Permit CITY OF TIGARD BUILDING PERMIT
' COMMUNITY DEVELOPMENT Permit #: BUP2012 -00013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/25/2012
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD A
Project: Fitness Center Subdivision: METZGER, TOWN OF Lot: 9
Project Description: TI
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 - 228 -3413 PHONE:
FAX: 503 - 228 -2770
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 01/25/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 01/25/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 01/25/2012 $663.33
Stories: 0 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 01/25/2012 $79.60
Value: $44,000 Plan Review 01/25/2012 $431.16
Plan Review - Fire Life Safety 01/25/2012 $265.33
Info Process /Archiving - Lg $2.00 (over 01/25/2012 $8.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,520.42
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: Yes 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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce er. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. • :7'. :00,332.2344.
Issued By: � �r . �i /. Permittee Signature:
"Ca - ' 75 by 7:00 a:m: for the next available inspection date.
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
,Commercial 0 FOR , �,� Received DateB OFFICE USE ONLY
of Tigard 13 I
. Permit No.:J /901 v
l'ili F n l 13125 SW Hall Blvd., Tigard, O ' 7 3 \ � v P O A Plan Review ►rr� Other Permit:
Phone: 503.639.4171 Fax: 503.598.1966r ` '\ \ C?``++ C \Q D at eB : �`,'
Ti G A k D G�
Inspection Line: 503.639.4175 ®` o \v\ Date Ready : y: See Page 2 for
Internet: www.tigard- or.gov � ` ` w\ , Notified/Method: Supplemental Information
. TYPE OF WORK . REQUIRED DATA:1- AND 2,FAMILY DWELLING
El 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: $
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 Lincoln - 10300 SW Greenburg Road New dwelling area: square feet
• City /State/ZIP: 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: A (195) Project name: Fitness Center Covered porch area: square feet
Cross street/directions to job site: SW Locust Street 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 application.
7,1-, Valuation: $$44,000.00
Existing building area: 2851 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT • Number of stories: 5
Name: Shorenstein Realty Services Type of construction: H -B
Address: 5335 Meadows Road, Suite 300 Occupancy groups:
City /State/ZIP: Lake Oswego, Oregon 97035 Existing: B
Phone: (503)619 -3200 Fax: (503)619 -3210 New: B
® APPLICANT El CONTACT PERSON NOTICE '
Business name: GBD ARCHITECTS All contractors and subcontractors are required to be
Contact name: Whit Middlecoff, AIA licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1120 NW Couch Street, Suite 300 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, Oregon 97209 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9656 Fax: : (503) 299-6273
E -mail: whit@gbdarchitects.com .
CONTRACTOR
Business name: Russell Construction BUILDING PERMIT FEES*
Address: 20915 SW 105 Avenue (Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP: Tualatin, Oregon 97062 -9511
Phone: (503) 228 -3413 Fax: (503) 228 -2770 FLS plan review fee (if applicable):
CCB lic.: 58918 Total fees due upon application:
Amount received:
Authorized signature: . This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Whit Middleco , AIA Date: 1/24/2012 * Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB)
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: ❑ Expedited Review
Plan Submittal Date:
To the Applicant:
➢ If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
➢ If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact Iiivt F4 I at 503 - 718 - Ali ,orr jot"' / @tigard- or.gov)
❑ Zoning ,k 6.-/ Permitted Use Yes LF No ❑
❑ Land Use Required: Yes ❑ No Le" (explain below)
Notes: —101 hew- irmut4I i• J "'' /'� ,t44- to r //eytl - 40, C /M..,yt v!{.
L4' Approved ❑ Not Approved Date: l/ / 141.
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
: \CURPLN