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Permit CITY OF TIGARD BUILDING PERMIT 1111 ° COMMUNITY DEVELOPMENT Permit#: BUP2009 -00106 T I G AR O 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 06/10/2009 Parcel: 151260000300 Jurisdiction: TIGARD Site address: 9585 SW- WASHINGTON- SQUARE- RD -MGMT -OFF 9 Subdivision: Lot: 0 Project: Activate Cellular Project Description: Assemble and anchor kiosk. Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount BY THOMPSON PROPERTY TAX SERVUCES, Permit Fee - COM 06/10/2009 $344.34 2235 FARADAY AVE STE #0 12% State Surcharge - Building 06/10/2009 $41.32 PHONE: Plan Review 06/10/2009 $223 82 Plan Review - Fire Life Safety 06/10/2009 $137.74 Contractor: R & H CONSTRUCTION CO 1530 SW TAYLOR ST PORTLAND, OR 97205 -1819 PHONE 503 - 228 -7177 FAX: 503 - 224 -3638 Specifics: Type of Use: COM Class of Work: ALT Dwelling Units: 0 Stories: 1 Height: 0 ft Bedrooms: 0 Bathrooms: 0 Value: $45,451 Floor Areas: Total Area 0 Accessory Struct: 0 Basement: 0 Carport' 0 Covered Porch 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $747.22 Required: Required Items and Reports (Conditions) Fire Sprinkler: Yes Parapet: Fire Alarm: Protected Corridors. No Smoke Detectors: Manual Pull Stations Accessible Parking: 0 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 the 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 � 9522 --001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. � Issued By: * +6 \ ( �r/ 1 ` �(j u W Permittee Signature: 2, � \i C y 11 r Call , 5003.639.4175 by 7:00 a.m. for an Inspection that business day. '�� -�` (�1 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 R. l //� 1 0 1 Commercial FOR OFFICE USE ONLY Re City of Tigard (, . ©Q Re ceive d e ve _ , • • Permit No : , .. r_`q • 4e i ° 13125 SW H Blvd., Tigard, OR 97223 lb Plan Revt � ' �'� Phone 503.639.4171 Fax: 503 598.1960 Date/B "MUM +' Other Permit. TIGARD Inspection Line: 503 639.4175 Date Rea ty. Jura ® See Page 2 for Internet: www.tigard- or.gov Notified/Method: ke_ Supplemental information TYPE OF 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 g Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling Igt Commercial /industrial Valuation: S ❑ 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: ` r) C1},� I (J�6AytTONt lf1/4 � �j \ I New dwelling area: square feet City/State/ZIP: i�-\ N ? 0i 9 4 -a3 7 Garage/carport area: square feet Suite/bldg. /apt. no.: `J 3 Project name: >c . 1vtriL ( , , vi AR 14- Covered porch area: square feet Cross street/directions to job site: Deck area: square feet 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 DESCRIPTION OF WORK work indicated on this application. Valuation: S 45 4 51. `-'° A�>rM3;:� 1L,C)SY-- AND IAA/4 .l ti Lo2 , i Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER • 'TENANT Number of stories: Name: AC-C-S-..I4,-C E C L t, l tea Type of construction: Address: -l5 (-.) 5r) kJ Ttiv\` t1V.' -, Occupancy groups: City/State/ZIP: 1/C� F:?..,1 Of l . QS � Existing: Phone: (503) j 5 5 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: A �. 1 . W16 r CA LL vAV_ All contractors and subcontractors are required to be Contact name: '`! ANCy licensed with the Oregon Construction Contractors Board vvN �A - under ORS 701 and may be required to be licensed in the Address: -\ 0 a.J3 /jS..M -?,uS ksic jurisdiction in which work is being performed. If the .' City/State/ZIP: -- e, eav � .. ION , q�O applicant is exempt from licensing, the following reasons r,� �1 apply: • Phone: (9j3) - loci -. e SS 1 Fax.: ( ) E -mail: CONTRACTOR Business name: 2.Y K Co/o ".,..(..{.7N Co BUILDING PERMIT FEES* Address: SW "` A�,A� 6 (Please refer to fee schedule) Structural plan review fee (or deposit): Cit /State/ZIP: f,�"cLkto. G C\--+D..05 5 J -34 - 5r • .f'_ Fax: ( 5Q ) FLS plan review fee (if applicable): Phone: ( 53a3 -3 G3R CCB lie.: . 33 Di / Total fees due upon application. Amount received: Authorized signature: 4 lif • This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Punt name: s J ! �� Date: ( .5 . O * Fee methodology set by Tri- County Building industry I Service Board i \Building\Permits\BUP -COM Permit • .p.doc 2/23/07 440- 4613T(11/02/COM /WED)