Permit CITY OF TIGARD BUILDING PERMIT
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IN COMMUNITY DEVELOPMENT Permit#: BUP2013 00302
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 12/03/2013
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 200
Project: KPD Insurance Subdivision: METZGER. TOWN OF Lot: 9
Project Description: TI: Minor demolition, constructing three offices and storage room for existing tenant
1/15/14: Reprinted to correct suite number from 250 to 200
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 12/03/2013 $70.00
Occupancy Grp: B Occupancy Load: 17 DC Provision Review,COM TI-LRP 12/03/2013 $10.00
Dwelling Units: 0 Permit Fee-Additions.Alterations, 12/03/2013 $301.85
Demolition
Stories: 5 Height: 0 ft 12%State Surcharge- Building 12/03/2013 $36.22
Bedrooms: 0 Bathrooms: 0 Plan Review 12/03/2013 $196.20
Value: $15,000 Plan Review - Fire Life Safety 12/03/2013 $120.74
Info Process/Archiving -Lg$2 00(over 12/03/2013 $4.00
11x17)
Floor Areas: Info Process/Archiving-Lg$2 00(over 12/03/2013 $2.00
11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage- 0
Mezzanine: 0
Total 5/41 0
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 Center 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 1987 or 1 800 332 2344
Issued By:�;;:; �, � Permittee Signature: /2 •
a .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.
CITY OF TIGARD BUILDING PERMIT
1 _ COMMUNITY DEVELOPMENT Permit #: BUP2013 -00302
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2013
TIC g
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 250
Project: KPD Insurance Subdivision: METZGER, TOWN OF Lot: 9
Project Description: TI: Minor demolition, constructing three offices and storage room for existing 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 12/03/2013 $70.00
Occupancy Grp: B Occupancy Load: 17 DC Provision Review, COM TI - LRP 12/03/2013 $10.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 12/03/2013 $301.85
Demolition
Stories: 5 Height: 0 ft 12% State Surcharge - Building 12/03/2013 $36.22
Bedrooms: 0 Bathrooms: 0 Plan Review 12/03/2013 $196.20
Value: $15,000 Plan Review - Fire Life Safety 12/03/2013 $120.74
Info Process /Archiving - Lg $2.00 (over 12/03/2013 $4.00
11x17)
Floor Areas: Info Process /Archiving - Lg $2.00 (over 12/03/2013 $2.00
11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $741.01
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 Center. 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 503.232 987 • 1.800 332 2344
Issued By: ' ermittee Signature:
AMA"
��,�
a 639.4175 by 7:00 a.m. for the next available inspection . _
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 aCtINVA) OFFICE. USE ONLY
City of Tigard Received // Permit No.:
5 r SW Hall Blvd., Tigard, OR 97223 �] Date/B � c) I i ,
•
1312
8 201 J Plan Review ��
Phone: 503.718.2439 Fax: 503.598.1960 DEC J Dates : A � Fj, �r:'
T l G n R D Inspection Line: 503.639 R 1 D ace Ready Juris: E See Page 2 for
Internet: www.tigard- or.gov GF TI No 'fi ed/M e thod : 'T Supplemental Information
CITY °Y
DI \A I .
TYPE OF WORT W i1 .- I 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 ® CommerciaUindustrial Valuation: $
El Accessory building ❑ 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: 1 Lincoln - 10300 SW Greenburg Road New dwelling area: square feet
City / State/ZIP: Portland, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: 250 Project name: KPD Insurance Covered porch area: square feet
Cross street/directions to job site: Project located north of SW oak street, Deck area: square feet
south of SW Locust Street and east of Greenburg Road 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.
