Permit i
BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00554
�r� DEVELOPMENT SERVICES DATE ISSUED: 12/6/2004
" s�''� .,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 '
SITE ADDRESS: 10230 SW WASHINGTON SQUARE RD C -12 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 10 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: $ 16,500.00
Remarks: DEMO SHEETROCK WALL COVERING
Owner: Contractor:
WASHINGTON SQUARE LLC CPS CONSTRUCTION INC
BY THE MACERICH COMPANY 12454 SW 114TH TERRACE
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD OR 97223
one
Phone: 503 - 579 -0148
Reg #: LIC 102248
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUPPLN] Pin Rv 11/24/2004 $134.23 Final Inspection
[FLS] FLS Pin Rv 11/24/2004 $82.60
[BUILD] Permit Fee 12/6/2004 $6.19 •
[TAX] 8% State Surchaq 12/6/2004 $16.52
(additional fees not listed here)
Total $223.02
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
952-00 1 . • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin (503) 246-669 or 14/0-332-2- • .
i
Issu By: ! ll '
Permittee
iiiiingOr
Signature: .,,,'����
all 639 -4175 by p.m. for an inspection the next business day
•
Building Permit Appl' EIVED FOR OFFICE USE ONLY
_ 'i' ly ��
City of Tigard Daced Permit No G4� j 4 131 SW Hall Blvd , Tigard, OR 97223 Plan Review ��� //
Phone- 503 639 4171 Fax 503 598 1960 NOV 4 200 '�I Date/By. Other Permit.
Inspection Line 503 639 4175 r _ Date Ready/By: Jura El See Attached Checklist for
Internet: www.ci.tigard.or.us CI 1 T Y OF TI Notified/Method. -1 Supplemental Information
BUILDING DIVISION
TYPE .OB WORK , - , _ _ . 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
N'Addition /alteratton/replacement El Other: equipment, matenals, labor, overhead, and the .rofit for the
. - - CATEGORY OF CONSTRUCTION ' . • work indicated on this application.
❑ 1- and 2- family dwelling (�Commercial/industrial
Valuation S
El Accessory building ❑ Multi - family Number of bedrooms.
❑ Master builder ❑ Other: Number of bathrooms
• .- JOB SITE INFORMATION , AND - AND LOCAT N - r — -`• - ;. Total number of :ors:
Job site address /623 0 at.) 14.084 ^ New dwellin: :rea: square feet
City/ State/ZIP: r , Garage/c. .ort area: square feet
Suite/bldg. /apt. no.: - Project name: Cove d porch area: square feet
Cross street/directions to job site: D- area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL- USECHECKLIST-,
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. ...--p
..r
I /
Valuation: $ /6
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER - - I . , 44 TENANT Number of stones:
Name: d esh, f / ,,,y�� Type of construction:
Address: iZS CalLop ,..t 6 / .p 66 Occupancy groups:
City /State/ZIP: Si. Lm�- / KEW bar Existing:
Phone: (3 r ti) ?61—_. SS Fax. ( ) New:
❑ -APPLICANT ' - ❑ CONTACT PERSON , _ NOTICE • S
Business name: CPS e 9/au t-- ..`jy L- All contractors and subcontractors are required to be
Contact name: ��� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: /B 2 ...r- � 6i� ( � r) jurisdiction in which work is being performed. If the
City/State/ZIP:
applicant is exempt from licensing, the following reasons
apply:
Phone: (3) 320 - 0 7 /� I g //�� I Fax: : (.Sa3) S 0 — owd
E -mail. re-01%)b P. L @ £C.1-& / k-f-
_ -. CONTRACTOR .
Business name: C ?s £ 7 ,
t "'- BUILDING PERMIT FEES* .
Address:
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application , / !
Y-7
Phone: ( ) Fax: ( )
Z 'Z�i 8 (� Amount received
CCB lic.: /0
/ I J jf �� 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: �0 ce" l t / 1/ , J Date. //^ 2. y oi * Fee methodology set by Tri- County Building Industry
i /
Service Board
1.\ Building \Permits \BUP- PermaApp doe 12/03 440- 4613T(I I /02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION. DIVISION Business .Line: (503) 639 -4171 MST
BUP 20/ `k -
Received �j� Date Requested f Z AM PM BUP
Location / 07 3 0 e L{* SO ley Suite MEC
Contact Person Ph (_672_,) 2-D 9'5' I PLM
Co tracto Ph ) SWR
Tenant/Owner .) ' I A ELC
Foundation ELC
Ft Drain
Access: ' /
Crawl Drain bo,r R- C /Y
Q. ELR
Slab Inspection Notes: SIT
Post & Beam _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation trak-SINNOAIIMUNI411 /11"7 Drywall Nailing �,
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Otr.
i'�_ RT FAIL
j �',T� G __ I
Post & Beam
Under Slab Emiii14_11111111,/
-'�_
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 fl Reinspection fee of $ required befor: next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call f. reins. ' ction RE: I Unable to inspect - no access
Fire Supply Line ��%7
ADA ./
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL