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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00141 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2020 T I[;:1 R p g Parcel: 2S102CB00100 Jurisdiction: Tigard Site address: 12850 SW GRANT AVE Project: Broadway Rose Theatre Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43 Project Description: Site utilities for East and West additions. Contractor: G&P OBRIST EXCAVATING INC Owner: TIGARD-TUALATIN SCHOOL 31619 LUSTED RD DISTRICT 23J GRESHAM, OR 97080 6960 SW SANDBURG ST TIGARD, OR 97223 PHONE: 503-663-5046 PHONE: FAX: FEES Quantity Description Date Amount 3 ea Catch Basin or Area Drain 06/02/2020 $56.28 Specifics: 232 If Footing Drain 06/02/2020 $125.07 7 ea Rain Drain Connector 06/02/2020 $131.32 Type of Use: COM 70 if Sanitary Sewer 06/02/2020 $62.54 Class of Work: ALT 845 if Storm Sewer 06/02/2020 $362.70 Type of Const: if 123Water Service 06/02/2020 $100.06 Occupancy Grp: 2 ea Backwater Valve 06/02/2020 $25.02 Stories: 1 Plan Review 06/02/2020 $215.75 1 12%State Surcharge- 06/02/2020 $103.56 Plumbing Total $1,182.30 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 OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: Call 503.639.4175 by7:00 a.m.for the next available a a able 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 Site Utilities FOR OFFICE LSE ONLY City ofTigard R 'CEIVED it/�-/z / Permit No.:NLM2020.00/4 13125 SWW Hall Blvd.,Tigard,OR 972Ys Plan Review 1 R` Phone: 503.718.2439 Fax: 503.598.1961k DateBy -13 aQ,b Other Permit No.:���1e1_ T 1 ti A it 1? Inspection Line: 503.b39.4175 H.I'R 8 2�2� Date Ready/By: r /1-...� Joule: is See Page 2 for �� Internet: www.tigard-or gov n . , Notified/Method o f. r "7St+ Supplemental Information TYPE DE Wt e ', .=si}s '""'' £-e t Eli. SCI-IEDJLE 0 New construction 0 Demolition For special information use checklist. Description [ Qty. I Ea. I Total ®Addition/alteration/replacement 0 Other: c isEri New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTI FF 117 i SFR(I)bath 312.70 ❑ 1-and 2-family dwelling Cammercla/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 SITTE,INFORMATION AND LOCATION Site utilities: Joh site address: 12850 SW GRANT AVE Catch basin or area drain %y,.Y 18.76 T y "� Drywell,leach line,or trench drain 18.76 City/State/ZIP: TIGARD/OR/97223 „ ,rya9 g /1?JU7 Footingdrain(no.linear ft.: Q,nfh7 Page 2 Suite/bldg./apt.no.: Project name:BROADWAY ROSE THEATRE Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 HWY 99W/SW PACIFIC HWY TO SW WALNUT ST TO SW GRANT Rain drain connector 7,( 18.76 .jy({;(1rj;j j,3) Sanitary sewer(no.linear ft.:111_) ( Page 2 62.54 Storm sewer(no.linear ft.: _1 5) 4.1 Page 2 _ 342 II6r j,1 Water service(no.linear ft.:, j) +C Page 2 at. L. Fix Subdivision: Lot no.:8700 Fixture or item: Tax luny/parcel no.. WCTM 2S102C800100 Backflowpreventer 31.27 Backwater valve r� 12.51 G./ .,r, DESCRIPTIO1COF WORK' Clothes washer 25.02 12-nn E.PLA6ci l/7- Ex1571IJt+ Cr+TGti 4iASiisSi 'iZ£ot-,ii4,E Dishwasher 25.02 oN5iiof SANrztsRii SfdtaCti. KcQuwTAi STuRM Drinking fountain 25.02 9 1 elf. i a - $TOLL_ Fo u Y i N C+ E t7(LA/►' Ejectors/sump 25.02 0 PROPERTY OWNER r TENANT --- "1'anaion tank 12.51 Fixture/sewer cap 25.02 Name: BROADWAY ROSE THEATRE:ATTN SHARON MARO EY+DAN MURPHY Floor drain/floor sink/hub 25.02 Address: 12850 SW GRANT AVE Garbage disposal 25.02 City/State/ZIP:TIGARD,OR,97223 Hose bib 25,02 Phone:( 503)603.9862 Fax:( 503) 6f0.8512 ice maker 12.51 APPLICANT ❑ CONTACT PERSON 11? Interceptor/greaseirap 25.02 Medical gas(value:$ ) Page 2 Business name:SCOTT EDWARDS ARCHITECTURE Primer 12.51 Contact name: MELISSE KUHN Roof drain(commercial) 12.51 Address: 2525 E BURNSIDE ST Sink/basin/lavatory 25.02 City/State/ZIP: PORTLAND/OR/97214 Solar units(potable water) 62.54 Phone:( 503) 896.5372 Fax: :( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: MKUHN@SEALLP.COM 25.02 Water closet CONTRACTOR Water heater 37.52 Business name: G} e O(3 2t$' t u 02,4. ,4 G B N C Water piping/DWV 56.29 Address: 3 t te i ej 5¢ L.t.r3 r t o 2 n Other: 25.02 Subtotal Kipp\,`i City/State/ZIP: [,Q S bl 9 M 0 R 1-7 d Minimum permit fee: $72.50 Phone:(.s�3) 3's(3 4r 6 Fax:(S-b;) (�(e 3 -9i op s Plan review (25%of permit fee) i5 CCB Lie.: tj 2S'S-4-) 7 J/49 Plumbing Lie.no.; pib ^43 Z, r t�l v i State surcharge(12%of permit fee) U`3 yzi Authorized signature: pA,,Goo�,. �I�19'v TOTAL PERMIT FEE 4/9r 3) rt ri�te:4/ �7 This permit application expires if a permit is not obtained within 180 days Print name: 24,,,,... A b3 Q i S T. t L C) after it has been accepted as complete. 