Permit II
CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2015-00308
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2015
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 550
Project: KPD Insurance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI-Some demolition,new walls,doors,relites&cabinetry.
Contractor: RUSSELL CONSTRUCTION INC Owner: LINCOLN CENTER LLC
20915 SW 105TH AVE BY SHORENSTEIN PROPERTIES LLC
TUALATIN, OR 97062 235 MONTGOMERY ST, 16TH FLOOR
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: Ig DC Provision Review,COM TI-Ping 10/29/2015 $88.00
Occupancy Grp: B Occupancy Load: 39 Permit Fee-Additions,Alterations, 10/29/2015 $509.05
Demolition
Dwelling Units: 0 12%State Surcharge-Building 10/29/2015 $61.09
Stories: 12 Height: 0 ft Plan Review 10/29/2015 $330.88
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/29/2015 $203.62
Value: $29,337 Info Process/Archiving-Lg$2.00(over 10/29/2015 $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 $1,200.64
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. • TIO : : -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 -001-0010 through OAR ••2-01 •■90. 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: / 9/ �I , Permittee Signature: '
Call 503.639.4175 by 7:00 a.m.for the next available inspecti .
This permit card shall be kept in a conspicuous place on the job site until c. letion of the p •ct.
Approved plans are required on the job site at the time of each inspection.
Building Permit ApplicationREpri
Commercial ViLl EIS FOR OFFICE USE ONLY
City of Tigard DateBea (4' ' / MESIM /p'D 5":".0 CI -r
III • 13125 SW Hall Blvd.,Tigard,OR 97223 2 9 2015 Plan Revie
11 Phone: 503.718.2439 Fax: 503.598 1 Date/B : try O /�` Other Permit:
T I c ii I) Inspection Line: 503.639.4175 C y Of !1(�AKll Date Ready/By: lurk: El See Page 2 for
Internet: www.tigard-or.gov pji�i D*��DIVISION A Notified/Method: Supplemental Information
Dl1 (� t .
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 CI Multi-family Number of bedrooms:
❑Master builder CI Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:Lincoln Tower-10260 SW Greenburg Road New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:550 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: 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 to include interior tenant improvements for a tenant on the 5th of Valuation: $$29,337.00
12 floors.Work to include demolition,new walls,doors,relites and cabinetry. Existing building area: 3866 square feet
New building area: 3866 square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 12
Name:Shorenstein Type of construction: I-B
4
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
0 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
Amount received:
Phone:(503)224-9560 Fax::(503)228-1285
E-mail:lrohde @mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic 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.
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: r 7 �,�j (-4 This permit application expires if a permit is not obtained
Ill _, within 180 days after it has been accepted as complete.
Print name:Lauren Rohde Date:10/29/15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
T I G A R D Building Permit Review — Commercial - No Land Use
n
Building Permit #: (� (" /5—0030 g
Site Address: \ J24o o Sw reo l-N b v Suite/Bldg#:
Project Name: k... ZY1 SurttrlCA_
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: r r -}Lri o i- f rt vex) 1.1-zs
Existing Business Activity: W VY10112xcA c=-C/ e GGi`c2
Proposed Business Activity: C..c VYI rYl.. / 6
XVerify site address/suite# exists and active in permit system.
- River Terrace Neighborhood: ❑ Yes €f-No
Zoning: Iv n 1ve -
4 Permitted Use: )2'Yes ❑ No El Spec Space
Confirm no land use required.
Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: M'f��Z�- 6,/0 c Dt— Date: t 0/2.°i1 I c
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date:
Site Plans: # 3
Building Plans: # 3
Building Permit#: a-Enter building permit# above.
Workflow Routing. 2-Planning o 2-Building
Workflow Sign-off: a�-Si '-off for Planning(include notes from planning review)
Route Application Documents: 2 Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: J� . 0-tC
Date: /e/9-5/s--
1:\Buil ding\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
Permit Coordinator Review
❑ Conditions"Met"prior to issuance of building permit
❑ Approved, NOT Release•• Date:
Notes:
Revisions (after Building Submittal 0 nly)
Revision Notice 1: Date Se t. pplicant:
Revision Notice 2: Date S- • Applicant:
Revision Notice 3: Da ent to :pplicant:
❑ SDC Fees Entered: Wash Co Trans -v Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
Ili Building Division
• Over-The-Counter (OTC) Building Permit
I c' \R l' Check List
Project Description: I 1
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
Class of Work*: PCL1 Occupancy Group: j Type of Construction: i f�
Type of Use**: Occupancy Load: -1 Oregon Specialty Code: 2
SPECIFICS
Number of Stories: try Buildin• Hei•ht: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT-SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Access() Structure: Covered Porch:
Basement: Gaza•e: 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: ('J Fire Alarms: Smoke Detectors:
Sprinkler Type: Alarm Type: Protected Corridors:
Standpipe Required: Pull Stations Required: Parapet:
Hazard Group: Battery Caks Provided:
Density: Cut Sheets Provided:
Design Area:
K Factor:
Total Project Valuation: $ 2 et ... - 7 C ' FEES DUE
$ `ek . DC Prov Rvw,COM TI—Ping
$ Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2015) $ es •4,` 12%State Surcharge
Project Valuation $ 0,r, 'Ian Review,Structural
Up to$4,999 $0.00 $ 21111)— ,AV* 'Ian Review,Fire Life Safety
$5,000-$74,999 $88.00 $ Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $220.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $351.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other: •
$ Other:
Building Staff: $ Other:
Date/Time: $ (2x, TOTAL 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 feq ([s,retaining walls,signs,awnings or canopies).
I:\Building\Forms\OTC_BUP 070115.docc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 550, TIGARD, OR,
97223
Commercial - Building
299 Final inspection
PASS - C of O
BUP2015-00308
Jeff Grove
Violation Summary:
Inspector Contractor