Permit tit
CITY OF TI GARD BUILDING PERMIT
Pik PERMIT #: BUP2005 -00115
6.j-1-1 13125 SERVICES DATE ISSUED: 4/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: TI: Walls partitions, bath and corridor wall contium.
•
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 86 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: $ 250,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC ELDER JONES INC
BY THE MACERICH COMPANY 1120 E 80TH ST #211
9585 SW WASHINGTON SQUARE RD • BLOOMINGTON, MN 55420
TOP' 0 503 g ?8865
Phone: 952 - 854 -2854
FEES Reg #: LIC 64459
Description Date Amount REQUIRED ITEMS. AND REPORTS
[BUPPLN] Pln Rv 4/21/2005 $864.05
[FLS] FLS Pln Rv 4/21/2005 $531.72
[BUILD] Permit Fee 4/21/2005 $1,329.30
[TAX] 8% State Surcharp 4/21/2005 $106.34
Total $2,831.41
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. 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 - 344.
Issued By: � / /f, ,� , % � Permittee Signature:
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 Aapi ` IVED roil orrlct: I si.: ()NI.,
City of Tigard mReceived : , Permit No.. „ - z 1S
13125 SW Hall Blvd., Tigard, OR 97223 PAR 2 r , 20E5
Phone: 503.639.4171 Fax: 503.598.1960 J /u „, `'c; I �\ Date/By: Other Permit:
Inspection Line: 503.639.4175 '� �� Date Ready/By: kris ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD - ” Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
X 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.
� { Valuation: $
❑ 1- and 2- family dwelling J°1r Commercial industrial
❑ 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: ! S , 1 v , 4 / /)(, row r see pd New dwelling area: square feet
77
City/State/ZIP: (, ,. �( 0/2 9-77Z-3 `, Garage/carport area: square feet
Suite/bldgJ�t . . C e Nc ST Project name: /3e� /3 r / GC e/ a /Pr.. Covered porch area: square feet
Cross street/directions to job site: \ � , /G.S A.) / „ Try) 6&0c,.0 1-12 /J Deck area: square feet
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.
OJ
Tti7G') i /Pew ,o-.eM e-i i : `-e./7' / T/ on I Valuation: $ Z5'0,o
t- e,./ . 17G eel/ 1 1, e %IC' i // C 4 / 7-/I'� Cw Existing building area: 7c/ square feet
,J /o/y) (7 t ., ,(57-0 / /7 / )h e i New building area: ay' 7 Li square feet
❑ PROPERTY OWNER NANT Number of s3ories: I
Name: / Pi i 3 / /G/G e c ∎NiC l c -' Type of construction: ill Address: / - 2 0 la 0A 79 0 5 Occupancy groups: 1I ili
City/State/ZIP: 3Se4,-7 /t» \ 5 j a/(/ n
Z
Phone: Ki Z 39 C9 g `j / Fax: O(.�1 qt./ 8 7 Y J New:
%APPLICANT lirCONTACT PERSON NOTICE
Business name: 7 </ /) y1 (6/701p " Cn) All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
G�� I t< L 1 e J IC I 1 under ORS 701 and may be required to be licensed in the
Address: ` (+ jurisdiction in which work is being (�' � U� / D � j g lerformed. If the
City/ State/ZIP: o /e N A f 8/99 applicant is exempt from licensing, dip fpllowing reasons
apply: ! f fIC .�J • ,3
Phone: (La 6 2.4./ 9 7 3S' Fax: Z ) 2153 a 1 '/6, / (eq. 0
E -mail: C, R/ I( KL. IIJk f M . cof`mil 5? ,72-
r CONTRACTOR to LQ , 3
Business name. ` • 'beg— ij_ BUILDING PERMIT FEES*
Address: j iv7 Please refer to fee schedule
City/ State/ZIP: Le 0 -77 - y-A_ i t&i
Fees due upon application
Phone: (03 ) 9 5a _E(.5.--,t51 I Fax: ( )
Amount received
CCB lic.:
Date received: •,
Authorized si This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print nam Date: 34q /O j — • Fee methodology set by Tri -County Building Industry
_1,' Service Board.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00115
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/21/2005
Phone: (503) 639 -4171 . 4 1 '41 illt •
Inspection Requests (24 Hrs.): (503) 639-4175
WORKSHEET FOR DATE: 9/9/2005 TIME: 7:07AM PAGE: 85
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H=4 -'5) ,CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE L L-OT #: TYPE OF USE:
PROJECT NAME: BEN-BRIDGE-JEWELERS
• DESCRIPTION: --- '�- -- " -�' -- -`
TI -Walls partitions bath and corridor wall contium.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.,639.0065
CONTRACTOR: ELDER JONES INC PHONE #: 952.054 -2054
Inspection Request Scheduled For: bate: 9/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 015232-01 612445-5719 Y ;
Corrections/Comments/Instructions: rv \
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MERNION Mir
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
-❑ FAIL ❑ CALL FOrl INSPECTION ❑ ADDITIO AL EES ASSESSED . .
inspector: �1 Date: v C 5 Phone #: (503) 718—