Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00586
JI� DEVELOP SERVICES
-639 -4171 CES DATE ISSUED: 11/14/2005
Hall
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD Y01 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Install prefabricated kiosk (10x10)
REISSUE: _. FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: A (I l 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: 1 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: $ 40,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC RICHARDS REMODELING LLC
BY THE MACERICH COMPANY 291 VALLEY RIVER CENTER
9585 SW WASHINGTON SQUARE RD EUGENE, OR 97401
Phone: °I:0§7019 5
Phone: 541 - 345 -3836
FEES Reg #: LIC 30422
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/2/2005 $395.80
[TAX] 8% State Surchar1 11/2/2005 $31.66
[BUPPLN] Pln Rv 11/2/2005 $257.27
Total $684.73
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 -246 •.: • 9 o 1- 800 -332 -2 , 4. /fj�
_ "c7
Issued By: w , , :�_J�� P ermittee Signature: ,�,
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.
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Building Permit Mtne Er FOR OFFICE USE ONLY
City of Tigard A Date/B I i ri OS Ltd Permit No.: 0 p is- 0058
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev l
Phone: 503.639.4171 Fax: 503.598e ' 26 2005 .4 I Date/B , Other Permit:
Inspection Line: 503.639.4175 e I I Date Rel : y: �' ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: / "Q al / Supplemental Information
. O IIGA
• � _ _ � 1 :x V . 100 t •
B ���' , : �'�ORK� 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
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
12 1- and 2- family dwelling ® 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: 9585 J tC,f//,,Jc rp,.) Rte, Yol New dwelling area: square feet
City /State/ZIP: Tigard/WA/97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Y -01 I Project name: Qwest Solutions Center - Kiosk Covered porch area: square feet
Cross street/directions to job site: Washington Square Mall (State Hwy 217 & S.W. Sholls Deck area: square feet
Ferry Rd
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $$40,000.00
Assemble 10'x10' commercial kiosk at the Washington Square Mall.
Existing building area: 0 square feet
I Located between Cheesecake Factory & Meier & Frank, space Y -01.
New building area: 100 square feet
❑ PROPERTY OWNER I ® TENANT Number of stories:
Name: Qwest Communications Type of construction: Kiosk
Address: 9585 SW Washington Square Road, Space #Y -01 Occupancy groups:
City /State/ZIP: Tigard/OR/97223 Existing: 0
Phone: (303)896 -5773 or 303 - 896 -9761 Fax: (303)295 -5031 New: 5
0 APPLICANT 0 CONTACT PERSON NOTICE
Business name: Qwest Communications All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Fran Mount or Spencer Martin under ORS 701 and may be required to be licensed in the
Address: 1801 California, Floor 44 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: Denver /CO/80202 apply:
Phone: (303) 896 -5773 or 303 - 896 -9761 I Fax: : (303) 295 -5031
E -mail: francies.mount @gwest.com or spencer.martin @gwest.com
CONTRACTOR
Business name: Richard's Remodeling BUILDING PERMIT FEES*
Address: 291 Valley River Center Please refer to fee schedule.
City / State/ZIP: Eugene/OR/97401 Fees due upon application
Phone: (541) 345 -3836 Fax: (541) 345 -3685
Amount received
CCB Iic.: 30422 ( (1113/00 t-----, Date received:
Authorized signat� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Francies L Mount Date: 10/25/05 * Fee methodology set by Tri County Building Industry
Service Board.
i:\ Building \Permits \BUP- PcrmitApp.duc 12/03 440- 4613T(I I /n2/COM/WEB)
t
CITY OF TIGARD 1:1===•
BUILDING DIVISION PERMIT #:c-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 IL
INSPECTION WORKSHEET FOR DATE: �/� az TIME: PAGE:
SITE ADDRESS: q564.73- sui (0A- `' R CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: Q (li ESr
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
E3 F C—. OZq Z Z l -
Corrections /Comments / Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL i ❑ CALL FOR INSPECTION ❑ ADDIT NAL FEES ASSESSED
Inspector: AV Date: O Phone #: (503) 718?
IIP
CITY
BUILDING DIVISION PERMIT #: BUP2005 -00586
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005
Phone: (503) 639 -4171 A doo,
Inspection Requests (24 Hrs.): (503) 639 -4175 " 'I I�
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 73
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD -- CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CTJ VE TS
DESCRIPTION: m all —2 prefabricated kiosk (10x10)
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503-639-8865
CONTRACTOR: RICHARDS REMODELING LLC PHONE #: 541- 345 -3836
Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
899 MFG - Structure final 021407 -01 503-358-6886 N
Corrections/Comments/Instructions:
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•
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NV IF
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED COW -...
Inspector: Date: ( 11 0' Phone #: (503) 718-