Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2021 00035
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/22/2021
TIGARD g Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 700
Project: Integrated Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Tenant Improvement:minor demo, new walls and finishes
Contractor: RUSSELL CONSTRUCTION INC Owner: LINCOLN CENTER LLC
20915 SW 105TH AVE BY SHORENSTEIN PROPERTIES LLC
TUALATIN, OR 97062 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-692-9002 PHONE:
FAX: 503-692-9008
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Ig Permit Fee-Additions,Alterations, 02/17/2021 $498.03
Demolition
Occupancy Grp: B Occupancy Load: 55 12%State Surcharge-Building 02/17/2021 $59.76
Dwelling Units: 0 Plan Review 02/02/2021 $323.72
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 02/17/2021 $103.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/17/2021 $199.21
Value: $29,000 Info Process/Archiving-Lg$2.00(over 02/17/2021 $10.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,193.72
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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: \\..\\A1 l ,\ Permittee Signature: Or\ c(ppy,c_�(
\Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 1
��Vll 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 < _ 40,
Commercial FOR OFFICE USE ONLY
la g City of Tigard RECEIVED Received `�,
g Date/By: Z.\.`�ZOZ\ �v PermitNo.:S\R2CZ-00d 3 5
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 JAN 21 2021 Date/By: off. 9-A ) Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: / l Jur s: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD N red/Method: / /! Supplemental Information
W O kDING DIVISION � `
TYPE OF O REQUIRE: !ATA:1-AND 2-FAMILY DWELLING
El 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:5 Lincoln-10200 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:700 Project name:integrated Healthcare Covered porch area: square feet
Cross street/directions to job site:Project located north of SW Oak Street, Deck area: square feet
south of SW Locust Street and east of Greenburg Road Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 1 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
DESCRIPTION OF WORK work indicated on this application.
Work to include minor demolition,new walls and finishes Valuation: $$29,000.00
Existing building area: 8156 square feet
New building area: n/a square feet
►.I PROPERTY OWNER ❑ TENANT Number of stories: 7
Name:Shorenstein Type of construction: I-B
Address:5335 Meadows Rd.,Suite 275 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing: B
Phone:(503)412-4844 Fax:( )
New: B
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Kelly Battaglia
FLS plan review fee(if applicable):
Address:1515 SE Water Ave Suite 100
Total fees due upon application:
City/State/ZIP:Portland,OR 97214
Amount received:
Phone:(503)224-9560 Fax::(503)228-1285
E-mail:kbattaglia@mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Russell Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:20915 SW 105th Avenue Solar Installation Specialty Code checklist.
City/State/ZIP:Tualatin,OR 97062 Permit fee(includes plan review
and administrative fees): $180.00
Phone:(503)692-9002 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:58918 (43
((( a�!� Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
—
within within 180 days after it has been accepted as complete.
Print name:Kelly Battaglia Date:01/21/2021 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
%,ZI 121
IICity of Tigard
I
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Commercial - No Land U s e
Building Permit #: ?jv -c)wZA - c.O 35
Site Address: /0.2Q(? gretild►� elSuite/Bldg#:
Project Name: �j�,lro rL ,a/1 �a,=e
(Name of -(ciotcmercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: ` ?
Existing Business Activity: 07C�
Pro..sed Business Activity: 2/
Verify site address/suite# exists and active in permit cyst
1 AI AO' er Terrace Neighborhood: ❑ Yes L1i1 No
IR oning: AV E
71
rmitted Use: Yes ❑ No ❑ Spec Space
Ifnfirm no land use required.
ICJ Business License:
1
Exists: ❑ Yes No,applicant was provided a business license application
Notes:
Approved by Planning:. . Date: JA-?4.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 1\2.\\1-1
Site Plans: # 3
Building Plans: # 3
Building Permit#: Q Enter building permit# above.
Workflow Routing: Gi Planning ["Permit Coordinator 2 Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: [fJ Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: 4` �(At'llc> �,[— Date: 2 t`IA
d
I:\Building\Forms\BldgPermitRvw_COM_No Land Use_111819.docx
Permit Coordinator Review
Nl Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
,°: Notes:
t Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
I 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 "g N/A
Parks SDC: ❑ Yes 43r N/A
I- OK to Issue Permit
Approved by Permit Coordinator: Date: 14ZI2v2-4
L:\Building\Fonns\BldgPermitRvw_COM_NoLandUse_111819.docx