Permit CITY OF TIGARD BUILDING PERMIT
° Permit ft: BUP2021-00180
COMMUNITY DEVELOPMENT Date Issued: 8/10/2021
T(t;ARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 125
Project: Fitness Center Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Upgrades to include interior demolition,new walls,doors,relites,casework and finishes.
Contractor: RUSSELL CONSTRUCTION INC Owner: LINCOLN CENTER LLC
20915 SW 105TH AVE BY SHORENSTEIN PROPERTIES LLC
TUALATIN, OR 97062 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-692-9002 PHONE:
FAX: 503-692-9008
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 08/09/2021 $1,619.35
Class of Work: ALT Type of Const: VB
Demolition
Occupancy Grp: A-3 Occupancy Load: 43 12%State Surcharge-Building 08/09/2021 $194.32
Dwelling Units: 0 Plan Review 07/27/2021 $1,052.58
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 08/09/2021 $647.74
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 08/09/2021 $14.00
Value: $184,500 11x17)
Metro CET 08/09/2021 $221.40
Tigard CET-Non-Residential-Admin 08/09/2021 $73.80
Floor Areas: Tigard CET-Non-Residential-AH 08/09/2021 $1,771.20
Total Area: 0 DC Provision Review,COM TI-Ping 08/09/2021 $434.00
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,028.39
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: ft° V De/wee Permittee Signature: OvvAhp �rt
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. f
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-- 7 15
Commercial JULOFFICE USE ONLY
U_.(4 1 5 2021 Received
City of Tigard 7�2 3 'lIII Permit N¢3 u P Z.v 2f�Cb r�'v
. (� Date/By:
13125 SW Hall Blvd.,Tigazd,OR 9722;`,I��LJY Ti��l4F{Q Plan Revie Q 4.41•
Phone: 503.718.2439 Fax: 503.598 DING DIVISION Date/By: ' u " ��i Other Permit:
Inspection Line: 503.639.4175 e ReadyBy: Jur'•� H See Page 2 for
TIGARD ifiedMeth Supplemental Information
Internet: www.tigard-or.gov f
TYPE OF WORK REQUIRED DATA:l-AND 2-FAMILY DWELLING
0 New construction 0 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: $
0 1-and 2-family dwelling ®Commercial/industrial
El Accessory building Multi-family Number of bedrooms:
❑
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:3 Lincoln-10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:125 Project name:Fitness Center Upgrades 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: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Work to include demolition,new walls,doors,relites,casework,and finishes. Valuation: $$184,500.00
Existing building area: 4377 square feet
New building area: 4377 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 1
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/A-3
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name:Mackenzie
Structural plan review fee(or deposit): /05 p
- ,5
Contact name:Samantha Ruddy
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
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:sruddy@mcknze.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic 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 105`h Avenue Solar Installation Specialty Code checklist.
City/State/ZIP:Tualatin,OR 97062 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)692-9002 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.:58918 Total fee due upon application: $201.60
Authorized signature: Samantha Rude'sk ", �se- s'e"i'am,ome . This permit application expires if a permit is not obtained
,400,4 2021 071416.237-0r
within 180 days after it has been accepted as complete.
Print name:Samantha Ruddy Date:07/14/2021 * 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)
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 184,500
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 46,125
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
Is!
i
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
i
City of Tigard
111111 q COMMUNITY DEVELOPMENT DEPARTMENT
1
Building Permit Review — Commercial - No Land Use
TIGARD
43,
Building Permit #: (3iit/J 2v Z I — 0 018'a
Site Address: L1ncou•1 - /b220 SvJ & Suite/Bldg#: 12 S----
Project Name: f l` 1 5 Ctr UeaPsPeS
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 'r'Ant t nflpeo‘renercnrc
Existing Business Activity:
Proposed Business Activity:
Vsite address/suite# exists and active in permit syste
r Terrace Neighborhood: ElYes No
ning: M I C- �/
P mitted Use:pi
1/J Yes ❑ No ❑ Spec Space
Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes: GOnFgmE0 No MIND►2 MOD A tD
Approved by Planning: s Date: 7/ /2)
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: 7/00, /,:2.-/
Site Plans: # 3
Building Plans: # 3
Building Permit#: ErEnter building permit#above.
Workflow Routing: Ig''Planning ❑ Permit CoordinatorSuilding
Workflow Sign-off: EL--Sign-off for Planning(include notes from planning review)
Route Application Documents: . ilding: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: C/ 1.ir_43.--_ Date: -0—V2.-f
I:\Building\Fonns\BldgPermitRvw_COM NoLandUse 111819.docx
Permit Coordinator Review
0 Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Ap;:cant:
Revision Notice 2: Date Sent to ' .plicant:
Revision Notice 3: Date Sent . Applicant:
❑ SDC Fees Entered: Wash 'o Trans Dev Tax: ❑ Yes ❑ N/A
T.:. d Trans SDC: ❑ Yes ❑ N/A
arks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Perm}x`Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx