Permit (186) CITY OF TIGARD BUILDING PERMIT
11-�' COMMUNITY DEVELOPMENT Permit#: BUP2016-00330
Iit;;\lt.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2016
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 115
Project: Reflex Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: New walls,doors&cabinetry
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 11/22/2016 $90.00
Occupancy Grp: B Occupancy Load: 30 Permit Fee-Additions,Alterations, 11/22/2016 $696.39
Dwelling Units: 0 Demolition
12%State Surcharge-Building 11/22/2016 $83.57
Stories: 3 Height: 0 ft Plan Review 11/22/2016 $452.65
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Lg$2.00(over 11/22/2016 $8.00
Value: $46,223 11x17)
Plan Review-Fire Life Safety 11/22/2016 $278.56
Floor Areas:
Total Area: 2959
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,609.17
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. ATT Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente. Those rules are set forth in OAR
952- 0010 through 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2.19: or 8 r r
Is ued By: /i / • Permittee Signature: if/Elf
i
Call 503.639.4175 by 7:00 a.m.for the next available insp: 'e.
This permit card shall be kept in a conspicuous place on the job site unti • pletion 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
111 City of Tigard g , Received L" .:� Permit No.: @ P �p-t� .
13125 SW Hall Blvd.,Tigard,OR 97 2 IN
Plan Revie
11: Phone: 503.718.2439 Fax: 503.598.1960 Date/B : � ,w � Other Permit:
TIC'ARD Inspection Line: 503.639.4175 NI 2 2 2016 Date Rea. : ions: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF 9 RUAD
TYPE 08 4 ENG DIVISION 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=11-and 2-family dwelling ®Commercial/industrial Valuation: $
ElAccessory building CI Multi-family Number of bedrooms:
EIMaster builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:4 Lincoln-10250 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:115 Project name:Reflex 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
Permit fees*are based on the value of the work performed.
Subdivision: Lot no.:
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.
Valuation: $$46,223.00
Work to include demolition,new walls,doors and new cabinetry
Existing building area: 2,959 square feet
New building area: 2,959 square feet
r PROPERTY OWNER .0TENANT Number of stories: 3
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*
(Please refer to fee schedule)
Business name:Mackenzie Structural plan review fee(or deposit):
Contact name:Kim Ford 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
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E-mail:kford@mcknze.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Submit two(2)sets of roof plan with connection details
Business name:Russell Construction and fire department access,along with the 2010 Oregon
Address:20915 SW 105th Ave Solar Installation Specialty Code checklist.
Permit fee(includes plan review
City/State/ZIP:Tualatin,OR 97062 and administrative fees): $180.00
Phone:(503)692-9002 Fax:(503)692-9008 State surcharge(12%of permit fee): $21.60
CCB lic.:58918 Total fee due upon application: $201.60
/ VAIP
This permit application expires if a permit is not obtained
Authorized signature: _ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Print name:Kim F. : Date:11/22/2016 Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard • BUILDING DIVISION
Ifil Over-The-Counter (OTC) Building & Fire Protection System Permit
< ; Appointment Checklist
Permit Record#: jjtc.P po((p —003 3 6 'I
Contact Name: KL_ ` -"Cc c Phone#: °DQ3- as`t-95-40
Business Name: et_O.-VNsinpall_— Appt. Date/Time: ///�'z (/OI
Site Address: 1 b"D-So ¶L....)444.P-4,62.1.41,.. 1L. Bldg/$uite #: i/5"
Project Name: _ er1 ir'o-.QJ -_.00-0-1_,,,
-1 `� 1 Qtgf - LLAC
Project Description: y�e,, meq � o �y�► #,e1•
T__ �L�K.R
Existing Use: lb New Use: 6
MMD Required: ❑ Yes 1,No Related Record#:
GENERAL INFORMATION
Class of Work: ,h` 1— Occupancy Group: Type of Construction: '7
Type of Use: a/ Occupancy Load: Oregon Specialty Code:
SPECIFICS
Number of Stories: f. 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: 'L.q/5'1' 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: \ 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: $ '/IP) a a 3
$ O di j DC Prov Rvw,COM TI–Ping
$ MM. Permit Fee–Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2016) $ '12%State Surcharge
Project Valuation $ + a!' an Review,Structural
Up to$4,999 $0.00 $ v 'lan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ y Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ C (TOTAL FEES DUE
I:\Building\Forms\OTC_BUP_FPS_070116.docx
City of Tigard
• N COMMUNITY DEVELOPMENT DEPARTMENT
III
T 1 G A R D Building Permit Review — Commercial - No Land U s e
Building Permit #: P act L-OO 3x0
Site Address: 102 So S w & r-e_o•n by r (-a- Suite/Bldg#: 11 S
Project Name: R c4-€..(
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: l'h.k-e rio r TI , ( , bcotim r1 o `- o Cc cz_
Existing Business Activity: O(�,i(.e__ I U ory.rntxt,+c4,1,.•
Proposed Business Activity: D (4/;CO— / (}p n rrt-esc.i cJ
Verify site address/suite# exists and active in permit system.
Q River Terrace Neighborhood: ❑ Yes C'No
Zoning: U E -
Permitted Use: ❑ Yes ❑ No ❑ Spec Space
pf Confirm no land use required.
C�l Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: M OA"��- V�- Date: t I /2'Li I c.
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: /(/tea",/lp
Site Plans: # 3
Building Plans: #
Building Permit#: 12—Enter building permit#above. _
Workflow Routing: ,®'Planning 'I� Perinl�C-Ts inator L�" Building
Workflow Sign-off: 0'Sign-off for Planning(include notes from planning review)
Route Application Documents: 0 Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes: V-re__
By Permit Technician: Cr (O Date: /t4-y/b
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NO :eleased: )ate:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Appli, : "t:
Revision Notice 3: Date Sent to : splicant:
❑ SDC Fees Entered: Was o Trans Dev Tax: ❑ Yes ❑ N/A
'gard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Per 4• t
Approved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse 070915.docx