Permit CITY OF TIGARD BUILDING PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: BUP2015-00044
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2015
Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Semiconductor Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant. Work to include new walls and doors.
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 02/26/2015 $75.00
Occupancy Grp: B Occupancy Load: 98 DC Provision Review,COM TI-LRP 02/26/2015 $11.00
Permit Fee-Additions,Alterations, 02/26/2015 $910.17
Dwelling Units: 0 Demolition
Stories: 6 Height: 0 ft 12%State Surcharge-Building 02/26/2015 $109.22
Bedrooms: 0 Bathrooms: 0 Plan Review 02/26/2015 $591.61
Value: $73,250 Plan Review-Fire Life Safety 02/26/2015 $364.07
Info Process/Archiving-Lg$2.00(over 02/26/2015 $6.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,067.07
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 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 1.800.332.2/344.
Issued By: Permittee Signature: /�. _ �
a 1 503.639.4175 by 7:00 a.m.for the next available inspection date. """��'�C
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 Division
Over-The-Counter (OTC) Building Permit
TIGARD Check List
Project Description:
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: Occupancy Group: Type of Construction:
Type of Use**: Occupancy Load: Oregon Specialty Code: •
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:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Calcs Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ 751 2 Q2) FEES DUE
$ '75(-715,CCD DC Prov Rvw,COM TI—Ping
$ _ I , fal DC Prov Rvw,COM TI—LRP
DC Provision Review Fee for COM TI(effective 7/1/2014) $ :1 C, Permit Fee—Add,Alt,Demo
Project Valuation Planning LRP $ 12%State Surcharge
Up to$4,999 $0.00 $0.00 $ . Plan Review,Structural
$5,000-$74,999 $75.00 $11.00 $ ► Q Plan Review,Fire Life Safety
$75,000-$149,999 $187.00 $28.00 $ ,tom Info Proc/Arch,Lg(over 11x17$2.00)
$150,000 and over $299.00 $44.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
Building Staff: $ Other:
Date/Time: $ O.C'lTOTAL FEES DUE
"TYPE 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_070114.docx
r
Building Permit Application
Commercial FOR OFFICE USE ONLY
City Tigard 1►
Cit of Ti and CEI NA Received
. TARIINIZEIMPIMENIE
13125 SW Hall Blvd.,Tigard,OR 97223 lilt Plan Revie
0 Phone: 503.718.2439 Fax: 503.598.1960 DateB S Gam!r Other Permit.
Inspection Line: 503.639.4175
FFB �+c� 6 20 5 Date Rea. : 65 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: L C ;AV Supplemental Information
TYPE OF WORI A t' - 11VA�� REQUIRED DATA:1-AND 2-FAMILY DWELLING
MICA-bon}-1( fl��IiCl,!1` Permit fees*are based on the value of the work erformed.
❑ New construction ® performed.
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 I-and 2-family dwelling ®Commercial/industrial Valuation: S
❑ 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 Rd New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:417 I Project name:Cypress Semiconductor 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: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Scope of work for the project includes interior tenant improvements for an Valuation: $73,250
approx.9,775 existing tenant on the 4th of 6 floors.Work to include new walls, Existing building area: 9,775 square feet
doors,relites and HVAC modifications. New building area: 9,775 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 6
Name:Cypress Semiconductor Type of construction: I-B
Address:10220 SW Greenburg Rd,Suite 417 Occupancy groups:
City/State/ZIP:Portland,OR 97258 Existing: B
Phone:(775)475-0542 Fax:( ) New: B
® APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Lauren Rohde
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:Irohde @ mcknze.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR 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 105th Ave Solar Installation Specialty Code checklist.
fee(includes plan review
City/State/ZIP:Tualatin,OR 97062 Permit
administrative fees): $180.00
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:
12424 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Lauren Ro de Date:02/26/2015 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
City of Tigard
•
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A u C7 Building Permit Review — Commercial - No Land Use
Building Permit #: Bt,Pao is--COO 40i
Site Address: 1022-0 S W 6 reQ,,• VnirJr, Suite/Bldg#: 117
Project Name: Cprtss S2 M'% Con dlkvctcr
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: 1 n 1-e,e;or +tr1 co f' .Ivh to CD`^exyv nfis For exist'n j 4-e tiny.)t on
4v+t r (off (-too( . Proloo 4. rn/Ovtc. 11,2w Wct11s, 'c(oOrf, Ceti itt ! 1-{V!9-c.
Existing Business Activity: CO on rnaA-c ca _
Proposed Business Activity: CJJ I ,,,,,n,l
Verify site address/suite#exists and active in permit system.
Cy' Zoning: MU C - 1
IZ Permitted Use: V Yes ❑ No ❑ Spec Space
$Confirm no land use required. e X i S tw vo -Gnu v1♦ , no tct no( U A.2 U,(n u n
❑ Business License:
Exists: jiYes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: i -� Date: 2/ '-i°1 15
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submits
Original Submittal Date: /5—
Site Plans: #
Building Plans: #
Building Permit#: nter building permit#above.
Workflow Routing: g ding
Workflow Sign-off: t ff for Planning(include notes from planning review)
Route Application Documents: uilding: original permit application,site plans,building plans,engineer and
�.�-y beam calculations and trust details,if applicable,etc.
Notes: V/ v
' ,:,..._;,.,F......„.. ---________
By Permit Technician: 1.... ., Date: a2A60S
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_020415.docx
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
•
I:\Building\Forms\BldgPerrnitRvw_COM_NoLandUse 020415.docx