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Permit CITY OF TIGARD BUILDING PERMIT Y� DEVELOPMENT Permit #: BUP2012 -00090 COMMUNIT TI G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/03/2012 Parcel: 1 S135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 110 1 Project: Terra Staffing 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: 513- 619 -3200 FAX: 503 - 228 -2770 FEES Specifics:, Description Date Amount Type of Use: COM DC Provision Review, COM TI - Ping 05/03/2012 $64.00 Class of Work: ALT DC Provision Review, COM TI - LRP 05/03/2012 $9.00 Dwelling Units: 0 Permit Fee - Additions, Alterations, 05/03/2012 $608.23 Stories: 5 Height: 0 ft Demolition Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 05/03/2012 $72.99 Value: $38,583 Plan Review 05/03/2012 $395.35 Plan Review - Fire Life Safety 05/03/2012 $243.29 Info Process /Archiving - Lg $2.00 (over 05/03/2012 $6.00 Floor Areas: 11x17) Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,398.86 Required: Required Items and Reports (Conditions) Fire Sprinkler: No Parapet: Fire Alarm: Yes Protected Corridors: Smoke Detectors: Yes 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. ATT • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 010 through R 952-061-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344: Issue By: / � Permittee Signature: Call 503.639.4175 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 F O R OFFICE LSI ONLY Cit y Tigard Re of Ti and RECE/ED Received Date/B / Permit No.: / / 9e5 3 I / � • 13125 SW Hall Blvd., Tigard, OR Plan Revie 2 Phone: 503.639.4171 Fax: 503.598.1',: t — 3 2012 Date/B : , �� Other Permit: I G n R D Inspection Line: 503.639.4175 Y Date Ready/By: mrls: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information CITY OF TIGAa „D TYPE cBUIfigliU UIVIS ON 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 0 Commercial/industrial Valuation: $ El 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: 1 Lincoln -10300 SW Greenburg Road • New dwelling area: square feet City/State/ZIP: 97224 Garage/carport area: square feet Suite/bldg. /apt. no.: 110 I Project name: Terra Staffing 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. Valuation: $$38,583.00 Existing building area: 2,131 square feet New building area: square feet 0 PROPERTY OWNER I ❑ TENANT Number of stories: 5 Name: Shorenstein Realty Services Type of construction: II -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 0 APPLICANT ❑ 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 I 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) City /State/ZIP: Tualatin, Oregon 97062 -9511 Structural plan review fee (or deposit): Phone: (503) 692 -9002 I Fax: (503) 692 -9008 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 Print name: Whit Middlecoff, AIA I Date: 05/03/2012 * within 180 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(I1 /02/COM/WEB) o ° Building Division Development Code Provision Review r i c n ii Commercial Projects - No Associated Land Use Case Building Permit No: 4 Expedited Review Plan Submittal Date: � 2 i / /�. 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 approved. Pla Review (contact ! k at 503-718-- or i _ @ tigard- or.gov) Ud Zoning in W/ I Permitted Use Yes ❑ LIB' Land Use Re.uired: Yes ❑ No (explain below) Notes: -444 % � . . ( ' / _ i// V Approved ❑ Not Approved Date: � /2 Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov) Notes: /V Routed back to Building Division Date: I: \CURPLN Building Division Over- The - Counter (OTC) Building Permit' TIGARD Check List Project Description: TT 'APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: Lf Occupancy Group: Type of Construction: *Type of Use: Cf Occupancy Load: i Oregon Specialty Code: 27:070 SPECIFICS Number of Stories: Building Height: Mixed Use: Number of Dw Units: Number of Bathrooms: Number of Bedrooms: BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES Story Square Footage: Accessory Structure: Covered Porch: Basement: Garage: Deck: Total Square Footage: Carport: Mezzanine: SETBACKS Sideyard Setback — Left Sideyard Setback — Front Sideyard Setback — Right Sideyard Setback — Back CONSTRUCTION Exterior Walls: Openings Protected: Firewall Separation: N: S: N: S: Occupancy Separation: E: W: E: W: Access. Parking Spaces: _ REQUIRED ITEMS Fire Sprinklers: Fire Alarms: j Smoke Detectors: Parapet: Manual Pull Stations: Protected Corridors: Total Project Valuation: $ CO FEES DUE $ /` DC Prov Rvw, COM TI — Ping $ , CO DC Prov Rvw, COM TI — LRP DC Provision Review Fee for COM TI $ r , Permit Fee — Add, Alt, Demo Project Valuation Planning LRP $ . 12% State Surcharge Up to $4,999 $0.00 $0.00 $ ' r j, Plan Review, Structural $5,000 - $74,999 $64.00 $9.00 $ •'5, Plan Review, Fire Life Safety $75,000 - $149,999 $160.00 $24.00 $ Mil Info Proc /Arch, Lg (over 11x17 $2.00) $150,000 and over $256.00 $38.00 $ Info Proc /Arch, Sm (up to 11x17 $0.50) $ Metro Construction Excise Tax $ School Construction Excise Tax $ Hourly Rate Fee Planning Staff: $ Hourly Rate State Surcharge $ Misc. Admin Fee Permit Coordinator: $ Other: $ Other: Building Staff: $ Other: Date /Time: $ 395 , %TOTAL 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. I: \Building \ Forms \OTC - BUP.docx 01/13/2011