Permit CITY OF TIGARD BUILDING PERMIT
m _ COMMUNITY DEVELOPMENT Permit #: BUP2012 -00065
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/04/2012
Parcel: 25101 DA00102
Jurisdiction:
Site address: 13221 SW 68th PKWY 450
Project: Spec Space Subdivision: VARNS ACRES Lot: 9
Project Description: TI
Contractor: RUSSELL CONSTRUCTION INC Owner: GK TRIANGLE CORPORATE PARK III
20915 SW 105TH AVE P.O. BOX 130174
TUALATIN, OR 97062 CARLSBAD, CA 92013
PHONE: 503 - 228 -3413 PHONE: 503 -221 -1900
FAX: 503 - 228 -2770
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 04/04/2012 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 04/04/2012 $9.00
Dwelling Units: • 0 Permit Fee - Additions, Alterations, 04 /04/2012 $744.51
Stories: 4 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 04 /04/2012 $89.34
Value: $51,090 Plan Review 04 /04/2012 $483.93
Plan Review - Fire Life Safety 04/04 /2012 $297.80
Info Process /Archiving - Lg $2.00 (over 04/04/2012 $10.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
• Total $1,698.58
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Manual Pull Stations: •
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: IMO - Permittee Signature:
Ca .0 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application .$
Commercial u
OFFICE Do P�O� hclli OFFICE USE ONLY
of Tigard Q � ,1G�S` Dat�e/Bca P ( cl o.: /� _ O(�•
:7 C ° 13125 SW Hall Blvd., Tigard, OR 972 A v ` Plan Revic �� vl�lia0
Phone: 503.639.4171 Fax: 503.598.1960' 1 " _G Date /B :
T I G A K D Inspection Line: 503.639.4175 C�9� Date Ready /By: �� ��.�j Supplemental � See Page 2 for
Internet: www.tigard or.gov Notified/Method: 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 El 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 El Multi-family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Triangle HI 13zZ ( 9,0 . & VI X New dwelling area: square feet
City/State /ZIP: Tigard, OR 9 Garage /carport area: square feet
Suite/bldg. /apt. no.: 450 /,/r Project name: Space Prep Covered porch area: square feet
Cross street/directions to job site: igiafA *4.4D2ESS Fes- V7...._ / Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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: $51,090
Work to include minor demolition, new walls, doors and cabinetry Existing building area: 2,096 square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories: 6
Name: GK Triangle Corporate Park 111; By Thomson Reuters Type of construction: I -B
Address: PO BOX 130174 Occupancy groups:
City/State /ZIP: Carlsbad, CA 92013 Existing: B
Phone: (503)221 -1900 Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Group Mackenzie All contractors and subcontractors are required to be
Contact name: Morgan Toth 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: jac @grpmack.com
CONTRACTOR
Business name: Russell Construction BUILDING PERMIT FEES*
Address: 1530 SW Taylor ST (Please refer to fee schedule)
City/State /ZIP: Portland, OR 97205 -1819 Structural plan review fee (or deposit):
Phone: (503) 228 -7117 Fax: (503) 228 -3638 FLS plan review fee (if applicable):
�[ Total fees due upon application:
9'18
CCB !ie.:438" 7
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: Tosha Reinmiller I Date: 04/03/12 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Petmits\BUP -COM PermitApp.doc 2/23/07 4404613T(11/02/COM/WEB)
° Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: iii o 2 )/� — �UC�S xpedited Review
Plan Submittal Date: y y ,2
To the Applicant:
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Pla Jv
Review (contact " / at 503 - 718 -ol4 or l @tigard- or.gov)
C�Z oning 4/ /4E Permitted Use Yes No
❑ Land Use Required: Yes ❑ No Ll (explain below)
Notes: 0/44 - f�c.
113 Approved ❑ Not Approved Date: VXf
Permit Coordinator Review (contact Albert Shields at 503 - 718 - 2426 or albert@tigard - or.gov)
Notes:
•
Routed back to Building Division Date:
I: \CURPIN