Permit (42) CITY OF TIGARD BUILDING PERMIT
a COMMUNITY DEVELOPMENT Permit#: BUP2016-00186
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/02/2016
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 200
Project: Farmers Insurance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-downsizing, includes minor demolition&new demising wall.
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: IIB DC Provision Review,COM TI-Ping 06/02/2016 $88.00
Occupancy Grp: B Occupancy Load: 132 Permit Fee-Additions,Alterations, 06/02/2016 $195.38
Demolition
Dwelling Units: 0 12%State Surcharge-Building 06/02/2016 $23.45
Stories: 7 Height: 0 ft Plan Review 06/02/2016 $127.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/02/2016 $78.15
Value: $8,000 Info Process/Archiving-Lg$2.00(over 06/02/2016 $4.00
11x17)
Address Fee 06/02/2016 $50.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $565.98
Required: Required Items and Reports(Conditions)
Fire Sprinkler: 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. ATTENTIO. •regon 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 OA' 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: �� Permittee Signature: CSA' e
Call 503.639.4175 by 7:00 a.m.for the next available inspection ate.
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.
r-
Building Permit Application
Commercial RECEIVED FOR OFFICE ISE ONLY
City of Tigard Date/Received Cr'L. a (6 gemPermit No.: ����-�l g
, IN . 13125 SW Hall Blvd.,Tigard,OR Q173 n 7 1 Plan Review m ���� Other Permit:
Phone: 503.718.2439 Fax: 503. 6 C Date/B :
�l
T I G A R D Inspection Line: 503.639.4175 ,,y,t, D Date Ready Juri.: 0 See Page 2 for
Internet: www.tigard-or.gov CITY( �F II sl� 's Notified/Method: Supplemental Information
TAJ `I DI`VISIOI
ORK 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.
Valuation: $
1:1I-and 2-family dwelling ®Commercial/industrial
❑Accessory building EI Multi-family Number of bedrooms:
[11 Master builder 111 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.:200 Project name:Farmers InsuranceCovered 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.
Interior tenant improvements for existing tenant on 2nd of 7 floors to downsize Valuation: $$8,000.00
to approx.13,169 SF.Vacant suite 250 will remain at 1,860 SF.Work includes Existing budding area: 15029 square feet
New buildingarea: 13169 square feet
Work includes minor demolition and new demising wall. q
® PROPERTY OWNER 0 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 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
Total fees due upon application:
City/State/ZIP:Portland,OR 97214
Phone:(503)224-9560 Fax::(503)228-1285 Amount received:
E-mail:Irohde @ 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.
review
City/State/ZIP:Tualatin,OR 97062 Permit fee(includes plan $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: $201.60
Authorized signature: ,,,,,,,i3L..k, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren Ro de Date:06/02/16 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
City of Tigard
71COMMUNITY DEVELOPMENT DEPARTMENT
■
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #:�-- ,k Pel Co -6t)(��o
Site Address: I vd of S w (.c.e„b 5 P-c1. Suite/Bldg#:
Project Name: -}arWleif 5 TV1 Sura•-.ut_ T I
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: �encn4- 1 S a o wn•5i -' 1 . \,I 4c a--%/l -2K/S-4 A 5 v- i u- sfig,u. -
001+$}r(Lek.ftc‘ u ally -I"D t r'taiC V•ew CAM- SPGCA..•
Existing Business Activity: 0-4U—
Proposed Business Activity: v 4,Gt...- - V,l4 (,-\ ( c.4- SPF ut_ -R.,- +'- ')
kr-Verify site address/suite# exists and active in permit system. -I'mPruCr - '(`r n L.) S IA.;
® -River Terrace Neighborhood: ❑ Yes t No
.it- Zoning: IA l
'Permitted Use: . Yes ❑ No ❑ Spec Space
,'Confirm no land use required.
'Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: C4%.t c+- Q . Cie Date: (o - D - ( to
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: (QVW{i
Site Plans: # 5
Building Plans: # 3
Building Permit#: 43-Enter building permit#above.
Workflow Routing: a Planning r Building
Workflow Sign-off: IT Sign-off for Planning(include notes from planning review)
Route Application Documents: If Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: (:)-re /
By Permit Technician: ( Date: (1 ,2//,6
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:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx