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Permit (138) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT ' - Permit#: PLM2018-00269 T I GA.R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ` Date Issued: 07/10/2018 \()\ --n_ \��c7 Parcel: 1S135DA02400 Jurisdiction: Tigard Site address: 11045 SW HALL BLVD Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7 Project Description: Interior plumbing for a new 32 bed residential care facility. 10/25/18:REPRINTED to correct address from 11035 to 11045. Contractor: OASIS PLUMBING INC Owner: BROOKSIDE RCF LLC 11177 S ALLEN CT 5987 SE ROBHIL DR OREGON CITY, OR 97045 MILWAUKIE, OR 97222 PHONE: 503-351-0743 PHONE: FAX: 503-212-0165 FEES Quantity Description Date Amount 1 ea Rain Drain Connector 07/10/2018 $18.76 Specifics: 1 ea Backflow Preventer 07/10/2018 $31.27 1 ea Backwater Valve 07/10/2018 $12.51 Type of Use: COM 5 ea Clothes Washer 07/10/2018 $125.10 Class of Work: NEW 2 ea Dishwasher 07/10/2018 $50.04 Type of Const: 2 ea Expansion Tank 07/10/2018 $25.02 Occupancy Grp: Stories: 5 ea Floor Drain/Floor Sink/Hub 07/10/2018 $125.10 1 ea Garbage Disposal 07/10/2018 $25.02 6 ea Hose Bib 07/10/2018 $150.12 1 ea Ice Maker 07/10/2018 $12.51 1 ea Interceptor/Grease Trap 07/10/2018 $25.02 5 ea Primer 07/10/2018 $62.55 53 ea Sink 07/10/2018 $1,326.06 7 ea Tub/Shower/Shower Pan 07/10/2018 $87.57 40 ea Water Closet 07/10/2018 $1,000.80 3 ea Water Heater 07/10/2018 $112.56 Total $4,370.31 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: \.....A7\i\..,,,...._ Permittee Signature: V> 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. CITY OF TIGARDIN PLUMBING PERMIT 2 COMMUNITY DEVELOPMENT Permit#: PLM2018-00269 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/10/2018 I f ='�" g Parcel: 1 S 135 DA02400 Jurisdiction: Tigard Site address: 11035 SW HALL BLVD Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7 Project Description: Interior plumbing for a new 32 bed residential care facility. Contractor: OASIS PLUMBING INC Owner: BROOKSIDE RCF LLC 11177 S ALLEN CT 5987 SE ROBHIL DR OREGON CITY, OR 97045 MILWAUKIE, OR 97222 PHONE: 503-351-0743 PHONE: FAX: 503-212-0165 FEES Quantity Description Date Amount 1 ea Rain Drain Connector 07/10/2018 $18.76 Specifics: 1 ea Backflow Preventer 07/10/2018 $31.27 1 ea Backwater Valve 07/10/2018 $12.51 Type of Use: MF 5 ea Clothes Washer 07/10/2018 $125.10 Class of Work: NEW 2 ea Dishwasher 07/10/2018 $50.04 Type of Const: 2 ea Expansion Tank 07/10/2018 $25.02 Occupancy Grp: 5 ea Floor Drain/Floor Sink/Hub 07/10/2018 $125.10 Stories: 1 ea Garbage Disposal 07/10/2018 $25.02 6 ea Hose Bib 07/10/2018 $150.12 1 ea Ice Maker 07/10/2018 $12.51 1 ea Interceptor/Grease Trap 07/10/2018 $25.02 5 ea Primer 07/10/2018 $62.55 53 ea Sink 07/10/2018 $1,326.06 7 ea Tub/Shower/Shower Pan 07/10/2018 $87.57 40 ea Water Closet 07/10/2018 $1,000.80 3 ea Water Heater 07/10/2018 $112.56 Total $4,370.31 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. e Issued By: Permittee Signature: ''�i 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 , ,,'._ . - 7a Building Fixtures FOR OFFICE USE. ONL\ 7i':eived {,_ City of Tigard `•te/By: PermitNo.:u 13125 SW Hall Blvd.,Tigard,OR 97223RECEIVE Plan Review . f ��f �'l+' 0 Phone: 503.718.2439 Fax: 503.598.1960 s Other Permit No.: q/1' -�_ y} Date/By: L._c).5-/p �"'/ � 1. ,LXI T I G A R D Inspection Line: 503.639.4175JUN 6 2018 Date Ready/By: � Jur s: See Page 2 for Internet: www.ti and-or. ov �(?)pi iy �'ti/J g g Dat Read/By: Q.,,� 0Supplemental2 Information TYPETOF WORK CITY()F TIGA * � fI "'t SCHEDULE ;:: ;, . Bi New construction ❑ t pT DIVISION For special information use checklist u + 17 ✓�i91i�di 1 Description Ea. Total p I Qty. 0 Addition/alteration/replacement ❑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 - I}I437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler('b u.sq.ft.) Page 2 JOB:"SITE INFORMATION AND LOCATION ':'.. Site utilities: Job site address: 1 t0' c 5 '\ t� Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: ( ANN C) ' CA� 2.23 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: NV1A)1-t.St Ac_)1 "("4-5''Lynufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector j 18.76 jF<<j Sanitary sewer(no.linear ft .)) Page 2 Storm sewer(no.linear ft.: p Page 2 Water service(no.linear ft.. )) Page 2 Subdivision: 1 Lot no.: Fixture or item: /j n ® Backflow preventer I 31.27 ')) ;a r`l Tax map/parcel no.: S`� � „�f� "' J Backwater valve l 12.51 1:1,s DESCRIPTION OF WORK : r'' -" Clothes washer .5 25.02 I;.