Permit CITY OF TIGARD BUILDING PERMIT
1111
s' COMMUNITY DEVELOPMENT Permit #: BUP2012 -00263
T[ GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2012
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress 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 - 692 -9002 PHONE:
FAX: 503 - 692 -9008
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 12/18/2012 $256.00
Occupancy Grp: B Occupancy Load: 98 DC Provision Review, COM TI - LRP 12/18/2012 $38.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/18/2012 $1,667.67
Demolition
Stories: 6 Height: 0 ft 12% State Surcharge - Building 12/18/2012 $200.12
Bedrooms: 0 Bathrooms: 0 Plan Review 12/18/2012 $1,083.99
Value: $192,844 Plan Review - Fire Life Safety 12/18/2012 $667.07
Info Process /Archiving - Lg $2.00 (over 12/18/2012 $16.00
11x17)
Floor Areas: Metro Const. Excise Tax - Commercial 12/18/2012 $231.41
Use
Total Area: 0 Application Fee 12/18/2012 $12.00
Accessory Struct: 0 Long Range Planning Fee 12/18/2012 $1.00
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $4,173.26
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 CCenente . 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 503.28 or 1.800.332.2344.
_ L_ „e_.___________ _ .
Issued By: P ermittee Signature:
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.
Building Permit Application
Commercial RECEIVED Received FOR OFFICE USE ONLY
- City of Tigard DateB : !- � 1 • S Permit No.: i pd490 _ 1)61,1413
" 13125 SW Hall Blvd., Tigard, OR 97223 DEC 18 2012 Plan Review -07 � ��
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : `r1
T I C A R [) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready : y. laru�/ p„ ® See Page 2 for
Internet: www.tigard- or.gov � DiNG DIVISION
Notified/Method: ( , 4 -4/ Supplemental Information
TYPE OF WORK IIVU tJ 1 V REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ I)emolition 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.
El 1- and 2- family dwelling Valuation: $
® Commercial /industrial
El Accessory building ❑ Multi- family Number of bedrooms:
El builder El 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: 97224 Garage/carport area: square feet
Suite/bldg./apt. no.: 417 I Project name: Cypress 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: $$192,844.00
Existing building area: 9775 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 6
Name: Shorenstein Realty Services Type of construction: II -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 be 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 -mail: whit @gbdarchitects.com
CONTRACTOR
Business name: Russell Construction BUILDING PERMIT FEES*
Address: 20915 SW 105 °i Avenue (Please refer to fee schedule)
City /State/ZIP: Tualatin, Oregon 97062 -9511 Structural plan review fee (or deposit):
Phone: (503) 692 -9002 Fax: (503) 692 -9008 FLS plan review fee (if applicable):
CCB lic.: 58918 Total fees due upon ap pli c a t ion:
Amou received:
Authorized signature: This permit app lication ex pires if a permit is not obtained
• within 180 days after it has been accepted as complete.
Print name: Whit Middlecoff, AIA Date: 12/18/2012 * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(I1 /02/COM/WEB)
1 Building Division
Over - The - Counter (OTC) Building Permit
r i c; A ii D Check List
Project Description: 71 I,Iu,avla-- DO aCa3
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: t2! Occupancy Group: Type of Construction: Zg
*Type of Use: ( ;(4 . Occupancy Load: Oregon Specialty Code: 2,Cf)
SPECIFICS
Number of Stories: 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 Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: _ W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: i 11 Fire Alarms: Nt Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ [42) cam , ( FEES DUE
/ $ • `, f,(o DC Prov Rvw, COM TI — Ping
$ r OW DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ 'Mier Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ ' r/I 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ • ` :"T Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ AM, , Q Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ ., CC) Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50)
$ 2_3 (. 4 ( Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ ilgaMilieFFOTAL FEES DUE
41 13.E
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 07/01/2012
IIII Building Division
° Development Code Provision Review
T I G A R D Commercial Projects - No Associated Land Use Case
Building Permit No: &U-P a- �(� 9-03 ❑ Expedited Review
Plan Submittal Date: ((
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.
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 \.70/1,41 F/7 at 503 - 718 - G or _J A 0 n (f @tigard- or.gov)
Proposal: &%e , 1. G ioc, G
Zoning /SUE -1
Permitted Use Yes IA No ❑
Land Use Required: Yes ❑ No la
Notes:
l Approved ❑ Not Approved Date: 42 — 4 - 4.1
,
REVISED 10/4/12
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
02/21/2013
BUP2012-00263
PASS - C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
Inspection Report
2633 Camino Ramon Dr
San Ramon, CA, 94583 Tel: 999-999-9999
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Building
245 Firewall
01/31/2013 00:00
BUP2012-00263
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
Inspection Report
2633 Camino Ramon Dr
San Ramon, CA, 94583 Tel: 999-999-9999
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Building
245 Firewall
01/31/2013 00:00
BUP2012-00263
PASS
Violation Summary:
Inspector Contractor