Permit n CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit #: BUP2012 -00117
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/09/2012
Parcel: 1 S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: TI for five separate areas in store.
Contractor: CSI CONSTRUCTION COMPANY Owner: PPR WASHINGTON SQUARE, LLC
17721 NE RIVERSIDE PKWY, STE. A BY J C PENNEY 0288 -1
PORTLAND, OR 97230 TAX SERVICES
PO BOX 10001
DALLAS, TX 75301
PHONE: 503 - 907 -0070 PHONE:
FAX: 503 - 907 -0077
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: VB Permit Fee - Additions, Alterations, 07/09/2012 $1,709.95
Demolition
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Building 07/09/2012 $205.19
Dwelling Units: 0 Plan Review 06/07/2012 $1,111.47
Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 06/07/2012 $683.98
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Lg $2.00 (over 07/09/2012 $4.00
Value: $200,000 11x17)
Info Process /Archiving - Sm $0.50 (up to 07/09/2012 $28.00
11x17)
Floor Areas: Metro Const. Excise Tax - Commercial 07/09/2012 $240.00
Use
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $3,982.59
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 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952-001-0090. You may py
y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
J \h al /j J 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
C ommercial E1 1 OR o1 OF ICE USE ONLY
a K��1 + _ ��I l ED Received
City of Tigard Date /B : / 7 alp Permit N a _/0// 7
• 13125 SW Hall Blvd., Tigard, OR 97223 Review �'�
C Phone: 503.718.2439 Fax: 503.598.1960 JUN 07 2012 Plan Date /B : leJ�i /� E : er Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready :yy: / b Suns: ® See Page 2 for
Internet: www.tigard- or.gov err OFTIGARD Notifi7. Method(( A 49- / l . ? 776- Supplemental Information
1 a t .1 _ a t: / : : W /J1I
. la mw
TYPE OF WORK / EQUIRED 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
[r 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: $:,,,S
E1 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: 01500 5W W ISU i k )(AMU 50. 1- New dwelling area: square feet
City/State /ZIP: r1 llP1/411. t nZ t:( -- rzzl Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: :Ft ?�NW`'� 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: I 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
_v" equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ � ad0 006
Existing building area: square feet ,-
IC 1 1 A.r 1NT l 5"l<1Q Fl3CZVQ3cS Ll t "r�/k
F \ QQQ, t Ow N O NAkivG 3 T0 E: tANz,S S , New hyil in ei, N /# square feet
❑ PROPERTY OWNER - TENANT Number of stories: Z
Name: S�l�c 14 N*-� -( f� WQ� 1 C Type of construction:
Address: W 0 S W W 1Wu 1 ik/ / I CZ Occupancy groups:
City /State /ZIP: 1 1 AN t 01Z eil Existing:
Phone: ("Ncrsd New 0 1 S? Fax: ( ) New:
(APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (Please refer to fee schedule)
C_S L C �i�5 - rQ J LTLC L NL Structural plan review fee (or deposit): //// , y7
Contact name: IN/l l - Vi QRw�A t..) FLS plan review fee (if applicable): 69 q,p?
Address: 1 2,1 1 t-1 V ettA l�. 1 ∎ J `'L
Total fees due upon a pp lication: /j 7 ff, yg
City/State /ZIP: N ,ImNb f*-- & --2,30 Amount 795, y5
�1- t l Amount received:
Phone: (5'0 \) c v l ' �e 117 0 I Fax: : Min ) 0 4101 - 00rri
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E -mail: VIA DrIAA«'A 0' C'% G L OKA Commercial and residential prescriptive installation of
CONTRALTO roof -top mounted PhotoVoltaic Solar Panel System.
Business name: SPr1Mv Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State /ZIP: Permit fee (includes plan review $180.00
and administrative fees):
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee): $21.60
CCB lic.: ---( $35 q els /,z, Total fee due upon application: $201.60
Authorized signature: ��. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: l 1 (_�1)-.1A/1gs& ) I Date: (O f ) i-> * Fee methodology set by Tri Building Industry
Service Board.
1: \Building \Pennits \BUP -COM PermitApp.doc 02/24/2011 440- 4613T(I 1 /02 /COM /WEB)
o ° Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit No: 449it P 02 0/A — OOP 7 ❑ Expedited Review
Plan Submittal Date: c ,Q4PA
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 approved.
Planning Review (contact D h ! ( at 503 - 718 - Mt or johme @tigard - or.gov)
❑ Zoning Permitted Use Yes IEK No ❑
❑ Land Use Required: Yes ❑ No (explain below)
Notes: 4 6 & zipe i'l URA
V kpproved ❑ Not Approved Date: C 7 /
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert @tigard - or.gov)
Notes:
Routed back to Building Division Date:
L: \CURPLN