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Permit
`CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00481 ZVI DEVELOPMENT SERVICES DATE ISSUED: 10/5/2004 °- .,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09800 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01108 SUBDIVISION: 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: 3N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 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: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 12,200.00 Remarks: Demo wall for new tenant. Owner: Contractor: SEARS ROEBUCK AND CO BLODGETT CONSTRUCTION ASSOC IN DEPT 768TAX, B2 -116A 4075 MALGA ALCOA HWY 3333 BEVERLY RD MALGA, WA 98828 HOFFM AN ESTATES, IL 60179 on Phone: 509 - 663 -9800 Reg #: LIC 122898 FEES REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required [BUILD] Permit Fee 10/5/2004 $168.10 Framing Insp [TAX] 8% State Surcharl 10/5/2004 $13.45 Final Inspection [FLS] FLS Pin Rv 10/5/2004 $67.24 Total $248.79 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 952-0 9-thrlzugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by c ng (503) 246 -66" or 1- 800 - 3344. Issued By: i , .. .,ie / Pe • cc Signature: A �j--■■ Call 639 -4175 by 7 p.m. for an inspection the next business day O Buildin g�P�'Ifllt A lication FOR OFFICE USE ONLY � City of Tigard Received ed /19©41 , � � �� ' DD `/ +6 ,/�� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review " , �"�� Phone: 503.639.4171 Fax: 503.598.1960 ��K ir� w4 A Date/Ey. y USv S -� Other Permit: Inspection Line: 503.639.4175 f� i I Date Ready/By: Tans ® See Attached Checklist for Internet: www.ci.tigard.or us Notified/Method. Supplemental Information k N D c9oo -Dndi • . _ - TYPE OF WORK • • - . REQUIRED DAT 1- AP[D•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: T/- equipment, materials, labor, overhead, and the profit for the .. - - CATEGORY 'OF CONSTRUCTION work indicated on this application. Valuation $ ❑ 1- and 2- family dwellingmmercial/industrial ❑ 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: f 0 sw ` bri yh New dfil New dwelling area: square feet City/ State/ZIP: A s r / J Garage/carport area: square feet V de Suite/bldg. /apt. no.: (/ Project name: %vi S Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL- USE,CHECKLJST ' 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 - ' _ DESCRIPTION OF WORK_ • work indicated on this application. /I Valuation: $ /4 '�p�j9�ca'.�t �(/1✓[ 3L.P •, . .Q-rL Existing building area: • square feet New building area: square feet ' - ❑', PROPERTY• OWNEER� e l� / . '. I ' ❑ TENANT Number of stones: � a A s /C , Name: c�k,_ E .. r,a Type of construction: .. A) Address: 9 goo S 41 10A3 4 ,, 7 /a,k, S 9 Xri, Occupancy groups: City/ State/ZIP: ! ` 0 x ne_ Existing: Phone: ( ) ` Fax: ( ) New: '_ , ❑ APPLICANT . ❑' CONTACT PERSON ' . NOTICE Business name: 73 e ec flsTueTe t, ,Iss- i!'_tCt Tec . All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: 7 � ./j .1> re eve under ORS 701 and may be required to be licensed in the Address: 4/0 5 44 4 , xieo� iiw jurisdiction in which work is being performed. If the City/ State/ZIP: . may/ / /9 applicant is exempt from licensing, the following reasons / / /'Cj / i ¢ J "my4 .�. lemi .78 apply: Phone: (569) : 06;3 _ F 0 ) E -mail: • • - • a _ . - - r CONTRACTOR '. - Business name: • S4._)"^ 43 ., i � n �� . - BUILDING 'PERMIT FEES* Address: Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) Fax ( ) CCB lic.: Amount received Date received: `'...—.. Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. `Print name: t 2z 1 ;,1 P,• Date: jo . U �, f * Fee methodology set by Tri- County Building Industry / Service Board. I \Buildmg\Perrnits\BUP- PennnApp doc 12/03 440- 4613T(I1 /02/COM/WEB) Building Division '' "� . Plan Submittal Requirement Matrix ■ �.� -- Commercial & Multi- Family - New, Additions or Alterations City of Tigard Type of Submittal # of Plans (Includes new, additions and alterations.) Required at Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (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 \COM- PlanSubReq.doc 12/24/03 CITY OF TIGARD 24 -Hour WILDING Inspection Line: (503) 639 -4175 INSPECTION-DIVISION Business Line: (503) 639 - 4171 MST BUP 000 oocal Received Date Requested 1? "� AM PM BUP c v f'T Location 9 K'6 - SE) Suite MEC Contact Person �? Ph ( Si)? ) C I-- O l a L PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation 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 Ro of Ar/10 ' ilinrK PART FAIL r ' : ING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains 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 bef•re next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call or reins • ection RE: 0 Unable to inspect – no access Fire Supply Line ADA � � Approach/Sidewalk Date Inspector Ext Other: Final ' O N I T REMOVE this Inspection record from the Job site. PASS PART FAIL •