Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2009 -00135
T t G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2009
Parcel: 151260000300
Jurisdiction: TIGARD
Site address: 9659 SW WASHINGTON SQUARE RD M06
Subdivision: Lot: 0
Project: Spencer Gifts
Project Description: Interior TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, Permit Fee - COM 09/01/2009 $655.30
2235 FARADAY AVE STE #0 Plan Review 07/20/2009 $425.95
PHONE Plan Review - Fire Life Safety 09/01/2009 $262.12
12% State Surcharge - Building 09/01/2009 $78.64
Contractor: Metro Const. Excise Tax - Commercial 09/01/2009 $137 64
HORIZON RETAIL CONSTRUCTION Use
1458 HORIZON BLVD
RACINE, WI 53406
PHONE' 262 - 638 -6008
FAX 262 -638 -6015
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $114,700
Floor Areas:
Total Area 0
Accessory Struct 0
Basement' 0
Carport. 0
Covered Porch 0
Deck. 0
Garage: 0
Mezzanine 0
Total $1,559 65
Required: Required Items and Reports (Conditions)
Fire Sprinkler. Yes Parapet
Fire Alarm Yes Protected Corridors: Yes
Smoke Detectors. No Manual Pull Stations
Accessible Parking. 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and at other applicable law All work wit
be clop = • - • •ce with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
• - 's ATTENTION. Ore• • • law re• .ires •u to follow the rules adopted by the Oregon Utility Notification Center Those rules are set f•rth in OAR
952- 001 -0010 through OAR -001-11' You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 66 ;J= 1 800 332 2344
Issued By: . i �� � ; / L Permittee Signature: _■
Call 503.639.4175 by 7:00 a.m. for an inspection that bu - 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.
Gt 1,0#.6A
Building Permit Application
R ECE Co mmercial I� FOR OFFICE USE ONLY
City of Tigard JUL 16 2009 Received C
. Date/B 4 Permit No Bu e2 o
, /S I
11111
° 13125 SW W Hall Blvd , Tigard, OR 97223 Plan Review r ��, l J �7� 1
Phone 503 639.4171 Fax. 503 598 1960 Date /B E I/ Other Permit
CITY OF TIGARD �wilr. .i1
Inspection Line: 503 639.4175 Date Ready "� ® See Page 2 for
TIGARD Internet: www tigard-or.gov BUILDING DIVISION Notified/Method` I� -� Supplemental Information
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement ® Other: int. bld out equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ID 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder ® Other: retail Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9659 SW Washington Square Road New dwelling area: square feet
City /State /ZIP: Portland, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: M06 Project name: Spencer Gifts Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Hwy. 217 /Greenburg, Hall and Scholls Ferry Exits Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Interior build -out of existing retail space in an existing mall Valuation: $$114,700.00
Existing building area: 2361 square feet
New building area: square feet
❑ PROPERTY OWNER C TENANT Number of stories: I
Name: Reecca Fletcher Type of construction: I I B
Address: 6826 Black Horse Pike Occupancy groups:
City /State /ZIP: Egg Harbor Township, NJ 08234 Existing: M
Phone: (609)645 -5703 Fax: (609)645 -5636 New: M
❑ APPLICANT ® CONTACT PERSON
NOTICE
Business name: Spencer Gifts All contractors and subcontractors are required to be
Contact name: Rebecca Fletcher licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6826 Black Horse Pike jurisdiction in which work is being performed. If the
City /State /ZIP: Egg Harbor Township, NJ 08234 applicant is exempt from licensing, the following reasons
apply:
Phone: (609) 645 -5703 Fax: : (609) 645 -5636
E -mail: rbecca.fletcher@spencergifts.com
CONTRACTOR
Business name;--T-131:1 4-1rvr i - y Con r LIC T C)YI BUILDING PERMIT FEES*
Address:
(Please refer to fee schedule)
Structural plan review fee (or deposit):
City /State /ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax:( )
CCB lic.: V
Q 5 1 Total fees due upon application: 655.30
Amount received: 655.30
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tn -County Building Industry
Service Board
1 \Budding \Permits\BUP -COM PermitApp doc 2/23/07 440- 4613T(1 l /02 /COM/WEB)