Work to include minor demolition, new walls, doors and cabinetry Valuation: $$15,000.00
Existing building area: 2370 square feet
New building area: 2370 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 5
Name: Shorenstein Type of construction: I -B
Address: One SW Columbia Street Suite 500 Occupancy groups:
City / State/ZIP: Portland, OR 97258 Existing: B
Phone: (503)412 -4902 Fax: (503)412 -4903 New: B
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: Mackenzie (Please refer to fee schedule)
Structural plan review fee (or deposit):
Contact name: Kim Ford
FLS plan review fee (if applicable):
Address: 1515 SE Water Ave Suite 100
Total fees due upon application:
City /State/ZIP: Portland, OR 97214
Phone: (503) 224-9560 Fax: : (503) 228 -1285
Amount received:
E -mail: kford @mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof -top mounted PhotoVoltaic Solar Panel System.
Business name: Russell Construction Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: 20915 SW 105'" Ave Solar Installation Specialty Code checklist.
City /State/ZIP: Tualatin, OR 97062 Permit fee (includes plan review
$180.00
and administrative fees):
Phone: (503) 692 -9002 Fax: (503) 692 -9008
State surcharge (12% of permit fee): $21.60
CCB lic.: 58918
Total fee 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.
I Print name: Kim Ford I Date: 12/03/2013 I * Fee methodology set by Tri- County Building Industry
Service Board.
I:1Building\Permits\BUP -COM PermitApp.doc 02/ 24/2011 440- 4613T(11/02/COM/WEB)
1 , 1 « Building Division
Development Code Provision Review
T I G A it iD Commercial Projects - No Associated Land Use Case
Building Permit No: (L(P( ) 63 - 000 _ - xpedited Review
Project Name: V P 0 -rni Si .t krfAiV ce—
Site Address: ID 3 0 0 3 t.J 4 r u.. 17,0 t '(Z 1 , Suite /Bldg #: Z5D
Plans Routed:
Original Plan Submittal Date: /43/ Routed By: /- %
1st Revision Submittal Date: Routed By:
2 Revision Submittal Date: Routed By:
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.) tA. :41A at (503) 718 -2 for IA d @tigard- or.gov)
Proposal: IAA • e 'r 1
o
, , 4 LI/4 (v ;f'i'u)
ND 6), 'sue ; try- G . L
Zoning Y) IA. E I ,/
Permitted Use Yes LET No ❑
Land Use Required: Yes ❑ No LA
Notes:
Q' Approved ❑ Not Approved ❑ DCPR Not Required — No DCPR Fees Due
Date Routed to Building:
1:\CURPLN\Masters\Development Code Provision RevievADCPR_COM_NoLandUse.doc Rev. 01/16/13
III 1
II Building Division
Over- The - Counter (OTC) Building Permit
T l G n li D Check List
Project Description: 1.
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work *: Occupancy Group: Type of Construction:
Type of Use * *: (1 . Occupancy Load: 7 ' - Oregon Specialty Code: 2�) 1 Q
SPECIFICS
Number of Stories: PS' 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: 5: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: c Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors: _
Total Project Valuation: $ ( C I FEES DUE
$ aD DC Prov Rvw, COM TI — Ping
$ ( cb.) DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI (effective 7/1/2013) $ . I S ermit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ . 1 .... 2212% State Surcharge
Up to $4,999 $0.00 $0.00 $ 4. , ale Plan Review, Structural
$5,000 - $74,999 $70.00 $10.00 $ riiv& Plan Review, Fire Life Safety
$75,000 - $149,999 $174.00 $26.00 $ b , Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $278.00 $41.00 $ 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: $ - 1-4i1 , ) ( TOTAL FEES DUE
'KI'YPE OF USE: COM = commercial; CMS = commercial manufactured structure.
*CLASS OF WORK ACS = accessory; ADD = addition; ADU = accessory dwelling unit; ALT = alteration; DEM = demo; NEW = new;
OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies).
I: \Building\ Forms \ OTC-BUP.docx 07/01/2013
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW GREENBURG RD 200, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
2014-02-28 00:00:00
BUP2013-00302
PASS - C of O
Violation Summary:
Inspector Contractor