Permit : w
4.A.1 I �
4,, CITY OF TIGARD PERMIT #: BUP2003 -00477
I� BUILDING PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 8/5/03
t--- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09493 SW WASHINGTON SQUARE RD A -3 PARCEL: 1S126C0 01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: Pia +'77 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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 59 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: $ 500.00
Remarks: Relocate (4) sprinkler heads.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQ. RD. TIGARD, OR 97223
PORTLAND, OR 97223
Phone:
Phone: 684 -2928
Reg #: MET 00004593
FEES LIC REQ�I INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 8/5/03 $62.50 Final Inspection
[TAX] 8% State Tax 8/5/03 $5.00
Total $67.50
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.
Issued B
Pe mi ittee
Signature: ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Bu if u Permit FOR OFFICE USE ONLY
_ Rec eive g� Building
Date/By. 5 " S Z 6 Permit No U Po2005 0D 9 /
City of Tigard Planning pproval Other �
5 2003 Plan Review PermitNo.•.l6(J�,�vU "5 - 00/ 85
13125 SW Hall Blvd. AUG O plan R Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 50f Q��GA" "'''"' itryli % t ' t. Post - Review Land Use
i . Date/By: Case No.
Internet: www.ci.tigard.or.us BUILDING DIVI _ _1 Contact Juns.: Z 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 -
E Addition/alteration/replacement ❑ Other:
' CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling 0 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 INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: q43Z SAO . ()Oast +. Sy 40 .. Total number of floors
f'[ New dwelling area (sq. ft)
Suite #: 1<- Z Bldg. /Apt. #: Garage/carport area (sq. ft.)
Project Name: 1A40-11,Aerl» oo i ki-etin i 1 Covered porch area (sq. ft.)
Cross street/Directions to job site: 1 Deck area (sq. ft.)
Other structure area (sq. ft.)
, ,, S i, . g:: REQUIRED. DATA:; a�.,= j='a , 'pf:, •:� .
=i' ' ig , '-TrtriQO( ; . t . , J $E'CHECKLIST XI', ''''-'.:
Subdivision:
Lot #: .. .- .-.- „,, :- . - iA ,,, ,+k B .1k..6.,- I
', - fv- :+Y'{l4.s - .,
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
_A : : DESCRIPTION OF WORK . ,' .. the value (rounded to the nearest dollar) of all equipment, materials, labor,
A overhead and profit for the work indicated on this application.
"� arpro 5 Valuation $ .5 —
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
, .❑a PROPERTY i: -:i= 0 TENANT , ',•'' A `' -f, : Type of construction
Name: pp 12, W ( -}In]( .,TO1F i LLC_ Occupancy group(s): Existing:
New:
Address: P. O, Goy, 2 3( 35”
City /State /Zip: f G A-t t'` cl - 7 . 127
Phone: Fes; NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
APPLICANT:. ❑CONTACT PERSON "-,•'-'-..;'
provisions of ORS 701 and may be required to be licensed in the
Business Name: F,/,____ CG�z-02 jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City/State /Zip:
Phone: Fax: ,,.,.. � xti * � �.,:.�_,. ��,,.,�: � �r:� •. :ta..
E -mail: i .� r ;w,. i "..,: '�' t:
_ :`�•�� � �l ea �i e: c''C �'fee s�e i:' , t , ;, ' - ,� �Y _ y `
. _ . • CONTRACTOR .. , . . , �.=w • a ,.,. L4... „ ,.,�; • '.� 4_ . a .,:..,.14r} ,;_:�, ... ... _ .
Business Name: GJY� R R E {'0c7 i1 Fees due upon application $
Address: g D i c S. (A) . 12,U12N WVA
City/State /Zip: '11 (, pain 0 (Z Amount received $
Phone: bo,4 __2g79 Fax: 604 -7 6s Date received:
CCB Lic. #: 64o`1
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: . �� /.L Date: g /s103 180 days after it has been accepted as complete.
R( Gl (is,;(2.0 go-1-(2___. - *Fee methodology set by Tri- County Building Industry Service Board.
(Please pnnt name)
is \ Dsts\Permit Forms\BldgPermitApp.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 .
INSPECTION DIVISION - Business Line: (503) 639 -4171 MST -
BUP 3
..� c r
Received Date Requested o �a �° AM PM BUP 3' 60 Y
Location 9 / G, A)/ 1 -S c • GZ p Suite 4 -3 EC 3 - d� e / 4 / CD
Contact Person Ph ( ) ?- f3,c5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain ae03— o0 y77
Slab Inspectio Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
i
PART FAIL
PL 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: El Unable to.inspect — no access
Fire Supply Line
ADA a ? /�
Approach/Sidewalk Date F / ! Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL