RD 6960 SW SANDBURG ST
WILSONVILLE, OR 97070 TIGARD, OR 97223
PHONE: 503-582-8525 PHONE:
FAX: 503-582-1914
FEES
Quantity Description Date Amount
1 ea Drywell, Leach Line or Trench 11/30/2021 $18.76
Specifics: Drain
24 ea Rain Drain Connector 11/30/2021 $450.24
Type of Use: COM 1 ea Backflow Preventer 11/30/2021 $31.27
Class of Work: NEW 3 ea Clothes Washer 11/30/2021 $75.06
Type of Const: 1 ea Dishwasher 11/30/2021 $25.02
Occupancy Grp: 6 ea Drinking Fountain 11/30/2021 $150.12
Stories: 1 ea Ejectors/Sump 11/30/2021 $25.02
1 ea Expansion Tank 11/30/2021 $12.51
48 ea Floor Drain/Floor Sink/Hub 11/30/2021 $1,200.96
22 ea Hose Bib 11/30/2021 $550.44
ea Interceptor/Grease Trap 11/30/2021 $25.02
16 ea Primer 11/30/2021 $200.16
44 ea Sink 11/30/2021 $1,100.88
28 ea Lavatories 11/30/2021 $700.56
2 ea Tub/Shower/Shower Pan 11/30/2021 $25.02
4 ea Urinal 11/30/2021 $100.08
Total $8,346.35
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
Issued By: HtrUtiJ Va De We-g� Permittee Signature: Ow A p- ;^^ l avt.
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 7,), a' / _
Building Fixtures
City of Tigard RR Received permit No.:
III w 13125 SW Hall Blvd.,Tigard,OR 9F21E� Date/By: l(���J ��� ���Z
S Plan Review q �t/
Phone: 503.718.2439 Fax: 503.598.1960 4 /U A t,.pl.Got l Other Permit No.:e hid�i5�
Date/By:
Inspection Line: 503.639.4175 2021 Date Ready/By: luris: ® See Pa et
2 for
TIGARD JIM 7 /', ,/-, S
Internet: www.tigard-or.gov Notified/Method: /ti 1/'.'J'(yl �� Supplemental Information
TYPE OF WORICITY OF TIGARL 4) :.1(,,/ y„,,,,t,e �E*,SCHEDULE
IX] New construction [SUR1 t tD,1V1S10N For sp cial to oorrn ation use checklist.
Description Qty. I Ea. 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
El1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑ Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: fiver Terrace Blvd Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 9724 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Art Rutkin Elementary School Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel na: - t F Backflow preventer 1 31.27
,, 5 y 0 t d Cc et:,ii c,°�r
DESCRIPTION OF WORK Backwater valve 1 12.51
:* Clothes washer 25.02
New two-story elementary school
Dishwasher 25.02
Drinking fountain 4 25.02
Ejectors/sump 1 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 1 12.51
Name: Tigard-Tualatin School Districtli
Fixture/sewer cap 25.02
Address: 6960 SW Sandburg St Floor drain/floor sink hub 46 25.02
Garbage disposal 25.02
City/State/ZIP: Tigard, OR 97223 Hose bib 12 25.02
r`V Phone:( 503) 431-4000 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 1 25.02
Medical gas(value:$ ) Page 2
Business name: Hydro-Temp Mechanical
Primer 15 12.51
Contact name: Zach Rich Roof drain(commercial) 12.51
Address: 28465 SW Boberg Rd Sink/basin/lavatory 70 25.02
City/State/ZIP: Wilsonville,OR 97070 Solar units(potable water) 62.54
Phone:( 503) 582-8525 Fax: :( ) Tub/shower/shower pan 2 12.51
Urinal 4 25.02
E-mail: ZachR@hydrotempmech.com
Water closet 41 25.02
CONTRACTOR
Water heater 2 37.52
Business name: Hydro-Temp Mechanical Water piping/DWV 56.29
Address: 28465 SW Boberg Rd Other: 25.02
City/State/ZIP: Wilsonville,OR 97070 Subtotal
Minimum permit fee: $72.50
Phone:( 503) 582-8525 Fax:( )
Plan review (25%of permit fee)
CCB Lie.: 63907 Plumbing Lic.no.:26-357PB
State surcharge(12%of permit fee)
Authorized signature: �/ � TOTAL PERMIT FEE
Print name: Zach Rich Date: 6/7/2021 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.
