Permit a CITY OF TIGARD BUILDING PERMIT
PERMIT #:
'''•"
COMMUNITY DEVELOPMENT DATES ISSUED: 6/26 2008
N'
T I G A R D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09755 SW WASHINGTON SQUARE RD D03 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: T MOBILE
Project Description: TI.
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: 49 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 75,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC BUSH DECOR & FIXTURE INC
BY THE MACERICH COMPANY 4431 W 8200 SOUTH SOUTH
9585 SW WASHINGTON SQUARE RD WEST JORDAN, UT 84088
TIGARD, OR 97223
Phone: Contact #: PRI 1- 801 - 280 -0424
Reg #: LIC 143353 4 ' •
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/26/2008 $282.85
[TAX] 12% State Surch 6/26/2008 $33.94
[BUPPLN] Pln Rv 6/26/2008 $183.85
[FLS] FLS PIn Rv 6/26/2008 $113.14
Total $613.78
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 - 4 01 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332. 344.
Issued B .i� t1 ��: Permittee Signature: i . I
/// y -
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.
Building Permit Application
Commercial �� FOR OFFICE USE ONLY
City of Tigard CO � Date/B 6 R eserved /
,► Permit No.:
° 13125 SW Hall Blvd., Tigard, �
i p Plan Rev�ey . i
��111 Phone: 503.639.4171 Fax:60 % 1. Other Permit:
T I G n R D Inspection Line: 503.639.4175 \ \N 14 iO Date Ready /By. loos VI Page 2 for
Internet: www.tigard- or.gov a �\(� � ` 0 � Notified/Method. No' Supplemental Information
0R
TYPE OF ,, �NGO ` REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction \ ► molition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
12),dditio alteratio replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling X Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Ci - svj I.iS - I N GTE tl SQ (AWE I) New dwelling area: square feet
City /State /ZIP: --t t GA.- 0 I O� . C� aa. Garage /carport area: square feet
Suite/bldg. /apt. no.: 0 _ 3 Project name: T_ (n J 6 , ck Covered porch area: square feet
Cross street/directions to job site: w iN S I _i,^. Sq 0 A1' u� NA. Deck area: square feet
Se �
� it _7 CO ( 1.- - / G Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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
`� � DESCRIPTI G O � N OF WORK wo ' dicated on this application.
i� i"t ` �\ f" n 1 a i� 1 F 1 c Air ra rA aluation: $ / WO a U
' tog building area: square feet
New building area: square IZ OWNER k ❑ TENANT Number of stories: I
Name: t t t fC C� I C k (c d- [ -�/lf(1 , f .IG� The of construction: a 6
Address: i I I A, - ---t p L� Q / Occupancy groups:
City /State /ZIP: 1.k er..1 )C A L . TO 2-R Existing:
Phone: (62) OS 3 s t -7 < 7 Fax: ( ) New:
❑ APPLICANT CONTACT PERSON NOTICE
Business name: ' 1 - - ( ' - Q , I (,ZZ F (� AI L - U ` p e� All contractors and subcontractors are required to be
Contact name: TcS ( j d L � ` licensed with the Oregon Construction Contractors Board
1'"' I under ORS 701 and may be required to be licensed in the
Address: I I f V ' 'v'l ASI-F t f.1 CT --) Sr . a jurisdiction in which work is being performed. If the
City /State /ZIP: CWI CA- ' I (_ _ / 'Z.__ applicant is exempt from licensing, the following reasons
y� / b 0 (�i 6 apply:
I Y
Phone: (n) 'L(pe - -7 a o f c) Fax: : �/ 2 ) 4,,--) _-? / , S
E -mail: /
- r OP r CONTRACTOR , ,
Business name: /5 cote r/ - 4 . vll 2.'r. BUILDING PERMIT FEES*
Address: (Please refer to fee schedule)
� ' Structural plan review fee (or deposit): _ [ 3 — / / n City /State /ZIP: �/ ?/y `./„�, , kr SOCr2r Phone: (f ) 13(
r/// i([/ Fax: ( )
CCB lie. � 7 oa FLS plan review fee (if applicable): (( 3 � � -
VV'"' �l N Total fees due upon application: 1
Amount received:
Authorized signa ; : n , t
I `J v This permit application expires if a permit is not obtained
j r` ��/ o' /& Da 7 ^(y within 180 days after it has been accepted as complete.
Print name:
/ ( r ze., (y * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Burlding\Permits \BIJP -COM PermitApp.doc 2/23/07 440- 4613T(11/02/COM/WEB)