Permit d -- CITYDF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00149
° ` COMMUNITY DEVELOPMENT DATE ISSUED: 5/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY BASEMENT ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
PROJECT: HEALTHNET
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: 19 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE / D 7 o • Ce
Owner: Contractor: °
HEALTHNET OREGON R & H CONSTRUCTION
13221 SW 68TH PARKWAY 1530 SW TAYLOR
TIGARD, OR 97223 PORTLAND, OR 97219
Phone: 916 - 935 -1690 Contact #: PRI 503 - 228 -7177
FAX 503 - 224 -3638
Reg #: LIC 38304
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/6/2008 $126.85
[TAX] 12% State Surch 5/6/2008 $15.22
[BUPPLN] Pln Rv 5/6/2008 $82.45
[FLS] FLS Pln Rv 5/6/2008 $50.74
Total $275.26
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 Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rul- • direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. _
/ /
Ise ed By: Permittee Signature: i
P itt Si . , r I' t '
y ► / / i g - .L/P_1
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.
1
• er
Building Permit Application F012 OFFICE USE ONi.v
r-. , ,,, 11 Received
City of Tigard o / Permit No.: i _�/
g � A l LC , ; f (, - lAl 1` Date/ _: / / - I
13125 SW Hall Blvd., Tigard, OR 97223 J ll _- D an Rev STA
Phone: 503.639.4171 Fax: 503.598.1960 '�i Date /B :Er ad Other Permit:
Inspection Line: 503.639.4175 f / \/ ' V ; -- ' - Date Rea. • : y: ® Sec Attached Checklist for
IInternet: www.ci.tiganl.or.us lu �r ` Notified/Method: Supplemental Information
TY115 OF WORK ; ` 4 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 /Statte / Tigard, OR 97223 Garage /carport area: square feet
Suite /bldg: /apt.!€ Project name: HealthNet - Mail / Copy Remodel Covered porch area: square feet
Cross street/directions to job site: 68 Parkway 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.
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.
Interior Tenant Improvement: Add 20 -min. rated double doors to existing storage room. Valuation: $$10,700.00
Change existing 20 -min. rated door with 20 -min. rated door with firelite glass. Additional Existing building area: 1,823 square feet
Electrical power and tele /data for equipment New building area: 1,823 square feet
❑ PROPERTY OWNER I ® TENANT Number of stories: 5
Name: HealthNet: Oregon Type of construction: I -B
Address: 13221 SW 68 Parkway Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing: B
Phone: (916)935 -1690 Fax: (916)9354445 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. #100 jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97293 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 224 -9560 I 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, OR 97205
Fees due upon application
Phone: (503) 228 -7177 Fax: (503) 224 -3638
Amount received
CCB lic.: 38304
Date received:
Authorized signatut j �� This permit application expires if a permit is not obtained
/■40„. within 180 days after it has been accepted as complete.
Print name: Peter Kim Date: April, 29, 2008 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 470- 4613T(11 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008 -00149
13125 SW Hall Blvd., Tigard, OR 97223 ,,; DATE ISSUED: 602008
Phone: (503) 639 -4171 470/1"
Inspection Requests (24 Hrs.): (503) 639 -4175 ° Ai
INSPECTION WORKSHEET FOR DATE: 7/18/20i8 TIME: 7:00AM PAGE: 38
SITE ADDRESS: 13221 SW 613TH PKWY BASEMENT CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: FiEALTHNET
DESCRIPTION: TI
OWNER: HEALTHNET OREGON, PHONE #: 916935 1690
CONTRACTOR: R &11 CONSTRUCTION PHONE #: 503. 2.213-7177
Inspection Request Scheduled For: Date: 7/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
2.99 Final inspection 072755.01 503 - 539-3626 d'
Corrections /Comments /Instructions:
•
•
PASS r PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 74/e Phone #: (503) 718
1
I
CITY OF TIGARD
BUILDING DIVISION _ PERMIT #: BUP2008001'19
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2008
Phone: (503) 639 -4171 Iv�°lMgn l oll
Inspection Requests (24 Hrs.): (503) 639 -4175 -- °`__..
INSPECTION WORKSHEET FOR DATE: 6/3/2008 TIME: 7:OOAM PAGE: 40
1 • i+,444
SITE ADDRESS: 13221 SW 68TH PKWY BASEMENT CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 002 TYPE OF USE:
PROJECT NAME: HEALTHNET
DESCRIPTION: TI
OWNER: HEALTHNET OREGON, PHONE #: 916 - 935 -1690
CONTRACTOR: R & H CONSTRUCTION PHONE #: 503 - 228-7177
Inspection Request Scheduled For: Date: 6/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 070660.01 503 -539 -3626 410 AIM
Corrections /Comments /Instructions:
PAS' F PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: De Phone #: (503) 718- -f-���