Permit �E - CITY OF TIGARD BUILDING PERMIT
t; COMMUNITY DEVELOPMENT . Permit #: BUP2012 00237
•
T [GARS` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/27/2012
Parcel: 1S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 110
Project: Fidelity National Title 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 - 692 -9002 PHONE:
FAX: 503 - 692 -9008
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review, COM TI - Ping 11/27/2012 $67.00
_ Occupancy Grp: B Occupancy Load: 39 DC Provision Review, COM TI - LRP 11/27/2012 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 11/27/2012 $475.99
Demolition
Stories: 7 Height: 0 ft 12% State Surcharge - Building 11/27/2012 $57.12
Bedrooms: 0 Bathrooms: 0 Plan Review 11/27/2012 $309.39
Value: $26,116 Plan Review - Fire Life Safety 11/27/2012 $190.40
' Info Process /Archiving - Lg $2.00 (over 11/27/2012 $8.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,117.90
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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 do n accordan 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
da . ATTENTION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
2- 001 -0010 through OAR 95 -0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 2,1 7 or 1.800.332.2344.
Issued By: L. / j ` Permittee Signature:
i 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 . • FOR OFFICE IJSL. ONLY •
a a — Cit W Ha B o rd ard. OR 9 R E CEIVED / �/0� .1:v2.5
City Tigard ed �I Permit No �
Tigard, Plan Review k
III
Phone: 503.639.4171 Fax: 503.598.19 Date/B : Other Permit:
Gov � 2 a zo� 1 ,.
'T I G A K D Inspection Line: 503.639.4175 Date Ready / : luric El See Page 2 for
Internet: www.tigard- or.gov CITY OF TIG Notified/Method: Supplemental Information
TYPE OFLORgING DIVISION 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.
El 1- and 2- family dwelling ® CommerciaUindustrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 5 Lincoln - 10200 SW Greenburg Road New dwelling area: square feet
City /State/ZIP: 97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: 110 Project name: Fidelity Title 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: $26,116
Existing building area: 3909 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 7
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
0 APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: GBD ARCHITECTS All contractors and subcontractors are required to be
Contact name: Whit Middlecoff 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)
City /State/ZIP: Tualatin, Oregon 97062 -9511 Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: (503) 692 -9002 Fax: (503) 692 -9008
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: 11/27/2012 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\PermitABUP -COM PermitApp.doc 10/01/09 440- 4613T(I I/02 /COM/WEB)
Building Division
Development Code Provision Review
T i c AR ° Commercial Projects - No Associated Land Use Case
Building Permit No: �" PAC /P• ^ CO o� 57 Expedited Review C
Plan Submittal Date: // 7 /?-1
/0700 G rt)16/(6%h4 Ls0
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 / at 503 - 718 -?. t or A&@tigard-or.gov)
Proposal: /, v
OFi� ri N_ 1 /
. - . " /
1
Zoning 4V/1-"37— /
Permitted Use Yes Iii'—No ❑
Land Use Required: Yes ❑ No
Notes:
Approved ❑ Not Approved Date: th
REVISED 10/4/12
Building Division
Over- The - Counter (OTC) Building Permit
T`lGnR>p Check List
Project Description: 1 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: (� Occupancy Group: Type of Construction: 2—P
*Type of Use: COM Occupancy Load: Oregon Specialty Code: �"(C)
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: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ 2 ( FEES DUE
$ -7, co DC Prov Rvw, COM TI — Ping
$ ) p,6--z3 DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ A-7 Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ �j 7, ` . 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ J, Plan Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ '�� Plan Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 $ CO Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $268.00 $39.00 $ 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: $ ()( Vi to 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 07/01/2012