'Fee methodology set by Tri-County Building Industry Service Board. f:lauildinaWamiii PLMU-PemutApp.doc I0N1/e9 440.4616r(10/02/COM WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Pee(er). '. ' brat Square.Feetage Permit fee:;. . Footing drain-1"100' 1 50.03 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' . 1.14 37.52 i 2,001 to 3,600 S 169.69 3,601 to 7,200 $233.20 Sewer- 1st 100' 1 62.54 h?,54 7,201 and greater S327.54 Sewer-cacti additional 100' 37.52 Water service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 "Valttatiort: 'Permit-Fee Storm St Rain Drain-1st 100' 1 62.54 82.64 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 1-46 37.52 279.52 $5,001.00 to$10,000-00 $72.50 for the first$5,000.00 and$1.52 for Inspections or Fees Other In Qty Fee(ea) , Total each additional$100.00 or fraction thereof,to 4>: .Fiiand including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first S 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.W 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*. Quantity by Fixture Type Plan Review for Plumbing Installatitias Fixture Type for Replace/ Plan review is required for anyof the following. Work Performed: Capped Added Relocate q g' Baptistry/Font Please check all that apply. Bath TublShower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool rlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thm ❑ 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 ❑ 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. 4.. Isometric or Miser Diagram Car Wash Drain Garbage Domestic-non-Food Ei Isometric or riser diagram is required for new buildings 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/Lay -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 1:1Building\Permits\PLMU_PcrmitApp.doc 2 Plumbing Permit Application ' Site Utilities FOR OFFICE USE ONLY City of Tigard Received ^ g Permit No.: ^ //'J • 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: �lt� / "- r�� a0d��l��Tf Plan Review �" Phone: 503.718.2439 Fax: 503.598.1960Other Permit No.:pv G� Date/By: '7-a �' aZ0�f1w ✓✓'-'�`/® lr/ " Y .I.I G 1 R tI Inspection Line: 503.639.4175 Date Ready/By: s' 'yle.�,e� H Page 2 for Internet: www.tigard-or.gov Notified/Method:5/M/l?(.) er . u-r� Su['Peleemental Information TYPE OF WORK l�J J end iTa�y v FEE* SCHEDULEI ❑New construction ❑Demolition + 6""'"�+- For special information use checklist Description I Qty. Ea. Total , Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ 1-and 2-family dwelling �Commerciallindustrial SFR(2)bath 437.78 ElAccessory building El Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 Cl Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: IAAC� S.� (srahte Catch basin or area drain 18.76 ,�g Drywell,leach line,or trench drain 18.76 City/State/ZIP: -1-(6,,,A OR•e1�` a3 i o` Footing drain(no.linear ft.:2 3A) 3 Page 2 125.041 Suite/bldg./apt.no.: I Project name: 5 ma/LA y fl tt 110S2 I►tCQ�� Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 7 18.76 f 3/.31 Sanitary sewer(no.linear ft.: 96 f Page 2 6a.Sf Storm sewer(no.linear ft.Agc) 9 Page 2 36�e76 Water service(no.linear ft.: 123) 1 Page 2 /00•04 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 3 L27 DESCRIPTION OF WORK Backwater valve � 12.51 2542 I 1 Clothes washer 25.02 •i. ('t- 'li-`a *(..or 1{QG✓ Addy rc' Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$_) Page 2 Primer 12.51 Contact name: 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 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal ga,qq Phone:( ) Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) .215. 15 CCB Lie.: Plumbing Lic.no.: /03 �6 State surcharge(12%of permit fee) , Authorized signature: TOTAL PERMIT FEE //$a,30 Print name: Date: This permit application expires if a permit is not obtained with&I80 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\PermitsiPLMU-PermitApp.doe 10/01/09 440-4616T(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-1a 100' i 50.03 550 03 0 to 2,000 $121.90 Footing drain-each additional 100' A 37.52 45,04 2, to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' !t 62.54 6.,� 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' l 62.54 62.54 Medical Gas Systems: Water Service-each additional 100' l 37.52 37,52 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' g 37.52 360.16 $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 (minimum charge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: (,5O.34 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! Plan review is required for any of the following. Work Performed: Capped Added Relocate Baptistry/Font Please check all that apply. CIAny 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 ❑ 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/Lay -Non-food related -Bradley I -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 1:1Building\Permits\PLMU_PermitApp.doc 2 • q Site Utilities — Plumbing Permit Application Plan Submittal Requirements TIGARD A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional,drawn to scale) labeled with: A. ❑ map& tax lot# D project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS -Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location,pipe size, type of material, slope of piping, manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. IABuilding\Pennits\PLMF-PermitApp_doc 12/30/05 Plumbing Permit Application • Site Utilities H�utiVE FOR OFFICE USE ONLY City of Tigard Received /� g Permit No.: p �,7�7, 1� /4 Date/BY: '/' [It > /-Ci'il�V[re/'C��-L it 13125 SW Hall Blvd.,Tigard OR 97223 MAR 0 2D20 Plan Review qq(��� /J, ^���0J0 51( Phone: 503.718.2439 Fax: 503.598.196 Da eBy /�)3-�Pu Other Permit No.. Inspection Line: 503.639.4175 LITY OF TIGARD Date Read iBy uds ® See Page 2 for TIGARl7i In cttslC P}u r..�;r.e. y ‘S ag Internet: www.tigard-or.gov _ r 'Notified/Method)_v�l/�t�` (� ep Supplemental Information TYPE OF WORK 14i f-vyly�llge4.. 1,7(� 11E6* El New construction El Demolition s'.For special information use checklist Description I Qty. I Ea. I Total •Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ I-and 2-family dwelling •Commercialiindustrial SFR(2)bath 437.78 SFR(3)bath 500.32 El Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑ Master builder El Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 12850 SW GRANT AVE Catch basin or area drain 2 18.76 37.52 City/State/ZIP: TIGARD/OR/97223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: 214) Page 2 92.80 Suite/bldg./apt.no.: I Project name:BROADWAY ROSE THEATRE Manufactured home utilities 50.03 Cross street/directions to job site: HWY 99W/SW PACIFIC HWY TO SW Manholes 18.76 WALNUT ST TO SW GRANT Rain drain connector 8 18.76 150.08 Sanitary sewer(no.linear ft.:70 ) Page 2 62.54 Storm sewer(no.linear ft.: 845) Page 2 342.06 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.:8700 Fixture or item: Tax map/parcel no.: WCTM 2S102CB00100 Backflow preventer 31.27 DESCRIPTION OF WORKBackwater valve 2 12.51 25.02 Clothes washer 1 25.02 25.02 EAST AND WEST ADDITIONS TO THE EXISTING THEATRE: 1923SF EAST Dishwasher 1 25.02 25.02 ADDITION ADDS A REHEARSAL STUDIO AND MARKETING OFFICE,2241SF WFST ADDITION RIGHT-SI7FS THE SHOP AND ADDS COSTI IMF STORAGF Drinking fountain 25.02 AND COSTUME SHOP. Ejectors/sump 25.02 . 