Permit � -- CITY OF TIGARD BUILDING PERMIT
"!`< COMMUNITY DEVELOPMENT Permit #: BUP2010 00157
,,TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/24/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9669 SW WASHINGTON SQUARE DR CO3
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Express
Project Description: TI. Combining Spaces CO3 and 004.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Permit Fee - Additions, Alterations, 08/24/2010 $2,313.95
CARLSBAD, CA 92008 Demolition •
PHONE: Plan Review 07/02/2010 $1,504.07
Plan Review - Fire Life Safety 07/02/2010 $925.58
CDC Building Review, COM 08/24/2010 $128.00
Contractor: CDC Planning Review, COM 08/24/2010 $128.00
HORIZON RETAIL CONSTRUCTION CDC Planning Review, COM - LRP 08/24/2010 $38.00
1500 HORIZON DR Metro Const. Excise Tax - Commercial 08/24/2010 $780.00
STURTEVANT, WI 53177 Use
PHONE: 262- 638 -6000 Building Permit - COM 08/24/2010 $1,971.50
FAX: 262- 638 -6015 12% State Surcharge - Building 08/24/2010 $514.25
Plan Review - Building 08/24/2010 $1,281.47
Specifics: FLS Plan Review 08/24/2010 $788.60
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $650,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $10,373.42
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: No Manual Pull Stations: Yes •
Accessible Parking: 0
This permi ' sue. s •' the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do ' in accordance with ap ved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
day ATTENTION: Oregon law re to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through OAR 952 -00 100. You ay obtain a copy of the rules or direct questions to OUNC by calli ' 03. `• :v. ' or 1.800.332.2344.
Is • ued By: Permittee Signature: � // �
v!
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. N.
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.
Mk , ,
ing Permit Application
Commercial �� FOR OFFICE USE ONLY
14 City of Tigard � Received �/ i�� ` Permit No Y/f!/o — W ls7
tJ g 9 Date y
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie .' , /f
Phone: 503.639.4171 Fax: 503.598.1960 10 B Date ° • A ( � Other Permit:
TI Inspection Line: 503.639.4175 `U - - Date Rear : y: luris: ® See Page 2for
Internet: www.tigard- or.gov I �� � D N otifi /Method: W MO( /d M Information ei
TYPE OF WOR 1 1�V O r it ✓ r
� REQUIRED 1- AND 2-FAMILY DWELLING ❑ New construction ❑ 1Temolition r 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: TI Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address % ( S( � / ,. �A j � / w � s New dwelling area: square feet
City /State /ZIP: Tigard, OR t Garage /carport area: square feet
Suite/bldg. /apt. no.: CO3 /LOy Project name: Express Covered porch area: square feet
Cross street/direc • ns joTi"st e: 'ngton Square � Deck area: square feet
T o CoM�j t N ,\ Lowe, f r y ,- R �I,(3 Other structure area: square feet
� _Se C1 S C-403 "t C ® 1 I EQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdi • ion: 1 r Lot no.: P rmit fees* are based on the value of the work performed.
ndicate the value (rounded to the nearest dollar) of all
Tax map /parce .: '7/`7/ i 8. . 1 .. equipment, materials, labor, overhead, and the profit for the
• DESCRIP7`fON'O1 -WORK . - — work indicated on this application.
TI- Combining two existing retail spaces into one retail space. consisting of Valuation: $$300;9e99�� 1 < )
ceiling, flooring, fixtures, finishes, partitions, MEP work, and storefront. Existing building area: 8338 square feet
New building area: 0 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: Express Type of construction: II
Address: One Limited Parkway Occupancy groups:
City /State /ZIP: Columbus, 011 43230 Existing: M
g�
Phone: (614)415.7000 Fax: (614)415 -5365 New: M
❑ APPLICANT @ CONTACT PERSON NOTICE
Business name: Permit Resources All contractors and subcontractors are required to be
�
a(A f,(� /MAO licensed with the Oregon Construction Contractors Board
Contact name: Mary Ryan
fr' `'t under ORS 701 and may be required to be licensed in the
Address: 22941 Triton Way, Suite 243 jurisdiction in which work is being performed. If the
City /State /ZIP: Laguna Hills, CA 92653 applicant is exempt from licensing, the following reasons
apply:
Phone: (949) 582 -3735 Fax: : (949) 768-8436
E -mail: mary \, @permitresources.com
/ ' ' - CONTRACTOR . c
Business name: TEO •40,2 t 7 ...t , to A trei t i (... ( / 'pli 7 ud_ 70A—) BUILDING PERMIT FEES*
Address: / 600 ( et .y0 IJ (Please refer to fee schedule)
y � � ���� ID 1 /77 S tructura l plan review fee (or deposit):
City/State/ZIP:
nl -- `', r' / ,i FLS plan review fee (if applicable):
Phone: 2 600 Fax: l lz 3 X _60 t e, —
CCB lic.: i 5 1 Total fees due upon application:
Amount received:
Authorized signature: permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*
Print name: Mary Ryan //� D a te: �/ � Fee methodology set by Tri- County Building Industry
s vE � / Service Board.
l: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)