Permit _ ,'J a[' ' .CITY O F T IGA BUILDING PERMIT
1
: : t PERMIT #: BUP2007 -00591
COMMUNITY DEVELOPMENT DATE ISSUED: 11/15/2007
:100.D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 571 ZONING: R -12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: TRELLEBORG
Project Description: TI
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 58 BASEMENT: sf AREA SEP. RATED:
STOR: 6 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 22,000.00
Owner: Contractor:
SHORENSTEIN REALITY SERVIVES RUSSELL CONSTRUCTION INC.
ONE SW COLUMBIA ST #300 20915 SW 105TH AVE.
PORTLAND, OR 97258 TUALATIN, OR 97062
Contact #: PRI 503 - 228 -4898
Phone: 503-412-4800 FAX 503 - 228 -2770
Reg #: LIC 58918
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUILD] Permit Fee 11/15/2007 $205.50
[TAX] 8% State Surcharl 11/15/2007 $16.44
[BUPPLN] Pln Rv 11/15/2007 $133.58
[FLS] FLS Pln Rv 11/15/2007 $82.20
Total $437.72
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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utili• Notification Center.
Those rules - : - • . h in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a Cory if these rules . dire' questions to OUNC by
calling ..3.246.6699 or ..00. .'.•344.
j
i / A ith
Issu: d By: / Permittee Signature: fi
Call 503.639.4175 by 7:00 a.m. for an inspection -that business day.
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 FOR OFFICE USE ONLY
City of Tigard IV �a�B a ll�o? PennitNo.: ; i j7�� , � fI
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.19601 U V 1 ' !! y .' Date /B : `�Y_ Other Permit:
�
Inspection Line: 503.639.4175 / @ y 6 611. Date Rea.y :y: ® See Attached Checklist for
G Internet: www.ci.ligard.or.us CITY 01; fIcARD Notified/Method: Supplemental Information
ButtoiNennusim
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: 3 LINCOLN 10220 SW GREENBURG RD New dwelling area: square feet
City /State /ZIP: TIGARD, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 571 Project name: Trelleborg Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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 appliicc 1
Interior Tenant Improvement
Valuation: O& �v 00
Improvements include minor demolition, new walls, doors and relites, and new cabinetry Existing building area: 5,772 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 6
Name: Shorenstein Reality Services Type of construction: I -B
Address: One SW Columbia St. Suite 300 Occupancy groups:
City /State /ZIP: 97258 Existing: B
g�
Phone: (503)412 -4800 Fax: (503)412 -4848 New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Group Mackenzie All contractors and subcontractors are required to be
Contact name: Kim Sedlak licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1515 SE Water Ave jurisdiction in which work is being performed. If the
City /State /ZIP: 97214 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9560 Fax: : (503) 228 -1285
E - mail: ksedlak @grpmack.com
CONTRACTOR
Business name: Russell Construction
BUILDING PERMIT FEES*
Address: 20915 SW 105 Ave
Please refer to fee schedule.
City /State /ZIP: Tualatin, OR 97062
Fees due upon application
Phone: (503) 228-4898
I Fax: (503) 228-2770
CCB lie.: 58918
' Amount received
Date received:
Authorized signature: ii,41, l,r Thi s permit application expires if a permit is not obtained
' l * within 180 days after it has been accepted as complete.
Print name: Kim Sedlak Date: 11/15/ 07 Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermitApp doc 12/03 440 - 4613x(11 /02/COM/WEB)
CITY OF TIGAIR
BUILDING DIVISION , PERMIT #: 13UN2007 -00691
13125 SW Hall Blvd., Tigard, Or, 3 DATE ISSUED: 'i'i/ i &/2007
Phone: (503) 639-4171 a NNnv i i,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/28/2007 TIME: ? :00AM PAGE: 68
SITE ADDRESS: 10220 SW GREENBURG RD 571 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: TRELLEf3ORG
DESCRIPTION: TI
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 603-412-4800
CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503-228-4898
Inspection Request Scheduled For: Date: 12/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final invection 062252 -01 503-780-3222 N
K Corrections /Comments/ Instructions:
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'C' / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: Date: i i Phone #: (503) 718 - _ _
CITY OF TIGARD
BUILDING DIVISION PER MIT #: EUF�2007- 005 =t1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/ 15/20177
Phone: (503) 639 -4171 izoil ' iInspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 11/30/2007 TIME: 7 :00AM PAGE: 46
SITE ADDRESS: 10220 SW GREENBURG RD 571 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: TRELLEI3ORG
DESCRIPTION: TI
OWNER: SHORENSTEIN REALTY SERVIVES, PHONE #: 503
CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503 -228 -4898
Inspection Request Scheduled For: Date: 11/30/2007 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
275 Framing 060520 -01 503- 780 -3222 N
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Inspector: Date: ` 61 Phone #: (503) 718-2-42—i
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BUILDING DIVISION-, , ,,, - / PERMIT #: BUNCV7413591
13125 SW Hall Blvd., Tigard, OR 97223 _ A 2 DATE ISSUED: - 11/16q007
Phone: (593)t639-4171
: 47//,fivill
InspectioqRequeSts (24 Hrs.): (503) 639-4175 4.1- e_i_.
INSPECTION WORKSHEET FOR DATE: 11/30/2007 ''v TIME: 7:00AM PAGE: 46
SITE ADDRESS: 10221) SW GREENBURG RD Ei77I . CLASS OF WORK:
SUBDIVISION: L INCOLN carrERnHREE LINCOLN' LOT #: 009 TYPE OF USE: .
PRbJECT NAME: "I
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DESCRIPTION: t) '
OWNER: SHORENSTEIN REALTY SE.RVIVES, PHONE #: &%4I2-
CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503-226-4898
Inspection Request Scheduled For: Date: 11/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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276 Framing 060520-01 503-7W-3222 N
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Inspector : Date: ' 1 4. 9 A? / Phone #: (503) 718-24;i4Y
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