Permit •
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00070
Date Issued: 04/30/2009
.T;EGARp 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 320
Subdivision: Lot: 0
Project: Ameriprise
Project Description: TI.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 04/30/2009 $226.95
CALIFORNIA ST 49TH FL Tax - 12% State Surcharge 04/30/2009 $27.23
PHONE: Plan Review 04/30/2009 $147.52
Plan Review - Fire Life Safety 04/30/2009 $90.78
Contractor:
RUSSELL CONSTRUCTION INC
20915 SW 105TH AVE
TUALATIN, OR 97062
PHONE: 503 - 228 -4898
FAX: 503- 228 -2770
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 6 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $25,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $492.48
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: Yes
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 . I work is suspended for more
the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center T ose rules are set forth 'n OAR
952 - 001 -0010 throu. h OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling ' .246.6 • • s : II .. 32. . 44.
Issued By: ' I , okiA • I ' Permittee Signature: - • WIf?
Call 503.639.4175 by 7:00 a.m. for an inspection that busi t . ay.
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
Commrercia RECEIVED FOR OFFICE USE ONLY
City of Tigard RECEIVED ��./\'�
- Date/Br a Permit No.: r` ,�� •
" 13125 SW Hall Blvd., Tigard, OR 97223 A PR 3 Q 2009 Plan Review Other Permit'
Phone: 503.639.4171 Fax: 503.598.1960 DateB :��p 'R
TIGARD Inspection Line: 503.639 CITY OF TIGARD Notified/ Method: tSee Supplemental Information
Internet: www.tigard-or.gov BUILDING DIVISION P
. , - -= ; 3 _:. 3 ,. a s avit ; ..::•, b .
g jd 7 TYPE OF W ORK ` .? yr. REQUIRED DATA .1 AND 2 FAMILY DWELLING
i
❑ 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
work indicated on this application.
CATEGORY OF CONSTRUCTION �? PP
111 1- and 2- family dwelling ® Commercial /industrial Valuation: $
111 Accessory building 111 Multi-family Number of bedrooms:
ID Master builder ['Other:
Number of bathrooms:
', �. �"�"- Total number of floors:
OB SITE' 31�7F0 µ ' A�T101 AND LOCATIN: -„ m..
Job site address: 2 Lincoln 10220 SW Greenburg Rd New dwelling area: square feet
City/State /ZIP: Portland, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 320 Project name: Ameriprise Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA' COMMERGIAL 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
.n = - q overhead, and the profit for the
e uipment materials labor, overhe d a e r
work indicated on this application.
z DES OF WORK
Interior Tenant Improvement Valuation: $$25,000.00
Work to include minor demolition, new walls, doors and cabinetry Existing building area: 2,412 square feet
New building area: square feet
. . ®PROP ERTYOWNE R
T - Number of stories: 6
Name: Shorenstein Type of construction: I -B
Address: One SW Columbia Street, Suite 300 Occupancy groups:
City/State /ZIP: Portland, OR 97258 Existing: B
Phone: (503)412 -4906 Fax: (503)412 -4848 New:
®APPLICANT .. ' COTACTPERSONs� v
; ,.. • k s , , NO
Business name: Group Mackenzie All contractors and subcontractors are required to be
Contact name: Morgan Roush licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1515 SE Water Ave Suite 100 jurisdiction in which work is being performed. If the
City/State /ZIP: Portland, OR 97214 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9560 Fax: : (503) 228 -1285
E -mail: mtoth @grpmack.com
d .. :ff.. k, COl\TRAC , ..:. .........
Business name: Russell Construction � iBU PERMITTFLES*7 * ~,
Address: 20915 SW 105th Ave
s. - (Please lo Jee sekediIle);:. , A 7_ A
•
Structural plan review fee (or deposit):
City/State /ZIP: Tualatin, OR 97062
Phone: (503) 228 -4898 Fax: (503) 228 -2770 FLS plan review fee (if applicable):
CCB lie.: 58918 Total fees due upon application:
Amount received: LH 2 .
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Kim For Date: 04/30/09
* Fee methodology set by Tri- County Building Industry
Service Board.
C \Butlding\Permits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02/COM /WEB)