Permit CITY OF TIGARD BUILDING PERMIT
' COMMUNITY DEVELOPMENT Permit it: BUP2015-00158
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/03/2015
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 305
Project: Matrix Absence Management Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for new tenant:New walls and doors.
Contractor: RUSSELL CONSTRUCTION INC Owner: LINCOLN CENTER LLC
20915 SW 105TH AVE BY SHORENSTEIN PROPERTIES LLC
TUALATIN, OR 97062 235 MONTGOMERY ST, 16TH FLOOR
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 06/03/2015 $75.00
Occupancy Grp: B Occupancy Load: 59 DC Provision Review,COM TI-LRP 06/03/2015 $11.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 06/03/2015 $317.06
Demolition
Stories: 6 Height: 0 ft 12%State Surcharge-Building 06/03/2015 $38.05
Bedrooms: 0 Bathrooms: 0 Plan Review 06/03/2015 $206.09
Value: $15,750 Plan Review-Fire Life Safety 06/03/2015 $126.82
Info Process/Archiving-Lg$2.00(over 06/03/2015 $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 $780.02
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 c the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 'tO 7 '`"71 Permittee Signature:
03.639.4175 by 7:00 a.m.for the next available inspectie1S 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 FOR OFFICE USE ONLY
City of Tigard Received �� L' ��
Dete/B _
yr
13125 SW Hall Blvd.,Tigard,OR 972 a+ ECEI�I E Plan Review i
P hone: 503.718.2439 Fax: 503.598. 7+ Date/13 : G, �� �^ I Other Permit
TIGARD Inspection Line: 503.639.4175 3 2015 Date Ready 77 ® See Page 2 for
Internet: www.tigard-or.gov ,�N Notified/Method: r _Y� Supplemental Information
Y of p1VIS ON
TYPE OF 18—%..0 DI 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.
❑ 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:3 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.:305 Project name:Matrix Absence Management 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.
Scope of work includes interior tenant improvements for an approx.5,805 sf Valuation: $$15,750.00
tenant on the 3rd of 6 floors.Work includes demolition,new walls,doors, Existing building area: 5,805 square feet
relites and cabinetry. New building area: 5,805 square feet
0 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: 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:lrohde @ mcknze.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
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 lit.:58918 Total fee due upon application: $201.60
Authorized signature: (2., This permit application expires if a permit is not obtained
/vim` within 180 days after it has been accepted as complete.
Print name:Lauren R de I Date:06/03/15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemrits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
ole COMMUNITY DEVELOPMENT DEPARTMENT
t �\ � Building Permit Review — Commercial - No Land Use
Building Permit #: ci&R}Cs.--Ln Ls-ii
Site Address: 1 022' S w Ell e,f-.bvir--0 (L�. Suite/Bldg#: 30 5—
Project Name: Met,--hr;X G{b) t ,,vt y,,,~*
(Name of commercial business occupying the sparse. If vacant,enter Spec Space.)
Planning Review
Proposal: t h t fl7 r' -t-,Gr-)C r)-I- i m pry wt-r)-12.,r)
Existing Business Activity: 0(r C1'ce / wm M.42.rG+?.�A.—
Proposed Business Activity: 0 7-4_ / (,co r-i -c.r-a.,
71 Verify site address/suite#exists and active in permit system.
-0 River Terrace Plan District ❑ Yes ,2r No
Zoning: M VC -1
Permitted Use: ❑ Yes ❑ No ❑ Spec Space
)2 Confirm no land use required. nl0 Gh pin r ,( i v-1 tJ{e
Business License: O
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: fie Oh Nu 6 a)D d_a Date: /3//
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: Cl Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: o�y,s
Site Plans: # i/q._
Building Plans: # ?
Building Permit#: EF"Eiiter l ding permit#above.
Workflow Routing. arming ❑ Permit Coordinator 0—Building
Workflow Sign-off: E Sign-off for Planning(include notes from planning review)
Route Application Documents: g: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 077---
By Permit Technician: , �� Date: 6/,V/3--
I:\Building\Forms\BldgPermitRvw_COM NoLandUse 031015.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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:
El OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_031015.docx
P P . ' Building Division
Over-The-Counter (OTC) Building Permit
(' '' Check List
Project Description: T(
GENERAL INFORMATION
Class of Work*: F\\LT Occupancy Group: F Type of Construction: 73
Type of Use**: en( .. Occupancy Load: Oregon Specialty Code: 2.C(,4-
SPECIFICS
Number of Stories: 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: 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: I
Total Project Valuation: $ (6 7 FEES DUE
1 � $ 75,0O DC Prov Rvw,COM TI—Ping
$ , or, DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ INF Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ I: r"j 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ i" Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ ff.,.'V Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ tij,c 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: $ 7117.0 TOTAL FEES DUE
*TYPE OF USE: COM=c,' • .r tial;al Ik . ...,,,, 1•;,ids iiactured strut a ..- - . ..e
**CLASS OF WORK ACS=accessory;ADD=addition;ADU=accessory dwelling unit;ALT=alteration;DEM=demo;NEW=new;
( . . •ngs 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 305, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00158
Chip Barnett
Violation Summary:
Inspector Contractor