Permit CITY OF TIGARD BUILDING PERMIT
'q 2 COMMUNITY DEVELOPMENT Permit# BUP2011 -00229
Date Issued 10/27/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 13135AB01004
Jurisdiction Tigard
Site address 10220 SW GREENBURG RD 150
Project Sleep Medicine Network Subdivision METZGER, TOWN OF Lot 9
Project Description TI
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 - 228 -3413 PHONE
FAX 503 -228 -2770
FEES
Specifics -
Description Date Amount
Type of Use COM DC Provision Review, COM TI - Ping 10/27/2011 $64 00
Class of Work ALT DC Provision Review, COM TI - LRP 10/27/2011 S9 00
Dwelling Units 0 Permit Fee - Additions, Alterations, 10/27/2011 $736 98
Stories 6 Height 0 ft Demolition
Bedrooms 0 Bathrooms 0 12% State Surcharge - Building 10/27/2011 $88
Value $50,673 Plan Review 10/27/2011 $47904
Plan Review - Fire Life Safety 10/27/2011 $294 79
Info Process /Archiving - Lg Sheet (over 10/27/2011 $6 00
Floor Areas: 11x17)
Total Area 0
Accessory Struct 0
Basement 0
Carport 0
Covered Porch 0
Deck 0
Garage 0
Mezzanine 0
Total $1,678 25
Required: Required Items and Reports (Conditions)
Fire Sprinkler Yes Parapet
Fire Alarm Yes 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 23 • • 800 332 2344
Issued By . ermittee Signature
Call 503 ' 9 41 f it\) . 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
Building Permit Application Dp
Commercial FOIt OFFICE USE ONLY
III - City of Tigard OCT 2 7 2011 Permit No , e � _� )-70)1 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review ME
Phone 503 639 4171 Fax 503 598 1960 OF T!GA iD Date /B l f1V!►!W®. Other Permit
TICiARD Inspection Line 503 639 4175 n DIVISION ai /B ® Page 2 for
Internet www tigard -or gov BUILDING DDIVISION Notified Date Re /M d ethod w Supplemen tal Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit tees* are based on the value of the work performed
Indicate the value (rounded to the nearest dollar) of all
0 Addition /alteration/replacement ❑ 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 Valuatlon $
❑ 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 Two Lincoln - 10220 SW Greenburg Road New dwelling area square feet
City /State /ZIP Tigard, OR 97224 Garage/carport area square feet
Suite/bldg /apt no 150 Project name Sleep Medicine Network Covered porch area square feet
Cross street/directions to job site SW Locust Street Deck area square feet
Other structure area square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision 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
Valuation $$50,673.00
Existing building area 3502 square feet
New building area 0 square feet
0 PROPERTY OWNER ❑ TENANT Number of stories 5
Name Shorenstein Realty Services Type of construction 2 -B
Address 5335 Meadows Road, Suite 300 Occupancy groups
City /State /ZIP Lake Oswego, Oregon 97035 Existing B
Phone (503)619 -3200 Fax (503)619 -3210 New B
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name GBD ARCHITECTS All contractors and subcontractors are required to be
Contact name Whit Middlecoff licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to he licensed in the
Address 1120 NW Couch Street, Suite 300 jurisdiction in which work is being performed If the
City/State/ZIP Portland, Oregon 97209 applicant is exempt from licensing, the following reasons
apply
Phone (503) 224 -9656 Fax (503) 299 -6273
E -mad whit @gbdarchitects.com
CONTRACTOR
Business name Russell Construction BUILDING PERMIT FEES*
Address 20915 SW 105 Avenue (Please refer to fee schedule
City /State/ZIP Tualatin, Oregon 97062 -9511 Structural plan review fee (or deposit)
Phone (503) 228 -3413 Fax (503) 228 -2770 FLS plan review tee (if applicable)
CCB he 58918 Total lees due upon application
re
Amount received
Authorized signature
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name Whit Middlecoff, AIA Date 10/27/2011
* bee methodology set by Tn- County Building Industry
Service Board
I \ Budding \Permits\BUP -COM PennitApp doe 10 /01/09 440- 4613T(I 1 /02/COM /WEB)
Building Division
Over- The - Counter (OTC) Building Permit
T[GARD Check List
Project Description
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
"Class of Work I Occupancy Group ] Type of Construction '2aff;
*Type of Use Ce9'f(,{ Occupancy Load ` Oregon Specialty Code . 200
SPECIFICS
Number of Stories (e; Building Height Mixed Use
Number of Dw Units Number of Bathrooms- Number of Bedrooms
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage. Accessory Structure Covered Porch
Basement Garage Deck
Total Square Footage Carport Mezzanine
SETBACKS
Sideyard Setback — Left Sideyaid Setback — Front
Sideyard Setback — Right Sideyaid Setback — Back
CONSTRUCTION
Exterior Walls Openings Protected Fnewall Separation
Occupancy Separation.
E W l W Access Parking Spaces
REQUIRED ITEMS
Fire Spunklers f(lr,Lj Fire Alarms Leto Smoke Detectors
Parapet Manual Pull Stations- Protected Corridors
Total Project Valuation: $ r J 0 6,73 FEES DUE
$ ,CO / DC Prov Rvw, COM TI — Ping
$ 4 , O DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM T1 $ TA °, , re Petnut Fee — Add, Alt, Demo
Project Valuation Planning LRP $ I r. a 12% State Surcharge
Up to $4,999 $0 00 $0 00 $ NAM Plan Review, Structural
$5,000 - $74,999 $64 00 $9 00 $ '-a' Plan Review, Fire Life Safety
$75,000 - $149,999 $160 00 $24 00 $ , fl Info Proc /Arch, Lg (over 11x17 $2 00)
$150,000 and over $256 00 $38 00 $ Info Proc /Arch, Sm (up to 1 lx 17 $0 50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff $ Hourly Rate State Surcharge
$ Misc Admm Fee
Permit Coordinator $ Other
$ Other
Building Staff $ Other
Date /Time $ ( (;:::21 TOTAL FEES DUE
*OPTIONS:
TYPE OF USE COM = commercial, CMS = commercial manufactured structure
CLASS OF WORK ACS = accessory, ADD = addition. ALT = alteration, END = foundation, DLM = demo,
PND = foundation, PPS = fire protection system, NEW = new, OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies),
REP = repair
\ Building \ Forms \OTC -BUP don 01/13/2(111
1111 'i Building Division
Development Code Provision Review
Tica RD Commercial Projects - No Associated Land Use Case
Building Permit No: _ „ P - • —.; 624xpedited Review
Plan Submittal Date l fi ?,7 / /
JD Z.2-j GjWU rc�,t f vs-l; Rd /4)
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
D If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section
Staff: please check items along left only if approved. /'
Planning Review (contact /%L'/ at 503-718- V Vd or / titi@ngard -oi gov)
” Zoning / / Per mitted Use Yes No ❑
/
i,and Use Required Yes ❑ No li / (explain below)
/ r `. 1 __
Notes. i , I ti 2 '
-/
. _ 1/4 t.
/Approved ❑ Not Approved Date. / ° /. 7-7 //
Permit Coordinator Review (contact Albert Shields at 503 -718 -2426 or allbert @tigard -or gov)
Notes.
A
Routed back to Building Division Date
I \LU PLN