Permit L, it
CITY OF TIGARD PERMIT
PERMIT #: BUP2003 -00106 SSUED: 4/30/03
mil DEVELOPMENT SERVICES DATE I
6 II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09491 SW WASHINGTON SQUARE RD A -4 PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 3,075 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 3,075 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 90 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: 1 IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 184,500.00
Remarks: Tenant improvement
Owner: Contractor:
PPR WASHINGTON SQUARE LLC HARDESTY + ASSOCIATES
BY THE MACERICH COMPANY 1991 VILLAGE PARK WAY
9585 SW WASHINGTON SQ. RD. SUITE 180
PORTLAND, OR 97223 ENCINITAS, CA 92024
Phone:
Phone: 619- 944 -0499
Reg #: LIC 97362
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUPPLN] Pln Rv 3/7/03 $699.27 Gyp Board lnsp
[FLS] FLS Pln Rv 3/7/03 $430.32 S Ceilng I
Structural w welddinin
g final repr
[TAX] 8% State Tax 4/30/03 $86.06 Final Inspection
[BUILD] Permit Fee 4/30/03 $1,075.80 .
Total $2,291.45
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 By: 7 e
Peg it a ` /4 ! �Jf�
Si nature: r /��
1 Call 639 -4175 by 7 p.m. for an inspection the next business day
q 91 .rte. wos /(c sa g ,p
Building Permit Application OFFICE USE ONLY
Date received: , G Q Permit no.: � C/ he, /e*
'"1r111 {= City of Tigard
"=--• Project/appl. no.: date:
Address: 13125 S A ` �1 ,, E "' 7223
City of Tigard
Phone: (503) 639 - 1 Dat issued: By:!! ' �tecei t no.:
` e .--t P
Fax: (503) 598 -1960 2003 Case file no.: Payment type:
Land use approval: MAR 0 1 &2 family: Simple Complex:
• TIGAI(D 5
'TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration /replacement ,-, Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: I 94/9 , ' ti/n0. a A-0 - . , 4 Bldg. no.: Suite no.: A -D
Lot: I Block: Subdivision: 'Tax map /tax lot/account no.: Q
�
Project name: Zl f M l E Z ( - i ll., ' - ro (Z W
Description and location of work on premises /special conditions: wneUc2. (L JOV A11011) OF 3 S f "F
Wrikii. C PACE IN LLAOW& - To it.-ET 260/K 57Zzig- 2m tRE5S IIS& Rixtrk S SiS &14-.
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 'ZV M 1 t 2. )114C- q0 13EC-1� FiLtEs EN) (Floodplain, septic cap solar, etc.)
Mailing address: 420 f f-(.t 5-ma -I 5 W SV as A 1 & 2 family dwelling:
City: State: (,J a ZIP: £ & 03 Valuation of work $
Phone ay 551- 1500'Fax• 4z,S�S,s'1- IyqiiE- mail:bec J ZtA lC2_ of bedrooms/baths
Owner's representative: 47 Q (0 (k,U(Z,Qf!`l' Total number of floors
Phone: 4 . , 1~ 1 ' ; S 1'7Maiilillt E -maild • E ' • + yiQgt o
a (sq. ft.)
APPLICANT Garage / carport area (sq. ft.)
Name: 'DA -yip P11.07. wuvc -w vetav Ps Covered porch area (sq. ft.)
Mailing address:210 1 N1NTS- ' V. #2-1,\ Dcck area (sq. ft.)
City: S -R-iz I State: Q I ZIP: 4 8' 172„1 Other structure area (sq. ft.)
Phone ?a 1 • , $• Fax: 3 ma E -mail: dr. � L ommercial /industrial/multi- family:
CONTRACTOR Valuation of work $ I8% SAD
Business name: .r , �, ; , , i - - - C • " e W ��s� Existing bldg. area (sq. ft.) 3 07 S cyrits
Address a.1 Qj 13,u 1�►� bS n 4 6 10
New bldg. area (sq. ft.)
0
City: t ate: ZIP: 1 Number of stories
Y art `t ri E. I ° I �- 6 a ` Type of construction III - Kf
Phone x b-- re, I).l , I Fax: I E -mail:
CCB no.: CC 7 Occupancy group(s): Existing: M
l7 New: M
City /metro lie, no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: DPctu10 MATRPF} L 1 ) DA-l//0 nwQQt.}•{ 2fc1{.. revisions of ORS 701 and may be required to be licensed in the
Address:210 1 NI N'ro_ Ave.. * 2-i jurisdiction Where work is being performed. If the applicant is
City: 5• 4-irL. I State:(JA I ZIP: Tel iiz-I exempt from licensing, the following reason applies:
Contact person: yAtOp 1V111( Plan no.: an„ wrp o
Phone: i .r , 3 1 —• , + Fax:34 I'll E-mail:..-, .,, vast ► tom
ENGINEER OFFICE USE ONLY
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP: Amount received $
Phone: I Fax: E -mail: Please refer to fee schedule.
I hereby certify I have re. , • examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All p ,� • '• i :. aw /and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied � . � •ecified herein or not. Credit card number: / /
/ / / / /� 1 Expires
Authorized signature: �,
VW / Date: 3 ) o 3 Name of cardholder as shown on credit card
Print name: � r ` M V R-P 111 Cardholder signature S Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been a � a l
accepted as ete. ,440 -4613 (6/00 /COM)