Permit CITY OF TIGARD BUILDING PERMIT
s , COMMUNITY DEVELOPMENT Permit #: BUP2011 -00038
T j GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2011
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9633 SW WASHINGTON SQUARE RD FC04
Project: Spec Space Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Prepare space prior to new tenant - Braganza Tea
Contractor: BNK CONSTRUCTION INC Owner: MACERICH WASHINGTON SQUARE MALL
45 82ND DR SUITE 53B 11411 N TATUM BLVD
GLADSTONE, OR 97027 PHOENIX, AZ 85022
PHONE: 503 - 557 -0866 PHONE: 602 - 953 -6750
FAX: 503 - 557 -1085
FEES
Specifics: Description Date Amount
Type of Use: COM DC Provision Review, COM TI - Ping 03/29/2011 $64.00
Class of Work: ALT DC Provision Review, COM TI - LRP 03/29/2011 $9.00
Dwelling Units: 0 Permit Fee - Additions, Alterations, 02/17/2011 $195.38
Stories: 2 Height: 0 ft Demolition
Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 02/17/2011 $23.45
Value: $8,000 Plan Review 02/17/2011 $127.00
Plan Review - Fire Life Safety 02/17/2011 $78.15
Info Process /Archiving - Lg Sheet (over 02/17/2011 $12.00
Floor Areas: 11x17)
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $508.98
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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. e rules are set forth in OAR
952 - 001 -0010 through AR 952- 001 -0090. You may obtain a co• • the rules or direct questions to OUNC by calling 503 2.1987 • .800.332. • 4.
•
Issued By: Perm ittee Signature: ��/ Adic
13.639.4175 by 7:00 a.m. for the next available is - pecti • n 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.
F
Building Permit Application RECEIVED
commercial FOR OFF If:F. I1SH: ONLY
Tigard
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City of FEB 17 2011 ,: �,, Pcm,it Nu.: Aor „ _ aex) •
13125 SW Hall Blvd., Tigard, OR 9722 Plan 'Review ����
'., Phone: 503. 639.4171 Fax: 503.598,1960 C 1TY pp TIGARD Date/B : Other ar Permit:
' �
1' l , A RI , Inspection Lite: 503.639.4175 Dato kaady/By: i loco M See Page 2 for
Internet www.tigard-or.gov a BUILDING DIVISION Notified/Meibodt.b 1'p i / /,,, ..I' - Suppteatenlal
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❑ New construction ® Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
i " ` °' 'IEIo�li l';i' ° ` 0 * e; �HJ {�7 � jt11t 1l( iE y "' '° a -p� ftjfla work indicated on this application.
siu ' rb f, $il 1 ,; ;,,.. vii ll TM R144 tat�SAtEc�'k rear ilgdiP"ttt
❑ I- and 2- family dwelling ® Commercial /industrial Valuation: $
0 Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
sA a r y ��., e (. t '- 4 c 2 :t;
`
"I;;'. i Rf' 7 , .._. :. . • '� e u; ' !a I ll � :. u :. R'• _.,.. • , d 1, Total number of floors:
a
Job site address:' 94 3 3 S.W. Washington Square Road New dwelling area: square fee:
City /State/ZIP: Tigard, OR 97233 Garage/carport area: square feet
Suite/bldgJapt. no.: FC-04 1 Project name: Braganxa.Toa• Covered porch area: square feet
Cross street/directions to job site: Oilt Oil e tehat Deck area: square feet
T
Other structure area: square feet
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Subdivision:ot no,: Permit fees* are based on the value of the work performed.
Tax maplpureel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the pro
; , x ; , :, , r • � � r 4 „.0 1 F , a .� WW1. „ , ,. %y0 , profit for the
,�,i t. . i, } ... r , .. °x i - : t. i' cold ' , , (; '# ; 'RI Il ! . ° i. Z w ork indicated o this application. .—
Partial Demolition of existing tenant improvements Valuation: $8,000.00
Minor new improvements to make ready for new Tenant- Braganza Tea Existing building area: 295 square feet
New building area: square feet
$: t< kPah k
wt�.:.i,;,tK:: ? � a 1. .d '.: :d F ':: `t•-;,'t, ;:? ';i fi icag.-- e4ta Number of stories:
Name: Macerich Washington Square Mall Attn: Aaron Pratt Typo of construction: 1- fully sprink
Address: 11411 N, Tatum Boulevard Occupancy groups:
City /State/ZIP: Phoenix, AZ 85028 Existing: M
Phone: (602)953-6750 Fax: ( )
y��yy � gy p� ,,�� New: M
flit Silt R :/J1°J 1NfI N[Gc� {4 E:''' `..:� :' HEIR sx 3!t .tP.7.l' '.", 'S „' ? � r � tdeG ' 'ir ' /iiiI1
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Business name: Timothy G. Pleger, Architect All contractors and subcontractors are required to be
Contact name: Tim Pleger licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15640 N. 7 Street, Suite 119 jurisdiction in which work is being performed. If the
City/State/ZIP: Phoenix, AZ 65022 applicant is exempt from licensing, the following reasons
apply:
Phone: (602) 293-3300 I Fax :: (602) 293 -3506 •
E-mail: thn@piegerbenry.com
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City/State/ZIP: C6f, ger 1 o2- --� Structural plan review fee (or deposit):
Phone: ( ,� Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: _ Total fees due upon application: $0.011
Amount received: ij 4436". Y$
Authorized signature: 7 Thi
WM/ permit application expires if a permit is out obtained
within 180 days after it has been accepted as complete.
Print name: Tim Pleger II Date: 2 -16 -11 * Pee methodology set by Tri- County Building Industry
Service Board.
1:1BuildinglPermilst3UP -COM PermitApp.. oc 10/01/09 440- 4613T(11 /02/COM/WEB)
Building Permit Application
Commercial ...-.,
ommercial - :. -°
I OR (II I It I I tit l \i.1
City of Tigard Received ���� As_ _ � 138
Date
/B B Permit No.: J d -
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1' ' Date/B : Other Permit
:
Inspection Line: 503.639.4175 ' F D ate Read B Lu ria:
I WARD
, , i Ready /By: Fa See Page 2 for
Internet: www.tigard- or.gov .?',k,I!`,)ai / „ „,.. .L, Notified/Method: -- lira. Supplemental Information
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.
El 1- and 2- family dwelling ® Commercial /industrial Valuation: $
El 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: . 94 3 3 S.W. Washington Square Road New dwelling area: square feet
City /State/ZIP: Tigard, OR 97233 Garage /carport area: square feet
Suite/bldg. /apt. no.: FC -04 Project name: e- =ea _es• Covered porch area: square feet
Cross street/directions to job site: 6701 t Mlei Deck area: square feet
Other structure area: square feet
JJ 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
Tax map /parcel no.: ( dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Partial Demolition of existing tenant improvements Valuation: $8,000.00
Minor new improvements to make ready for new Tenant- Braganza Tea Existing building area: 295 square feet
New building area: square feet
■+ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Macerich Washington Square Mall Attn: Aaron Pratt Type of construction: 1- fully sprink
Address: 11411 N. Tatum Boulevard Occupancy groups:
City /State /ZIP: Phoenix, AZ 85028 Existing: M
Phone: (602)953 -6750 Fax: ( ) New: M
El APPLICANT ® CONTACT PERSON
NOTICE
Business name: Timothy G. Pleger, Architect All contractors and subcontractors are required to be
Contact name: Tim Pleger licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15640 N. 7 Street, Suite B9 jurisdiction in which work is being performed. If the
City /State /ZIP: Phoenix, AZ 85022 applicant is exempt from licensing, the following reasons
apply:
Phone: (602) 293 -3300 Fax: : (602) 293-3506
E -mail: tim @plegerhenry.com
CONTRACTOR ?>
Business name: BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
City /State /ZIP:
Structural plan review fee (or deposit):
Phone: ( ) Fax:
( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application: $0.00
Amount received: I F (13 : ! Q 8
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Tim Pleger Date: 2 -16 -11 * Fee methodology set by Tri -County Building Industry
Service Board.
l:\Building\Permits\BUP -COM PermitApp.doc 10/01/09 440- 4613T(I1/02 /COM/WEB)
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: a6 I I -aoa 3 g ❑ Expedited Review
Plan Submittal Date: c9/17///
To the Applicant:
➢ If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
➢ If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if I proved.
Plann' g Review (contact ay/ at 503 -71 g� ��1�or @ tigard or.gov)
u Zoning ermitted Use Yes g No ❑
Land Use Required: Yes ❑ No 1g' (explain below)
Notes:
ArNintargaMESIVL
1
Approved 0 Not Approved Date: /
Permit Coordinator Review (contact Albert Shields at 51. 18 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Buil., g Division Date:
I: \CURPLN