Permit • (1% em. CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00034
411 DEVELOPMENT SERVICES DATE ISSUED: 2/3/04
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09693 SW WASHINGTON SQUARE RD C-9AB 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: 40 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:* 12 - 0 / 000
Remarks: TI, new walls and storefront.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC CHEROKEE GENERAL CORP
BY THE MACERICH COMPANY 255 DEPOT ST SUITE A
9585 SW WASHINGTON SQ. RD. FAIRVIEW, OR 97024
PORTLAND, OR 97223
Phone:
Phone: 503 - 661 -1113
Reg #: LIC 88339
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 2/3/04 $822.30 Electrical Permit Required
[TAX] 8% State Surcharl 2/3/04 $65.78 F Frr aming aming Permit Required
Insp
[BUPPLN] Pln Rv 2/3/04 $534.50 Gyp Board lnsp
[FLS] FLS Pin Rv 2/3/04 $328.92 Susp Ceilng lnsp
Total $1,751.50
Final Inspection
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 .i • . -.99 or 1- 800 - 332 -2344.
If
Issu By: I s l .,.... !' '
Permittee
Signature: x & 1 11/fr
Call 639 -4175 by 7 p.m. for an inspection the next business day
- Bu-iLd ng Perm Applicati R ece i ved ,iOR OFFICE USE ONLY
pry Building / j 2
Date/B : ' d !/ Permit No.: j i ��i J
City of Tigard Planning Ap. ova Other
Date /B : Permit No.:
-
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/B : 2 - � ' j Permit No
Phone: 503- 639 -4171 Fax: 503'-598 -1960 A,„, 1\ Post - Review Land Use
Internet: www.ci.tigard.or.us ^�^�^°� I I • Case No.
Contact
® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method //f„ . Su . lemental Information
TYPE OF WORK • • . - - " : . • REQUIRED DATA: . .
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
® Addition/alteration/replacement ❑ Other:
" • • 'CATEGORY OF CONSTRUCTION . . , . Note: Permit fees* are based on the total value of the work performed Indicate
El 1 & 2- Family dwelling ❑ Commercial/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
El Master Builder El Other: Valuation $_
JOB SITE-INFORMATION 'and LOCATION - No. of bedrooms: No. of baths:
Job site address: 103 51) 1.4Aspo4 T? N sq e Total number of floors
New dwelling area (sq. ft.)
Suite #: Coq d ow I Bldg. /Apt. #: Garage/carport area (sq. ft.)
Project Name: WA$14, SQ Nr1ALL — $ E MI L-1— Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
- REQUIRED DATA: ' -
COMMERCIAL - USE C HECKLIST
Subdivision: I Lot #: •
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
. .. ': :" ' `'_` . C ' j ‘ . ' ZDESCRIPTION OF WORK .• • . : the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
RENoJ r11ON 04a Otis-not .)o4H4soK E i rtuarfot S +OE
smite c 04 ro T014.600 541oP { =cXt.. 1 Valuation $ J 2.43 OGO .
Existing building area (sq. ft.)
5446 . 1"I1u.. 't'LI . 140 NT STbleE'r 114 teal o2 TE 14 M 41- New building area (sq. ft.)
lHM O ✓4= A' o41L( Number of stories
IN: PROPERTY.OWNER • I ID TENANT : , , Type of construction
Name: Occupancy group(s): Existing:
New:
Address:
City/State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
IR APPLICANT . _'': I" CONTACT: PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: G CSta Ar c4.1.1'fEC I i }40,312P0ektfa9jurisdiction where work is being performed. If the applicant is exempt
Contact Name: GO-,4 l c AJ►S
from licensing, the following reason applies:
Address: ii LO Ww' CfJC:kt sr- ) 5tlrlrc 300
City /State /Zip: 1RiCeTC.A wit, 02. 1 7'v0 1
Phone:so3 ZZf{-945z, I Fax: 244-C273
E-mail: q ' _ ` 1 - ,,�}� .• BUILDINGTERMIT FEES *" . w
s - _ - Please refer to•fee scheddle.• • : . _
_ . . - cJCONTRACTOR
Business Name: C_ e E 6ENE( tL. CO Q,, Fees due upon application $
Address: 2 i3s per- 'T. ASV rrE .-
City /State /Zip: ' 2V 1 c-c...) 6 4-. nj 7 oz g' Amount received $
Phone: ,$b3 461 -J J 13 I Fax :5 b3 uY - pdBS Date received:
CCB Lic. #: $ $ 337
Authorized ,
Notice: This permit application expires if a permit is not obtained within
Z
Signature: Date: 2..04 180 days after it has been accepted as complete.
CAA fa A NIS *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 -
,�, 1 1l Commercial & Multi- Family
City of Tigard New, Additions or Alterations
:'TYPE OF SUBMITTAL # of Plans
`•(Includes 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:\Building \Forms \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST //
BUP dDa 7"
J
Received Date Requested 3 - (y AM PM BUP
Location 7I y'3 1,0 - SO, Suite MEC 0 "d 00,5—T
Contact Person Ph ( ) S 7a-3531 PLM
Contractor Ph —y, () SWR
BUILDING Tenant/Owner 4-4 _ 2 0 1 , Q) ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: , SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof f f d , V /P 5 - 16N/1 E A T /
Other: _
Aiirk /N DI (;/47/A) lr �• D00k S 70 /2 /14/,v v N LO / LLD
PART FAIL
• BING 20141/ 06- 130 _5/ 4 E55 1/00/U 1)
Post & Beam
Under Slab
Rough -In 3
Water Service 0
Sanitary Sewer Ci I
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: v
• Final
PASS PART FAIL
MECHANICAL I!
Post & Beam 1 � j
Rough -In f ‘frP1
Gas Line O
0
e Dampers
40 0'ART FAIL
ICAL
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 El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line / A/ Lit
Approach/Sidewalk Date � � ' r D Inspector 6� kal L✓� Ext��ii
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL