Permit CITY OF TIGARD BUILDING PERMIT
II
`'�1 s COMMUNITY DEVELOPMENT Permit#: BUP2021-00239
Date Issued: 10/13/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 200
Project: Spec Space Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: TI-Work to include interior demo,new walls,doors,cabinetry, plumbing 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
FEES
Specifics:
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IB Permit Fee-Additions,Alterations, 10/12/2021 $1,341.51
Occupancy Grp: B Occupancy Load: 70 Demolition
12%State Surcharge-Building 10/12/2021 $160.98
Dwelling Units: 0 Plan Review 10/05/2021 $871.98
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 10/12/2021 $274.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/12/2021 $536.60
Value: $138,970 Info Process/Archiving-Lg$2.00(over 10/12/2021 $14.00
11x17)
Metro CET 10/12/2021 $166.76
Floor Areas: Tigard CET-Non-Residential-Admin 10/12/2021 $55.59
Total Area: 0 Tigard CET-Non-Residential-AH 10/12/2021 $1,334.11
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $4,755.53
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. u 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: -� . /l�GGt,I
Call 503.1i397175 by 7:00 a.m.for the next available inspection date.
ff
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.
Y
Building Permit Application Z _ • la
Commercial RECEIVED FOR OFFICE USE ONLY
Received/ov Z1/ �1 1P /^Der, 3
City of Tigard SEP
DateB : U 7" Permit Norl�j,J �J`j V Zr`
111 --° 13125 SW Hall Blvd.,Tigard,OR 97223 S E P 2 8 2021 Plan Review,
11 Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 'Q' $ d
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD DateReadyBy: J ® See Page 2for
Internet: www.tigard-or.gov BUILDING DIVISION 4ir
7...).
"�e-71 Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑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 ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
ElAccessory building ❑Multi-family Number of bedrooms:
Ill Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:4 Lincoln-10250 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:200 Project name:Vacancy Space Prep 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 demoltion,new walls,doors,cabinetry,plumbing,and finishes. Valuation: $$138,970.00
Existing building area: 10499 square feet
New building area: 10499 square feet
® PROPERTY OWNER ❑ 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
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Mackenzie
Structural plan review fee(or deposit): ,87/`r
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 �p roof-top mounted Photo Voltaic Solar Panel System.
Business name: yetiS,SL,, L°v�S GI G A a„ 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 $180.00
and administrative fees):
Phone:(503)692-9002 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB tic.:58918 Total fee due upon application: $201.60
Authorized signature: FrIvri‘a This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Samantha Ruddy Date:09/27/2021 * 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] $ 138970
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 34742.50
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): $
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
III II
e COMMUNITY DEVELOPMENT DEPARTMENT
T I G A u D Building Permit Review — Commercial - No Land U s e
Building Permit #: '(J/ZO2/'00239
Site Address: 9 ^1(41 ) - 10250 0 SW ( gettJeu g Suite/Bldg#: 2.a,
Project Name: S gT S(JAC6-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: lhitla 1 I
Existing Business Activity: p Its
Propose Business Activity: �V�
Vp i site address/suite# exists and active in permit system.
jiver Terrace Neighborhood: ❑ Yes 111&•‹
:..,' ning: MIX
mitted Use: IV Yes ❑ No ❑ Spec Space
1 Confirm no land use required.
C l Business License:
Exists: E Yes ❑ No, applicant was provided a business license application
Notes:
Approved by Planning: /111_ z Date:- 9 j2 9/Z 1
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: D t/28/24.Z./
Site Plans: # u3 .
Building Plans: # 3
Building Permit#: enter building permit# above.
Workflow Routing: lifeIslanning Permit Coordinator I Building
Workflow Sign-off: ''Sign-off for Planning(include notes from planning review)
Route Application Documents: TrBuilding: original permit application, site plans,building plans, engineer and
beam calculations and tru t details,if applicable, etc.
Notes:
By Permit Technician: t�.iiir77' Date: /0/4//Za1/
1:\Building\Fonns\BldgPennitRvw_COM_NoLandUse_111819.docx
1
•
Permit Coordinator Review
Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant
SDC Fees Entered: Wash Co Trans Dev Tax: El Yes e2r N/A
Tigard Trans SDC: ❑ Yes tel N/A
Parks SDC: ❑ Yes rlf N/A
OK to Issue Permit
Approved by Permit Coordinator: iL Date: I to l 5/21:14
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx