Permit CITY OF TIGARD BUILDING PERMIT
1111 y �1
COMMUNITY DEVELOPMENT Permit#: BUP2015-00348
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/15/2015
Parcel: 1S135A604500
Jurisdiction: Tigard (\
Site address: 10250 SW GREENBURG RD 116
Project: Hillshire Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: TI for new tenant. Wall demolition and construction.
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 12/15/2015 $88.00
Occupancy Grp: B Occupancy Load: 19 Permit Fee-Additions,Alterations, 12/15/2015 $225.80
Demolition
Dwelling Units: 0 12%State Surcharge-Building 12/15/2015 $27.10
Stories: 3 Height: 0 ft Plan Review 12/15/2015 $146.77
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/15/2015 $90.32
Value: $9,825 Info Process/Archiving-Lg$2.00(over 12/15/2015 $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 $581.99
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 co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Nitib
Issued By: Permittee Signature:
". 9.4175 by 7:00 a.m.for the next avai .• 'i • ion date.
This permit card shall bo kept in a conspicuous place on the job site u 11 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 i
City of Tigard `��+
Date/13 HENSON
314 13125 SW Hall Blvd.,Tigard,OR 972 ('��`v y Plan Review,
= Phone: 503.718.2439 Fax: 503.59 Date/B : ,.1I� Other Permit:
TIG R D Inspection Line: 503.639.4175 \ , ( 2p15 Date Ready :y: ® See Page 2 for
Internet: www.tigard-or.gov OC 1 Notified/Method: f AMFAILEM Supplemental Information
• TYPE OF W"'
[
, `c O v,S,Or REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction b e tition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
►1 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
111I-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 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.:116 Project name:Hillshire 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 to include interior tenant improvements for a tenant on the 151 of Valuation: $$9,825.00
3 floors.Work to include cabinetry modifications. Existing building area: 1,884 square feet
New building area: 1,884 square feet
® PROPERTY OWNER 0 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 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Please refer rofee 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 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: Gut/ This permit application expires if a permit is not obtained
""� within 180 days after it has been accepted as complete.
Print name:Lauren R de Date:12/15/15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I l/02/COM/WEB)
City of Tigard
CO
I/
S MMUNITY DEVELOPMENT DEPAR'1MEN'1'
T I C;A R D Building Permit Review — Commercial - No Land Use
Building Permit #: eiv1 j6--60 3y17
Site Address: 10250 SV Greenburg Rd, Suite/Bldg#: I k 6
Project Name: E{I l lsh I te,
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Tl : demo and n2..w ca\oine}s I work S-}'a+ir n
Existing Business Activity: Crf4 cc. GI xcant)
Proposed Business Activity: sgme,
dVerify site address/suite# exists and active in permit system.
XI River Terrace Neighborhood: ❑ Yes 1 No
MA/Zoning: MUC-1
Permitted Use: MYes ❑ No ❑ Spec Space
Confirm no land use required.
47 Business License:
Exists: "Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Ti6 pyl 1.-e,1i(-`oad') Date: 1211S1 I,s
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: /9///5//j
Site Plans:
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: ,CT l i es' ng ❑ Permit Coordinator _-B i'ding
,
Workflow Sign-off: L� Sign-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:
By Permit Technician: Date: 4/1/5-/ir
1:\Bui Iding\Fonns\BldgPennit Rvw_COM_NoLandUse_0709I 5.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: •
I:\Building\Fonns\BldgPennitRvw_COM_NoLandUse_0709I 5.docx
III Building Division
Over-The-Counter (OTC) Building Permit
T l G n lug Check List
Project Description: 7-1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION ``11 —T ���
�'
Class of Work*: r`fOccupancy Group: C� �
Type of Construction: ::2--(7
Type of Use**: A, Occupancy Load: `(d Oregon Specialty Code: 0.C)44-
SPECIFICS j44-
SPECIFICS
Number of Stories: ' �7 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: ll(- 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: q.
Total Project Valuation: $ l�e c---c-) FEES DUE
$ a jir)DC Prov Rvw,COM TI—Ping
$ fr r Z. Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ , r& 12%State Surcharge
Project Valuation $ `Ly- Plan Review,Structural
Up to$4,999 $0.00 $ r,.- 'lan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ ,. jib 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: $ 75•%
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
10250 SW GREENBURG RD 116, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00348
Chip Barnett
Violation Summary:
Inspector Contractor