0 PROPERTY OWNER 1 i TENANT Expansion tank 12.51 Name:BROADWAY ROSE THEATRE:ATTN SHARON MARONEY+DAN MURPHY Fixture sewer cap 25.02 Floor drain/floor sink,Rtub 25.02 Address: 12850 SW GRANT AVE Garbage disposal 25.02 City/State/ZIP:TIGARD,OR,97223 Hose bib 4 25.02 100.08 Phone:( 503)603.9862 Fax:( 503) 670.8512 Ice maker 12.51 115. APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$_) Page 2 Business name:SCOTT EDWARDS ARCHITECTURE Primer 12.51 Contact name: MELISSE KUHN Roof drain(commercial) 12.51 Address: 2525 E BURNSIDE ST Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP: PORTLAND/OR/97214 Solar units(potable water) 62.54 Phone:( 503) 896.5372 Fax: :( ) Tub/shower/shower pan 12.51 E-mail: MKUHN@SEALLP.COM Urinal 25.02 Water closet 25.02 CONTRACTOR - / 1 Water heater 37.52 Business name: B&G BUILDERS ATTN:GREG CAPEN 4 Water piping/DWV 56.29 Address: 4213 NE ALBERTA ST Other: 25.02 City/State/ZIP: PORTLAND/OR/97218 Subtotal Phone:(503 )839.4030 Fax:( ) Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.: 197519 Plumbing Lic.no.: State surcharge(12%of permit fee) Authorized st e: ,t� / // rya J ♦ TOTAL PERMIT FEE Print name: / • �J�/ Al /�` Date: 3��W This permit application expires if a permit is not obtained within 180 days v after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:113uilding\Permas1PLMU-Permit pp.doc 10/01/09 440-46I6T(10/02/COI1/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' 1 50.03 50.03 0 to 2,000 S121.90 Footing drain-each additional 100' 1.14 37.52 4P.77 2,001 to 3,600 $169.69 3,601 to 7,200 S233.20 Sewer-1st 100' 1 62.54 62.54 7,201 and greater S327.54 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' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 7.45 37.52 279.52 $5,001.00 to$10,000.00 $72.50 for the first S5,000.00 and$1.52 for Other Ins ctions or Fees Qt~'• Fee(ea) Total additional$100.00 or fraction thereof,to l� 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 tee 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*. by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ review is required for any of the following. Work Performed: Capper Added Baptiary Pont Please check all that apply. Bath Tub%Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool i 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 1 ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ 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" Isometricor Riser Diagram Car Wash Drain ❑ 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 2 1 -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes 1 Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal ' plumbing permit can be issued. Other Fixtures: I:\BuildinglWebPageForms\PLMU_PermitApp.doc 2 Branden Taggart From: Branden Taggart Sent: Friday, May 8, 2020 12:28 PM To: Melisse Kuhn Subject: Broadway Rose Plumbing Permits: PLM2020-00141 & 190 - 12850 SW Grant Ave. Attachments: Branden Taggart2.vcf; Broadway Rose Plumbing &Sewer Permit Invoices.pdf Hi Melisse, The Plumbing and Sewer permits for Broadway Rose Theatre are ready to issue now. I have attached invoices above for you to reference, and the fees due are as follows: Broadway Rose Theatre Permit# Fees Due PLM2020-00141 $ 1,182.30 PLM2020-00190 $ 252.20 SWR2020-00098 $ 2,204.00 Total: $ 3,638.50 The above fees 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, and I can email the Building Fixtures Plumbing permit to you; however, the Site Utilities Plumbing permit(PLM2020-00141)will need to be picked up due to the size of the plans. The permit and plans can be picked up between the hours of 8:00 a.m. and 3:00 p.m., Monday through Thursday. We are closed on Fridays. Furthermore,the permit fees for PLM2020-00190 and SWR2020-00098 will both need to be paid before we can issue either of them. Please let me know if you have questions. Thank you, Branden Taggart f" ' City of Tigard Senior Permit Technician TF6 AKO.7 Community Development 13125 SW Flail Blvd Tigard, OR 97223 (503)718-2449 brandent@tgard-or.gov 1 Branden Taggart From: Branden Taggart Sent: Thursday,April 2, 2020 8:49 AM To: Melisse Kuhn Cc: #Building Permit Technicians;Agnes Lindor Subject: RE: Question: Broadway Rose Theatre Site Development Permit Attachments: Branden Taggart2.vcf; PLMF_PermitApp.pdf; PLMU_PermitApp.pdf; TransmittalLetter_Revisions_052512.pdf Hi Melisse, We will need (1) additional set of the Geotechnical report for a total of(2) sets. Also, I noticed that the Site Utilities Plumbing Permit Application included the interior plumbing fixture counts on it. We generally see separate plumbing contractors complete the site utilities and interior plumbing work, which is why we ask for separate plumbing applications—Site Utilities and Building Fixtures Plumbing Permit Applications. We would appreciate it if you can complete both plumbing applications attached above, and include a description of work that is fitting for each. If the contractor has not been selected for the interior plumbing work,you do not need to submit this application. Thank you for your help with this. Lastly, I have included a Transmittal letter for you to include with the second Geotechnical report. Thank you, ItBranders Taggart a, City of Tigard Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent@tigard-or.gov From: Melisse Kuhn <MKuhn@seallp.com> Sent: Tuesday, March 31, 2020 8:27 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: Question: Broadway Rose Theatre Site Development Permit Caution!This message was sent from outside your organization. Hi Julie, I originally submitted geopier drawings and calculations as a deferred submittal for the Broadway Rose Theatre a week ago. Tom gave me direction to combine them with the site development permit drawings (I dropped those off yesterday with the site development application). Do you have the original geopier deferred submittal plans to combine them with the site development plans or should I send a new set over? Thank you, 1 Melisse Kuhn Associate SCOTT I EDWARDS ARCHITECTURE LLP SIEA HEADQUARTERS IS UNDER CONSTRUCTION Our temporary office location: 2709 SE Ankeny St. Mailing Address: 2525 E Burnside St. Portland, OR 97214 0: 503.226.3617 I D: 503.896.5372 I www.seallp.com From: Tom Hochstatter<TomH@tigard-or.gov> Sent: Monday, March 30, 2020 4:14 PM To: Melisse Kuhn <MKuhn@seallp.com> Subject: RE: Broadway Rose Theatre Site Development Permit Just take them to the city and Julie will put them together From: Melisse Kuhn <MKuhn@seallp.com> Sent: Monday, March 30, 2020 4:05 PM To:Tom Hochstatter<TomH@tigard-or.gov> Subject: Broadway Rose Theatre Site Development Permit Hi Tom, Wanted to let you know that I submitted the Site Development Permit for the Broadway Rose Theatre today, and like an idiot completely forgot to put the geopier drawings and calculations in with the site development application/drawings. Shall I submit it as a deferred submittal or can I run the drawings out to you tomorrow? I'm so sorry. Best, Melisse Kuhn Associate CZ SCOTT I EDWARDS ARCHITECTURE LLP SIEA HEADQUARTERS IS UNDER CONSTRUCTION Our temporary office location:2709 SE Ankeny St. Mailing Address: 2525 E Burnside St. Portland, OR 97214 0: 503.226.3617 I D: 503.896.5555 I www.seallp.com DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 2 III Accumulative Sewer Tally Tenant Name: Broadway Rose Theatre sWR# T l Kn Site Address: 12850 SW Grant Ave PLM# Parcel#: 2S102CB00100 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 (1 1 0 0 0 Drinking Fountain 1 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain/Sink: 2 inch 2 0 0 0 0 0 -3 inch 5 0 0 0 0 0 -4 inch 6 0 0 0 0 0 -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 0 0 0 Living Unit 16 0 0 0 0 0 Oil Sep(Gas Station) 6 0 0 0 0 0 Rec.Vehicle Dump station 16 0 0 0 0 0 Shower: -Gang(per head) 1 0 0 0 0 0 -Stall 2 0 0 0 0 0 Sink: -Lav/Bar-Non-Food Related 2 9 0 1 8 0 3 0 0 0 -Bradley 5 0 0 0 0 0 -Com/Serv/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 11 0 0 0 Washer-Clothes 6 1 0 6 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 10 0 60 0 0 0 0 Urinal 6 3 0 18 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 0 0 0 0 Current Fixture Value 110 _ divided by 16= - 6.875 _Current EDU 1 EDU = $5,800.00 Previous Fixture Value 102 _ divided by 16= _ 6.375 _Previous EDU Change_ 8 _ divided by 16= _ .5 _ over (under) $ - Enter EDU Change Here 0.000 * *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.Ol. Notes: Authorized Name/Signature: _ Date: Building Division ote: 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\S ewerTallyS hect_5800_070119.xlsx