Permit CITY OF TIGARD BUILDING PERMIT
1,1
COMMUNITY DEVELOPMENT Permit#: BUP2014-00221
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2014
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 250
Project: Sodexo Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant: Wall construction and minor demolition.
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 DC Provision Review,COM TI-Ping 09/23/2014 $75.00
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Occupancy Load: 18 ' DC Provision Review,COM TI-LRP 09/23/2014 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 09/23/2014 $423.53
Demolition
Stories: 6 Height: 0 ft 12%State Surcharge-Building 09/23/2014 $50.82
Bedrooms: 0 Bathrooms: 0 Plan Review 09/23/2014 $275.29
Value: $22,386 Plan Review-Fire Life Safety 09/23/2014 $169.41
Info Process/Archiving-Lg$2.00(over 09/23/2014 $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 $1,011.05
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Yes 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: Permi-eeSignature: nk .
9.4175 by 7:00 a.m.for the next available inspec n date. J
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 CONt‘
FOR OFFICE USE ONLY
Cit of Ti and � Received
0+� 1, �� Permit No.:`.
City g Date-/B ak
13125 SW Hall Blvd.,Tigard,OR 97223 �7 Plan Reviell
S `l`` Date/B : ij !+ Other Permit: '
Phone: 503.718.2439 Fax: 503.598.1960 C,�Q A ` r.
11, `r i, Inspection Line: 503.639.4175 �,�1+ Date Rea' t : ` ® See Page 2 for
Internet: www.tigard-or.gov ��,�YV� ON 1%
otified/Method: /, �J/, Supplemental Information
TYPE OF WOW-- 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.
III I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑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:2 Lincoln-10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:250 I Project name:Sodexo 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: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Interior Tenant Improvements for an approximately 1,744 square foot tenant on Valuation: x2286
the 2"d of 6 floors.Work to include demolition,new walls,doors,relites and Existing building area: 1,744 square feet
cabinetry. New building area: 1,744 square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 6
Name:Shorenstein Type of construction: I-B
Address:One SW Columbia Street Suite 500 Occupancy groups:
City/State/ZIP:Portland,OR 97258 Existing: B
Phone:(503)412-4902 Fax:(503)412-4903 New: II
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie
(Please refer w fee schedale)
Structural plan review fee(or deposit):
Contact name:Lauren Rohde
FLS plan review fee(if applicable):
Address:1515 SE Water Ave Suite 100
Total fees due upon application:
City/State/ZIP:Portland,OR 97214
Phone:(503)224-9560 Fax::(503)228-1285
Amount received:
E-mail:Irohde@mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name:Russell Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:20915 SW 105th Ave 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:(503)692-9008 State surcharge(12%of permit fee): $21.60
CCB lie.:58918 Total fee due upon application: $201.60
Authorized signature: pu,9-c This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren R de Date:09/23/2014 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
IIIIIII • " Building Division
Over-The-Counter (OTC) Building Permit
T I CARD Check List
r
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: -_ &1:j J�"U Occupancy Group: j Type of Construction: Z�j
Type of Use**: Occupancy Load: tl 6 Oregon Specialty Code: --21")r(
SPECIFICS
Number of Stories: (am 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 r�� Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area: —
K Factor: �
Total Project Valuation: $ -)� Gk4C FEES DUE
$ -7 OA DC Prov Rvw,COM TI-Ping
$ „ Its DC Prov Rvw,COM TI-LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ aR4� Permit Fee-Add,Alt,Demo
Project Valuation Planning LRP $ 4"1,11)K 212%State Surcharge
Up to$4,999 $0.00 $0.00 $ " jp'W' Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ g` Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ ,I Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other: _
$ _ Other:
Building Staff: $ Other:
Date/Time: $ (f1(I'C�TOTAL FEES DUE
*TYPE OF USE: COM=commercial;CMS=commercial manufactured structure.
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
OTIR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070114.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
I
1.l�; �� Building Permit Review — Commercial - No Land Use
AR
'n
Bu><ld>< g Permit #: 6/„Pao ti-r--cro,),)./
Site Address: 0pC10 6Yr/e41 6i € ivo Suite/Bldg#:
Project Name: SO4,y6
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: alliCe X Q6lu - 7-41,1-47-41,1-44.-- 7-1
iiw at„turw
Existing Business Activity: Ge`e4
Proposed Business Activity: OdikiE.
❑ Verify site address/suite #exists and active in permit system.
❑ Zoning: AO ( ,_,_,�
❑, 1>rmitted Use: [ Yes ❑ No ❑ Spec Space
LY Confirm no land use required.
Notes:
Approved by Planning: Ai " Date: 9-#2 3-"/4
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: CI } /l/
Site Plans: # ,1 A
Building Plans: LSE
Building Permit#: r building permit#above.
Workflow Routing: IL�'IP ing ❑ Permit Coordinator l�Building
Workflow Sign-off: LJ'Sign- for Planning(include notes from planning review)
Route Application Documents: uilding: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: 06i
�
By Permit Technician: � _ Date: �P�� 7
r0
I:\Bui l ding\Forms\BldgPermitRvw_COM_NoLandUse_071514.docx
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
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:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\B ldgPermitRvw_COM_NoL andUse_071514.docx
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 250, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00221
Jeff Grove
Violation Summary:
Inspector Contractor
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPART ENT
IN _ r Transmittal Letter
T I G A R I 13125 W Hall Blvd. • Tigard, Oregon 97223 • 503.718.21 : • www.tigard-or.gov
TO: 1 ATE RECEIVED:.
DEPT: BUILDING DIVISION
OCT 14 2014
FROM: Lpv A vr.A1 Rovicte__ CITY OF WARD
BUILDING DIVISION
COMPANY: 1,4 acteernti e_ . I
PHONE: 5D 3 241 ct b o
RE: 10 220 S vt! m(1 to tA, �il� eg /-e° ,22/
ite ress rya. (Permit m
Z 1.4 vl (5I vt - S t t,i 1-e 2 5 e oe.e a
(Project name or subdivision name and lot n mb•�
ATTACHED ARE THE FOLLOWI IT ^ S:
Copies: Description: I Copies: Description:
Additional set(s)of pl Revisions:
Cross section(s)and d ails. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS: a- -4-a
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No F-e Description: Amount Due:
Special
Instructions:
Reprint Permit(per PE): ❑ Yes I ❑No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012