Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00055
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/17/2016
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 425
Project: American United Development Group Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-New walls,door and window.
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: IB DC Provision Review,COM TI-Ping 02/17/2016 $88.00
Occupancy Grp: B Occupancy Load: 10 Permit Fee-Additions,Alterations, 02/17/2016 $210.59
Demolition
Dwelling Units: 0 12%State Surcharge-Building 02/17/2016 $25.27
Stories: 5 Height: 0 ft Plan Review 02/17/2016 $136.88
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/17/2016 $84.24
Value: $9,000 Info Process/Archiving-Lg$2.00(over 02/17/2016 $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 $548.98
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. on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 1-0010 through OAR 2-001- You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2/344.
Iss d By: G Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti e.
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
CommercialFOR OFFICE USE ONLY
City of Tigard Received
Date/By: Perm t No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Re Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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.
❑ 1-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:1 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.:425 Project name:AUDG 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 4a'of Valuation: $9,000
5 floors.Work to include new walls,door and window. Existing building area: 925 square feet
New building area: 925 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 to ee 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°i 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: Q This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren kohde Date:02/17/16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pemuts\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 #:
Site Address: /0300 Suite/Bldg#:
Project Name: /7i7k�V, ? &166?6�2-L
(Name of commercial business occupying the space. If vaca ,enter Spec Space.)
Planning Review
Proposal: TeA'V_1_ -If :7A4,011Z 2npw
Existing Business Activity: s .Q
Proposed Business Activity: JOP C,
Verify site address/suite# exists and active in permit systt
ver Terrace Neighborhood:
El LvJ No
Vtoning:
Vermitted Use: ❑ Yes ❑ No ❑ Spec Space
Bonfirm no land use required.
usiness License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: — -i? �G Date: 02 I
65,
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: 7/1
Site Plans: #
Building Plans: #
Building Permit#: D'-nter building permit# above.
Workflow Routing: Planning E_Qrff,i�t lam'Building
Workflow Sign-off: ❑-Sign-off for Planning(include notes from planning review)
Route Application Documents: Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: QTc-
By Permit Technician: Date: /7 6
I:\Building\Fonns\B1dgPennit Rvw_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Release Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent t pplica
Revision Notice 2: Date S to Applicant:
Revision Notice 3: Da ent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes /A
❑ OK to Issue P mit
Approved by Perini oordinator: Date:
I:\Building\Forms\B1dgPermitRvw COM_NoLandUse_070915.docx
Building Division Me� ,,,/
' Over-The-Counter (OTC) Building Permit 5O3�';2' —955—
Appointment Check List
Building Permit#: Appointment Date: 02 17//6
Site Address: l D?'00 'b� ek-e JA"e-F b Bldg/Suite #:
Project Name: M 9,y 1 �2cxt�
Project Description: tp Eo LSA LL,S ,moo Q, 14 Li TE .
Existing Use: 0 Fr1 e ti New Use: QFF ce-
MMD Required: ❑ Yes �K No Related Record #:
GENERAL INFORMATION
Class of Work*: (�— Occupancy Group: T e of Construction:
Type of Use**: Occupancy Load: Oregon Specialty Code:
SPECIFICS
Number of Stories: Building Height: Mixed Use:
Number of Dw Units: I 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.Parkina 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:
Densi : Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ ��
$ 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
$ Misc.Admin Fee
Building Staff. $ Other:
Date/Time: $ IC-,, 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_020916.docx