Permit (116) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00064
. * 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/25/2016
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 360
Project: CLM Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for new tenant to Lincoln Center. Scope of work includes demolition,wall construction,and new doors.
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: Ig DC Provision Review,COM TI-Ping 02/25/2016 $88.00
Occupancy Grp: B Occupancy Load: 42 Permit Fee-Additions,Alterations, 02/25/2016 $827.34
Demolition
Dwelling Units: 0 12%State Surcharge-Building 02/25/2016 $99.28
Stories: 7 Height: 0 ft Plan Review 02/25/2016 $537.77
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/25/2016 $330.94
Value: $62,432 Info Process/Archiving-Lg$2.00(over 02/25/2016 $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 $1,889.33
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: �]���� Signature:
Call 503.639. by 7:00 a.m.for the next available inspe ' n 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 �Q�� Date/By: U. Permit No.: V" J&
13125 SW Hall Blvd.,Tigard,OR Plan Review
Phone: 503.718.2439 Fax: 503.59 160 th� Other Permit:
Date/B
Inspection Line: 503.639.4175 �(` ��� G`13 75ate Ready Jure ® See Page 2 for
Internet: www.tigard-or.gov ��_ ��� Notified/MethodSupplemental Information
TYPE OF W 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:5 Lincoln-10200 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:360 Project name:CLM 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 to include interior tenant improvements for a tenant on the 3rd of Valuation: $$62,432.00
7 floors.Work to include demolition,new walls,doors,relites and new Existing building area: 4,187 square feet
cabinetry. New building area: 4,187 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 7
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
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*
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 Ro de Date:02/25/16 * 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 • BUILDING DIVISION
s �
Over-The-Counter (OTC) Building & Fire Protection System Permit
Appointment Checklist
Permit Record#:
Contact Name: Phone #: -'2W-55-66)
Business Name: /' Appointment Date: WR S tC 14 Z04-l"-7
Site Address: Bldg/Suite #: e
Project Name:
Project Description: �►
Existing Use: c6a,dt New Use:
MMD Required: ❑ Us No Related Record#:
GENERAL INFORMATION
Class of Work: L Occupancy Grou : d; Type of Construction:
Type of Use: Occupancy Load: "2 Oregon Specialty Code:
SPECIFICS
Number of Stories: Budding 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.Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
S rinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor: �l
Total Project Valuation: $ ��J�
$ ,� DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ 12%State Surcharge
Project Valuation $ 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
$ Nfisc-Admin Fee
$
Other:
Building Staff $ Other: \
Date/Time: $ �Fe51?1;;.;1-T0T"ES DUE
I:\B61ding\Forms\OTC_BUP_FPS_020916.docx
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
Building Permit Review — Commercial - No Land Use
Building Permit #: _ &6 ((0—dLXX0q
Site Address: l(, oo grevo6v Suite/Bldg#: �
Project Name: 0410
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review Co"-sal: -T. 1r, 3 f zt /0 r�v>wC h dti/ jv?4
Existing Business Activity: ffG�.
Proposed Business Activity: O1f'/e*e
Verify site address/suite#exists and active in permit s stem.
River Terrace Neighborhood: ❑ Yes No
R zoning: d jlyE` /
'9 Permitted Use: ;K Yes ❑ No ❑ Spec Space
4 Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date:
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:
Site Plans:
Building Plans: L'?n7t-er
Building Permit#: building permit#above.
Workflow Routing 15-15fann ng ❑ Permit Coordinator 9— hlTding
Workflow Sign-off: P`91 n;_-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: v l(s
I:\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