I`_`,Building'Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(I0/02/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' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 1 62.54 7,201 and greater $327.54
Sewer-each additional 100' 77 37.52
Water Service-1st 100' 1 62.54 Medical Gas Systems:
Water Service-each additional 100' 58 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $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
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
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 S50,000.00 $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 S50,000.00 and$1.20 for
(minimum charge 1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Thr as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial 0 Any multipurpose fire sprinkler system.
-Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4„ 0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LaviBar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
Cityof Tigard Received /n �/yn�)�_� ..�
DECEIVED Date/By: W i� �/ er): Permit No.: PLM �b2I_abasq
III • 13125 SW Hall Blvd.,Tigard,OR 97 2 v"i
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 7 Angt ID ft
/G-///_ Other Permit No.a j 0 '1 ^Lz
CUL i Date/By: e Page
for
!
Inspection Line: 503.639.4175 e P
TIGARD Jai Date Ready/By: Juris: ® SeePage2fo
Internet: www.tigard-or.gov �y, Notified/Method: i6`V,�//)I Supplemental Information
TYPE OF WORK "I!T OF TIGARD j * SC EDULE
New construction ❑�LA6C Ib16C� ,) ,,, tires For special inforn ation use checklist.
Description Qty. Ea. Total
❑Addition/alteration/replacement D Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ,Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1i 1 t1 Catch basin or area drain 18.76
S bv0 (.,,lJe.r l wrack... G tuc
City/State/ZIP: Drywell,leach line,or trench drain ! 18.76 is.1‘T f 0. ►d " °1 y Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:At Rut fGh eksienteol Schap( Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector If 18.76 1150,21
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer �'31.27 3[, i
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02 '75,0 b
i`iA e'r`Uw Pkttwtbi.1 ,Ce RA..`,-, - a„-'�- S ILO�1 Dishwasher 25.02 as.d2
.e Leyvt..eex+e r,% SCGrr_.p,( Drinking fountain 6 25.02 150, 12
Ejectors/sump / 25.02 a5.o1
0 PROPERTY OWNER 0 TENANT Expansion tank / 12.51 Vol.S 1
Fixture/sewer cap 25.02
Name:
Address: Floor drain/floor sink/hub ei$ 25.02 j a o0,9 b
Garbage disposal 25.02
City/State/ZIP: Hose bib a. 25.02 550. l/y
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap f 25.02 25,oa
Medical gas(value:$ ) Page 2
Business name: g
Primer (6 12.51 coos i6
Contact name:
Roof drain(commercial) 12.51
Address:
7 Sink/basin/lavatory '1 2 25.02 i.801.yk
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan a 12.51 a5,01
E-mail: Urinal I/ 25.02 too, 08
CONTRACTOR Water closet ql 25.02 1 b)5 in.
Water heater a 37.52 'IS ay
Business name: Water piping/DWV 56.29
Address: Other: (See_. O 1/4 . - S k.e...A-) I a. 25.02 360,3.11
City/State/ZIP: Subtotal 66 y0,21
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee) /323,0 6
CCB Lie.: Plumbing Lic.no.:
State surcharge(12%of permit fee) 931,0`i
Authorized signature: TOTAL PERMIT FEE 8f346,31
Print name: Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodologyy set by Tri-County Buil 3nd1usstry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) L cAu Z a$ if:.
=i(il S.
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- I'' 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $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 S1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional S100.00 or fraction thereof,to
and including$10,000.00.
