Permit CITY OF TIGARD BUILDING PERMIT
3 ._` COMMUNITY DEVELOPMENT Permit #: BUP2013 -00138
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2013
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 135
Project: AmCheck Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Modification for new tenant
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 06/06/2013 $67.00
Occupancy Grp: B Occupancy Load: 25 DC Provision Review, COM TI - LRP 06/06/2013 $10 00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 06/06/2013 $718 43
Demolition
Stories: 6 Height: 0 ft 12% State Surcharge - Building 06/06/2013 $86 21
Bedrooms: 0 Bathrooms: 0 Plan Review 06/06/2013 $466 98
Value: $48,697 Plan Review - Fire Life Safety 06/06/2013 $287.37
Info Process /Archiving - Lg $2.00 (over 06/06/2013 $8.00
11x17)
Floor Areas:
Total Area: 0
h Accessory Struct: 0
Basement' 0
Carport. 0
Covered Porch: 0
Deck: 0
Garage. 0
Mezzanine: 0
Total $1,643.99
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes 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 i Ice 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
clays. TENTION: Or- c • n law -quires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 1 -0010 through OAR 9'. ;11-00* %. ou may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800.332.2344.
Is ued By: / J / / 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 ApplicationRE
Commercial C E� , EIV FOR OFFICE uSh: ONLY
City of Tigard JUN - 6 2013 Da e/B , d , Permit No : _. /I ,/ -�('3 O
° 13125 SW Hall Blvd., Tigard, OR 9 7223 Plan Review
• I Phone: 503.639.4171 Fax: 503.598. atrY � T' MIMEO IMEO Other Permit:
T I G A R D Inspection Line 503.639.4175 Dl t'� 11 �ri11_ Date/B Date Ready /: r Juru• 65 See Page 2 for
Internet: www.tigard - or.gov u V DING DIVISION Notified/Method: Supplemental Information
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 ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 3 Lincoln - 10220 SW Greenburg Road New dwelling area: square feet
City /State/ZIP: 97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: 135 Project name: Amcheck 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: I 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: $$48,697.00
Existing building area: 2543 square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 6
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
® 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 S W 105 Avenue (Please refer w 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 du upon application:
Am ount received:
Authorized signature:
aiA /� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Whit Middlecoff, AIA I Date: 06 /06/2013 * Fee methodology set by Tn County Building Industry
Service Board.
1•\BuildingWermits\BUP -COM PermitApp.doc 10/01/09 440-4613T(I1 /02/COM/WEB)
11114 a Building Division
° Development Code Provision Review
TI G n R D Commercial Projects - No Associated Land Use Case
0
Building Permit No: tit.), P bo i S -CSC / 3? Xi Expedited Review
Project Name: a
Site Address: 1 02 - 9 - 0 �c.� � � �'-a w. _ W W. / 3.5 Suite/Bldg #: /3S g
Plan Submittal Date: I tp I 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 if approved. le
Planning Review (contact Vcs Vk w V1 - "' at 503 - 718 -'t - or +' -- @tigard - or.gov)
Proposal: EJ•s� It I A ..*f 4%444104 t eta ft.)
/-e4S.4t
Zoning M VC
Permitted Use Yes eNo ❑ —/
Land Use Required: Yes ❑ • No L�
Notes:
lld Approved ❑ Not Approved Date: 4 1 4 72-43
I: \CURPLN\Masters\Development Code Provision RevievANo Land Use Comm.doc REVISED 10/4/12
IPIII ° Building Division
Over- The - Counter (OTC) Building Permit
T I G A R D Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work:
IA , Occupancy Group: Type of Construction: 215 *Type of Use: ( Occupancy Load: 2.2" Oregon Specialty Code: 20(4
SPECIFICS
Number of Stories: b Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOT AGES
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: 1 1 7 6 Fire Alarms: ( s -V3 Smoke Detectors:
Parapet: _ Manual Pull Stations: Protected Corndors:
Total Project Valuation: $ 4B ) (:39 00 I FEES DUE
$ 7,•a) DC Prov Rvw, COM TI — Ping
$ / 6 16 DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ M i Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ =ram 12% State Surcharge
Up to $4,999 $0.00 $0.00 "�'`'
$ � �, � Ian Review, Structural
$5,000 - $74,999 $67.00 $10.00 $ _.r(,.. - .n Review, Fire Life Safety
$75,000 - $149,999 $167.00 $25.00 . f',c2X 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)
t $ Metro Construction Excise Tax
y $ School Construction Excise Tax
A Y 7 ,? $ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ TAL FEES DUE
1 Y
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
1 = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
l: \ Building \Forms \OTC - BUP.docx 07/01/2012