Permit CITY OF TIGARD BUILDING PERMIT
'`1 I COMMUNITY DEVELOPMENT Permit#: BUP2015-00169
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2015
Parcel: 1S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 214
Project: Gerald Miller Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: TI for existing tenant:New demising wall construction to downsize office space.
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: Ilg DC Provision Review,COM TI-Ping 06/17/2015 $75.00
Occupancy Grp: B Occupancy Load: 7 DC Provision Review,COM TI-LRP 06/17/2015 $11.00
Permit Fee-Additions,Alterations, 06/17/2015 $149.75
Dwelling Units: 0 Demolition
Stories: 3 Height: 0 ft 12%State Surcharge-Building 06/17/2015 $17.97
Bedrooms: 0 Bathrooms: 0 Plan Review 06/17/2015 $97.34
Value: $5,000 Plan Review-Fire Life Safety 06/17/2015 $59.90
Info Process/Archiving-Lg$2.00(over 06/17/2015 $4.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $414.96
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 colrr direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ■ i�� Permittee Signature: C� 1
C .• •.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 FOR OFFICE USE ONLY
Received
City of Tigard Permit •No.:� .0, i r
5 g �iJClU��L Date/B : '�) .,
L
13125 SW Hall Blvd.,Tigard,OR 97 Plan Review
e Phone: 503.718.2439 Fax: 503.598.1960 Date/B : g ra%KZ, .ltl•il0 other Permit:
i I GA K D Inspection Line: 503.639.4175 Date Ready/: H See Page 2 for
Internet: www.tigard-or.gov JUN 17 2015 Notified/Method: �r�t Supplemental Information
TYPE OF WORK' ',' '',i ', ';.I 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 ID Multi-family
Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:4 Lincoln-10250 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:214 Project name:Gerald Miller TI 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 to downsize an existing Valuation: $$5,000.00
tenant to approx.679 SF space on the 2nd of 3 floors.Remaining vacant space to Existing building area: 1,893 square feet
be 1,214 SF.Work to include new building standard demising wall. New building area: 679 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 3
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*
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
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 105'h 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 signatu • 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:06/17/15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:1BuildingTermits\BUP-COM PeimitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
I • ' Building Division
Over-The-Counter (OTC) Building Permit
I "\R D Check List
Project Description: 77
GENERAL INFORMATION
Class of Work*: Air Occupancy Group: Type of Construction: Z
Type of Use**: COM _ Occupancy Load: ---7 Oregon Specialty Code: 204—
SPECIFICS
Number of Stories: J 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: It70 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: $ 5-COO. FEES DUE
$ S / • DC Prov Rvw,COM TI—Ping
$ % .A DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI (effective 7/1/2014) $ a .75- Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ , 7 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ 4. • irl Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ ' •"9'0 Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ 1 ,OD 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: $ -414 e cg, TOTAL FEES DUE
.EOF i" -a , '— -.- t, Ak1, .. ': co 'itii'...4 1 ' w.i ' ii I':."i.,lr .
**CLASS OF WORK: AC =a Gesso .10D=addi:on•ADU= .ccesso . •w . :lout;ALT=alteration.D M=demo;NEW=new;
I:\Building\Forms\OTC_BUP_070114.docx
City of Tigard
•
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - No Land Use
Building Permit #: 8i P02o I S-D0/61
Site Address: 10250 SW Greenbu,y Rc� . Suite/Bldg#: 2!6
Project Name: G6(03 cc M i 11er J
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T\ +o Apwnsl2e, exiskin tenant's
Existing Business Activity: 4-Ci ce_
Proposed Business Activity: says
LI Verify site address/suite#exists and active in permit sysst m.
,ver Terrace Plan District ❑ Yes [ No
'Poning MUE- 1,
ermitted Use: MYes ❑ No ❑ Spec Space
M Confirm no land use required.
Business License:
Exists: Vg Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: ' ai L- so Al Date: 6 17 15
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: 67/7 /5-
Site Plans: # /f1/
Building Plans: L
Building Permit#: nter building permit#above.
Workflow Routing: [d�P1 nning ❑ Permit Coordinator L_ wilding
Workflow Sign-off: D. 3tgn-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: D77_
By Permit Technician: Date: 6//�/!5' •
:4:-
I:\Building\Fonns\BIdgPermitRvw_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:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\FormslB1dgPermitRvw COM_NoLandUse_031015.docx