Permit .
A - C ITY OF TIGARD
PERMIT #: BUP2003 -00173
v%11 DEVELOPMENT SERVICES DATE ISSUED: 4/14/03
,. I� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09700 SW WASHINGTON SQUARE RD NORDS PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: Y REQD SETBACKS REQUIRED
FLOOR LOAD: 125 psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 16,000.00
Remarks: Addition of 458 sq. ft. of mezzanine
Owner: Contractor:
PPR WASHINGTON SQUARE LLC R & H CONSTRUCTION
BY THE MACERICH COMPANY 1530 SW TAYLOR
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97219
PORTLAND, OR 97223
Phone:
Phone: 503 - 228 -7177
Reg #: LIC 38304
FEES REQUIRED INSPECTIONS
Description Date Amount Struc Steel Insp
[BUILD] Permit Fee 4/14/03 $196.90
Framing Insp
[TAX] 8% State Tax 4/14/03 $15.75 Final Inspection
[FLS] FLS Pln Rv 4/14/03 $78.76
[BUPPLN] Pln Rv 4/14/03 $127.99
Total $419.40
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 than 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1-800-332-2344.
_4_
Issued By:
Pe rm ittee
/
Signature: ,/✓ �/ / a iv
Call 639 -4175 by 7 p.m. for an inspection the next business day
, ..
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Buildin`g�'ermit Application � FOR OFFICE USE ONL
i / L , u IZCO ed 1
p
DaDate/By: v e Permit No.� 3
City of Tigard Plannin d t. Approval ' Other
Building
y g DateBy: Permit No.:
13125 SW Hall Blvd. Plan Review 1..' Cp L., Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 - 598 -1960 � /, A "601*.v1 Date/By: Post 1.', 6 L Case Land No
Internet www.ci.tigard.or.us - ^^ °� e Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
O ' Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note Permit fees* are based on the total value of the work performed. Indicate
❑ I & 2- Family dwelling Iommercialandustrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $ '-
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: 9 - 1 o h u J (joe3 % i N �nt-tS _ Total number of floors
y New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: lI o2z,sTIto 1x Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
A4 D . Li b 1 e Mez to ■ FL- - tz g° 0.(:) Valuation $
t N 3 SpACE� Existing building area (sq. ft.)
New building area (sq. ft.) 1 15 9
Number of stories
❑ PROPERTY OWNER I ❑ TENANT Type of construction
Name: ,2ps tu- .. -VppZ LJA`�IktcAGT)lC1 Occupancygroup(s): New
Address: i),5155 5t^1 6 xt_ke x - 2 d -
City /State /Zip: RA 14ea.-.- O(L l 3
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: 7 - PC31L1 --t tT MC, h.tT jurisdiction where work is being performed. If the applicant is exempt
Contact Name: --ro t.•� A 1 -LP t.N -2t� -f2 from licensing, the following reason applies:
Address: - o C 4 cxli
City /State /Zip: F TL, o 09- h z-i O
Phone: R,3 g3Zo SS i I Fax:
BUILDING PERMIT FEES*
E -mail: Ti-t ' tZ I & c o C q--, . cep Please refer to fee schedule.
CONTRACTOR
Business Name: 1Z ,t N Cv:-' 5—k - Fees due upon application $
Address: 153 0 -1,J - ? ' c, 5 - V ,
City /State /Zip: ?acz (- Q ( ei 7 7.6 5 Amount received $
Phone: S3 I Fax: - z- ' -3(„3.€ Date received:
CCB Lie. #: 31 4
Authorized / Notice: This permit application expires if a permit is not obtained within
Si: atu _ '"s�/ Date: 3/14 / S 180 days after it has been accepted as complete.
'°"------- \--5.7� t� e V ` V *Fee methodology set by Tri -County Building Industry Service Board.
lease print nam.
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
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Commercial Plan Submittal
rV'i I •
1, �:! Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 *
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP 60 13
Received ? 7 6 Date Requested 0 6-7" AM PM BUP
ocat • • fa ) /q' - S Q - y 1� Suite MEC
Contact Person Ph ( ) PLM
Contractor 0, LS Ph ( ) � 9(o1 SWR
= UILDIN Tenant/Owner — 21.0J) ELC
ELC
• • • ation Access:
Ftg Drain • ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam -
Shear Anchors
Ext Sheath/Shear 1 —�t/t �� ��=Q -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
P • :ING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL •
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date i � 0 Inspector 7 ---- & f-1 " 1 7 Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL