Permit CITY OF TIGARD BUILDING PERMIT
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' . COMMUNITY DEVELOPMENT Permit#: BUP2016-00067
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/01/2016
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 200
Project: Rian Group Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Includes demolition,new walls,doors,relites and new cabinetry
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 03/01/2016 $220.00
Occupancy Grp: B Occupancy Load: 32 Permit Fee-Additions,Alterations, 03/01/2016 $1,030.65
Demolition
Dwelling Units: 0 12%State Surcharge-Building 03/01/2016 $123.68
Stories: 5 Height: 0 ft Plan Review 03/01/2016 $669.92
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 03/01/2016 $412.26
Value: $90,000 Info Process/Archiving-Lg$2.00(over 03/01/2016 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,464.51
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
952-001-00 rough 0•' 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.
Issu d By: �, `1 ,` �� r Permittee Signature:
•
Call 503.639.4175 by 7:00 a.m.for the next available inspec .
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.
City of Tigard • BUILDING DIVISION
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Over-The-Counter (OTC) Building & Fire Protection System Permit
T I G A R D Appointment Checklist
Permit Record#: P 36l 6,-6)00(7
Contact Name: s ,ri e,,A. a.- Q Phone #: 95-163-9,D,4- 4 d
Business Name: rnr,.-c-,�--e..,,,. Appointment Date: Z/i @ /O;o6 r9T')
Site Address: i o o4W c-► a Bldg/Suite #: aop
Project Name: �t et:::::- ,re,-(.�� si
• , •, -„ _� --- L, �v v��vL (°�. �
-t
Project Description: `V.,,,
, aart t a,-� s_-v � l,ud-ki� - -Ae1JIa `t-C.>�c
I
Existing Use: t•
New Use: (licea.
MMD Required: es No Related Record #:
71 'Pt/CATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work: �Tl Occupancy Group: �j Type of Construction: it,
Type of Use: 1,\ Occupancy Load: 2 Oregon Specialty Code: 1A—
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
Sideyard Setback—Left Sideyard Setback—Front
Sideyard Setback—Right Sideyard Setback—Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: 5: Occupancy Separation:
E: W: E: W: Access. Parking 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: $ go, , p .. '4rI UE
$ L2 ', y.,C Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ 2 ,..2,C 12%State Surcharge
Project Valuation $ i .&r Plan Review,Structural
Up to$4,999 $0.00 $ ,I g , Plan Review,Fire Life Safety
$5,000-$74,999 $88.00 $ i 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
(P-/l(P �-..Q� ...0.— --t � l90 coo $ School Construction Excise Tax
$ Hourly Rate Fee
a 46-6, 1 $ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ 2,IVA5( TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_02091 G.docx
Building Permit Application VI 11�
Commercial RECEIVED FOR OFFICE USE ONLY
Received
City of Tigard Raters • 3 /,�� Permit No.: / 0ap/( ..-001 ,
Mil
't 13125 SW Hall Blvd.,Tigard,OR 9 %!: a 1 2016 Plan Review
Phone: 503.718.2439 Fax: 503.59:. •.`'t Date/B : `e Other Permit
TIGARD Inspection Line: 503.639.4175 CITY •-•.,t-
t: T1GARD Date Rea, Juris: ® See Page 2for
Internet: www.tigard-or.gov V t, �S t�'tf-�I Notified/Method: Supplemental Information
l { ;1. "Z
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
work indicated on this application.
CATEGORY OF CONSTRUCTION
❑ 1-and 2-family dwelling Valuation: $
®Commercial/industrial
❑ Accessory building 11Multi-familyNumber of bedrooms:
12Master 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.:200 Project name:Rian Group 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 2nd of Valuation: $90,000.00
5 floors.Work to include demolition,new walls,doors,relites and new Existing building area: 3,119 square feet
cabinetry. New building area: 3,119 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
0 APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Please refer 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
City/State/ZIP:Portland,OR 97214 Total fees due upon application:
Amount received:
Phone:(503)224-9560 Fax::(503)228-1285
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: This permit application expires if a permit is not obtained
Fritniit
within 180 days after it has been accepted as complete.
Print name:Lauren Rohde Date:03/01/16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildingTermits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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City of Tigard
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COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Commercial - No Land Use
Building Permit #: 7Pao(lo 000007
Site Address: I 0300 SW Cl rr-e. (%j V r9 a d. Suite/Bldg#:
Project Name: 12l Girl EI rOv p
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Ti Y e4-l-13r T L
Existing Business Activity: COMM-Matt— 0 LI Cst..
Proposed Business Activity: C.' Y )YTLQ%t-, A- 0 LC-C.C2L.
Verify site address/suite#exists and active in permit system.
9/River Terrace Neighborhood: ❑ Yes IVNo
7 Zoning: i li/l v C - 1
XPermitted Use: UU�� �� 7 Yes ❑ No ❑ Spec Space
/Confirm no land use required.
4 Business License:
Exists: 0 Yes 0 No,applicant notified to obtain business license
Notes:
7-170 0 Approved by Planning: I i10 Date: 3) 1 J I (Gi
Revisions (after Building Submittal only) Reviewer Date
Revision 1: 0 Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Building Permit Submittal
Original Submittal Date: Zfi /16
rix
Site Plans: #
Building Plans: # 3
Building Permit#: Er-Enter building permit#above.
Workflow Routing: ffPlanning & uilding
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: OrFuild ng original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
/�,.
Notes: (1 r e
By Permit Technician: , CiQ-y,l,` i Date: Z--/--/ ''
I:\Building\Forms\BldgPetmitRvw_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.BldgPennitRvw_COM_NoLandUse_0709I5.docx