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Permit CITY OF TIGARD DEVELOPMENT SERVICES BUILDING PERMIT PERMIT #: BUP2006 -00255 g J ,� DATE ISSUED: 7/31/2006 I - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: TI - wall, ceiling and storefront (1,457 sq ft area) 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: 2N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 47 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: y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : y HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE:0' / 5-g 000.00 Owner: Contractor: WASHINGTON SQUARE LLC IN LINE COMMERCIAL CONSTRUCTION , BY THE MACERICH COMPANY PO BOX 5837 9585 SW WASHINGTON SQUARE RD ALOHA, OR 97006 TIGARD, OR 97223 Phone: 503 - 639 -8865 Contact #: PRI 519 3970(CEL) PRI 642 - 5117 Reg #: LIC 51880 FEES Description Date ' Amount REQUIRED ITEMS AND REPORTS [TAX] 8% State Surcha 6/21/2006 $77.64 [BUPPLN] Pin Rv 6/21/2006 $630.83 [BUILD] Permit Fee 6/21/2006 $970.50 [FLS] FLS PIn Rv 6/21/2006 $388.20 Total $2,067.17 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: 0 / 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. y25/ sw Wad 1 p� ',i_ , . Building Permit em . 1:OI2 OFFICE USE ONLY Tigard R eceived of Ti g Ci ` —�11 City / _ �I Perrin! No f/L�/ �/ /�� `1 DateB i , 13125 SW Hall Blvd., Tigard, OR 97 1 4 20061 � 'al ' I Plan Review Phone: 503.639.4171 Fax 503.598.1960 �. f1i Date/B t �� Other Permit J s Inspection Line 503 639 4175 CITY OF TIGARD 0 Date Ready t, tip �� ® See Attached Checklist for Internet: www ci.tigard or us BUILDING DIVISI ra N Notified/Me" 3 (/Q f 1.1 ' ` � Supplemental Information s q e\<,-z- L"/ C.\c:3 8-o t•-- TYPE OF ORK REQUIRED DATA: 1- 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 ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ I- and 2- family dwelling Z Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ® Other: Tenant Improvement Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 9751 SW Washington Square Rd New dwelling area: square feet City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: #D -01 I Project name: Advanced Nutrition Covered porch area square feet Cross street/directions to job ste: 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. 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. Tenant Improvement - Washington Square Mall - 1,588 SF Valuation: $$158,000.00 Existing building arca: square feet New building area square feet 0 PROPERTY OWNER I ® TENANT Number of stories: I ,_ Name: Jim Foster Type of construction: Type II I 1 451 Address: 1116 Lancaster Dr NE Occupancy groups: City /State /ZIP: Salem, OR 97301 Existing. M L 9 Phone: (503)364 -9392 Fax: ( ) New: M 'l ❑ APPLICANT ® CONTACT PERSON NOTICE Business name: Arbuckle Costic Architects, Inc. All contractors and subcontractors are required to be Contact name: Clayton Vorse licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 363 State Street jurisdiction in which work is being performed. If the City/State/ZIP: Salem, OR 97301 applicant is exempt from licensing, the following reasons apply: (130.16 Phone: (503) 581 -4114 I Fax: : (503) 581 -3655 ri1,� 3,10"0 E -mail: cvorse @arbuclecostic.com 1LS g # r.14 0 cc v 1 CONTRACTOR 4 R- 9 0 t O Business name :Adding s \ \ 4-T e C c ,--, - 0 Y 1 j • BUILDING PERMIT FEES* Address: ? 0 T x T- s / Please refer to fee schedule. City /State /ZIP: A\ 0\..., 1 01,-. G 3 — 7 (c) Fees due upon application Phone:) ek" — 57 J 7 Fax: ( ) Amount received CCB lic.: Date received: Authorized signature: W"rie L ��,, �/J This permit application expires if a permit is not obtained 13 C� L/r"'o' -�Q * within 180 days after it has been accepted as complete. Print name Clayton Vorse Date Fee methodology set by Tri- County Building Industry Service Board I \Buildmg'Permos\BUP- PermitApp doc 12/03 440- 4613T(II /02 /COWWEB) CITY OF TIGARD BUILDING DIVISION a PERMI 200 oo��.� 13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 , m∎N.I J1 INSPECTION WORKSHEET FOR DATE: S Qty a / f„ TIME: PAGE: SITE ADDRESS: 01 7 5 1 t&) (S 1 54, CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ` Q DESCRIPTION: i""" V - tL' C. - 4.. N l44 L OWNER: • PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: If J Code # Inspection Description Confirm # Contact # Message C 1 6 1 lam p 6 1 p - v1/) Corrections/Comments/Instructions: ji • - y l ‘ . . . , . Ii 1 i \:1 . / :P ; ■ ' . u i , ' ., .., c 1 1/ °: i . • ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,.. 