Permit CITY OF TIGARD BUILDING PERMIT
111111 g" COMMUNITY DEVELOPMENT Permit#: BUP2014-00303
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2014
Parcel: 1S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 740
Project: Pollmeier Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-demolition,new walls,doors,relites&relocation of 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: 24 DC Provision Review,COM TI-LRP 12/23/2014 $11.00
Permit Fee-Additions,Alterations, 12/23/2014 $531.09
Dwelling Units: 0 Demolition
Stories: 7 Height: 0 ft 12%State Surcharge-Building 12/23/2014 $63.73
Bedrooms: 0 Bathrooms: 0 Plan Review 12/23/2014 $345.21
Value: $31,221 Plan Review-Fire Life Safety 12/23/2014 $212.44
Info Process/Archiving-Lg$2.00(over 12/23/2014 $4.00
11x17)
Floor Areas: COT Address Fee 12/23/2014 $50.00
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,292.47
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 ENTION • -•on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
-001-0010 through OAR• -001-.1,90. 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: / // • / ' Permittee Signature: A / __ n k!
Call 503.639.4175 by 7:00 a.m.for the next available inspecti
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 FOR OFFICE USF.ONLY
City of Tigard RECEIVED
Received
Dat Permit No.: _
• 13125rSW Hall Blvd.,Tigard,OR 97223 Plan Revie n��� /'
m Phone: 503.718.2439 Fax: 503.59 E1 2 3 2014 DateB •m mg,A 4, Other Permit.
T I GAR D Inspection Line: 503.639.4175 Date Rea. :y: Juns: 10 See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
TYPBI111)Dl.DIVISION REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction Z 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.
❑ I-and 2-family dwelling Z Commercial/industrial Valuation: $
El building 11 Multi-family
Number of bedrooms:
❑Master builder CI Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:5 Lincoln-10200 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:740 Project name:Polhneier 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 2,382 square foot tenant Valuation: $31,221
the 7a'of 7 floors.Work to include demolition,new walls,doors,relites and Existing building area: 2,382 square feet
relocation of cabinetry. New building area: 2,382 square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 7
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
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Mackenzie
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: IA/Ai; .`f
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 105's 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: ar_ ` This permit application expires if a permit is not obtained
{/� within 180 days after it has been accepted as complete.
Print name:Lauren a Date:12/23/2014 * Fee methodology set by Tti-County Building Industry
Service Board.
1:1Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
71 City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
TIGA Building Permit Review — Commercial - No Land Use
RD
Building Permit #: `L Po/d e 3
Site Address: I QZp 0 5\1\1 Greznbu9 Rd, Suite/Bldg#: 71-1O
Project Name: Pol l mel QX-
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review `
Proposal: -fenarl4 rd0 a--1 n WI+in Score IDtnII C] In.9; ( i 51� - e- -c corn
i ot r��e,( o_.s�l i r 3 J
Existing Business Activity: ice
Proposed Business Activity: acci c,€.1—;d/Verify site address/suite #exists and active in permit system.
�n r
4oning: 1 Y IU L—i/Yes/Permitted Use: ❑ No ❑ Spec Space
Confirm no land use required.
Notes:
Approved by Planning: n'} . �'�r C.X,/( ) Date: 4 ZZI t q
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: / t 0 1
Site Plans: #
Building Plans: # 3
Building Permit#: .-Enter building permit#above.
Workflow Routing: . Planning r e Building
Workflow Sign-off: EI--Sign-off for Planning(include notes from planning review)
Route Application Documents: J1uilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: jkr,.ec' eL-ketAk 6,,LIAITL > sIgLA_:_e__P
By Permit Technician �� �_�cS1 Date: /01/9-7// e.
I:Building Worms\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:\BuildingWorms\BldgPermitRvw_COM_NoLandUse_O715 I 4.docx
511111 _ ' Building Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description: -1-7
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*:
N( Occupancy Group: Type of Construction: f r
Type of Use**: (,\ Occupancy Load: /� Oregon Specialty Code: 20
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: (t96-1 Fire Alarms: Vj 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: $ 3 (,--2...z..., FEES DUE
$ '75• DC Prov Rvw,COM TI—Ping
$ 4/1 DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ W Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ at' 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ ,•I'W 1 Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ ' Mitt Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ ,.f 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 ��
$ 7C7'ev Other. ��D Q s f 7_
_ $ Other:
Building Staff: $ Other:
Date/Time: $ OTAL FEES DUE
t l2N/A. 17
*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
10200 SW GREENBURG RD 740, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2014-00303
Chip Barnett
Violation Summary:
Inspector Contractor