Permit CITY OF TIGARD BUILDING PERMIT
• • COMMUNITY DEVELOPMENT Permit#: BUP2012 -00108
Date Issued: 05/24/2012
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 1 S135A601006
Jurisdiction: Tigard
Site address: 10500 SW GREENBURG RD 200
Project: Mutual Fund Store Subdivision: ASHBROOK FARM Lot: 6
Project Description: TI
Contractor: BNK CONSTRUCTION INC Owner: LINCOLN CENTER LLC
45 82ND DR, SUITE 53B BY SHORENSTEIN PROPERTIES LLC
GLADSTONE, OR 97027 • 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 557 -0866 PHONE:
FAX: 503 - 557 -1085
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 05/24/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 05/24/2012 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 05/24/2012 $597.21
Stories: 1 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 05/24/2012 $71.67
Value: $37,400 Plan Review 05/24/2012 $388.19
Plan Review - Fire Life Safety 05/24/2012 $238.88
Info Process /Archiving - Lg $2.00 (over 05/24/2012 $4.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,372.95
Required: Required Items and Reports (Conditions)
Fire Sprinkler: No Parapet:
Fire Alarm: 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. ATT ION: Ore! on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0 0 through OAR '52-0* *090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: / / Permittee
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 144,�2si 2-..60‘
Commercial FOR OFFICE USE ONLY
g
City of Tigard
RECEIVED Received Ot /J, / Permit No.: G 1 10/A .- ek 4 S
u Da[dBv: `/ I w �
13125 S W Hall Blvd., Tigard, OR 97223 2 i
C Phone: 503.718.2439 Fax: 503.598.1960 MAY 2 4 2012. Plan Review + er Permit:
Ag
D ate / 13 : dil
TIGARD Inspection Line: 503.639.4175 Date Ready / : y: hits: El See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ 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: $
❑ Accessory building ❑ Multifamily Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10500 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP: Portland OR 97223 Garage /carport area: square feet
Suite/bldgJapt. no.: 200 I Project name: Mutual Fund Store Covered porch area: square feet
Cross street/directions to job site: 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.
New interior Partition Walls Valuation: $$37,400.00
Existing building area: 2,200 square feet
New building area: N/C square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Shorensteln Properties LLC Type of construction: VB
Address: 235 Montgomery Street, 16th Floor Occupancy groups:
City/State/ZIP: San Francisco, CA 94104
Existing: B
Phone: (503' )412 -4906 Fax: ( )
New: N/C
CO APPLICANT ❑ CONTACT PERSON BUILDING PER\IIT FEES*
Business name: NW Precision Design (Please refer to fee schedule)
Design
Structural plan review fee (or deposit):
Contact name: Darin Bouska
FLS plan review fee (if applicable):
Address: 22605 SW Pinehurst Ct
City/State/ZIP: Sherwood OR 97140 Total fees due upon application:
Phone: (503) 680-6444 I Fax: : ( ) Amount received:
E -mail: Darin@NW-Precision.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Cotmmercia +nd residential prescriptive installati. r of
CONTRACTOR roof -top moun -d PhotoVoltaic Solar Pane . -stem.
Business name: BNK Construction Submit two (2) s. s of roof plan with • ection details
and fire department cess, alone the 2010 Oregon +
Address: 45 82 Drive, Suite 53B Solar Installation Spec . iv C- e checklist.
City/ State/ZIP: Gladstone OR 97027 Permit fee (includ :..n review $180.00
and ad .'strativ - :- ):
Phone: (503) 557 -0866 I Fax: (503) 557 -1035 State stuch. a , 12% of permit fee): $21.60
CCB lic.: 107555
Total due upon application: $201.60
Authorized signature: This permit application expires If a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Darin Bouska I Date: 5/24/12 • Fee methodology set by Tri -County Building Industry
Service Board.
o ° Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: v ° - / ❑ Expedited Review
Plan Submittal Date:
01(//P-
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
�� iif / approved.
Planning Review (contact Jul h . Fit t "( at 503-7184-H or @tigard - or.gov)
❑ Zoning VE ( Permitted Use Yes No ❑
❑ Land Use Required: Yes ❑ No (explain below)
Notes: /V a ('4mw15p, 4- UR.,
M Approved ❑ Not Approved Date: 5 /
Permit Coordinator Review (contact Albert Shields at 503- 718 -2426 or albert @tigard- or.gov)
Notes:
Routed back to Building Division Date:
I: \CURPLN
1 111 o ° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: PLT Occupancy Group: Type of Construction: ; j
*Type of Use: G'e(/u Occupancy Load: 7�Z Oregon Specialty Code: 2Q(C)
SPECIFICS
Number of Stories: I 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 'P � . �
Fire Sprinklers: �) Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ - 37 r FEES DUE
$ A,D DC Prov Rvw, COM TI — Ping
$ I OD DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ /.2I Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ 7 I . 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ 'is j Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ 2 Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ 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:
.
Building Staff: $ 0 r:
Date /Time: ./ $ I37Z,' FEES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manu red structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = altera • FND = foundation; DEM =
FND = foundation; FPS = fire protection system; NEW = new; OTR = other use ornces, dec s, retaining walls, sign, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 01/13/2011