Permit „ CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00243
Date Issued: 08/13/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB01003
Jurisdiction: TIGARD
Site address: 10300 SW GREENBURG RD 290
Project: X5 PDX Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for new tenant.
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 08/13/2015 $88.00
Occupancy Grp: B Occupancy Load: g Permit Fee-Additions,Alterations, 08/13/2015 $164.96
Demolition
Dwelling Units: 0 12%State Surcharge-Building 08/13/2015 $19.80
Stories: 5 Height: 0 ft Plan Review 08/13/2015 $107.22
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 08/13/2015 $65.98
Value: $6,000 Info Process/Archiving-Lg$2.00(over 08/13/2015 $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 $449.96
Required: Required Items and Reports(Conditions)
Fire Sprinkler: No 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: .r` % Permittee Signature: eN ,q-7o,4-/m-i Z A.J
Call 503.639.4175 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.
IIII
" Building Division
Over-The-Counter (OTC) Building Permit
r I GARD Check List
Project Description: T( 4/0,3_,0 iS O �
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION _
Class of Work*: A Occupancy Group: Type of Construction: ��J
Type of Use**: _ Occupancy Load: Oregon Specialty Code: '2
SPECIFICS
Number of Stories: Buildin. Hei.ht: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accesso Structure: Covered Porch:
Basement: Gara.e: 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 ' `�-YJ
Fire Sprinklers: h 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: $ b I O.00 FEES DUE
$ C"7 DC Prov Rvw,COM TI—Ping
$ (it5`l Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ , ape 12%State Surcharge
Project Valuation Planning $ • ..7Z-2--Plan Review,Structural
Up to$4,999 $0.00 $ ' Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ Aljkir Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $220.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $351.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
$ Other:
Building Staff: $ Other:
Date/Time: $ A4' ,%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;
OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP_070115.docc
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
DateBea • -Fo lh( (4. , Permit Nil / S.'410.2
1114 • City of Tigard , /
13125 SW Hall Blvd.,Tigard,OR 97223 AU G 1 3 2015 Plan Review N7,
Phone: 503.718.2439 Fax: 503.598.1960 AUG : 0 v��
Other Permit
T I G A R I) Inspection Line: 503.639.4175 CITY OF TiGARD Date ReadyBy: 61 See Page 2 for
Internet: www.tigard-or.gov Notified/Metltod: Supplemental Information
DUILAIG 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.
❑ 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:Three Lincoln-10300 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:290 Project name:X5 PDX 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.
Scope of work includes interior tenant improvements for an approx.889 SF Valuation: $6,000
tenant on the 2nd of 5 floors.Work to include new walls and glazed relite. Existing building area: 889 square feet
New building area: 889 square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 5
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 Oler 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:Irhde@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: �,,, . (L 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:08/13/2015 * 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)
111111 City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A ft D Building Permit Review — Commercial - No Land Use
Building Permit #: , a.,°o2a/. nQo2 /3
Site Address: f O,3o o d retviiv3 Suite/Bldg#: 90
Project Name: )(5 1PQX
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: -/✓J fm-fr- ) /, no (ilia hJ ' !'JC,
Existing Business Activity: Die.
Proposed Business Activity: Ofirec
rerifv site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes V(No
WI, Zoning. 4 tz,
Permitted Use: ; Yes ❑ No ❑ Spec Space
X Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: ���/S
7
Revisions (after Building Sub ittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: e//3 --‹
Site Plans: # a
Building Plans: # ,,g.
Building Permit#: erEnter building permit#above.
Workflow Routing. CI Planning ❑ Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: ,B—Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: 0 %C._
By Permit Technician: Date: ��3/5-
_41).421 .___,____l:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.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:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\B1dgPermitRvw_COM_NoLandUse 070915.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
10300 SW GREENBURG RD 290, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00243
Chip Barnett
Violation Summary:
Inspector Contractor