1 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:
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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial �f/..,, d, "Ll Any multipurpose fire sprinkler system.
Domestic Any complex structure as defined in OAR918-780-0040.
Drinking Fountain 6
Eye Wash I Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" 3).
3" to Isometric or Riser Diagram
6 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains a Comments regarding fixture work:
Oil Separator(Gas Station) ee c ,1 Jla � /N f� (.deli` 4 e 3 etRec.Vehicle Dump Station of /idn/I ;notr''&.f C►Ja f-i* Neritd, 01.1.14.,
Shower: -Gang
-Stall 0. 4 T.
Sink: -Lav/Bar non-food related - (.3 Pei tiNwire‹,1-6.hkite.
-Bradley
-Com/Serv/Util food related GrA s) V'di�q Pet',}
-Service J?y *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet Li j plumbing permit can be issued.
Urinal Y
Other Fixtures:
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Branden Taggart
From: #Building Permit Technicians
Sent: Thursday, October 21, 2021 1:59 PM
To: zachr@hydrotempmech.com
Cc: Debbie Pearson
Subject: Art Rutkin Elementary School Interior Plumbing Permit: PLM2021-00254 &
SWR2021-00272 - 15600 SW River Terrace Blvd.
Attachments: Art Rutkin Plumbing Permit Invoice.pdf; Art Rutkin Sewer Permit Invoice.pdf; Art Rutkin
Sewer Tally.pdf
Hi Zach,
The Plumbing and Sewer permits for Art Rutkin Elementary School are ready to issue now. I have attached invoices
above for you to reference, and the fees due are as follows:
Art Rutkin Elementary
Permit# Fees Due
PLM2021-00254 $ 8,346.35
SWR2021-00272 $ 215,702.00
Total: $ 224,048.35
I have copied Debbie Pearson with Otak for payment of the Sewer permit fees. If Hydro-Temp will be paying the
Plumbing permit fees, the above balance can be paid online now through our
website: https://aca.accela.com/TIGARD/Default.aspx. From there, click on the Building tab, enter the permit numbers
in the Record Number field, and click Search. Once paid, please notify us at tigardbuildingpermits@tigard-or.gov so that
we may issue these permits and place the approved plans in our open Permit Center conference room for someone to
pick up between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on
Fridays. Furthermore, the permit fees for both permits will need to be paid before we can issue either of them. Please
let me know if you have questions.
Thank you,
Branden Taggart
71 _ RI City of Tigard
i . Senior Permit Technician
Community Development
TIGARD
13125 SW Hall Blvd
Tigard; OR 97223
(503)718-2449
brandenttigard-or,gov
1
Accumulative Sewer Tally
II II III Tenant Name:ART RUTKIN ELEMENTARY SWR# 2021-00272
TIGARD Site Address: 15600 SW RIVI?R'I'IRR:A(:I?BLVD PLM# 2021-00254
Parcel#: 2S108CC00100
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 6 6 6 6
Eye Wash 1 0 0 1 1 1 1
Floor Drain/Sink: -2 inch 2 0 0 32 64 32 64
-3 inch 5 0 0 ' 10 50 10 50
-4 inch 6 0 0 6 36 6 36
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
, -Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 2 2 2 2
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehide Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 2 4 2 4
Sink:
-Lay/Bar-Non-Food Related 2 0 0 63 126 63 126
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 6 18 6 18
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 3 18 3 18
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 41 246 41 246
Urinal 6 0 0 4 24 4 24
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 176 595 176 595
Current Fixture Value 595 divided by 16= 37.188 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 595 divided by 16= 37.188 over (under) $ 215,702.00
Enter EDU Change Here 37.190 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: (1)DISHWASHER AND(3)SINKS WERE NOT ASSESSED SDC FEES AS THEY WERE INDIRECT WASTE TO FLOOR DRAINS
WITH A HIGHER FIXTURE VALUE.
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 10/21/2021
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallyShect_5800_070119.xlsx