Permit # �f CITY OF TIGARD - BUILDING PERMIT
I) PERMIT #: BUP2009 -00025
° COMMUNITY DEVELOPMENT
DATE ISSUED: 2/11/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 375 ZONING: C -
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG
PROJECT: MASTERCARE
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: 29 BASEMENT: sf AREA SEP. RATED:
STOR: 12 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 11,500.00
Owner: Contractor:
SHORENSTEIN REALTY SERVICES RUSSELL CONSTRUCTION INC
ONE SW COLUMBIA ST #300 20915 SW 105TH AVE
PORTLAND, OR 97258 TUALATIN, OR 97062
Phone: 503 -412 -4800 Contact #: PRI 503- 228 -4898
FAX 503 - 228 -2770
Reg #: LIC 58918
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/11/2009 $134.00
[TAX] 12% State Surch 2/11/2009 $16.08
[BUPPLN] Pln Rv 2/11/2009 $87.10
[FLS] FLS Pln Rv 2/11/2009 $53.60
Total $290.78
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 Util' Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 0' R 952 - 001 -0100. You may obtain a copy
of the - rules or .. -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
1
Issue y: . 1_26. ce4Qpa J Permittee Signature ' ` Alli.
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.
% ■
-, Budding Permit Application
:Commerc a
FOR. USE ONLY
City of Tigard RECEIVED Date /B ea 0 G 9 P ermit No.: �
I :14
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
-
Phone: 503.639.4171 Fax: 503.598. nip 200 Date B Other Permit:
J Y: (
T[GARD Inspection Line: 503.639 Date Ready .y: Mil Ei See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITY OFTIGARD
:i ''i. r '. "' .,, ... ei , .d O "= „, . . . `,.: ":m.r `.: `l a. :. ,.. REQII IREE : AND 2 FAMILY DWFCLII\G,:
w F
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
z Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
3IVI a m 3 ,' -' s ORY OF� ay a l ,' I O611-.z.-:1, r work indicated on this application.
..t A ;, Po .n k '::
4, " CATEG wi TRUC T . , -.
1=1 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ['Other:
Number of bathrooms:
- JO B SITE INFORMATIO AND :- ' ? q Total number of floors:
,:,:, ., _.4�w ..,r,- c._-.. �.c a r§+6 *x 9'gwir,.a.: t** _r� otRI w _, t'_ -_a
Job site address: Lincoln Tower 10260 SW Greenburg Rd New dwelling area: square feet
City /State /ZIP: Portland, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 375 Project name: Mastercare Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
- R D A T A 5 CO M ME RCIALE CT
. <. � �, � .
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
r , = n DE ION OF "WORK '-''',--:-:- '1 ' tin - ,:.,:wm work indicated on this application.
Interior Tenant Improvement Valuation: $11,500
Work to include minor demolition, new doors, new demising wall, new one hour Existing building area: 2,926 square feet
rated wall, extension of corridor ceiling tiles and grid, new lights /exit signs New building area: square feet
' .:°� .
., ° .
.. rya.'• , � - i %a
���PRQPERTY OWNER NANT3I 4 Number of stories: 12
Name: Shorenstein Type of construction: I -B
Address: One SW Columbia Street, Suite 300 Occupancy groups:
City/State /ZIP: Portland, OR 97258 Existing: B
Phone: (503)412 -4906 Fax: (503)412 -4848 • New:
"` - APPLICANT °$' ..�. CONTACT PERSON _ t ;_.MS:, 1 , ` a t" . � � ti
,, ,,,4A,..,„:' ,. M � -� a:1a4 �.e � t��? a� � °� '�� „_ .N; � �" . _ . NOTIC a t. a ir . ,:.v ,, r ..
Business name: Group Mackenzie All contractors and subcontractors are required to be
Contact name: Morgan Toth licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1515 SE Water Ave Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97214 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9560 Fax: : (503) 228 -1285
E -mail: mtoth @grpmack.com
t .:� 4£ $ t i,r : CONTRACTOR ; 1 r s ` '' 1 a
Business name: Russell Construction 4 9i BUILDING PERIGIIT- -'FEES* ;. , a 3'' F P
Address: 20915 SW 105th Ave 144! kii � ' .., ti; heJufe)a, , - , d" W.
City/State /ZIP: Tualatin, OR 97062 Structural plan review fee (or deposit):
Phone: (503) 228 -4898 / Fax: (503) 228 - 2770 FLS plan review fee (if applicable):
CCB lie.: 58918 �1/ j0 0 Total fees due upon application:
��' , Amount received:
Authorized signatur . - .
• This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Kim Fo Date: 02/11/09 * Fee methodology set by Tri- County Building Industry
Service Board.
l: \Building \Permits\BUP - COM PermitApp.doc 2/23/07 440- 4613T(11/02/COM /WEB)
III Building Division
Over- The - Counter (OTC) Building Permit
TicARD Check List
Description of Project: Ti
GENERAL INFORMATION
Class of Work:* IT Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* ( rf7AA First floor: N: S:
Type of Construction: ,J Second floor: E: W:
' Occupancy Group: �J Third floor: _ Openings Protected Y /N ?:
Occupancy Load: ?. c 1 Total sq ft.: N: S:
Stories: 2/ Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor sq. ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: --, Handicap access:
Smoke detector: Protected corridors: } _� e-=,
Fire alarm: y---, Parking spaces ( #):
Notes:
Total Valuation: $ 1
INSPECTIONS FEES DUE
Footing /foundation Firewall $ '72 1 , CO Permit Fee
Post /beam structural Smoke detector $ 4o, =' State Surcharge
Shear wall h'hsc. inspection $ r I Plan Review Fee
Masonry Approach /sidewalk $ 3. i FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
. C Other:
` Tota Fees Due
$
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; 0 FR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \ Building \Forms \OTC - BUP.doc 08 /19/08