Permit U CITY OF TIGARD BUILDING PERMIT
ill m ' COMMUNITY DEVELOPMENT Permit #: BUP2010 00281
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/23/2010
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9530 SW WASHINGTON SQUARE RD H10
Project: Apple Store Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: TI - Breakroom on second floor.
Contractor: OAKSTONE CONSTRUCTION INC Owner: PPR WASHINGTON SQUARE LLC
4065 YOSEMITE PL 2235 FARADAY AVE STE #0
PLACERVILLE, CA 95667 CARLSBAD, CA 92008
PHONE: 530 - 642 -8858 PHONE:
FAX: 530 - 642 -8847
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/23/2010 $564.15
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/23/2010 $67.70
Stories: 2 Height: 0 ft Plan Review 12/23/2010 $366.70
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 12/23/2010 $225.66
Value: $34,735
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,224.21
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors: No
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This pe•• is issue• ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be • e in accordance 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
da . ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR 952 i I 40 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I ued By: / Permittee Signature:
Call 603.639.4175 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.
UPI°
"dui!ding Permit Application
Commercial RECFP4'F° F OR OFFICE USE OiNL •� � - = '�ce 1,":1,1k -
City of Tigard R Date/ve ived : /a a 3 Permit No.: p ,, _
• 13125 SW Hall Blvd., Tigard, OR 97223
,� C DEC 2 3 2010 Plan Review .►, M I ®
Phone: 503.718.2439 Fax: 503.598.1960 DateB Other Permit:
. i t; A t D Inspection Line: 503.639.4175 Date Ready/By: 7aris: 63 See Page 2 for
Internet: www.tigard - or.gov CITY OF TaGARD Notified/Method: Supplemental Information
BUILDING DIVISION
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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling jEt Commercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
1
Job site address: .Q.6"--
. f" 5 1,0 ti) �} S h i n tD n Se/ . RA New dwellin g area: s q uare feet
City/State /ZIP: 4C44'lc( l 0 t(e. 4 a a 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: ( ( Project name: 4 p /e_ ,514-1L , Covered porch area: square feet
Cross street/directions to job site: S 5 4 a J/5 1� r ri ( 4e / Deck area: square feet
/.()/9 -g hi nj lo Yl 57te Arc- 11 re ii Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
Con ✓ees I o A O f €- I`51 �nq Skirt c ,7 pace_ I tp Valuation: $ 'I &
,1e1,j cyn p /o y Ce_ b r k. roo/� `/ U !'l Existing building area: /.19 o square feet
/ New building area: _e, square feet
p PROPERTY OWNER ( ] TENANT Number of stories:
Name: O pp /o a re Type of construction:
Address: / jaa 1...-ev Occupancy groups:
City/State /ZIP:.,ei . CL, / o . p ?) / (t 950 /1 Existing: f7 , nr�,� 4.1' )E ( /arii )
Phone: (5 / 25 q- 0.Co9 S Fax: ( ) New: Bra k room
AoZ
❑ APPLICANT i1 CONTACT PERSON NOTICE
Business name: (gyp / I7 5.1.0„,_,,142)....... All contractors and subcontractors are required to be
Contact name: A 1.)( d l,�a t'_ licensed with the Oregon Construction Contractors Board
,t under ORS 701 and may be required to be licensed in the
Address: ( 4 3a h n y t. .W R F E jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
Ci
ty S�-k✓ -\ l z q 7 3 03 apply:
Phone: c 03) 593 -Co a 5 Fax: �/ ( )
E-mail: ID t o - e _va e r Q OA-I it -one eomS -tru- .t 1 orl , eon.
CONTRACTOR /
Business name: �Iak e C n bns'Fr(,c c4 f opt. BUILDING PERMIT FEES*
Address: hia 1 5 (0 5 e ✓n l ,� 12/4e.� (Please refer to fee schedule)
Structural plan review fee (or deposit):
City/State /ZIP: 77/4c_c r ✓ ' r e CA 93
Phone:53O) (yea - ?S58 ( Fax: 6 424a - W W � j7 FLS plan review fee (if applicable):
CCB lic.: 4 6 - a 9 63 Total fees due upon application:
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: b A y d g (, - Date: I 'a-I a 3110 * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -COM PermitApp.doc 09 /09/10 440- 4613T(11 /02/COM/WEB)
iv
.
I ° Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
I
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] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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): $
I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08
e . ° Building Division
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project: T(
GENERAL INFORMATION
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* 4 First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: 4 Third floor: Openings Protected Y /N ?:
Occupancy Load: j Total sq ft.: • N: S:
Stories: 2 Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: Handicap access:
Smoke detector: Protected corridors: MC)
Fire alarm: Parking spaces ( #):
Notes:
Total Valuation: $ ) 7a5
INSPECTIONS FEES DUE
Footing/ foundation Firewall $ Permit Fee
Post /beam structural Smoke detector $ r State Surcharge
Shear wall Misc. inspection $ 36 Plan Review Fee
Masonry Approach /sidewalk $ 2-0-5, ‘::„.> FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ ( ? Z_ 24 Total Fees Due
*OPTIONS: •
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I: \Building \Forms \OTC - BUP.doc 08/19/08