Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00358
al
A DEVELOPMENT SERVICES DATE ISSUED: 8/21/02
, .� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09755 SW WASHINGTON SQUARE RD 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: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 50 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:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR:, PARKING:
VALUE: $ 50,000.00
Remarks: Tenant improvement, interior walls & soffits.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC BUSH DECOR & FIXTURE INC
P.O.BOX 21545 4421 W 8200 S
SEATTLE, WA 98111 WEST JORDAN, UT 84088
Phone: 503 - 521 -1396 Phone: 1 -801- 280 -0424
Reg #: LIC 143353
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PRMT CTR 8/21/02 $470.80 27200200000 Framing Insp
Gyp Board Insp
5PCT CTR 8/21/02 $37.66 27200200000 Susp Ceilng Insp
PLCK CTR 8/21/02 $306.02 27200200000 Final Inspection
FIRE CTR 8/21/02 $188.32 27200200000
Total $1,002.80
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Perm ittee -
Sign7ture• ----'\ 6 i r
lest} d By: _ (7,
Call 639 -4175 by 7 p.m. for an inspection the next business day
r
Building Permit Application : OFFICE USE ONLY
A City of Tigard Date received: B�m Permit no.:A/P_,, _,
A City of Tigard
Project/appl. no.:
• City f Address: 13125 SW Hall Blvd, Tigard, OR 97223
Ci of Tigard Phone: (503) 639 -4171 Date issued: 4'J Receipt no.
Fax: (503) 598 -1960 Case file no : Payment type.
Land use approval: I &2 family: Simple Complex:
• TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement lit Tenant improvement O Fire sprinkler /alarm O Other:
JOB SITE INFORMATION
9 'KS J s . a r ' • C .r W Rs n 01) N 364044 i4Eril Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name:T rn f •
Description and location of work on premises /special conditions: 1414 it 1Q.1'1 + (nit prnre rn Cm* N ct IrShN 4
' • ....i . d vi,Inc€ WI . 1Crio( finish c , e• ,' . ..,_.t„,, ONs.
OWNER - FOR SPECIAI. INFORMATION, ION, USE CHECKLIST
' . V ,,± , ( Floodplain ,septiccapacity,solar,
Mailing address: I • q NE 74 .+- 1 & 2 family dwelling:
Elar - , a M State:y 1 ZIP: geo,2. Valuation of work $
Phone: 424.8 . '1 • , : • ;: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: • gl, a Covered porch area (sq. ft.)
Mailing address: Zif, $• 6 - $T. Deck area (sq. ft.)
�lI � ZIP: V*76Z Other structure area (sq. ft.)
Phone:312, , Ziff iiiEt•rZll E -mail: Commercial industrial /multi- family:
CONTRACTOR ..;'• ; Valuation of work $ g CC)
A
Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.)
Address: - • Z, k • : O.
Number of stories
EINPFMIL / State:Ur* ZIP: ; • , ; 5
Type of construction
Phone ; ei • • v , ,, ;,; Occupancy group(s): Existing:
CCB no.: • 4
New:
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
..t RCI I ITECT /DESICNER . licensed with the Oregon Construction Contractors Board under
Name: ;` • provisions of ORS 701 and may be required to be licensed in the
Address: '2. s • 5 _ sr. jurisdiction where work is being performed. If the applicant is
ZIP: ; 70 exempt from licensing, the following reason applies:
Contact person: " , V,' Ian no.:
Phone: • .t}t9.40 1 ranZnalr
ENGINEER OFFICE USE ONLY
A Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have r- • , and examined this application and the Not all jurisdictions accept credit cards, please call junsdtctton for more information.
attached checklist. . isions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be . plies . , t whet, a pe.•fied he or nod, " Credit card number. / /
�' Expires
Authorized signa iii./..,_ / Date: / "L Name of cardholder as shown on credit card
Print name: JQ r t, Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00 /COM)
CITY OF TIGARD 24 -Hour
• BUtLDING Inspection Line: (503) 639 - 4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 ST
BUP - �� 3_5
Received Date Requested 7/ AM PM BUP
Location 70 Suite MEC
Contact Person 1- 121) - 117 Ph ( PLM
Contractor Ph ( ) 7 SWR
BUILDING Tenant/Owner 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
Oth - • I,. _.S414
141211
frASS) PART FAIL
PLUMBING
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 before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 9
Inspector `� ` C
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour -
- BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 ST
a oa.3.
Received Date Requested ( /1 AM PM BUP
Location l 7 cS I i) it • S Q • (g_D' Suite MEC
Contact Person jQj� Ph (__) S"S PLM
Contractor Ph ( .
) SWR
7°
BUILDING Tenant/Owner / �/ ® 6. L. ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ( FL"
Framing
Insulation UGG P C 5q• ��., (,/('
- _ 1
Drywall Nailing ` ! [y
Firewall 1 ° C e > � v 3 7 0 C £ � �+er5 N
Fire Sprinkler � �� v
Fire Alarm �f� �
� -, � : 449
Susp'd Ceiling , " " �
Roof PG.
Other:
= V‘ 1)
a pap FAIL
• IMB •
Post & Beam 7 ,
Under Slab
Rough -In -7 et C__ - F
Water Service (�C�C� ` �v
Sanitary Sewer ' . F414
Rain Drains • •
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL __ 60 7' ) / XC 2 -ce- 2. X
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line J v(2. , 2
ADA I I ( s
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OFTIGARD 24 -Hour
•
BUILDING Inspection Line: (503) 639 -4175 T
- ► MST
INSPECTION DIVISION Business Line: (503) 639 -4171
• BUP ��
- 0 - 0
_
Received Date Requested AM PM BUP
Location 7s n, KO, Suite MEC
Contact Person • 841 � ' Ph ( / ) SS 8 - S 3 9 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain •
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall 691/
Fire Sprinkler
Fire Alarm
Roof
Other:
Fi
, 2354 PART FAIL
PLUMBING
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 b :fore ne • spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for rei pection RE: .a Unable to inspect — no access
Fire Supply Line
71, -
ADA _
Approach/Sidewalk Date / Inspector �� Ext
Other:
Final 0 NOT REMOVE this Insp lo record from the job site.
PASS PART FAIL
CIT:' OF TIGARD 24 -Hour
BUILDING' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
�/� BUP — D - D ,„5
Received Date Re nested AM PM BUP
Location 9 7 Suite MEC
Contact Person Ph ( ) go /--5$ ? PLM
Contractor Ph ( 7 SWR
BUILDING Tenant/Owner 7 I' l -6--6-Le. ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
- Ext Sheath/Shear
Int Sheath/Shear
am ni
Dry wa ll Nailing a- .�
Drywall Ole •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi
ASS RT FAIL
NG
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 L Reinspection fee of $ required bef• : • -c ' • . Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for inspection RE: da D Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 41 e-- Inspector NW Ext
Other: r
Final DO NOT REMOVE this ins 1 +++" "" on - cord from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: (503) 639 -4175
MST
INSPECTION DiVISrON Business Line: (503) 639 -4171 ` " • _ 3�
BUP
Received Date Requested
AM PM BUP
Location - • D Suite MEC
Contact Person Ph ( ) _ O I - 5 PLM
Contractor Ph ( ) 6 7 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
rami
Insulation
a aii
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
; PART FAIL
PLUMBING
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 before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
1BUILDING Inspection Line: (503) 639 -4175 4.
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Cro a
Wi 3s8`
Received Date Requested AM PM C aZ — CC .36 0
Location I - 7 s3 14J S D, Suite MEC
Contact Person /3aJ1. . Ph ( ) S 1 'S 5S ' PLM �
Contr nr Ph ( ) S 3 7 7 SWR /F
DI Tenant/Owner T 1 ELC
oudg ELC
Foundation Access: t(-0
Ftg Drain ELR
Crawl Drain F�eZaova - 00 VII a, qa (, /17 22O -ae3 7a
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 7 NEW • 2 O _ OZ — �r
Framing (kY)
Insulation / ") /O Z_
Drywall Nailing �"�l/
Firewall
Fire Sprinkler •
Fire Alarm I 0 j— 0 Z — O C f �� S , ,�
Susp'd Ceiling 1( `�
Roof p
Othe
y- e EFATP b
j 6 — O037 PL BING • ► ' U�
Post & Beam a S5 / q/C V 2'
Under Slab
Rough -In
Water Service
Sanitary Sewer ,. . - 2 _ f C) Z — Oo 3 - vV�
�w S
Rain Drains -
Catch Basin / Manhole � Z
S • ' /106. ' C v
Storm Drain J F)
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 before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA 1
Approach/Sidewalk Date _( Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL