Permit I r-
1
C al
OF TI CARD BUILDING PERMIT
PERMIT #: BUP2005 -00408
�
- 13125 SW I�k DEVEL r SO R9 ICES -639 -4171 DATE ISSUED: 8/18/2005
PARCEL: 1512600 -00300
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: TI, walls.
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: 71 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: 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: 41 ,0,4,5 - 00
• Owner: Contractor:
WASHINGTON SQUARE LLC CUSTOM COMMERCIAL BUILDERS INC
BY THE MACERICH COMPANY 688 SWEET LANE
9585 SW i WASHINGTON SQUARE RD COTTAGE GROVE, OR 97424
- PRAT?' 0- 503 g7 6".3.8865
Phone: 541 - 767 -0605
FEES Reg #: LIC 151674
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/18/2005 $1,387.05
[TAX] 8% State Surcharl 8/18/2005 $110.96
[BUPPLN] Pln Rv 8/18/2005 $901.58
[FLS] FLS PIn Rv 8/18/2005 $554.82
Total $2,954.41
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. ATTE TION: Oregon la
req . s you to folio the rules adopted by the Oregon Utility Notification Center. T e r les are set forth in 0 A J
9 - 001 -0010 through •AR 9. 011 -0100. You may obtain a copy of these rule or direc • - .• ns to OUN • by
c fling 503 - 246 -6699 o1- ��f 2 -2. -4.
Is ued By 4 4., 1 i. . -.1 Permittee Si. nature A� , Ai‘,
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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 tiplicaPortCE
' I op orrlCr uSl ONLY
Received /�
Ci of Tigard �UG r 2�� D ate iv q' /g 0 l,, . �_ � ia� a. ill
1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Rem Phone: 503.639.4171 Fax: 503.598.1960 "- + - "3'ti "' ' Date/B Other Permit:
Ins ection Line: 503.639.4175 F TIC till' Date Ready/By
NM ®See Attached Info Checklist for
:'l- AND 2- FAMILY DWELLING
p CITY O 49. .
Internet: www ci.tigard.or.us gU�L DINC' D C Notified/Method /Meihod Supplemental rm ation
TYPE OF, WORK R EQUIRED DATA
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.
❑ I- 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: (,,, 6 W w 1 4 j 1,.] (,TOv.4 G . e-to New dwelling area: square feet
City /State /ZIP. Garage /carport area: square feet
Suite/bldg. /apt no.: Project name 410, cT. O t3 e_ Hisierer Covered porch area: square feet
Cross street /directions to job site: Wb. k 1,0 -tp (...] `jCkL(, Deck area. square feet
L L. . 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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
- ?e r ad t L- — 1 - e,1. - 3 IS... (�t i� &CO e-g- Valuation: $ . 6, s �� O a , D d
r m.- o etT Existing building area: square feet
New building area: 12,e70 Q square feet
V PROPERTY OWNER ❑ TENANT Number of stories:
Name 1.A ik. e (Gvk co µ Pr. ii Type of construction: 11 t3
Address: `its 1 I Usti, t 1P' B(.- J) Occupancy groups: M 4 -4 eAed, A.4- .)-i•(,.
• City /State /ZIP: St — A.._ 1.40j A / e�A. /3 4 0 ( Existing
Phone: ( 31 o) 39 (c 00O Fax: ( )
New:
. ' e1. APPLICANT - ❑ CONTACT PERSON NOTICE
Business name: eptt.V (V p, 1_,..e.k{• 4 (6, jSOei All contractors and subcontractors are required to be
Contact name: �� L 10 A. • L ■`f licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: j4- Gj ‘171e... I.L.3 (�q, isae. 1. jurisdiction in which work is being performed. If the
City /State /ZIP: 1J 0 'T 4 3 33
applicant is exempt from licensing, the following reasons
apply:
Phone: (3 p) (,(OCO (01 C I Fax:: (3. 3 0) 40'&40 b 334
E -mail:
CONTRACTOR . ....10
O B A.- L.,e,6 r(e A ,
Business name:co c T o d . , GO K sk ei ,ed t ht., 5c [t t�1/jcie s • BUILDING PERMIT FEES*
• Address: O$ C % J -T L
Please refer to fee schedule.
City /State /ZIP: co e altzt:Aft, D e q142,4 Fees due upon application
Phone: (54() 1 c O c 5 I Fax: ( )
CCB lic.:
1 Amount received
' 1
Date received:
Authori.ed s•._nature%
/ This permit application expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print nam '-' a .. t�1q Q LEA . la , / _ .( Date: .9 � C5 • Fee methodology set by Tri- County Building Industry
[ ` Service Board.
i \ Building \Pcmiits\BUP- TI- PermitApp doc 12/03 440- 4613T(11 /02/COM/WEB)
Building Division
Plan Submittal Requirement Matrix
EJI Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
, Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(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 is 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 \ Buildmg\Permrts\BUP- 71- PermiWpp doc 12/03 440- 4613T(I I /02/COM/WEB)
1,
CIT:;;iOF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (50.3)'639 -4171 Ap,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 69
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK: .
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE'OF USE:
PROJECT NAME: WI-IITEHOUSE BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.639 -8865
• CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 10/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
245 Firewall 017203 -01 253 - 709-7055 N
Corrections /Comments /Instructions:
laff (04
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: Phone #: (503) 718-
.4 •
CITY ,OF TIGARD ..':.
BUILDING DIVISION PERMIT #: BUP2005`00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 „alit _
1
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 67
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
. SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WI-IITEHOUSE BLACK MARKET .
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 10/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 017203 -03 253 - 709-7055 N
Corrections /Comments /Instructions:
Ai f / /
. r 1 7..strIIP Ifrimr
- (
S"\eiptit( V fi OCR
iial • 1 kg / is
& e
swr”
•
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONA EES ASSESSED .
Inspector: I V Date: #: (503) 718-
CITX. OF TIGARD
•
BUILDINt DIVISION PERMIT #: BUP2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/200;
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: - 68
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 1013/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 017203 -02 253-709-7055 N
Corrections /Comments/ Instructions:
•
•
s!
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL OR INSPECTION ❑ ADDITIO AL EES ASSESSED
° •
Inspector: , Date: Phone #: (503) 718 -
•
CIT. , TI
�OF GA RD.,
BUILDING DIVISION PERMIT #: BUP2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 60
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, • PHONE #: 503 - 6338865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 54 767 -0605
Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing • 01772301 253 - 7037055 N
Corrections /Comments/ Instructions:
•
„ 4111.1
•
V ter - • /
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITION L FE S ASSESSED
1111 A
Inspector: WAWA Date: 1 (503) 718-
CITY..O.F TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2005
Phone: (503) 639-4171 it
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/1/2005 TIME: 7:06AM PAGE: 22
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
•
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 11/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 020007 -01 253- 709.7055 N
Corrections/Comments/Instructions: .
a • �.. ■
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION • ❑ ADDITI NAL FEES ASSESSED
Inspector: 4,` Date: j C 6 #: (503) 718-
CITY' Q.F TIGARD
BUILDING DIVISION PERMIT #: BUP2005- 0040$
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639 -4171 4 1411t Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 72
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE.BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 1114/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 020327 -01 253 -709 -7055 N
Corrections /Comments /Instructions:
elQ6-Extv
L9geD ECc Zws -- oo 60(
'_ Nov (D M ''_ y 1'LL`o4 APB -kvw LC)1 INS
m° taw
( ScES
❑ - PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1
Inspector: Date (I
✓ Phone #: 503
p � ) 718 -
_CITN.20 TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00408
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 Atilt
INSPECTION WORKSHEET FOR DATE: 11/812005 TIME: 7:00AM PAGE: • 9
SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WHITEHOUSE BLACK MARKET
DESCRIPTION: TI, walls.(2,800 sq ft area)
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503. 639.8865
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541- 767 -0605
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 020618-01 253 - 709 -7055 N
Corrections/Comments/Instructions:
(Th f•N
(K ,
•
,•
AS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F R INSPECTION ❑ ADDITIO AL F ? Phone ES ASSESSED Alt
,4 Inspector: 1 �/ 718-
sp ctor: D ate: #: (503) 718