Permit (210) INCITY OF TIGARD BUILDING PERMIT
t . COMMUNITY DEVELOPMENT Permit#: BUP2016-00334
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 12/06/2016
F[ a .T3 9
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 250
Project: Fidelity National Title Subdivision: METZGER,TOWN OF Lot: 9
Project Description: TI for existing tenant relocating to second floor. Work includes 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: IB DC Provision Review,COM TI-Ping 12/06/2016 $90.00
Occupancy Grp: B Occupancy Load: 19 Permit Fee-Additions,Alterations, 12/06/2016 $453.95
Demolition
Dwelling Units: 0 12%State Surcharge-Building 12/06/2016 $54.47
Stories: 7 Height: 0 ft Plan Review 12/06/2016 $295.07
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 12/06/2016 $181.58
Value: $24,261 Info Process/Archiving-Lg$2.00(over 12/06/2016 $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 $1,081.07
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 I- .lessor direct questions to OUNC by calling 503.232.1987 or 1.8007f2, .332.2344.
Issued By: er e Signature: v�
o4-------
CCC
C.
Si ..39.4176 by 7:00 a.m.for the next available inspectio 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 USE ONLY
City of Tigard 1 1 Received � Permit No.: &l/�'_
Plan R
14 13125 SW Hall Blvd.,Tigard,OR 9722_
g Plan Review
S Phone: 503.718.2439 Fax: 503.598.19 Date/B ���Other Permit
TI G A R D Inspection Line: 503.639.4175 (a� f11� Date ReadyBy: N Juris: ® See Page 2 for
Internet: www.tigard-or.gov EC 17 ! Notified/Method:
DEC Supplemental Information
TYPE OF WOTANU NisiO REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction ❑ � Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑ either: 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: $
IDAccessory building 1:1 Multi-family Number of bedrooms:
El Master builder ❑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:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:250 Project name:Fidelity National Title 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.
Work to include new walls,doors and relites and cabinetry Valuation: $$24,261.00
Existing building area: 1,860 square feet
New building area: 1,860 square feet
®PROPERTY OWNER 0 TENANT Number of stories: 7
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
El APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:Mackenzie (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Kelly Justice
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:kford@mcknze.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
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: citi `‘ .-----' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Kelly Justice Date:12/06/2016 * 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)
1
City of Tigard
INw COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 cA R D Building Permit Review — Commercial - No Land Use
Building Permit #: g'elf..20/4) -00 33y
Site Address: "I 0200 Sw (=1 rerein b zj 02SSuite/Bldg#: Z S .
Project Name: i Cl C.(t {-x N 00-iv.in cAk. fi LL
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: T h .-0 r T L
Existing Business Activity: Cc An dv\JJ UA i L
Proposed Business Activity: CA3 vYN er ar c c tJ -
Verify site address/suite# exists and active in permit system.
River Terrace Neighborhood: ❑ Yes 4 No
Zoning: I V 'v C 4_ 1_
W Permitted Use: YJ Yes ❑ No ❑ Spec Space
7 Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: A �- --- Date: 1 2—/ G0/ I (i
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: # 4 "'-
Building
r¢Building Plans: #
Building Permit#: t nter building permit#above.
Workflow Routing: ening ❑ Permit Coordinator Chi ding
Workflow Sign-off: Lam' off for Planning(include notes from planning review)
Route Application Documents: 31 Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ...... ...7.,,,,,,..,.e,...., Date: 6/ 61
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_060116.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:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_070915.docx
City of Tigard • BUILDING DIVISION
II
6- Over-The-Counter (OTC)) Builth ng & Fire Protection System Permit
I L> Appointment Checklist
Permit Record#: ,0,� o 33
Contact Name: L,,,,,�'J_.�coa Phone #: 5C3— g..9.4-?6? O
Business Name: k r h Appt. Date/Time: is f 0 a�) /c.,00
Site Address: ttja,pp }atJ i.ae..1/41j kt4. Bldg/Suite #: Aso
Project Name: ;z0..�t `nasi t Tom.
Project Description: p LAD eka l tO .A I Atafr ' 0_6-6
(F4i�z:.� 1�f s..ai .4.-i—_04/11..r1d)i+4.j-fr o ...,PP_O-t",t>
Existing Use: (j New Use:
MMD Required: 0 Yes P No Related Record#:
GENERAL INFORMATION
Class of Work: tet.A..- Occupancy Group: Type of Construction:Type of Use: Occupancy Load: Oregon Specialty Code: —20 yk—
SPECIFICS
Number of Stories: v/ 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: YEA- ) 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: ie -, 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: $ 2kt
$ L. DC Prov Rvw,COM TI—Ping
$ 3k 'Permit Fee—Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2016) $ .6tV12%State Surcharge
Project Valuation $ 2_ m' Plan Review,Structural
Up to$4,999 $0.00 $ rv ,r� Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ a eflrld Info Proc/Arch,Lg(over 11x17$2.00)
$75,000-$149,999 $224.00 $ Info Proc/Arch,Sm(up to 11x17$0.50)
$150,000 and over $357.00 $ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
Building Staff: $ Other:
Date/Time: $ E Cet.67 TOTAL FEES DUE
I:\Building\Forms\OTC_Bup_Fps_o7o116.docx
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
10200 SW GREENBURG RD 250, TIGARD, OR,
97223
Record Type:
Commercial - Building
Inspection Type:
299 Final inspection
Result:
PASS -CofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
B U P2016-00334
Inspector:
Jeff Grove
Contractor