Permit A
a CITY OF TIGARD BUILDING PERMIT
e COMMUNITY DEVELOPMENT Permit #: BUP2009 -00118
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/25/2009
Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 100
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: Spec Space
Project Description: Demo select walls to open space for future tenants.
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Description Date Amount
BB# 73- 1771- GK1130, CBRE, PO BOX 2096 Permit Fee - COM 06/25/2009 $191.20
WARREN, MI 48090 Plan Review 06/25/2009 $124.28
PHONE: Plan Review - Fire Life Safety 06/25/2009 $76.48
12% State Surcharge - Building 06/25/2009 $22.94
Contractor:
R & H CONSTRUCTION CO
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: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $414.90
Required: Required Items and Reports (Conditions)
Fire Sprinkler: 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.669• •r 1.800.3 2.2344.
Issued By: l ).11A Permittee Signatur -. _ ----
---- � �/
Call 503.639.4175 by 7:00 a.m. for an inspecti • at business • ay.
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.
r Bhilding Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard Received Date /B : " permit No.: L go
Ill
° �J g 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 5 2009 Plan Review
II Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: ® See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION 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: Portland, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 100 Project name: First Floor Vacant Demo Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
68 Parkway 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.
Demolition: remove selected existing walls and ceiling to provide an access Valuation: $$20,000.00
through an vacant suites Existing building area: 19361 square feet
New building area: 19361 square feet
® PROPERTY OWNER l 0 TENANT Number of stories: 5
Name: GK Triangle Corp. Park 111 c/o CB Richard Ellis Type of construction: I -B
Address: 1300 SW 5 Ave. Suite 200 Occupancy groups:
City /State /ZIP: Portland, Oregon 97201 Existing: B
Phone: (503)221 -4889 Fax: (503)221 -4873 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: 1515 SE Water Ave. Suite 100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, Oregon 97214 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9560 Fax: : (203) 228 -1285
E -mail: pkim @grpmack.com
CONTRACTOR
Business name: R & H Construction BUILDING PERMIT FEES*
Address: 1530 SW Taylor Street (Please refer to (ee schedule)
Structural plan review fee (or deposit):
City /State /ZIP: Portland, Oregon 97205
Phone: (503) 228 -7177 Fax: (503) 224 -3638 FLS plan review fee (if applicable):
CCB lic.: 38304 Total fees due upon application:
Amount received: a " v 1 t Q
Authorized signature: �� � � This permit application expires if a permit is not obtained
J- , within 180 days after it has been accepted as complete.
Print name: Peter Ki , Date: June 24, 200 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building\Pennits \BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02/COM /WEB)