Permit ii CITY Y OF 1 IGARDr_ BUILDING PERMIT
PERMIT #: COMMUNITY DEVELOPMENT DATE ISSUED: BUP8 20 8 0 - 8 00372
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
PROJECT: KPD INSURANCE
Project Description: TI.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 24 BASEMENT: sf AREA SEP. RATED:
STOR: 5 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: N SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 17,500.00
Owner: Contractor:
SHORENSTEIN REALTY SERVICES RUSSELL CONSTRUCTION INC
ONE SW COLUMBIA ST #300 20915 SW 105TH AVE
PORTLAND, OR 97258 TUALATIN, OR 97062
Phone: 503-412-4800 Contact #: PRI 503 - 228 -4898
FAX 503 - 228 -2770
Reg #: LIC 58918
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/18/200€ $176.90
[TAX] 12% State Surch 11/18/200€ $21.23
[FLS] FLS Pin Rv 11/18/200€ $70.76
[BUPPLN] Pin Rv 11/18/200€ $114.99
Total $383.88
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 than 180 days. ATTENTION: Oregon law requi -s you to follow the rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throut, h' AR 952 - 001 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.234-
•
Issued By ���� �` Permittee Signature: /�A _
`'/ .
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 .
•
,C "OIIlmerc.al FOR OFFICE USE ONLY
v Received y ity of Tard -�E Datem : i i C.p , �� 077 Permit No.: /2
11111
. ° 13125 SW Hall ig Blvd. Tigard, OR 97 Plan Revie
Q j i � Other Permit:
503.639.4171 Fax: 503.598.1960 $ 200 Date/B : je ■z g
T.IGARD Inspection Line: 503.639.4175 IQ \I Date Ready /By: El See Page 2 for
. Internet: www.tigard - or.gov IIG D Notified/Method: R • Supplemental Information
..�:, e „ , - - � .- , -�.�., �°,° 9 ", !t' . ►�1 � ��'+ � '�''n �- _�.v ; -., " ,,;. _ ,-m ,.�;.: .� .,..-s.:,. ° °" " �-.';.�;-se . °: :r x "ass . >r: .
s'.a , ": . . .,.< "e, n� 3 'OM C 1' ..:. ; : I �t 6 5 .: pS k
"`` ri > ::. ,e . 5 ' : : , , YPE OF :,•.:, •,t <� „„ s ff .. g .g : RE._ UIRED DATA, l -AND , ,,ah , �[ILY�DWELLING
'; ..... - '��.� -..z.n ���k� =��rv�� "�- .P- �- ��- a�x - "� -i _ ‘, ,._,._ �'. a � �_ ' �ai� tilt =..xi � *. _ � a <. .;- s- �����a�s�..�*r �='�`' °.�a?-R��r
❑ 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
I " °a; - ;1 " r work indicated on this application.
" " !" * GATEG 4"''''""`.. RY ONSTRLIC ION > :t " : , * , ; :
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
= JOB SITE -INFORMATION AND
I. ON 6 Total number of floors:
9 - ..,.,..,, ,6 �lt.`w,",k4. ;4:, ,x`t s.." .R'S":m`„n„,ma „- . - n.. '!"':4 N
Job site address: 1 Lincoln 10300 SW Greenburg Rd New dwelling area: square feet
City/State /ZIP: Portland, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 200 Project name: KPD Insurance Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQIIIRED,DATA CO 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
_^ :, - -' 'DES CRIPTION OF W ORK 4 work indicated on this application.
Interior Tenant Improvement Valuation: $$17,500.00
Work to include minor demolition, new walls and new doors Existing building area: 2,370 square feet
New building area: square feet
°t .. , - .„,, . -. ' - zr::
PROD QWNER :T t -
: ❑;” T Number of stories: 5
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:
= ® '4 I ,:. ..� ,.z ^CONTt1 T # PE12SON *.o `' NOTICE; „4__.:� t e , '
.. i- '`:: °� -� a .:,. '
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
- - . ' is m w ' a O R , ; . '. ,. ., € 1 ... ,
Business name: Russell Construction ', f3 wi >"a gL{)I;DIN,C'.goisIIT; " FEES* i.
Address: 20915 SW 105th Ave c "tf % " of iser feb ;; eesch'ito s . : ; :g, x,� d_,_._
City/State /ZIP: Tualatin, OR 97062 Structural plan review fee (or deposit):
Phone: (503) 228 -4898 Fax: (503) 228 -2770 FLS plan review fee (if applicable):
CCB lie.: 58918 _ Total fees due upon application:
Amount received:
Authorized signature: ` /c_,
This permit application expires if a permit is not obtained
Print name: Kim Ford Date: 11/18/2008 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I: \Build \Permits \B UP -COM PermitApp.doc 2/23/07 440- 4613T(11/02/COM /WEB)
r ,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008-00372
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/18/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 -111.
INSPECTION WORKSHEET FOR DATE: 12/18/20 18 TIME: 8:38AM PAGE: 2
SITE ADDRESS: 10300 SW GREENBURO RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: KPD INSURANCE
DESCRIPTION: TI
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503. 412.4800
CONTRACTOR: RUSSELL CONSTRUCTION INC PHONE #: 503
Inspection Request Scheduled For: Date: 12/17 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 079059 -01 503-780-3222 N
Corrections /Comments /Instructions:
PAS 1/4 "ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL • ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: r L- S i Phone #: (503) 718- L
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200B- 00372 ,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2008
Phone: (503) 639 -4171 �m� a+m�„� Iki
Inspection Requests (24 Hrs.): (503) 639 -4175 �,, W ` __..
INSPECTION WORKSHEET FOR DATE: 11/21/:1000 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 10300 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: KPD INSURANCE
DESCRIPTION: TI
OWNER: SHORENSTFIN REALTY SERVICES, PHONE #: 503.:412 -4800
CONTRACTOR: RUSSELL CONSTRUCTION INC PHONE #: 503- 220.4838
Inspection Request Scheduled For: Date: 11/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 078360 -01 503 -780 -3222 N
Corrections /Comments/ Instructions:
A 5 Qcc p Plan S
,A/1C ; OK 1 (oL- e✓
•
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: OA/eve/8 Phone #: (503) 718- 2023
5 1 , ' 1 .