Permit CITY OF TIGARD BUILDING PERMIT
Ie s . COMMUNITY DEVELOPMENT Permit#: BUP2018-00166
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2018
t F. 9 Parcel: 2S 101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Project: Health Net Subdivision: None Lot: None
Project Description: TI for existing tenant:Demolition,new walls,suspended ceiling repairs,light fixture relocation,power receptacles,
cabinets,relocation of fire sprinklers,and HVAC duct work. Tenant will take over entire floor.
Contractor: RUSSELL CONSTRUCTION INC Owner: GK TRIANGLE CORPORATE PARK III L
20915 SW 105TH AVE ATTN KBS REALTY ADVISORS
TUALATIN, OR 97062 P 0 BOX 28270
SANTA ANA, CA 92709
PHONE: 503-692-9002 PHONE:
FAX: 503-692-9008
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIA Permit Fee-Additions,Alterations, 06/25/2018 $2,676.35
Demolition
Occupancy Grp: B Occupancy Load: 231 12%State Surcharge-Building 06/25/2018 $321.16
Dwelling Units: 0 Plan Review 05/30/2018 $1,739.63
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 06/25/2018 $361.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 06/25/2018 $1,070.54
Value: $360,000 Info Process/Archiving-Lg$2.00(over 06/25/2018 $64.00
11x17)
Metro Const.Excise Tax 06/25/2018 $432.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $6,664.68
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,:les are set forth in OAR
952-001-0010 through OAR 952-001-0090. You •- •• - • -copy of the rules or direct questions to OUNC by calling .1987•r 1.800./ .2344.
Issued By: /f - mittee Signature• . _ AO/
-.111111111111eallikm1111L—r.
.60°OF Call 503.639.4175 by 7:00 a.m.for the next availa•le 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 l OR o1Tin t . Uyl ,
City of Tigard p,:'4,.ov rte'
1111 4113125 SW Hall Blvd.,Tigard,OR 97223 ppinapevlew fil Permit Na: R/,��/
a Phone: 503.718.2439 Fax: 503.598.1960 may. —/+ I ,t —__I Wit:
t t G A v,i, w line: 503.639.4175 di I ' *,/ r el GI P Dare Ready/B7r• 1� F- / ' � R Sec Paas 2 for
Internet: www.tigard�.gov N ti6edMledro �( I Supplemcahllnformadoi
TYPE OF;y + . ' , jt, ,r`y,is
RE(PIREA DATA.i-APID 2-FAMILY DW».i1VG
❑New construction 0 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 Oder: equipment,materials,labor,overhead,and the profit for the
- work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: S
❑1-and 2-family dwelling ®CommerciaUmdustrial
❑Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other. Number of ballrooms:
JOB SITE INFORMATION ANIf I.00:A'CIO1Q Total number of floors:
Job site address:13221 SW 686'Parkway, New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldgJapt no.:S00 Project /Mk 4/44,- Covered porch arca: square feet
Cross street/directions to job site:Sw 66th Ave Deck area: square feet
near intersection of I-5 and Beaverton-Tigard Hwy Other structure arca: square feet
UIRED DATA,COMMIrRCIAL-IJSE CBBCIQIST.
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.:2S101DA00102
equipment,materials,tabor,overhead,and the profit for the
DESCRIPTION OF WOpk' work indicated on this application.
Demolition of non-load bearing interior partitions,doors,elect New walls, Valuation 13360,006.110
suspended ceiling repairs,light fixture relocation,power receptacles,cabinets Existing building aura: 23098 square feet
relocation of fire sprinklers,hvac ducting. Tenant expanding Into full floor New building area: 0 square feet
* ] PROPERTY OWNER 1 ...Iii ENANT Number of stories: I
•Name:Centeno Corporation Type of construction: II-A
t •
Address:7700 Forsyth Blvd.(Facilities)
Occupancy groups:
City/State/ZIP:St Louis,MO 63105 Wig' B
Phone:(314)349-8842 Fax:( ) New: B
0.-1411494,M. ,.
ApM494,M. rfl. .. ACP P of4 WILDING PERMIT FM* tt
Nam"declaims aahAlmOt
Business name:ADL Design Architects
Structural plan review fee(or deposit):
Contact name:Heather Larsen
FLS plan review fee(if applicable):
Address:1410 Glen View Court
City/State/ZIP:Roseville,CA 95747 Total fees due upon application:
Phone:(916)773-6758 Fax::(916)773-2875 Amount received:
PHOTOVOLTAIC SCII,AR RANI6L SYS TEM i',1.,0*Email:heather®hdlaia.eom , -
;•. Commercial and residential prescriptive installation of
CONTRACI�OR. .J roof-top nmwted PhotoVoltaic Solar Panel System.
Business name:Russell Construction Submit two(2)sets of roof plan with connection details
and fire department access,along with the 31110 Oregon
Address:20915 SW 105t'Ave. Solar Installation Specialty Code checkliaTif,Alk
Permit fee(includes plan review
Tl
City/State/MI: sailatin,OR 97062 $180.00
and administrative fees):
Phone:(503)692-9002 Fax:(503)692-9008 State surcharge(12%of permit fee): $21.60
CCB lic" Vol I bTotal fee due upon application: $201.60
Authorized signature: :.I ao r �, This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print e:heather Lunn n Date:05-24-2018 * Service
Fee Board.Fee sd by Tri-County Building Industry
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46137I 1/02/COM/WEB)
III _ llBuilding Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $ 360,000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 90,000
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
NO MOCiiricaffiokis pvoposed. Xe"4ediQfleyy) Per Tena,44,- 4r611
gevved (Floor 5) Con4p/ef-e4 h i 20/7 Goit-di Perm if-
BU P 20/7-0021F5'.
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
Dianna Howse
From: Samuel Copelan
Sent: Thursday, May 31, 2018 11:21 AM
To: 'heather@hdlaia.com'
Cc: Oscar Contreras;#Building Permit Technicians; Stephen Cochran
Subject: RE:Tenant Improvement at 13221 SW 68th Parkway
Good morning Heather,
Thank you for the information.The following is a link to the address form that you can fill out and then send to Oscar to
retire the suites: http://www.tigard-or.gov/document center/Building/address application.pdf.There will be a fee
associated with the address removal that the Building Division will be add to the Building Permit cost. I will continue the
planning check and make a note that Building and Engineering should be anticipating an Address Form Application.
Sincerely, JTJ v /it/ 6 t.cf id /C,/66
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Monday-Wednesday
Phone: (503)-718-2450
Email: Samuelc@tigard-or.gov
From: heather@hdlaia.com <heather@hdlaia.com>
Sent:Thursday, May 31, 2018 10:37 AM
To:Samuel Copelan <samuelc@tigard-or.gov>
Cc:Oscar Contreras<OscarC@tigard-or.gov>; #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>;
Stephen Cochran<SCOCHRAN@CENTENE.COM>
Subject: RE:Tenant Improvement at 13221 SW 68th Parkway
Hello Sam,
The entire floor should become Suite 500. Please retire the additional suite numbers.
Thank you.
Heather
Heather Larsen,NCARB,AIA
Principal Architect,Interior Designer
HDL Design,Architects
1410 Glen View Court,Roseville,CA 95747
(916)773-6758. Cell: (916)792-9837
heather@hdlaia.com
1
From:Samuel Copelan<samuelc@tigard-or.gov>
Sent:Wednesday, May 30, 2018 4:23 PM
To: 'heather@hdlaia.com'<heather@hdlaia.com>
Cc:Oscar Contreras<OscarC@tigard-or.gov>;#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject:Tenant Improvement at 13221 SW 68th Parkway
Good afternoon Heather,
Planning is looking over your Commercial Building Application for 13221 SW 68th Parkway, and we had a question
regarding the address: Do you plan on having the entire floor use Suite 500, or will you be maintaining the other Suite
numbers that currently exist on the 5th floor?The application states that the tenant will be expanding to the entire floor,
and so we need to know if suite numbers need to be retired. Please let us know as soon as possible so that we know
how to proceed with your application.Thank you!
Sincerely,
Sam Copelan
Assistant Planner
City of Tigard; Community Development
13125 SW Hall Boulevard
Monday-Wednesday
Phone: (503)-718-2450
Email: Samuelc@tigard-or.gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-rnails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
2
Branden Taggart
From: Branden Taggart
Sent: Wednesday, May 30, 2018 1:38 PM
To: 'heather@hdlaia.com'
Cc: #Building Permit Technicians
Subject: Building Permit for Centene Corporation: BUP2018-00166; 13221 SW 68th Pkwy
Attachments: BUP2018-00166 Centene Corp Receipt.pdf; BUP2018-00166 Centene Corp
Application.pdf
Hi Heather,
I have attached the receipt for the plan review fee. Also, before we can begin plan review, we will need you to sign the
application form. Once we receive the signed application, I will route your permit for plan review.
Thank you,
Branden Taggart
INCity of Tigard
t ^s Senior Permit Technician
Community Development
TICARD
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
bra ndent@tigard-o r,gov
1
Health Net Health Plan of Oregon,Inc.
RECEI 13221 SW 68th Parkway
Tigard,Oregon 97223
Flea1th Net' Phone 888.802.7001
MAY 2 9 2018 www.healthnet.corn
CITY OF TIGARD
BUILDING DIVISION
May 24,2018
Attn: Building Official,City of Tigard
13125 SW Hail Blvd,
Tigard,OR 97223
Our company,Health Net,a division of Centene,is expanding on the 5th floor in our Tigard building
located at 13221 SW 68th Parkway,Tigard,OR 97223.We are an insurance business office with internal
conferencing,training and accessory break room areas that are used only by our staff.We offer training
to our employees only and the training room will occupy no more than 49 participants at any given time.
