Permit (31) MI
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00038
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/02/2016
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 390
Project: Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant: Demising wall construction for new conference room.
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: Ig DC Provision Review,COM TI-Ping 02/02/2016 $88.00
Occupancy Grp: B Occupancy Load: 30 Permit Fee Additions,Alterations, 02!02/2016 $301.85
Demolition
Dwelling Units: 0 12%State Surcharge-Building 02/02/2016 $36.22
Stories: 12 Height: 0 ft Plan Review 02/02/2016 $196.20
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/02/2016 $120.74
Value: $15,000 Misc Administration Fee 02/02/2016 $50.00
Info Process/Archiving-Lg$2.00(over 02/02/2016 $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 $797.01
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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �W rmittee Signature:
Call 175 by 7:00 a.m.for the nextavailable-n ction 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.
UPI Building Division
Over-The-Counter (OTC) Building Permit
Check List
Project Description: L
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION ,
Class of Work*: L Occupancy Grou : L Type of Construction:t2 [
TY e of Use**: ' Occupancy Load: Ore on Specialty Code:
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
Side and Setback—Left Side and Setback—Front
Side and Setback—Right Side and Setback—Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access.ParkinR 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:
Total Project Valuation: $ •-5 FEES DUE
$ DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ '2— 12%State Surcharge
Project Valuation $ ,L Plan Review,Structural
Up to$4,999 $0.00 $ Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ ) 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: $ ,Q 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.docx � QU
�q�.o
Building Permit Application
Commercial nFOR OFFICE USE ONLY
City of Tigard Q� � :1�. Received U0 /
dR`9T�z Date/By 1!1 Permit No.:
13125 SW Hall Blvd.,Tigard, Plan Review j
Phone: 503.718.2439 Fax: 503.598 q 2016 DateB • 10 Other Permit: g
Inspection Line: 503.639.4175 2 Date Rea tures -OSee Pae 2 for
Internet: www.tigard-or.gov v t�� Notified/Method:A Supplemental Information
Ty OF
TYPE 4 VMV 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.
❑ 1-and 2-family dwellingValuation: $
®CommerciaUindustrial
❑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:1 Lincoln-10300 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garagetcarport area: square feet
Suite/bldg./apt.no.:390 Project name:Building Conference Room 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 i
DESCRIPTION OF WORK work indicated on this application.
Scope of work to include interior tenant improvements for a tenant on the 3'd of Valuation: $15,000
5 floors.Work to include demolition,new demising wall and new lighting. Existing building area: 457 square feet
New building area: 457 square feet
® PROPERTY OWNER ❑ 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 refer tofee schedule
Structural plan review fee(or deposit):
Contact name:Lauren Rohde
Address:1515 SE Water Ave Suite 100 FLS plan review fee(if applicable):
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*
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''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: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren R de Date:02/02116 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
Building Permit #: a�V" a )ho- ouo3 3'
Site Address: 10300 SVS Suite/Bldg#: 3q 0
Project Name:
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T t -�pf r1o,,w fooy"n I(1yo c_aV4' SU v
Existing Business Activity: e/, �;(,� 04 I C.
Prroo osed Business Activity: Ce✓
L'7! \'eri • site address suite#exists and active in ermit system.
f1 � P Y
River Terrace Neighborhood: ❑ Yes -;k No
Zoning:
Of
FermiC -
tted Use: El No Spec Space
/onfirm no land use required.
LST Business LicenVyes
Exists: ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: 1 , Y-r, I C Date: L 12-1 16
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: pZ
Site Plans: #
Building Plans: #
Building Permit#: EnZter building permit#above.
Workflow Routing: � �arining ❑ Permit Coordinator P_vuuiTdt g
Workflow Sign-off: E-$ -off for Planning(include notes from planning review)
Route Application Documents: CT riiulding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: � te: ��
:\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:
I:\Building\Fonns\BldgPenTiitRvw—COM—NoLandUse-070915.docx
2-1
City of Tigard cryo
Address & Commercial Suite App ication
Addresses and suite numbers are assigned by the City of Tigard. Once a new address/suite is issued, the City notifies
911, USPS,Washington County and various utility providers. This does not change any account information or
replace a "change of address" form.
Directions To Submit Form
► Fill in form ► Via email: pauli@tigard-or.gov
►Attach Site Map or Suite Layout Map (see below) ► By fax: 503-684-8840
► Fees will be charged when new address is assigned ► In person: Permit Center Building Counter
(13125 SW Hall Blvd, Tigard, OR)
Fees:Do not pay when you submit form City of Tigard Addressing Contact:
► Per address$50 Paul Izatt, Public Works
► Per suite$50 pauli@tigard-or.gov
► Suite or address to be retired—no charge 503-718-2589
► Re-activating suites in our system—no charge
REQUIRED
Attach Site Map or Suite Layout Map
► For Site Maps—show location of building on lot, front entrance&location of driveway along street
► For Suite maps—show the locations of current active suites, new suites and suites to be retired
Site Information
Parcel Number or Current Address: M'�2 00 S li3 C-IvCAAA6�1 t?�du
❑ Residential Property -OR- 10 Commercial Property
Building Name(if applicable): 1 L-- Vt(olyl
Is this property currently in the Land Use process(i.e. partition, site development review)? ❑ Yes No
Contact Information
Contact Person: fIeW V AOl2P
Property Management Company(if applicable): SJS�a
Phone: 5c3.tol Cl ..�3 too
Email: ILVIa,A-3lJl: KIAM1�unOfA in, cow
VOFS'KM W0rW *M MOkMW Form For mon information,pleare vire wwwaigard-orgov
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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 390, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00038
Jeff Grove
Violation Summary:
Inspector Contractor