Permit I e= ar :' CITY OF TIG A RD BUILDING PERMIT
IIII PERMIT #: BUP2007 00298
COMMUNITY DEVELOPMENT DATE ISSUED: 6/7/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-01002
SITE ADDRESS: 10220 SW GREENBURG RD 201 ZONING: R -12
SUBDIVISION: LINCOLN CENTER /THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: INFINITY REHAB
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: 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 9,500.00
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST RUSSELL CONSTRUCTION INC.
ONE SW COLUMBIA ST #300 20915 SW 105TH AVE.
PORTLAND, OR 97258 TUALATIN, OR 97062
Contact #: PRI 503 - 228 -4898
Phone: FAX 503 - 228 -2770
Reg #: LIC 58918
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/7/2007 $139.30
[TAX] 8% State Surcha 6/7/2007 $11.14
[BUPPLN] Pin Rv 6/7/2007 $90.55
[FLS] FLS Pin Rv• 6/7/2007 $55.72
Total $296.71
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 Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rul- :. • t que tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
L_ / , l ` 1- '
Is : : • w / Permittee Signature: 0 ,
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.
I
Building Permiiati lica(t><ont ', v � '-' FOR OFFICE USE ONLY
11 v.
t ,- - , - ,
City of Tigard Received
f 001 i Date/By: � Permit No.: ° gi p" ?�a( 9
4 ,
13125 SW Hall Blvd., Tigard, OR 972231 ��� I i *% '
Plan Review'
Phone: 503.639.4171 Fax: 503.598.19 t Other Permit:
1i' Date/B : i
Inspection Line: 503.639.4175 , �.. , t ..3 .`, � "!! j Date Ready/By: en ® See Attached Checklist for
Internet: www.ci.tigard.or.us (,i .i < - — Iv "7, 1' Notified/Method: Supplemental Information
�..., - -, .._.> ga'�: ".v' - " ":: - +a;" 0';',,,:,:r a :,. ._ .:.:', ..t + °;�,� .., ; °:;.�, ;. �s,_ ° « E f . ^�.�; .e: ... ..: ,.av�s, �-ek ��a =:� =""'�a -a ^"ii'..ftpaa�•� �, a-,
.. °`.„ ' TYPE OF.m 60 � 1 "' ` RE DIRE D1 .14 . A: iNisiD ; 2'-FAMILYDWELL IN G'
❑ 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.
AT'EGORY`, - a g0 fRUGTION
� -.- _;_ .::� � .��.. T....:...- `. .:.: -mss :: .;'aa s�. �- . ...w`i:a s. «° i> �_� .:� ....
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB : S1Ta A INFOR TION . D- "'LOGAT ON
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.: 201 Project name: Infinity Rehab Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED<DAii'A raMiiIiCIAI'i S rifiGKLIS
. A % - i-:5", � . , ' . "-- ,, . V,,0
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
Tax overhead, and th
equipment, materials, labor, overhe d, a the pr ofit for the
DE GRI _ P d =b4WO
i RK » " work indicated on this application.
_ ' . t ,ate -: ,, `- -_ _ ; t
Interior Tenant Improvement Valuation: $9,500.00
Existing building area: 5,409 square feet
New building area: square feet
®`. PROPERTY OWNER . A_= ; � TENA ' E Number of stories: 6
Name: Shorenstein Realty 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:
.W:
s APP T -, ' C- ' , ` ; T PERSON " i
k
.Y . -_ - igt _ - °y%�vaF: __ __. S _timA@ � � n ccr ,�o _ 4i 4 ® ISE
NIT �...,:..;r " $`��4r. �� .a. � . . r " � �•,„f "b
Business name: Group Mackenzie All contractors and subcontractors are required to be
Contact name: Stacey Alexander licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1515 SE Water Ave. #100 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: salexander@grpmack.com
1P4 « RAC
,, , : CQNT sTOR _
Business name: Russell Construction t,.= „, t2- a, �,r
,, a %y r x _µT -, r' BUILDING PFrRtl1IT ,FEE N �
Address: 20915 SW 105 Ave « � "
Please refer to fee schedule.
City /State /ZIP: Tualatin, OR 97062
Fees due upon application
Phone: (503) 228 -4898 Fax: (503) 228 -2770
Amount received
CCB lie.: 58918
// Date received:
Authorized signature: (/�// f/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Stacey Alexander / Date: 06/07/ 07 * Fee methodology set by Tri -County Building Industry
Service Board.
is \ Building \Permits \BUP- PermitApp doc 12/03 440- 4613T( I I /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007.00298
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 6/712007 .
Phone: (503) 639 -4171 AO ii Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 6/2912007 TIME: 7:00AM PAGE: 47
SITE ADDRESS: 10220 SW GREENBURO RD 201 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: INFINITY REHAB
DESCRIPTION: TI
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503 - 228 -4898
Inspection Request Scheduled For: Date: 6/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 051173-01 503. 312.3876 Y
Corrections /Comments /Instructions:
ip PASS � PA :TIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL .LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
.. -
CITY OF TIGARD , , -
BUILDING DIVISION PERMIT #: BUP2007 -00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 617/2007
Phone: (503) 639 -4171 7
Inspection Requests (24 Hrs.): (503) 639 -4175 . 'ire_
INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AM PAGE: 3
SITE ADDRESS: 10220 SW GREENBURG RD 201 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: INFINITY REHAB ``—°"
DESCRIPTION: TI
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503 -228 -4898
Inspection Request Scheduled For: Date: 6119/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess. se
0 275 Framing 050495 -01 503. 312 -3876 (0-i L-
Corrections /Comments/ Instructions:
%' •� sL ° 41"
A A ,- 4
C -O V C._- `
1- P/ c \ /(3 P>z' ,_
1-
I PASS ABTIAL APP; • ❑ CANCEL I I NO ACCESS
FAIL • CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
O F t._... f--6 1 7 1 Y
Inspector: Date: 6 /6 / Phone #: (503) 718 -