Permit (r \
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00599
i ; � DEVELOPMENT SERVICES DATE ISSUED: 10/2/03
- I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09616 SW WASHINGTON SQUARE RD G -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: 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: 25 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: U SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 80,000.00
Remarks: TI New wal and entry.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC BARTEL CONTRACTING INC
BY THE MACERICH COMPANY PO BOX 1445
9585 SW WASHINGTON SQ. RD. OREGON CITY, OR 97045
PORTLAND, OR 97223
Phone:
Phone: 650 -4084
Reg #: LIC 79970
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 10/2/03 $634.90 Framing Insp
TAX 8% State Tax 10/2/03 $50.79 Gyp Board Insp
[TAX] Finallnspection
[BUPPLN] Pln Rv 10/2/03 $412.69
[FLS] FLS Pln Rv 10/2/03 $253.96
Total $1,352.34
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: A i; ,/ � A /
Pe rm ittee �
Signature: �ir.7A1 %.0.
3 75 by 7 p.m. for an inspection the next business day
FOR OFFICE USE ONLY
Building Perm •- ����_ > r I
t Received Building
•
J Date /By: �j /3 Permit No E,03 -Ot�S7
City of Tigard `� 2�� Planning Appr val Other
�(' Q Date /By Permit No.
13125 SW Hall Blvd. v , . Plan Review Other
Tigard, Oregon 97223 Q f j ' , a Date /By /D -L - 033D Permit No
Phone: 503- 639 -4171 Fax: 50 If • ''' (" � Post - Review Land Use
Internet: www.ci.tigard.or.us -` I Date /By Case No
Inspection Request: 503- 639 -4175
Contact runs Su See Page l for
24 -hour Ins
P 9 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
❑ i & 2- Family dwelling igCotnmercial/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: q(, � b S . w . ii ASII.1 / N bToA) SO. Total number area floors ............... ......
Suite #: Bld /A t. #: New dwelling area (sq. ft.)
g p Garage /carport area (sq ft.)
Project Name: SOPA €...1 /N to S i L■l CIL Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.) ... . .
Other structure area (sq. ft) ...
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.
. (0o ' SC) /ET. TE,. Nwr 1 wt?aov EIM6 p r
Valuation ............. $ 430,00a
Existing building area (sq. ft.)
New building area (sq. ft.)... ..
Number of stories
❑ PROPER Y OWNER 1 ❑ TENANT Type of construction V#-)
Name: r
Q.,C �/� Occupancy group(s): Existing: I'V\
1
New: 1ex
Address: 4S $ 5 bt,� LCt . `r3Q ,
City/State/Zip . l t after 02 R 79-x--3
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: 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:
E -mail: BUILDING PERMIT FEES*
CONTRACTOR Please refer to fee schedule.
Business Name: 1 a Cotv -r( G? I/s I 1 N G Fees due upon application $
Address: I 3S £, 4€woft D ST
City /State /Zip: GL.AOSioflE O2 crl0`Z? Amount received $
Phone: 533 . 6,S'D . 4084 Fax: I 503. 4c d • 41 4 Date received
CCB Lic. #: 9 g 7 0
Authorized
Signature: �,•. t� --'� . / Notice: This permit application expires if a permit is not obtained within
g � Date: I D 2 / 6 j 180 days after it has been accepted as complete. •
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i. \Dsts\Permit Forms\BldgPermitApp.doc 01/03
Plan Submittal Requirement Matrix
■ t,j. �•� � Commercial & Multi- Family
City of Tigard New, Additions or Alterations
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. \Bwlding \Forms \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 6 175
INSPECTION DIVISION . Business Line: (50 - 171 MST
�
j BUP 3 - eoSS?
Received Date Requested / 1 - AM / PM BUP
Location c 7 Co 160 l d ff • 56 Suite - ` MEC
Contact. Person Ph ( ) I / PLM
Contractor Ph ( ) • SWR
BUILDING Tenant/Owner = - . ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain _
Slab Inspection Notes: 6 .6 4 4_ 1 7, K . SIT
Post & Beam �/� •
Shear Anchors / ) ( A Y`-
Ext Sheath/Shear ( '
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: _
0 7-1 ' . PART FAIL
MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer 1 , I d 1 5 4\1\
Rain Drains r
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 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Date , Inspector
v
Approach/Sidewalk Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
o —