Permit •
3 � CITY OF TIG/4R® BUILDING PERMIT
,„ COMMUNITY DEVELOPMENT Permit #: BUP2010 -00156
13125 SW H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2010
T1C''ARU g Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 200
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: HealthNet
Project Description: TI
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Description Date Amount
BB# 73 1771 GK1130, CBRE, PO BOX 2096 Permit Fee - Additions, Alterations, 06/30/2010 $1,347.55
WARREN, MI 48090 Demolition
PHONE: 12% State Surcharge - Building 06/30/2010 $161.71
Metro Const. Excise Tax - Commercial 06/30/2010 $168.00
Use
Contractor: Plan Review 06/30/2010 $875.91
R & H CONSTRUCTION CO Plan Review - Fire Life Safety 06/30/2010 $539.02
1530 SW TAYLOR ST
PORTLAND, OR 97205 -1819
PHONE: 503 -228 -7177
FAX: 503 - 224 -3638
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 5 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $140,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,092.19
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: Yes
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This per ' is to the regulations contained in the Tigard Municipal Code „State of OR. Specialty Codes and all other applicable law. All work will
be a in accordance with approved . -n This permit will expire if work is not started within 180 days of issuance, or if work'is suspended for more the 180
d s. ATTENTION: Oregon law rep ires you to the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52- 001 -0010 t rough OAR 95 001 -6101 Ibu may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
iff
I ued By: di, // ' is , ' ' Permittee Signature:. / ,,,////// ''' '1l
_ Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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
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a , 1e u l,N M i� ... t ,�,Ap t c ¢t," , ; ,
Commercial ,e ,G n ,, , ,�� r FOR OFFICE USE ONLY
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' a , u',W Received
��1 old; City of Tigard i d Permit No.:
l � � � ''''' Date/By: t i'll MI —.06 [ 5 /
MV i ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review _ �' ,� �n O
, �[s, Other Permit:
�4 P
' Phone: 503.639.41.71 Fax: 503.598.1960 Date/By: � � � � t
,, Ni "t�� Inspection Line: 503.639.4175 Date Ready /By: See Page 2 for
T I G ARD
a � '.0 "N. v Internet: www.t - or.gov Notitied/Method: • Supplemental Information
. � ,'r TY PE OF WORK , , 4 _ _ .. REQUIRED DATrA I D 2 FAMIL ;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
-6 - 5 - :' work indicated on this application.
u . .- , ' G t3F CONSTRUCTION
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
e Total number of floors:
• JQB w SITF I FORMATION AND�t)OCA�TdQN �
Job site address: Triangle III, 13221 SW 68th Parkway New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 200 &300 Project name: HealthNet Covered porch area: square feet
Cross street/directions.to job site: Deck area: square feet
Other structure area: square feet
REQUI A : COMMER U CHECK
��
Subdivision: 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 a WORK work indicated on this application.
Interior Tenant Improvement Valuation: $140,000 •
Work to include minor demolition, new walls, doors, operable partition, and Existing building area: square feet
cabinetry. New building area: square feet
I
®ROPERTY OWNER TENANT 1 Number of stories: 5
Name: GKTriangle Corp Park III LLC, c/o CB Richard Ellis Type of construction: I -B
Address: 1300 SW 5 Ave. Suite 200 Occupancy groups:
City/State /ZIP: Portland, OR 97201 Existing: B
Phone: (503)221 -1900 Fax: (503)221 -4873
New B
�"® APPLICANT a try° , !COTACT PER SO I\' ~ 114
,.�:?' . 9�..._,m � _ NOTIC
Business , Group Mackenzie All contractors and subcontractors are required to be
Contact Nicole Bekken licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1515 SE Water Ave Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97214 applicant is exempt from licensing, the following reasons
apply
Phone: (503) 224 -9560 Fax: : (503) 228-1285
E -mail: nbekken @grpmack.com
CONTRACTOR ' '
Business name: R & H Construction BUILDING PERMIT °FEES*
Address: 1530 SW Taylor Street ,t r r(Ptease f tofee /e : ;
Structural plan review fee (or deposit):
City/State /ZIP: Portland, OR 97205
FLS plan review fee (if applicable):
Phone: (503) 228 -7177 • Fax: (503) 224 -3638
CCB lic.: 38304 Total fees due upon application:
Amount received:
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Nicole Bekken Date: 06/25/10 * Fee methodology set by Tri-County Building Industry
Service Board. *..
I:ABuildingA?ermits\BUP -COM PermitApp.doc 2/23/07 u440- 4613T(1'1 /02 /COM /WEB):' - I r v%
•
. Building Division
Over The - Counter O C) Building Permit .,
TIGARD
Description of; Project:
.. � er,13K�Y 7a.....,. k _ _ r J - .: Ts�€s r....Kbat
Class of Work: *` LT Floor Areas (sq. £t )`: Exterior Wall Construction:
Type of Use :* (' ,� z ,' First floor , }" N:, S'
Type/of Construction.; 4 - �X. Second floor: " E: W
Occupancy Group: , �' ,, Third floor _ .. Openings Protected Y /N?
O Load: — c. N • Total sq f t:;: y • N`= S:
A ter Note: C: E F. ` `
S'tortes
2 Combine, total floor area, for
T ,
Floor Load: � r�t add oo the third third r flgof t ancl� f; Roof Construction:
g , .
Fire 'Retardant '
Basement: a -i r Basement: Area Separation Rated: "
lvfezzanine: ,;" 7 4 G'arag _� Occu Separation Rated:
• .r , _ , ,, ;+ a ? f aRE 4 I� RE� , TE ,, Waltz, - f51& ' _..
Fire sprinkles: ko -5 , i Handicap access:
_.. _ . t ,
Fire alarm, detector R�' Protected corridors:
Smoke . r 6.6 'w , ? e , Parking spaces ( #)s
Not
Total Valuation: '$' ( .
'r ' , _ ' a I$NS7P ells ON * ::' ; Y - .° �,. . W. , : crift l- E_ Ni Mi i ` 1
., Footing /foundation Firewall $ Wti`i- Permit Fee
' - Post /beamstrucnnral Smoke detector $ K'
e State Surcharge
wall, Vfisc. :ins ecti'on°
'She
p $ 4 1 15: I 7 Plan Review Fee.
Masonry nn Approach /sidewalk $ vj j , ( FLS Plan Review Fee.
Framing, $ _ Additional Permit Fee
"` Irnsulation ." Sprinkler rough -in; _$ Additional Plan "Review Fee
Gyp board - Fire alarm $ f j.e . c n , Metro'Construction se Tax
Suspended ceiling Sprinkler final $ School Construction Excise.Tax,
.
Final inspection $ Misc. Fee •
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$i, Other:
$ ge , - Total Fees Due
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*.OPTrIONS { ;1 ti � r . � ? � ' 1 � z �. � "�'" 4 +,� � � ti a�, � � � :� rl .;:,1'..
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TYPE* ; C®M e n w . � commercial manufactured structure ' '� ' o , !, r�x ti ' :0 ` • WOO RK O'er accessory; t1•DD addition ;�0. lt fouind DEM•t o e o Y o rs
FND found € * protectton �� t - , f 0 03 5 0 tl •
, 'Si 'canopn repar� ;' ?.. : - �` w "
I: \Building \Forms \O1 C- BUP.doc 08/19/08