Permit CITY OF TIGARD BUILDING PERMIT
s • COMMUNITY DEVELOPMENT Permit#: BUP2021-00247
Date Issued: 11/2/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 545
Project: Gallagher Basset Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-work include interior demo, 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
Class of Work: ALT Type of Const: IB Permit Fee-Additions,Alterations, 10/28/2021 $864.99
Occupancy Grp: B Occupancy Load: 18 Demolition
12%State Surcharge-Building 10/28/2021 $103.80
Dwelling Units: 0
Plan Review 10/14/2021 $562.24
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 10/28/2021 $110.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/28/2021 $346.00
Value: $67,394 Info Process/Archiving-Lg$2.00(over 10/28/2021 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,993.03
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: Ho{d,tj Vo-w De Wecje Permittee Signature: Oyt Apr,u_c_afixr,
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.
ice. , , .. .. - _
Building Permit Application ,, I <',
Commercial �p
City of Tigard RECEIVE Receive
Date/By:d �����/f��� PermitNo.:L�/1—����ei
lig " 13125 SW Hall Blvd.,Tigard,OR 97223
g nQ Plan Review 0 „.ca.‘ cv I/ Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 OCT 12 ZOZ1 Date/By:
T I G,.RD Inspection Line: 503.639.4175 Date Ready/By: Auris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notifi /Method: A Supplemental Information
TYPE OF W 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 LECommercialiindustrial
❑Accessory building ID 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.:545 Project name:Gallagher Basset TI 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: I 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 demolition,new walls,doors,relites,casework and finishes. Valuation: $$67,394.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
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*
Business name:Mackenzie (Please refer to fee schedule)
Structural plan review fee(or deposit): CJ4,2
2-171
Contact name:Taylor Orlando
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. torlando a mcknze.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Russel 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 $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: $201.60
Thispermit application expires if a permit is not obtained
Authorized signature: (Si h_y____„(
PP P
within 180 days after it has been accepted as complete.
Print name:Sarah Winegar Date: 10/11/2021 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TlGA D Building Permit Review — Commercial - No Land Use
Building Permit #: BUP2o2 00ZL4(0
Site Address: 10210 S(A) 6 a tJ Suite/Bldg#: Uetc 'f 7 3
Project Name: 60 1 ( G(, k &r. Q,� -�-
(Name of comncial business occupying the space. If vacant,enter Spec Space.)
Planning Review // I r, / /,
Proposal: °Vl0 (, -('0vi. or- ex, 4-? i wia`lJ G/S r ;is i�l/mks
eayel�o r�C.� 2— P l/.S-
� ✓`CW (Jog � I t"
Existing Business Activity: 4 f$z€G Spa .e- ( )
-C-€
Proposed Business Activity: A � 'Sags?4- (o- j l
r.�.' Verify site address/suite# exists and active in permit system. 1
❑ River Terrace Neighborhood: ❑ Yes gi No
Zoning: A UC —
?I Permitted Use: 21 Yes ❑ No ❑ Spec Space
Xi Confirm no land use required.
Business License:
Exists: )V Yes ❑ No,applicant was provided a business license application
Notes:
•
Approved by Planning: 4 Date: W `Li/�Z1
l
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: I O f I Z./Z02./
Site Plans: # 3
Building Plans: # 3
Building Permit#: [ Enter building permit#above.
Workflow Routing: [Planning ❑ Permit Coordinator ['Building
Workflow Sign-off: Er—Sign-off for Planning(include notes from planning review)
Route Application Documents: 213uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: fit Date: /Vl/hI/202(
1:\Building\Fonns\BldgPermitRvw_COM_NoLandUse 111819.docx
ill
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: ❑ Yes 0 N/A
Tigard Trans SDC: ❑ Yes 0 N/A
Parks SDC: 0 Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx
RECEIVED
M A C K E N 21 E , OCT 122021
1515 SE Water Ave.Suite 100•Portland OR 97214 pr
PO Box 14310•Portland OR 97293 VI�y IY OF TIGARCD
TEL:503.224.9560•NET:MCKNZE.COM•FAX:503.228.1285 3UILDING DIVISION
Letter of Transmittal
65263-1
Date: October 12, 2021 Project Number: 2190952.11
To: City of Tigard
13125 SW Hall Blvd
Tigard, OR 97223-8199
Attention:
Project Name: 10220 3 Lincoln -Suite 545/Gallagher Bassett TI
Enclosed: Quantity Medium Description Comment
3 Bond Full Permit Set For your review
Remarks:
Signed: Sarah Winegar
Transmitted
Employee Delivery (MMF)
Via:
If enclosures are not as noted, kindly notify us at once.
Mackenzie reference url:Document link:3LIN_STE545_CD_2021-1011.pdf