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Permit • • ; -. a CITY OF TIGARD BUILDING PERMIT °' ` COMMUNITY DEVELOPMENT DATE ISSU 328200 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25101 DA -00102 SITE ADDRESS: 13221 SW 68TH PKWY 401 ZONING: MUE SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG PROJECT: HEALTH NET Project Description: TI REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2FR sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 18 BASEMENT: sf AREA SEP. RATED: STOR: 4 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 31,359.00 Owner: Contractor: TIGARD TRIANGLE I LLC R & H CONSTRUCTION 4650 SW MACADAM AVE STE 220 1530 SW TAYLOR PORTLAND, OR 97201 PORTLAND, OR 97219 Contact #: PRI 503 - 228 - 7177 Phone: FAX 503 - 224 -3638 Reg #: LIC 38304 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcha 3/28/2007 $26.86 [BUPPLN] Pln Rv 3/28/2007 $218.27 [FLS] FLS Pln Rv 3/28/2007 $134.32 [BUILD] Permit Fee 3/28/2007 $335.80 Total $715.25 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 than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon 1 y N • . 'cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of thes: rules or dir- t que gs to OUNC by calling 503.246.6699 or 1.800.332.2344. Issue. By: , / ‘ ... iii, / / Permittee Signature: �A A I _ . &NA 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. CITY OF TIGARD BUILDING DIVISION - PERMIT #: BUP2007 -001B3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2007 Phone: (503) 639-4171 ' 39 -4171 0 Inspection Requests (24 Hrs.): (503) 639 -4175 W lit INSPECTION WORKSHEET FOR DATE: 6/11 /2007 TIME: 7:OOAM PAGE: 44 SITE ADDRESS: 13221 SW 68TH PKWY 401 CLASS OF WORK: SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE: PROJECT NAME: HEALTH NET DESCRIPTION: TI OWNER: TIGARD TRIANGLE I LLC, PHONE #: CONTRACTOR: R'& 11 CONSTRUCTION PHONE #: 503-228-7177 Inspection Request Scheduled For: Date: 6/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Me - - 299 Final inspection 049951 -01 503-475-2037 FA1 Corrections /Comments/ Instructions: • . PASS % '� RTIAL APPROVAL ❑ CANCEL El NO ACCESS ❑ FAIL / � . LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: C///07 Phone #: (503) 718 - G*4 CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2007 -00183 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2007 Phone: (503) 639- 4171�d " ill Inspection Requests (24 Hrs.): (503) 639 -4175 ...' :_— INSPECTION WORKSHEET FOR DATE: 5/1 /2007 TIME: 7:00AM PAGE: 51 SITE ADDRESS: 13221 SW 68TH PKWY 401 CLASS OF WORK: SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE: PROJECT NAME: HEALTH NET DESCRIPTION: TI OWNER: TIGARD TRIANGLE I LLC. PHONE #: CONTRACTOR: R & H CONSTRUCTION PHONE #: 503- 228-7177 Inspection Request Scheduled For: Date: 5/1 /2007 Pour Time: Code # Inspection Description Confirm # Contact # M- ;- ;: 275 Framing 047374 -01 503-539-3626 Corrections /Comments /Instructions: Ala. i''.g--, I► P �/'� \ Pc___,o1 e y 9� t_cf -t r APic3' u hicr.� .cam- e,g7 vc„.. _ ❑ PASS In • ' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL j ' ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector. Date: LS / O Phone #: (503) 718- _ Aar Ma .� Building Permit Application- ;�,''r 9 FOR OFFICE USE ONLY Received City of Tigard �� ` Date /B : ,��0 Permit No.: 1 �/1 3 • 13125 SW Hall Blvd., Tigard, OR 972 Plan Review'1 / 4 '� . Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 � , , ;, ,"' �f ��'� Date/B : AWL r. Inspection Line: 503.639.4175 ��' i \'\ j<<� Date Ready : • . Ln ® See Attached Checklist for Internet: www.Ci.tigard.or.us � �� a Notified/Method: , Supplemental Information 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 ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 13221 SW 68 Parkway New dwelling area: square feet City/State /ZIP: TIGARD, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: 401 Project name: Health Net - Addition Covered porch area: square feet Cross street/directions to job site: SW Hampton St. & SW 68 Pkwy. Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST 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 OF WORK work indicated on this application. Interior Tenant Improvement Valuation: $$31,359.00 Existing building area: 1,716 square feet New building area: 1,716 square feet ❑ PROPERTY OWNER ® TENANT Number of stories: 4 Name: Health Net - Oregon Type of construction: I -B Address: 13221 SW 68 Parkway Occupancy groups: City /State /ZIP: Tigard, Oregon 97223 Existing: B Phone: (800)672 -5941 Fax: ( ) New: B ® APPLICANT ❑ CONTACT PERSON NOTICE Business name: Group Mackenzie All contractors and subcontractors are required to be Contact name: Peter Kim licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 0690 SW Bancroft St jurisdiction in which work is being performed. If the City /State /ZIP: 97239 applicant is exempt from licensing, the following reasons apply: Phone: (503) 224 -9560 Fax: : (503) 228-1285 E -mail: pkim @grpmack.com CONTRACTOR Business name: R &H Construction BUILDING PERMIT FEES* Address: 1530 SW Taylor St. Please refer to fee schedule. City/State /ZIP: Portland, Oregon 97205 Fees due upon application Phone: (503 : -7177 Fax: (503) 224 -3638 Amount received CCB I 38304 . • ' : 7 Date 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: Peter M Ki Date: 03/27/ 07 * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T( I I /02 /COM /WEB) a CITY OF TIGARD OF OCCUPANCY ° ` COMMUNITY DEVELOPMENT PERMIT #: BUP2007 -00183 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2007 PARCEL: 25101 DA - 00102 ZONING: MUE JURISDICTION: TIG SITE ADDRESS: 13221 SW 68TH PKWY 401 SUBDIVISION: TRIANGLE CORPORATE PARK BLOCK: LOT: 002 CLASS OF WORK: ALT TYPE OF USE: COM TYPE OF CONSTR: 2FR OCCUPANCY GRP: B OCCUPANCY LOAD: 18 TENANT NAME: HEALTH NET REMARKS: TI Owner: TIGARD TRIANGLE I LLC 4650 SW MACADAM AVE STE 220 PORTLAND, OR 97201 Phone: 503 - 228 -7177 Contractor: R & H CONSTRUCTION 1530 SW TAYLOR PORTLAND, OR 97219 Phone: 503- 228 -7177 503- 224 -3638 Reg #: LIC 38304 This Certificate issued 6/11/2007 grants occupancy of the above referenced building or porti • hereof and confir • - - building has been inspected for compliance with the :t. - • Oreg • . • = salty Codes for the group, occupancy, and use under which the ref r - i perm ` sued. 4 / ? B " G INSPEC '� BUILDIN 47. FFICIAL POST IN CONSPICUOUS PLACE