Permit (86) CITY OF TIGARD BUILDING PERMIT
IN ' COMMUNITY DEVELOPMENT Permit#: BUP2019-00028
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2019
T r C.;ti R j) 131259 Parcel: 25101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 300
Project: Health Net Subdivision: None Lot: None
Project Description: TI for existing tenant:Interior remodel of suite 300 expansion space,new walls,modified ceiling,and new finishes.
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: VB Permit Fee-Additions,Alterations, 02/20/2019 $3,521.95
Demolition
Occupancy Grp: B Occupancy Load: 183 12%State Surcharge-Building 02/20/2019 $422.63
Dwelling Units: 0 Plan Review 02/20/2019 $2,289.27
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 02/20/2019 $388.00
Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 02/20/2019 $1,408.78
Value: $500,000 Info Process/Archiving-Lg$2.00(over 02/20/2019 $50.00
11x17)
Metro Const.Excise Tax 02/20/2019 $600.00
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $8,680.63
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. hose rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.23 . •87• .800. .1.2344.
Vi
Issued B / /�"I'% ttee Si nature: .. `�' .
By: ,�i �. 4,L,4, AkAi, t/_-,, g ./� �/_
Call 503.639.4175 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
1
Commercial ^� FOR OFF ICI: USE ONLY
City of Tigard i t !!ie' /
` � d,
s Permit No.: o"
:i _ u 13125 SW Hall Blvd.,Tigard,OR 9722�3,�r�``ki 0 2019 ✓loll ��f� � �
Phone: 503.718.2439 Fax: 503.598.1516t)`N •) Other Permit:
Date/By:
i�_A it D Inspection Line: 503.639.4175 �s _ dr i"t Date Ready/By: �� Juris: H See Page 2 for
Internet: www.tigard-or.gov elTy g �" (MRn"t+ otified/Metho / /� T Supplemental Information
31)11 ) N1 1'e ,,I ,S\.h
❑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 Other: equipment,materials,labor,overhead,and the profit for the
CARYC43
',-r-,,,,;1, , work indicated on this application.
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
i1Br , N l 4i : *° yh ' Total number of floors:
Job site address:13221 SW 68th Parkway New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:300 Project name; tic. 4 i/17 Nei Covered porch area: square feet
Cross street/directions to job site:SW 66th Ave Deck area: square feet
Triangle Corporate Park III Other structure area: square feet
'",-;,:-P1';':-1 ¢tsps ce t t ' fi-: E 1iiAt x.:44
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. T=
Tax map/parcel no.:2510 ID A00102 Indicate the value(rounded to the nearest dollar)of all
.x equipment,materials,labor,overhead,and the profit for the
DES��I AI t, ti, t N , work indicated on this application.
Expansion of Suite 300,including interior remodel of expansion space,new Valuation: $$500,000.00
walls,modified ceiling,lighting plumbing,electrical,fire sprinklers,elect Existing building area: 13313 square feet
cabinets,furniture and finish materials. New building area: 0 square feet
'c ,,ti. ,.PA O T.O ...,«,. ii,, R< 0:1`, .,., , Number of stories: 5
Name:Trillium(Centene Corp) Type of construction: II-A
Address:771 Carondelet Ave Occupancy groups: f g3
City/State/ZIP:St.Louis,MO 63105 Existing: B
Phone:(314)349-8842 Fax:( ) New: B
.'^ "a.x `+' K."r" 0 #
is ' r '-V n:7:1`14:
$ ;;;-17 .€a d x e i v t 114
„0 h
"" ' " L'" "`
Business name:HDL Design Architects
Structural plan review fee(or deposit):
Contact name:Heather Larsen
FLS plan review fee(if applicable):
Address: 1410 Glen view Court
Total fees due upon application: ) 17 7
City/State/ZIP:Roseville,CA 95747 /A
Phone:(916)773-6758 Fax::( ) Amount received:
C SOS
E-mail:heather@hdlaia.com AILAR Pa ;,IL'„�lam`` f
Commercial and residential prescriptive installation of
} s x 4 . " {'";k q roof-top mounted 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 2010 Oregon
Address:20915 SW 105th Ave. Solar Installation Specialty Code checklist.
1 City/State/ZIP:Tualatin,OR 97062-9511 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)692-9002 Fax:(503)692-9008
State surcharge(12%of permit fee): $21.60
CCB lic.:58918
Total fee due upon application: $201.60
Authorized signature/ i gpor / gyp,,, /,/ I This permit application expires if a permit is not obtained
' L�t C// within 180 days after it has been accepted as complete.
Print name:Heather Larsen Date:01-28-2019 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Buiiding\Pennits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
_ ` Building 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] $ 500,000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 125,000
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: $ 1000
(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): $ 1000
I:\Building\Pernuts\BUP-COM PemutApp.doc 03/03/2011
City of Tigard
N COMMUNITY DEVELOPMENT DEPARTMENT
illhl
T1cAao Building Permit Review — Commercial - No Land Use
Building Permit #: /iii0 i 1- ,,,,,,,r
Site Address: /� / C7k) ("Alh cii3Ox Suite/Bldg#: .300
Project Name: P..K,AL ki-e4
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: -7,0,34 f lY 1tw-P.1?.0 - ),; b -74-,, --E____
Existing Business Activity: 0/4'0
Proposed Business Activity: 1/
Verify site address/suite# exists and active in permit syste .
II ver Terrace Neighborhood: 111 Yes No
rii-oning: —TM OG
ermitted Use: Yes El No El Spec Space
C firm no land use required.
Business License.
Exists: Yes ❑ No,applicant notified to obtain business license
Notes:
c<dApproved by Planning: Date: f/Z//
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Building Permit Submittal
Original Submittal Date: 19/Sii/ll
Site Plans: # /L//f
Building Plans: #
Building Permit#: e uilding permit#above.
Workflow Routing: mngermtt Coordinator -B'ti din
g
Workflow Sign-off: -off for Planning(include notes from planning review)
Route Application Documents: LBuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: - .-'-_, C:77,--.3) ""' Date: ;11/-7// `f
I:\Building\Forms\BldgPennitRvw_COM 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:
WrsDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes
Tigard Trans SDC: 0 Yes N
Parks SDC: 0 Yes rd N/A
OK to Issue Permit
Approved by Permit Coordinator: /hr/late: .z/7 i
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13221 SW 68TH PKWY 300, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2019-00028
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor