Permit CITY OF TIGARD BUILDING PERMIT
1 1- COMMUNITY DEVELOPMENT Permit #: BUP2011 00004
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/06/2011
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9355 SW WASHINGTON SQUARE RD T19
Project: Spec Space Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: TI - prep space for future tenant
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, 01/06/2011 $164.96
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 01/06/2011 $19.80
Stories: 2 Height: 0 ft Plan Review 01/06/2011 $107.22
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 01/06/2011 $65.98
Value: $6,000 Info Process /Archiving - Sm Sheet (up to 01/06/2011 $5.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $362.96
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet: 1 Structural Welding
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. ATTENTIO.. •rego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 • ough OAR 952 00 .1:0. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.800.332.2344.
Issued By / r" / Permittee Signature:
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 ,
Commercial FOR OFFI(1-: 1'S1 :ON'I.1
City of Tigard • R ECE IVE D D eB N� T' Permit No IiirrAy`
lig
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan R e . " aMW Other Permit:
C
' Phone: 503.639.4171 Fax: 503.598.1 0 6 2011 Date/B i jAL
r i C n k I Inspection Line: 503.639.4175 J Pt Date R'!". y: Loris. 55 See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF 'BOARD 1 .
A�
TYPE 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:
JOB SITE INFORMATION AND LOCATION Total number of floors: .
Job site address: 9355 SW Washington Square Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 - Garage/carport area: square feet , -
Suite/bldgJapt. no.: T -19 Project name: Vacant Space -Floor Infill - 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.
Indicate the value (rounded to the nearest dollar) of all '
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the '
DESCRIPTION OF WORK work indicated on this application.
Infill Existing Stair opening with new Concrete and Pan Deck Valuation: $$6,000.00
• - Existing building area: square feet
- - - New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: .
Name: MACERICH • - - Type of construction: '
Address: 11411 N tatum Blvd. - Occupancygroups: -
City/State /ZIP: Phoenix, AZ 85028 - Existing:
Phone: (602)953 -6200 Fax: (602)953 -6449 - - 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 required Co 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
app Y
Phone: (503) 680 -6444 I Fax: : ( I . -
E -mail: Darin@NW- Precision.com
CONTRACTOR -
Business name: BNK Construction Co. BUILDING PERMIT FEES*
Address: 45 82 Dr., Suite 5313 (Please refer to fee schedule)
Structural plan review fee (or deposit): .
City/State /ZIP: Gladstone, OR 97027 -
' Phone: (503) 557 -0866 I Fax: (503) 557 -1085 FLS plan review fee'(if applicable):
CCB lic.:- 0107555 Total fees due upon application: - -
Amount received: -
Authorized signature I This permit - application expires if a permit is not obtained OLA.f.;:—. // within 180 days after it has been accepted as complete. ,
Print name: '� la , jZ 0 S �� Date: i / s 1 L 1 ' Fee methodology set by Tri-County Building Industry
-� c Service Board.
71 a Building Division
Over- The - Counter (OTC) Building Permit
T I G A R D Check List
Description of Project: 1 1 •
•
GENERAL INFORMATION
Class of Work:* AO Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* L First floor: N: S:
Type of Construction:] Second floor. E: W:
Occupancy Group: fM Third floor: Openings Protected Y /N ?:
Occupancy Load: — Total sq ft.: N: S:
Stories: '� _ . Note: Combine total floor area for E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: _ add to the third floors . ft. - _Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: i Handicap access:
Smoke detector: Protected corridors:
Fire alarm: ' , Parking spaces ( #):
Notes:
Total Valuation: $ , ("x')
INSPECTIONS,. FEES DUE
Footing/ foundation Firewall $ 1 (/ ,��� Permit Fee
Post /beam structural Smoke detector $ 19, , fi`f) State Surcharge
Shear wall Misc. inspection $ ( 0,7 , 1 Plan Review Fee
Masonry Approach /sidewalk $ ( ,C 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
011P ..urly Rate State Surcharge
$ Other:
50 $ i ` '` ♦ 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