�„ .i( y 1 v"v.Fov Std v- ki W e -- Dishwasher 2. 25.02 SC,, L q 17 l , Drinking fountain - 25.02 Ejectors/sump 25.02 xu PR�t�.ry OWNER r 0 , 1 i n Expansion tank Z 12.51 5 O � � Fixture/sewer cap 25.02 Name: pyl� ‘evh\I 0pOn"VA.1/r , Floor drain/floor sink/hub 5 25.02 /2 5./(, Address: C.3 ‘ „, Oir Garbage disposal j 25.02 2 5,C; City/State/ZIP: VNA(,1 l.).1 C)t2 `-'1I- 7.3_1_ Hose bib (0 25.02 j5L,/a Phone:(4505) 19 m- 1- Fax:( ) Ice maker j 12.51 ;a6/ .`4. 'A ` AGT ,TA.,,,,,,, ; Interceptor/grease trap j 25.025,ea Business name: c --- 5\L. \,k,... 1M e�/N�,... (,..��-e.. Medical gas(value:$ ) Page 2 \ �� \ Primer 5 12.51 ‘.':-.1,SJ Contact name: c.�Vv.t CA.."-- Roof drain(commercial) 12.51 Address: Cc\C, 1 j f2 1--.+ t IJ l" Sink/basin/lavatory 41 25.02 '- I:�6�C�C- City/State/ZIP: \s4\‘k�,;c11/411k--$Ji O\Z ctn..'Let., Solar units(potable water) 62.54 Phone:( cu 1 1Ct 1/4\-%�� Fax::( ) Tub/shower/shower pan y 12.51 6'1.S r) Urinal 25.02 E-mail: why -.V-voCkl-‘ O .LALO • (-u-�,N - ' CO)'fiTli �,t�►CTa. Water closet 40 25.02 GLC„''o .., ,.-.,'. . Water heater % 37.52 1i ,S' Business name: 4 J \ Water piping/DWV 56.29 Address: /` a s- 3 Other: _ 25.02 City/State/ZIP: 1 0 -201,3- Subtotal 3 j cit.,..c j Phone:(S 0'9 '')--/_, rj 7/? Fax:( ) Minimum permit fee: $72.50 so CCB Lic.: t (0, t Z i 1 4 Plumbing Lic.no.: Pea C 6 - Plan review (25%of permit fee) 997, State surcharge(12%of permit fee) `?� +;),; Authorized signature: '..'SA TOTAL PERMIT FEE -3%,6 i Print name: ' Date: a This permit application expires if a permit is not obtained within 1.80 days `>z_��� �` ,,,..\,,,1/4.k„,,1/4.i,� / �I a after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permds\PLMU-PemtitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 1 AU S = Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities :, Fee ea) notal Square Foota "' Pennilt Fee: f 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' 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 Value t o n,: '` 'e1r nt 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 tea) 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$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 90.00/1r $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 Quantityb' ixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial / 0 Any multipurpose fire sprinkler system. Domestic ❑ 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 3" Isometric or, ser Diagraltal sF , 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./Refiig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 Branden Taggart From: Branden Taggart Sent: Friday, June 29, 2018 2:09 PM To: 'Benny Damian' Cc: #Building Permit Technicians Subject: RE: Brookside Memory Care Sewer Fee Estimate: BUP2017-00068; 11035 SW Hall Blvd Attachments: Branden Taggart3.vcf Hi Benny, The plumbing and sewer permits for Brookside Memory Care are ready to issue. The fees due are as follows: Brookside Memory Care Permit# Fees Due PLM2018-00269 $ 4,370.31 SWR2018-00173 $ 71,545.00 Total: $ 75,915.31 The permit fees can be paid online now at https://aca.accela.com/TIGARD/Default.aspx or in person between the hours of 8:00 a.m. and 4:30 p.m., Monday through Thursday. We are closed on Fridays. If you pay online, please notify us at tigardbuildingpermits@tigard-or.gov. Thanks, Branden Taggart w City of Tigard R q Senior Permit Technician Community Development TIGARD 13125 SW Kali Blvd Tigard,OR. 97223 (503)718-2449 brandent@tigard-or.gov From: Branden Taggart Sent:Thursday, May 03, 2018 6:22 PM To: 'Benny Damian' <bennydamian@yahoo.com> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Brookside Memory Care Sewer Fee Estimate: BUP2017-00068; 11035 SW Hall Blvd Benny, One correction,the current sewer rate will remain the same until June 30, 2018. On July 1,the fee will increase as described below. Thanks, 1 • Branden Taggart II ■ City of Tigard 0 i:.. Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent©tigard-o r,gov From: Branden Taggart Sent:Thursday, May 3, 2018 6:20 PM To: 'Benny Damian' <bennydamian@yahoo.com> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Brookside Memory Care Sewer Fee Estimate: BUP2017-00068; 11035 SW Hall Blvd Hi Benny, After some research regarding the number of bedrooms, it turns out our land use case listed the number of bedrooms at 42, and this information was incorrectly carried over to the building permit. The building permit application that was submitted did have the bedrooms listed at 32, and so I have revised your permits to show the correct number of bedrooms. I have attached the revised permits above for your records. Also, since a residential dwelling was demoed, I have revised the sewer estimate to include demo credits. Please see my estimate below. Furthermore,the address for Brookside Memory Care is currently the address of the residential property that was demoed. It is our policy to provide a new address for a new building when there was prior demolition of a property. Since the demolition has already taken place and the address fee was previously collected, our engineering department is in the process of assigning a new address. We will let you know what the new address is once it is created. Brookside Memory Care Estimate(32 Bedrooms) Calculation Fees 1 DUE for first 5 bedrooms $5,500.00 1 DUE for every 2 bedrooms over 5 = (13) - (1) Demo Credit = 12 DUE's at$5,500 $66,000.00 Inspection fee $45.00 Total: $71,545.00 Lastly, please note that the sewer fees for 1 DUE will remain the same until July 1, 2018. After July 1,the sewer fees will increase to$5,650.00. Please let me know if you have any questions. Thanks, Branden Taggart 111 q City of Tigard ) 0 gw Senior Permit Technician tICIARD Community Development 13125 SW Hall Blvd Tigard,OR 97223 (5031718-2449 brandent@tigard-or.gov 2 ' From: Branden Taggart Sent:Wednesday, May 2, 2018 6:38 PM To: Benny Damian <bennydamian@yahoo.com> Cc:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: Brookside Memory Care Sewer Fee Estimate Hi, Benny, Per our conversation, I have attached the sewer permit fee estimates for Brookside Memory Care. As we discussed, the first sewer SDC fee estimate with 42 bedrooms was based off of the number of bedrooms listed in the building permit. I have included the second estimate for 32 bedrooms per your request. Please let me know if you have any questions. Brookside Memory Care Estimate (32 Bedrooms) Calculation Fees 1 DUE for first 5 bedrooms $ 5,500.00 1 DUE for every 2 bedrooms over 5 = (13) $ 71,500.00 Inspection $ 45.00 Total: $ 77,045.00 Brookside Memory Care Estimate (42 Bedrooms) Calculation Fees 1 DUE for first 5 bedrooms $ 5,500.00 1 DUE for every 2 bedrooms over 5 = (18) $ 99,000.00 Inspection $ 45.00 Total: $ 104,545.00 Thank you, Branden Taggart 11,4 a City of Tigard ■�.. Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449 brandent,4tigard-or.gov From: Branden Taggart Sent: Wednesday, May 02, 2018 9:05 AM To: Benny Damian <bennydamian@yahoo.com> Cc:#Building Permit Technicians<TigardBuildingPermitsWtigard-or.gov> Subject: Brookside Memory Care Sewer Fee Estimate Hi Benny, I just wanted to let you know that I should have the sewer estimate for Brookside Memory Care to you this afternoon. 3 Thanks, Brannen Taggart q City of Tigard 0 _,;, Senior Permit Technician Community Development ID A RD 13125 SW Hail Blvd Tigard,OR 97223 (503)718-2449 bra ndentP@tigard-o r.gov 4 Accumulative Sewer Tally IIIC Tenant Name: BROOKSIDE MEMORY CARE SWR# 2018-00173 TI G A R D Site Address: 11035 SW HALL BLVD PLM# 2018-00269 Parcel#: 1S 135DA02400 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 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 14 224 14 224 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 0 0 0 0 0 -Bradley 5 0 0 0 0 0 -Com/Sery/Util-Food Related 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer-Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet-Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 1 16 TOTALS 0 0 0 0 14 224 14 208 Current Fixture Value 208 divided by 16= 13.000 Current EDU 1 EDU= $5,500.00 Previous Fixture Value 0 divided by 16= 0.000 Previous EDU Change 208 divided by 16= 13.000 over (under) $ 71,500.00 Enter EDU Change Here 13.000 * *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.01. Notes: 1 DUE FOR EVERY 2 BEDROOMS OVER 5=(13)-(1)DEMO CREDIT= 12 DUE'S AT$5,500.00 PLUS INSPECTION FEE. Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 6/6/2018 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\SewerTallySheet_5500_070117.xlsx City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 11045 SW HALL BLVD, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2018-00269 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Correction's are complete, plumbing final Approved Violation Summary: Inspector Contractor