Permit 1TY OF T I G i4 R D PERMIT #: BUP2003 -00174
,L �l�,� DEVELOPMENT SERVICES DATE ISSUED: 4/15/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107
SITE ADDRESS: 09426 SW WASHINGTON SQUARE RD K -4
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 9 BASEMENT: sf AREA SEP. RATED:
STOR: 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: # oZ S, 000
Remarks: Tenant improvement
Owner: - Contractor:
PPR WASHINGTON SQUARE LLC SCHMIDT CONSTRUCTION INC
BY THE MACERICH COMPANY 5520 S CORKERY RD
9585 SW WASHINGTON SQ. RD. SPOKANE, WA 99223
PORTLAND, OR 97223
Phone:
Phone: 509 - 456 -2074
Reg #: LIC 149970
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 4/15/03 $358.30 Plumbing Permit Required
rm
TAX 8 S tate Tax 4/15/03 $ 28.66 Framing Insp
[TAX] - Gyp Board Insp
[BUPPLN] Pln Rv 4/15/03 $232.90 Final Inspection
[FLS] FLS Pln Rv 4/15/03 $143.32
Total $763.18
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 -669,9 or 1- 800 - 332 -2344.
. Issue y: ;= daliaL 0 d_„„;,_
Pennittee `-*�
Signature: i m
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building- Permit Application' . d , / FOR OFFICE USE ONLY
R eceive, _/ Building Q,((_
Date /By: ", / 0 -3 Permit No.: �P3 OD C ?�
• City of Tigard Planning Approval Other
y g Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 �"''�a "dtj�l'`� Post - Review Land Use
Internet: www.ci.tigard.or.us IL -' Date/By: Case No. Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: •
❑ New construction ❑ Demolition I & 2 FAMILY DWELLING
Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
111 1 & 2- Family dwelling Commercial/Industrial 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 I FORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: ( Total number of floors
a.)/ , ck t� , New dwelling area (sq. ft.)
Suite #: Z,/ l Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: &hi t!o - rJ PrN A rio rd A' i Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
�/RS I,, "c TO(✓ Sc vrar.e nnal
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: 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.
0
Valuation $ e, Obo
Existing building area (sq. ft.) (6 00 5 j FT'
New building area (sq. ft.)
Number of stories I
❑ PROP R OWNER I ❑ TENANT Type of construction Ti I r p
Name: . f _ (� • 'ti)�, Occupancy group(s): Existing:
New:
Address: ctsg6 t.3 L�0- -. .
City /State /Zips ( 3 i2) C2 97a
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: 4V v VD X r errAT(e r✓4 I jurisdiction where work is being performed. If the applicant is exempt
Contact Name: et A-e from licensing, the following reason applies:
Address: i t Coen c3 v, ,4-
City /State /Zip: 17Ac " 1( C A— • , u cc} 4
Phone: c,D3 -c, 5� -33cl s Fax: 5 .>S -8 0- (,)(4
BUILDING PERMIT FEES*
E -mail: C t h(1 Ge 1 r-e TTP c n n / • C o r"1 Please refer to fee schedule.
CONTRACTOR
Business Name: C14 M fbr L0 )4 71&ftCT(jle due upon application $
Address: 55 - a Co LV LY
City /State /Zip: ?c)14-NA*:)€. Lo _ 4G 9-'�3 Amount received $
Phone: 5o9 - (15()- ( 94,7V I Fax: Date received:
CCB Lic. #: (q- CiQ'70
Authorized , Notice: This permit application expires if a permit is not obtained within
Signature: , p Date: ��� S 180 days after it has been accepted as complete.
!}� �ji P I Ne7f l *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03
Commercial Plan Submittal
•�,L 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 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:\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 ; :t
BUP 3 06 / 74 1
Received 2& Date Requested ^ 1. 7 AM PM BUP
//
Location "/_ / � 'I� Suite e Li MEC
Contact Person Di Ph (_40___) 4 99 ilL5 Llli� oo 2 -c - 1
Contractor Ph ( ) SWR
UILD Tenant/Owner ELC
ooting ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation • j/ ' 7 5
Drywall Nailing
Firewall P — .2_ C7 Z-3
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot - r:
744g,
i PART FAIL
BING
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: 0 Unable to inspect – no access
Fire Supply Line /
ADA C I �`"I U
Approach/Sidewalk Date Inspector ( Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL