Permit f _ n
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00125
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/07/2016
Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 640
Project: Old Republic Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant:Demolition and construction of a new demising wall.
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 04/07/2016 $88.00
Occupancy Grp: B Occupancy Load: 14 Permit Fee-Additions,Alterations, 04/07/2016 $453.95
Demolition
Dwelling Units: 0 12%State Surcharge-Building 04/07/2016 $54.47
Stories: 6 Height: 0 ft Plan Review 04/07/2016 $295.07
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 04/07/2016 $181.58
Value: $24,110 Info Process/Archiving-Lg$2.00(over 04/07/2016 $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 $1,077.07
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 1 332.2344.
Issued By: f' Permittee Signature:
fr64j1( '
39 639.4175 by 7:00 a.m.for the next available inspea' 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
pp
Commercial FOR OFFICE USE ONLY
City of Tigard 1C)4Received ,
Date/B
7/C+ ow Permit No.:z
, : -
'III 2 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 ` PlanROther Permit 503.718.2439 Fax: 503.598.1960 Date/B :
Inspection Line: 503.639.4175 p l '
TIGARD Date Read /B � ® See ragee 2 for
Internet: www.tigard-or.gov n Notified/Method:1� .rr ' Supplemental Information ormation
l )`` Oki ,Pa`.
TYPE OF WORK �� REQUIRED DATA:1-AND 2-FAMILY DWELLING
.. y(c. Q Q
❑New construction 0 De
y��" Permit fees*are based on the value of the work performed.
Q � Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Ot r: 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 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:2 Lincoln-10220 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:640 Project name:Old Republic 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 an existing tenant on Valuation: $$24,110.00
the 6th of 6 floors.Work to include demolition,new demising wall and new Existing building area: 1336 square feet
cabinetry. New building area: 1336 square feet
® PROPERTY OWNER 0 TENANT Number of stories: 6
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*
(Please refer to fee schedule)
Business name:Mackenzie
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
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 Photo Voltaic 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: 62Afil--e" Thiswipermit apdays
expires
has beef a permit isnotcoobtained
within 180 days after it has been accepted as complete.
Print name:Lauren Rohde Date:04/07/2016 * 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
1 v COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Commercial - N o Land Use
e„
Building Permit #: 04o711/<v--( jl `-
Site Address: 10120 9W Greenburo, Rd. Suite/Bldg#: 6140
Project Name: Nein Republic
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: -TI +p redu,Gt, e i siin 1-ena + space.,
Existing Business Activity: ice,
Proposed Business Activity: j .e/
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes No
FA Zoning: AUE-1
iermitted Use: NYes ❑ No ❑ Spec Space
Zig onfirm no land use required.
Business License: /
Exists: ❑ Yes l 1 No,applicant notified to obtain business license
Notes:
Approved by Planning: Tim Leirlitoadn Date: \-1116
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: Lt/7A'
Site Plans: # ,iv/4-
Building Plans: # 3
Building Permit#: E--Enter building permit#above.
Workflow Routing: 1 ing ❑ Permit Coordinator eH3tding
Workflow Sign-off: t ff 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: OTC_
By Permit Technician: s —`�cir1F.--- - Date: il7A,
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_07o915.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 0 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\BldgPermitRvw_COM_NoLandUse 07091 5.docx
City of Tigard • BUILDING DIVISION
ei
IN I
Over-The-Counter (OTC) Building & Fire Protection System Permit
I l i, \RI) Appointment Checklist
Permit Record#: 84/26,20i(p--(tel aS`
Contact Name: AA-C 4., Phone #: -214-q t
Business Name: 1..{0.C, �� .}ta., Appointment Date: q/i//& /O.eOm
Site Address: (perp "al-0"al-0 C f .,n�u„�q l•&, Bldg/Suite Lc..(��
Project Name: Q 1✓ p�.h E �1
Project Description: _ • i, a a• a •„
Existing Use: Oinil,PL New Use: 0[1;x, o
MMD Required: ❑ Yes No Related Record #: (�
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION . _
Class of Work: Occupancy Group: Type of Construction: l�j
Type of Use: C_L,.54, Occupancy Load: t 4 Oregon Specialty Code: 2,::)f
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: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: 7 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: $ 724A1) . '-) FEES DUE
$ C DC Prov Rvw,COM TI—Ping
$ 4110110010 ermit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI (effective 7/1/2015) $ , 12%State Surcharge
Project Valuation $ "I'‘' 1 Plan Review,Structural
Up to$4,999 $0.00 $ Ian Review,Fire Life Safety
$5,000-$74,999 $88.00 $ illtdi 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:
Building Staff: $ Other:
$
Date/Time: 2C??IC'7 T TAL FEES DUE
r .
/_—
I:\Building\Forms\OTC_BUP_FPS_020916.docx --'
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
10220 SW GREENBURG RD 640, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2016-00125
Jeff Grove
Violation Summary:
Inspector Contractor