Permit CITY OF TIGARD BUILDING PERMIT
11 1 2 COMMUNITY DEVELOPMENT Permit #: BUP2010 -00285
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9355 SW WASHINGTON SQUARE RD T19
Project: VERIZON WIRELESS Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Removing existing interior staircase.
Contractor: BNK CONSTRUCTION INC Owner: PPR WASHINGTON SQUARE LLC
45 82ND DR SUITE 53B 2235 FARADAY AVE STE #0
GLADSTONE, OR 97027 CARLSBAD, CA 92008
PHONE: 503 - 557 -0866 PHONE:
FAX: 503 - 557 -1085
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/29/2010 $119.33
Class of Work: ALT Demolition
Dwelling Units: . 0 12% State Surcharge - Building 12/29/2010 $14.32
Stories: 0 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $2,200
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $133.65
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 -d by the Oregon Utility Notification Center. Those les are set forth in OAR
952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy , s ct questions to OUNC by calli' • 503.232.1987 • 800 2344.
Issued By: Permittee Signature:
Cal :1F "x.5 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.
o
Building Permit Application ,e
Commercial '1.%6\ 1•01( OFI•It I. I SI. () \ I.
City of Tigard ( ( , � P� ( jg 1} L ID ,� Permit No.: ���( 0'- 0c SS
• 13125 SW Hall Blvd., Tigard, OR 97223 Q ` \ \ , \ Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 V�\� Other Permit: et, 0 do j 0 , r
r i G n it p ®
Inspection Line: 503.639.4175 G\ \C\ Date Ready/By: Juris:
Internet: www.tigard - or.gov ` \\,o � Q Date/By: Notified/Method: ' I j4,9 -
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.
❑ 1- and 2- family dwelling ® Commercial/industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
q.- JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site addres Washington Square Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg./apt. no.: T19 I Project name: Va ell (fc -(A}; r e„,( 4 ,s5' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
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.
Remove existing, interior Stair Valuation: $$2,200.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
•
Address: Occupancy groups:
City/ State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: NW Precision Design All contractors and subcontractors are required to be
Contact name: Darin Bouska licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 22605 SW Pinehurst Ct. jurisdiction in which work is being performed. If the
City/ State/ZIP: Sherwood, OR 97140 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 680-6444 I Fax: : ( )
E -mail: Darin @NW - Precision.com
CONTRACTOR
Business name: BNK Construction Co BUILDING PERMIT FEES*
Address: 45 82' Drive, Suite 53B (Please refam fee schedule)
City/State/ZIP: Gladstone, OR 97027 Structural plan review fee (or deposit):
FLS plan review fee (if applicable):
Phone: (503) 557 -0866 I Fax: (503) 557 -1085
Total fees due upon application:
CCB tic.: 0107555 l �•� •
Amount received: 3 3 • co
Authorized sign 1 This permit application expires if a pe it is not obtained
within 180 days after it has been accepted as complete.
Print name: Darin Bouska ate: 12/29/10 I • Fee methodology set by Tri-County Building Industry
Service Board.