Permit a CITY OF TIGARD BUILDING PERMIT
' - a . COMMUNITY DEVELOPMENT Permit #: BUP2009 -00045
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/17/2009
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 953_0 SW WASHINGTON SQUARE RD H10
Subdivision: Lot: 0
Project: Apple Store
Project Description: TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, Permit Fee - COM 03/17/2009 $606.70
2235 FARADAY AVE STE #0 Tax - 12% State Surcharge 03/17/2009 $72.80
PHONE' Plan Review 03/17/2009 $394.36
Plan Review - Fire Life Safety 03/17/2009 $242.68
Contractor: Metro Const. Excise Tax - Commercial 03/17/2009 $120.00
DICKINSON CAMERON CONSTRUCTION CO INC Use
5861 EDISON PL
CARLSBAD, CA 92008
PHONE• 760- 438 -9114
FAX: (760)438 -9149
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 1 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $100,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,436.54
Required: Required Items and Reports (Conditions)
Fire Sprinkler. Yes Parapet:
Fire Alarm: Yes Protected Corridors Yes
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is 'ssued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work
will b one in actor e with - : • roved plans. This permit will expire rf work is not started within 180 days of issuance, or if work is suspended for more
th 80 days ATTENTION: f. rego law - ' uires you to follow the rules adopted by the Oregon Utility Notification Center Th. rules are set forth in AR
2- 001 -0010 through 0' 2-001-0 r r You may obtain a py of the rules or direct questions to OUNC by calling 503 2..699 or 1 800 332
ssued By: Permittee Signature:
1 4"--
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.
... Bwilding Permit Application
Commercial FOR OFFICE USE ONLY .
,... 11 RE0 R eceived _� Clty Of Tlgard Date/B Permit No i: Vr
° 13125 SW Hall Blvd , Tigard, OR 9722M 17 2009 Plan Review EVIWIBI M
° , Phone: 503 639.4171 Fax. 503.598.1960 Date/B /AWL Other Permit
TIGARD
Inspection Line. 503 639 CITY O1= TIGARD Date Ready /By Runs ® See Page 2 for
Internet' www.tigard - gov Notified/Method Supplemental Information
BUILDING DIVISION
. TYPE OF WORK REQUIRED DATA: 1= AND 2- FAMILY DWELLING
El New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
dditio (alteratio eplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION ' work indicated on this application.
Valuation:
❑ 1- and 2- family dwelling K6ommercial /industrial $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: q 53,0 5 Vl( WAs Rio 67 P-a (1u 14- 14 New dwelling area: square feet
City /State /ZIP: T 6412.P G 0 R 9-7 2:2_, Garage /carport area: square feet
Suite/bldg. /apt. no.: �_ 10 ` Project name: A 'PL _ �11 R� No Imo. Covered porch area: square feet
Cross street/directions to job site: 1N IAASV i U-T-D so uP�R.E 4 Deck area: square feet,
5V4 E L I Aorx. LIB ' ,S I Ac c . -1 0 . Other structure area swap feet
11 ) REQUIRED DATA: COMMERCIAL -Uy CHECKLIST
Subdivision: WAS 14)1.1 6T '
o .i 5Q U,h2.E 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.
M U,\AD2- GG,, D I*l..- - TO r, 1S 6 A- STO gE. Valuation: $ / t� o .
R JL.AC.� .5A1.-g, FIX7 u1P .Si f-E OC'TE L C DU lLE Existing building area: e:13 5 s quare feet
gE1A1 .SI / f*g. CF go✓A5E . Ma C1-1/0-16E5 to CEILi1J6 ti11i1L1.S New building area: square feet
❑ PROPERTY' /1 OWNER X' TENANT OR L-16N P R• Number of stories: I
Name: APPLE tw ei r t , KJ C • Type of construction: � ) c pR 1 N S
Address: I I 14 F in o r Occupancy groups: M
City /State /ZIP: �,P�iZZ to , / C4 � 5 - p 7 14 Existing:
Phone: (4b) 974 • 3$ 2_2_, Fax: ( ' ,{ ND ) 97+. 7335 New:
- "APPLICANT . , CONTACT PERSON , NOTICE
Business name: f59 f TRaIK ( 1 2 ERM 1"` R‘,/1C_5._ All contractors and subcontractors are required to be
Contact name: G ER, Fo X licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 5 0 3 O V I GERD \ / AVE-- jurisdiction in which work is being performed. If the
11,, applicant is exempt from licensing, the following reasons
City /State/ZIP:
a 0..► RG f 'PS to 0 apply:
Phone: ( 95I ) 2. / ! . Dl/0 04 Fax: (95i ) 2 7 9 . 0 6) / q 7
E -mail: q 4 D X & pt.(' YY1 t f f (ST• CO Y\
J `' c , `t l CONTRACTOR •
`�,.
Business name: / PICf.� / I l GolA A MER.D�I C0 '` TR D M a, (1vt_, . BUILDING PERMIT FEES*
' (Please refer to fee schedule) •
Address: 5 3 G I El 0 pi_
Structural plan review fee (or deposit):
City /State /ZIP: CA. g si,A 9 20 0 8
Phone: (3 p) 43 • 9 11 4 / Fax: ( 7 t o) 4 -3 1 47
FLS plan review fee (if applicable):
CCB Ric.: I I -005 9// /0 Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit Is not obtained
within 180 days after it has been accepted as complete.
Print name: G ER I FD1( Date: 3 17 1 1 0?
* Fee methodology set by Tn -County Building Industry
Service Board.
I• \Bmlding\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(I I /02 /COM/WEB)
_- , <i
az
' PI . . Building Division
•
Over- The - Counter (OTC) Building Permit
TIGARD Check List
Description of Project:
GENERAL INFORMATION
Class of Work: *�� Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* C.4,7�(/1 First floor: N: S:
Type of Construction: Second floor: E: W:
Occupancy Group: (� Third floor: Openings Protected Y /N ?:
Occupancy Load:1 Total sq ft.: N: S:
Stories: _ ( Note: Combine total floor area for E: E:
Height: all floors above third floor and _Roof Construction:
_
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: 1 1 Handicap access: [ �� r
Smoke detector: Protected corridors: TK—
Fire alarm: lef Parking spaces ( #):
Notes:
Total Valuation: $ Io0 coo
INSPECTIONS _ FEES DUE
Footing /foundation Firewall $ ( jsj :70 Permit Fee
Post /beam structural Smoke detector $ 72.- ,63 State Surcharge
Shear wall Misc. inspection $ '7' , '3 Plan Review Fee
Masonry Approach /sidewalk $ FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinkler rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Metro Construction Excise Tax
Suspended ceiling Sprinkler final $ School Construction Excise Tax
Final inspection $ Misc. Fee
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Other:
$ 'I3 (c, i 54 Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
or canopies); REP = repair.
I \Building\ Forms \ OTC-BUP doc 08/19/08