Permit CITY OF TIGARD BUILDING PERMIT
.11111
311 ' COMMUNITY DEVELOPMENT Permit#: BUP2016-00304
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/26/2016
j i�" g Parcel: 2S 101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 200
Project: Health Net Subdivision: None Lot: None
Project Description: TI for existing tenant:New wall partition for breakroom.
Contractor: R&H CONSTRUCTION CO Owner: GK TRIANGLE CORPORATE PARK III L
1530 SW TAYLOR ST ATTN KBS REALTY ADVISORS
PORTLAND, OR 97205-1819 P 0 BOX 28270
SANTA ANA, CA 92709
PHONE: 503-228-7177 PHONE:
FAX: 503-224-3638
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB DC Provision Review,COM TI-Ping 10/26/2016 $90.00
Occupancy Grp: Occupancy Load: Permit Fee-Additions,Alterations, 10/26/2016 $377.90
Demolition
Dwelling Units: 0 12%State Surcharge-Building 10/26/2016 $45.35
Stories: 5 Height: 0 ft Plan Review 10/26/2016 $245.64
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 10/26/2016 $151.16
Value: $19,748 Info Process/Archiving-Lg$2.00(over 10/26/2016 $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 $918.05
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 1.800.332.2344.
Issued By: / —r—s Permittee Signature: �� t
503.639.4175 by 7:00 a.m.for the next available inspecti e.
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 r`. FOR OFFICE USE ONLY
CityIII of Tigard d Received .- /"
g Date/By: l0f V t 0 Permit No.: /�c4f')0 f to c3o y
C 13125 SW Hall Blvd.,Tigard,OR 97223 16 �,J r'� /
Plan Review A}�
Phone: 503.718.2439 Fax: 503.598.1960 Ti Da e/By; ( t O .6_t'j ( +, Other Permit:
T 1 C;A K D Inspection Line: 503.639.4175t Ready y: Juris: la See Page 2 for
Internet: www.tigard-or.gov I1 ot�21'i /Method: /0(40/t6 y Supplemental Information
Yvtiv} ØS1
k O. it e` ;, r.,':.'.'Ali, i 1' .. 11 f,Il 1 j I ,r-
El 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 0 Other: equipment,materials,labor,overhead,and the profit for the
"A {EGO, Iti1si.it" '" work indicated on this application.
-' a , Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
Accesso buildin Number of bedrooms:
Elry g ❑Multi-family
0 Master builder 0 Other: Number of bathrooms:
(y'1,...J.:,•-•ON ii E.® ATT' Total number of floors:
Job site address:13221 SW 68th PKWY New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: W I Project name:Health Net Break room TI Covered porch area: square feet
Cross street/directions to job site:SW 66th AVE and SW 68th Parkway Deck area: square feet
Other structure area: square feet
Subdivision: 1 Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 2S101DA00102 Indicate the value(rounded to the nearest dollar)of all
r:
l o -i i r work indicatedton thislappli ationead,and theprofit for the
equipment, r
Addition of a breakroom that includes a wall partition,cabinetry and a sink. Valuation: $19,748
Existing building area: 150 square feet
New building area: 150 square feet
m: : t
Number of stories: 1
Name:GK Triangle Corporate Park III L Type of construction: Type 1-B
Address:PO Box 28270 Occupancy groups:
City/State/ZIP:Santa Ana,CA 92709 Existing: B
Phone:( ) Fax ( )
New: No Change
Business name:R&H Construction
Structural plan review fee(or deposit):
Contact name:Jon Smith
FLS plan review fee(if applicable):
Address:1530 SW Taylor St
Total fees due upon application:
City/State/ZIP:Portland,OR 97205
Amount received:
Phone:(503)972-5565 I Fax: :( )
E-mail:jsmith@nc�onst.comb' ,NV. l a, 'al
c : - , .„ Commercial and residential prescriptive installation of
+. O ' :ANL.i.,, roof-top mounted PhotoVoltaic Solar Panel System.
Business name:R&H Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1530 SW Taylor St Solar Installation Specialty Code checklist.
City/State/ZIP:Portland,OR 97205 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)228-7177 Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:38304
Total fee due.upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Jon Smith Date: 10/21/2016 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 I/02/COM/WEB)
City of Tigard
III " COMMUNITY DEVELOPMENT DEPARTMENT
R
T1cAlzD Building Permit Review — Commercial - No Land Use
Building Permit #: wa,,,,t, --otj3 j
Site Address: ka22-1 SW U $hn Pay i wa....1 Suite/Bldg#: Zoo
Project Name: } 01 l l i v -F
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: iilei Cf is -1 crF loreoLY-Mom
Existing Business Activity: O Lp Cho C.4it CJ Q --ex tsfil„n Adie err)
Proposed Business Activity: ( u
,Verify site address/suite# exists and active in permit system.
F River Terrace Neighborhood: ❑ Yes 4St.No
Zoning: M Us
APermitted Use: Yes ❑ No ❑ Spec Space
Confirm no land use required.
- Business License:
Exists: X'Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: 1/i Valk Date: Lb I WI Le
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: /) - 6
Site Plans: # it,•
Building Plans: #
Building Permit#: building permit#above.
Workflow Routing: D'Tl nning ❑ Permit Coordinator 1li g
Workflow Sign off: Ki-"Sign-off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: OTC_ /
By Permit Technician: — Date: `d/�ej/i0
I:\Building\Forms\BldgPermitRvwCOM 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
Over-The-Counter (OTC) Building & Fire Protection System Permit
Appointment Checklist
Permit Record#: /5 /(p--030'7/
Contact Name: " -d` ,_ pJ-r7 s Phone #: cr ^ 97— "4;23--
Business
oZS`Business Name: AL /9 (QrkS —,)iJ Appt. Date/Time: /01,,r, , 0:C.0
Site Address: /SA:2/ ct-J 6$11 "GAT. Bldg/ uite #: ob0
Project Name: ?'4 /77
Project Description: 6414//p,y' [J/v -&r / „,u j 4DuM , ,,S'yX-/," ,t,
Existing Use: New Use: Lf'
MMD Required: ❑ Yes o Related Record#:
GENERAL INFORMATION
Class of Work: Occupancy Group: Type of Construction: 2..%-g
Type of Use:, 1L Occupancy Load: Oregon Specialty Code: 1
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: te - 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: $ (1 48
c�
$ dr I ago DC Prov Rvw,COM TI-Ping
$ ir ,.rte Permit Fee-Add,Alt,Demo
DC Provision Review Fee for COM TI(effective 7/1/2016) $ 12%State Surcharge
Project Valuation $ . - CA 'Ian Review,Structural
Up to$4,999 $0.00 $ 11l` Plan Review,Fire Life Safety
$5,000-$74,999 $90.00 $ 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: $�----- 0 - •
$ Li(g �JZ
Date/Time: , ' TOT' FEES DUE
I:\Building\Forms\OTC_BUP_FPS_o7o116.docx - aot • (00
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13221 SW 68TH PKWY 200, TIGARD, OR, 97223
Record Type:
Commercial - Building
Inspection Type:
299 Final inspection
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
BUP2016-00304
Inspector:
Jeff Grove
Contractor
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13221 SW 68TH PKWY 200, TIGARD, OR, 97223
Record Type:
Commercial - Building
Inspection Type:
275 Framing
Result:
PASS
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
BUP2016-00304
Inspector:
Jeff Grove
Contractor