Typically training will be for staff already located on this floor,but at peak times we may have up to 10
visitor employees in addition.Conference rooms will be accessible by employees on other floors,which
could add up to 26 additional staff in the conference rooms at peak times.This floor will have no public
access and will seat 120 full-time employees.The total number of people that would occupy this floor at
a peak time would be 156.
Should you need any clarifications,please feel free to contact me.
661#4 6-01ely—
Amanda Hershberge
Health Net of Oregon
Financial Analyst
Direct:503-213-5018
amanda.j.hershberger@healthnet.com
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171 r
•
TIGARD
Project Name: Centene Corporation
Site Address: 13221 SW 68TH PKWY 500
Receipt Number: 417492 - 05/30/2018
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
BUP2018-00166 Plan Review 230-0000-43106 $1,739.63
Total: $1,739.63
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 6076 BTAGGART 05/30/2018 $1,739.63
Payor: HDL Design
Total Payments: $1,739.63
Balance Due: $0.00
Page 1 of 1
HDL DESIGN 6076
City of Tigard 5/25/2018
Plan Check Fees 1,739.63
HDL Checking Acct. Plan Check Fees 1,739.63
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
IIIIII
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: afroVd-- / 49
Site Address: /'3102/ s 6 " Suite/Bldg#: SOO
Project Name:
kiName of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review 1
Proposal: Detholl}-4�r\ o� r4loA lo� VJiij i� roreav4it,I�la^4j[horci elcci. Nw L- 4 , f+����Jt.`( C'r y
nP 1114 Fff4ff. rt.dr lfil"j (04�r/" fUt C1�S J Caokrs rtIoc' r sp- kIuSi hVAC ,/G-irj•
-feN4 a 0,.(P/ 441 et"' (�C
Existing Business Activity: (l
Proposed Business Activity: ( 2c
�I�erify site address/suite# exists and active in permit sysstte . '�. o��.t 00 ;S ii� i vt g4Jre
11d"River Terrace Neighborhood: ❑ Yes LLl' No
L1oning: T VV
5/Permitted Use: Y es ❑ No ❑ Spec Space
iyr onfirm no land use required.
LId Business License:
Exists: ❑ Yes liNo,applicant notified to obtain business license ?e +1 S`3 i'1
Notes: PIiZt>,,.t i k . /1a#W ueyttk A-Au For" Iv ic,{ai LJc e;hs Soo- S 1\ Cu* PO,
oc S'- 31-lei �-+� h i.,r1 Gtt1 re i-() a) Ad c 4 ka„K e" Leila . -Sc
Approved by Planning: ,S....0 `4pt Date: S-31-10
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: S/rte/iie
Site Plans: # Ai/-
Building Plans: # 3
Building Permit#: 0.--Fifer building permit#above.
Workflow Routing: nning t Coordinator -Biill'ding
Workflow Sign-off: g--Iign-off for Planning(include notes from planning review)
Route Application Documents: Li ,g: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician: 9i_e,
'—'C' Date: .�'er1r
I:\Building\Forms\B1dgPennitRvw_COM NoLandUse 060116.docx
Permit Coordinator Review
IlitcConditions "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
VOK to Issue Permit
Approved by Permit Coordinator: AKA 0 � "'^f " �` Date: (Q �j
I I )
L•\Building\Forms\3ldgPermitRvw_COM NoLandUse 070915.docx
RECEIVED
HElL Design :,,
• Architecture & Interiors ■ MAY
LA I (.lb iK( AAD
BUILDING OxV S ON
Letter of Transmittal
To: ("tfic,/ c'j 7y ,,D Date: �5-25'-/P�
Address: Regarding: C.-607ENE
City: HDL Job Number: CE/Voir 4-
Attention: p,9-//i'J4- / W5E
Via: 0 Mail XCourier
0 Blueprinter 0 Pick Up
0 Fax Number:
Total Pages:
We are sending you:
'Herewith 0 Originals 0 Specs 0 Samples
0 Under Separate Cover Prints 0 Shop Drawings 0
For Your:
0 Use 0 Record )Approval Review& 0 Distribution to
Comment others
gTS A-ke#, MEC'il, Eteer',('[,uate. pt-4-N6
SONE. PVEr 5Ic;NNP /AIC6.)
PgR /r' 4PPucA CW Gvl 0/$479t-€o c555-8ARQ/ / k v . P(-470
I.:�,00ser
L T-E g_ p,e 4 TEA-L+'-r' fZf 1/9720/.J4 U sE d' oce vPA-ur 4-1)4W
If enclosures above are not received,please notify us at once.
HDL Design,Arc�ects c.c.
By:
1410 Glen View Court,Roseville,CA 95747
• (916)773-6758 • Fax(916)773-0518 • heather@hdlaia.com • hdlaia@aol.com
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13221 SW 68TH PKWY 500, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2018-00166
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - CofO
Comments:
Violation Summary:
Inspector Contractor