Permit 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.
III 4
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
I 1 G A R D 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503.718.24 ' • www.tigard-or.gov
TO: t 14 L.4c0 h, DATE IR 1 R W I1,P
DEPT: BUILDING DIVISION
JAN 12 2015
FROM: L nve--1✓1-4 12_01-1.17 . CITY OFTIGARD
BUILDING DIVISION
COMPANY: i-1> t4ZC a
PHONE: 5o3 224 01c5b , \ Cy
RE: 1 t72_2_o svU Carl✓t--4 J ' —7 57-E 220 13U P2x cl.. - polo 4
(Site Address) / (Permit Number)
A ' ( S'E'sTEN\S --r. .
(Project name or subdivision name and lot umber)
ATTACHED ARE THE FOLLOWING I P MS:
I Copies: I Description: I Copies: I Description:
Additional set(s) of plans. 2 Revisions: # 1 (A2.i AL, .1, A6. 0
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR O FICE USE ONLY
Routed •to Permit Tec ' tan~ l ate: ( (�1�.S— Initials_
Fees Due: ❑ Yes 'o Fee Descriptio : Amount Due:
$
$
$
$
Special
Instructions:
Re 9 rint Permit (••r PE): ❑ Yes AV! ❑ will i
A
A. i licant Notified: Date: Efi WM i 1 .'.E' i=f Jl/
Of,�zopA t,fc ..p
1:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
CITY OF TIGARD BUILDING PERMIT
p
• s COMMUNITY DEVELOPMENT Permit#: BUP2014-00304
T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2014
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 220
Project: Apex Systems Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-demolition,new walls,doors,relites&cabinetry.
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 12/23/2014 $75.00
Occupancy Grp: B Occupancy Load: 29 DC Provision Review,COM TI-LRP 12/23/2014 $11.00
Permit Fee-Additions,Alterations, 12/23/2014 $542.11
Dwelling Units: 0 Demolition
Stories: 6 Height: 0 ft 12%State Surcharge-Building 12/23/2014 $65.05
Bedrooms: 0 Bathrooms: 0 Plan Review 12/23/2014 $352.37
Value: $32,365 Plan Review-Fire Life Safety 12/23/2014 $216.84
Info Process/Archiving-Lg$2.00(over 12/23/2014 $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 $1,268.37
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 '• - • •ance 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
d- ATTENTION: • -•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001-0010 through OA' •52-00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /J
Issued By: (�� Permittee Signature: �� ///
(� Call 503.639.4175 by 7:00 a.m.for the next available inspe do ate. �-PJ'�
This permit card shall be kept in a conspicuous place on the job site until mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application.
CommercialtECEIVEP FOR OFFICE USE ONLY
City g Received f����� G ,
Cit of Tigard r" Date/B iv Permit No.: i �'
" 13125 SW Hall Blvd.,Tigard,OR 97223 1, 2 3 2014 Plan Review 1
li Phone: 503.718.2439 Fax: 503.598.1960 Cp Date/B :AIA r
TIGARD Inspection Line: 503.639.4175 �;lll,I OF TIGARD Date Rea`I�M! luris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK 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.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder El 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.:220 I Project name:Apex Systems 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.
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.
Interior Tenant Improvements for an approximately 2,836 square foot tenant Valuation: $$32,365.00
the 2°d of 6 floors.Work to include demolition,new walls,doors,relites and Existing building area: 2,836 square feet
cabinetry. New building area: 2,836 square feet
0 PROPERTY OWNER I 0 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: B
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie
(Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Lauren Rohde
FLS plan review fee(if applicable):
Address:1515 SE Water Ave Suite 100
City/State/ZIP:Portland,OR 97214
Total fees due upon application:
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 Photo Voltaic 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 lic.:58918
Total fee due upon application: $201.60
Authorized signature:4 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren Rohde Date: 12/23/2014 * Fee methodology set by Tri-County Building Industry
Service Board.
l:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46I3T(I I/02/COM/WEB)
City of Tigard
14 ■ COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G A K D Building Permit Review — Commercial - No Land Use
Building Permit #: 4 ..F.)1A P 0 3/ / 3'
Site Address: /6 2 9/0 GYee/?b 7<".. Suite/Bldg#: 220
Project Name: 'eX "% c1 m5
(N a of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: S % ' j / L G Jl%L �_I 44 j L" / / , //
/4a_ ii .Jtt�JelIVE.1:
Existing Business Activity: / of G,--
Proposed Business Activity: °Q----
❑ Verify site address/suite #exists and active in permit system.d
g: /�'! j
Permitted Use: ,Yes ❑ No ❑ Spec Space
Confirm no land use required.
Notes:
Approved by Planning: II . / Date: /2-/ g// /
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: 42 i13//V
Site Plans: #
Building Plans: # 3
Building Permit#: Enter building permit#above.
Workflow Routing: Er Planning r ZI-1SCUilding
Workflow Sign-off: Er Sign-off for Planning(include notes from planning review)
Route Application Documents: ®wilding. original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician k___:-Aggildiediri6,„(
C--- - Date: //0c,!
I:\Building\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:
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse_071514.docx
Ph Building Division
Over-The-Counter (OTC) Building Permit
TIGARD
Check List
Project Description: t t
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction: .
Type of Use**: Al Occupancy Load: Oregon Specialty Code: 2t)_ jr r��
. P- ..SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: f 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: 412.0 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: 1
Total Project Valuation: $ ' 1 31 ,c'12) FEES DUE
1 $ '75000 DC Prov Rvw,COM TI—Ping
$ 041+ DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ "lt.Wirt Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ erii gmi 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ ji. , y Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ _ „ filf�■ 'lan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ ,„, ,toy 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
'21 $ Hourly Rate State Surcharge
f) $ Misc.Admin Fee
4 `6 $ Other:
ii $ Other:
Building Staff: $ Other:
Date/Time: $ ZLf TTOTAL 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;
OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC BUP_070114.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 220, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00304
Chip Barnett
Violation Summary:
Inspector Contractor