Permit CITY OF TIGARD BUILDING PERMIT
111 11 * COMMUNITY DEVELOPMENT Permit #: BUP2009 -00126
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/09/2009
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 450
Subdivision: Lot: 0
Project: Credit Union Home Loan Center
Project Description: TI
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - COM 07/09/2009 $148.30
CALIFORNIA ST 49TH FL 12% State Surcharge - Building 07/09/2009 $17.80
PHONE: Plan Review 07/09/2009 $96.40
Plan Review - Fire Life Safety 07/09/2009 $59.32
Contractor:
RUSSELL CONSTRUCTION INC
20915 SW 105TH AVE
TUALATIN, OR 97062
PHONE: 503 - 228 -4898
FAX: 503 - 228 -2770
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 5 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $13,500
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $321.82
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Yes Protected Corridors: Yes
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 i • • . - ith 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. TENTION: Oregon-law re. - s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 •01 -0010 through OAR 9 -001 -110'. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss ed By: ) , / � ����b � V Perm ittee Signature: .
' \ .. / /...L
Call 503.639.4175 by 7:00 a.m. for an inspection that busine bey.
This permit card shall be kept in a conspicuous place on the job site until corn • etion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
FOR OFFICE USE ONLY
RECEIVED D Re a ce.ved q _,67:5/
City of Tigard
13125 SW Hall Blvd., Tigard 598.1960
, OR 97223 j 0 9 2009
* Phone: 503.639.4171 Fax: 503.'' ut. Plan Review'hMillkydirl i npli other Permit:
Date/B : 41,
Inspection Line: 503.639.4175 Date ReadyT Juris El See Page 2 for
Internet: www.tigard CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA 1- AND 2-FAmiLy DWELLING
O New construction 11 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
e Addition/alteration/replacement fl Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation:
1- and 2-family dwelling El Commercial/industrial
El Accessory building El Multi-family Number of bedrooms:
▪ Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 Lincoln 10300 SW Greenburg Rd New dwelling area: square feet
_City/State/ZIP: Portland, OR 97223 Garage/carport area: square feet
Suite/bldg./apt. no.: 450 Project name: Credit Union Home Loan C_1.4-r12.. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
Interior Tenant Improvement Valuation: $$13,500.00
Work to include new wall, door, full height cabinetry and new finishes Existing building area: 1,498 square feet
New building area: square feet
0 PROPERTY OWNER j D TENANT Number of stories: 5
Name: Shorenstein Type of construction: I-B
Address: One SW Columbia Street, Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97258 Existing:
Phone: (503)412-4906 Fax: (503)412-4848 New:
J81
APPLICANT D CONTACT PERSON it
NOTICE
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 I Fax: : (503) 228-1285
E-mail: mtoth@grpmack.com
Business name: Russell Construction I i" IT FEES*
Address: 20915 SW 105th Ave (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State/ZIP: Tualatin, OR 97062
Phone: (503) 228-4898 Fax: (503) 228-2770 FLS plan review fee (if applicable):
Total fees due upon application:
CCB lic.: 58918
Amount received:
Authorized signature
V This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Kim For Date: 07/09/09 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 2/23/07 440-4613T(11/02/COM/WEB)
Transmittals for 2070955.49: Dan Nelson at City of Tigard, Kim Ford at Group Mackenzie - Portland Page 1 of 2
G R 0 U P
'-" ACKE NZI E
1515 SE Water Ave. Suite 100 • Portland OR 97214 •
PO Box 14310 • Portland OR 97293
TEL: 503.224.9560 • NET: GRPMACK.COM • FAX: 503.228.1285
Letter of Transmittal
40369 -1
Date: July 7, 2009 Project Number: 2070955.49
To: City of Tigard
13125 SW Hall Blvd
Tigard, OR 97223 -8199
Attention: Dan Nelson
Project Name: 10300 1 Lincoln - Suite 450 / Credit Union Home Loan Center TI
Enclosed: Quantity Medium Description Comment
1 Bond Full Stamped permit set For your review
Remarks:
Signed: Kjerstine Yachter
Transmitted Employee Delivery (KJF)
Via:
If enclosures are not as noted, kindly notes us at once.
http: / /www.grpmackweb. com/gm /transmittal /preview_transmittal.php ?admin =l &transmittal SetId= 40369 &db... 7/7/2009
II
I " , B uilding Division
Over -The- Counter (OTC) Building Permit
TIGARD
'� Check List
Description of Project: l
GENERAL INFORMATION
Class of Work:* LT- Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* 1 First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: Third floor: Openings Protected Y /N ?:
Occupancy Load: Total sq ft.: N: S:
Stories: Note: Combine total floor area for E: E: _
Height: all floors above third floor and Roof Construction: _
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: 1�> Handicap access: t
Smoke detector: Protected corridors:
Fire alarm: ( Parking spaces ( #):
Notes:
Total Valuation: $ la, 5 °'
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 4rte ik Permit Fee
Post /beam structural Smoke detector $ State Surcharge
Shear wall Misc. inspection $ ' ,' • Plan Review Fee
Masonry • Approach /sidewalk $ 9.3 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
$ Other:
$ 7! , c ...2 otal 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; OTR = other (use for fences, decks, retaining walls; signs, awnings
or canopies); REP = repair.
T: \Building \Forms \OTC - BUP.doc 08/19/08