4 Inspector: ti Date: t �� T' Phone #: (503), 718- 2.Y2-4 CITY OF TIGARD .. '- - BUILDING DIVISION PERMIT #: BUP200& -00255 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 713I/ 06 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 s' ��I J . ■ INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7 : 02AM PAGE: 7 SITE ADDRESS: 09761 SW WASHINGTON SQUARE RD D1 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: ADVANCED NUTRITION DESCRIPTION: TI - wall, ceiling and storefront (1,457 sq ft area) OWNER: WASHINGTON SQUARE LLC, PHONE #: 5O3.639 -8865 CONTRACTOR. IN LINE COMMERCIAL CONSTRUCTION PHONE #: 518- 3970(CEL) Inspection Request Scheduled For: Date: 10/11/2006 Pour Time: (�/ • • Code # Inspection Description Confirm # Contact # M- •.age 299 Final inspection 038032 -01 5a -0577 Y Correctio /Co en /Instructions: nifA ' ' "V‘ 51 A ELC Zo ©4 _ ® - ®66. 0 C 'S - � L ) lace. ?tea - 00 2-‘1 is L --i-- ) i c /k 1/4 4 HIV'' 5c.' L° - f� A . W41 , --i 5 k - - '' ( .Y0.-- 5 ,S . v �- Ce -rt e ��o - N r 1 I/ 1 1 • ❑ A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \ZL ‘/_ Date: / © / `t! Phone #: (503) 718- �� ri CITY,=bF BUILDING DIVISION PERMIT #: BUP2006 -00255 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/31/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 .. 41111tV I.. INSPECTION WORKSHEET FOR DATE: 101212006 TIME: 7 :03AIVt PAGE: 14 SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: ADVANCED NUTRITION DESCRIPTION: TI - wall, ceiling and storefront (1,457 sq ft area) OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865 CONTRACTOR: IN LINE COMMERCIAL CONSTRUCTION PHONE #: 519-3970(CEL) _ Inspection Request Scheduled For: Date: /0/2/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 037501 -02 503 - 572 -0577 N Corrections /Comments /Instructions: 'ZOO - 66 - J e Ri T � ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL Fs.' INSPECTION ❑ ADDITIONAL FEES ASSESSED .,1 Inspector: ∎I Date: Phone #: (503) 718 - �� CITY-OF TIGARD • BUILDING DIVISION PERMIT #: BUP2006 -00255 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006 Phone: (503) 639 -4171 4 r 1;l Inspection Requests (24 Hrs.): (503) 639 -4175 s' °:_.. ' INSPECTION WORKSHEET FOR DATE: 9/26f2006 TIME: 7 :06AM PAGE: 2 SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: ADVANCED NUTRITION DESCRIPTION: TI - wall, ceiling and storefront (1,457 sq ft area) OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8855 CONTRACTOR: IN LINE COMMERCIAL CONSTRUCTION PHONE #: 519.3970(CEL) Inspection Request Scheduled For: Date: 9/26/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 287 Suspended ceiling 037175 -03 503-572-0577 N Corrections /Comments /Instructions: /11) 1 111UMN a r ( (- � PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL . ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A If Inspector: Date: q 0 Phone #: (503) 718 CITY -OF TIGARD '_ • :r' BUILDING DIVISION PERMIT #: BUP2006.00255 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/310006 Phone: (503) 639 -4171 �a�gptr�rri�� Inspection Requests (24 Hrs.): (503) 639 -4175 ,,..r it INSPECTION WORKSHEET FOR DATE: 8/31/2006 TIME: 7:00AM PAGE: 47 SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: ADVANCED NUTRITION DESCRIPTION: TI - wall, ceiling and storefront (1,457 sq ft area) OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.639 -8865 CONTRACTOR: IN LINE COMMERCIAL CONSTRUCTION PHONE #: 519- 3970(CEL ) • Inspection Request Scheduled For: Date: 8/31/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 285 Drywall nailing 035868.01 503.572 -0577 N Corrections /Comments /Instructions: ki 1' Z: A itd, Pee -Ls'. Wl moo (e - 0040S CUB J' - . 751vCv Zaa (2 —0 C ry 6 C 1 G l . C _) . ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL, ❑ CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED Inspector: Date: W� ‘7 f. Phone #: (503) 718- - ne 2. _y ! — .- . CIS 4OF ..TIGARD BUILDING DIVISION PERMIT #: BUP200E�00266 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006 Phone: (503) 639 - 4171 . 1 I e. Inspection Requests (24 Hrs.): (503) 639 -4175 ,_ &.. "� L. INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7:00AM PAGE: 56 SITE ADDRESS: 09751 SW WASHINGTON SQUARE RD D1 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: ADVANCED NUTRITION DESCRIPTION: TI - wall, ceiling and storefront (1,457 sq ft area) OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865 CONTRACTOR: IN LINE COMMERCIAL CONSTRUCTION PHONE #: 619-3070(CEI-) Inspection Request Scheduled For: Date: 8/21:12006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 035614 -01 5503 -572 -0577 N Corrections /Comments /Instructions: . A U. - )c? TlaftcrEitottxri /A :44 i L 0r - ' . 4/IIIP Air ' li ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED )\ Inspector: rlk� t Date: 6 2 ilo - Phone #: (503) 718 - 0Q-7--.