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Permit
CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00585 i DEVELOPMENT SERVICES DATE ISSUED: 11/10/2005 '� I ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD Y04 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Install prefabricated kiosk.(10x15) REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: /9Yf 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: 2 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: $ 70,000.00 Owner: Contractor: WASHINGTON SQUARE LLC SUMMIT CONSTRUCTION BY THE MACERICH COMPANY PO BOX 10345 9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97210 TIM?' C R 503 8865 Phone: 503 - 223 -9703 FEES Reg #: LIC 63249 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 11/10/200f. $580.20 [TAX] 8% State Surchan 11/10/200; $46.42 [FLS] FLS Pln Rv 11/10/200: $232.08 Total $858.70 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 -6699 or 1-800- 332 -2344. Issued By: rLt Permittee Signature w � � 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. OCT-25-2005 TUE 11 16 AM Bishop fix ure FAX NO. 7154853316 P. 03/03 • X55 ' Sg yo ' • Buildin>? Permit Application— „ City of Tigard EN�u E � t Received pi p.. wo /) 13125 SW Hall Blvd., Tigard, 9114 flan Rrclen ILIs/ iKlxr l'ernut Phone: 300 3.639.4171 71 F ax: ax: 30303 .598.1960 � "• 0,411, � Uate Y.c l c 1 � Inspection Line: 503.639.4175 (}� �� '_. _., h .c a te Rcad ' m n. V 63 See Attached Checklist for w Internet: ww.Ci.tigard.oLUS Notified/Method/ ' I f � . y ' Supplemental Information FTIGARD f.. el� ll ti,.h- c.-c4. 0Nr'e• C. -W. / e 6 . 01@e\10IiK REQUIRED DATA: 1- AND 2- F.A111ILI' DWELLING ❑ New construction � '�— ❑ Demolition Permit tees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ® Other: 1 :C111 -M ¶ . O S %L equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling © Commercial/industrial Valuation: S ❑ Accessory building 1:1 Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: ej 5 3 5 S W Via t W. n 9.vb Q ,' Q R New dwelling area: square feet City/State/ZIP: T; (7 a ft. D O (Z 91 a , 3 Garage/carport area: square feet Suite /bldg. /apt. Ito.: yer7 Project name I VP ri'1Ct1 V-i BAIL_ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet AS \I N (, lb n l l.Ci re, 010J\ Other structure area: square feet REQUIRED DATA: C'Ol1IAIERCL1L -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 DESCRRIPTION OF WORK work indicated on this application. S. i 0— rJ I12.- 00 n1 C C43 el-- Valuation: ' l 0 �. $ VQ C In. 61% W i r4.Ao s K...) oS Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER I RI TENANT Number of stories: Name: V vi Lon V4 1 (le \tS S Type of construction: 1t= IS . V--■ Ci S ft•- Address: Occupancy groups: L A (2- 2 city/State/ZIP: VVV���+++ Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT 5 CONTACT PERSON NOTICE Business name: 131,0, P r i X F P s All contractors and subcontractors are required to be Contact name: SA LLy G 00 S s € t1 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: ,. ` .. It 0 % EAGLE 1) RCN e.., jurisdiction in which work is being performed. If the City /State/ZIP: 13 i S A rf1 L e- W I 54 81 O applicant is exempt from licensing, the following reasons Phone: (11 5 ) s 5 °13 ' (1 I S.) y SC S 33 b . a �� Fax: :( E-mail: Sc .1 \ 5 `� 61 Alpe� x r e$ . Co '0 CONTRACTOR Business name. ' •5 U AN w- 'T CO 1-.1S T ILL2. -r ea..( BUILDING PERMIT FEES* Address:. r ` P6 . ( "�Tc (03 r - I S' ~ ' Please refer to fee schedule. City/State/ZIP: O e- fL t 9,--t 4 J tT /L 4 '7 25 16 - Phone: ( 5(j, 2.2 3 -9 7o - 3 Fax: (' 3 1'4 — Tj S 4I — Fees due upon application CCB lic.: , >Z4 +,� Amount received . ...----.) Date received: Authorized signature: - . t'1 _ This permit application expires If a permit is not obtained I within 180 days after it has been accepted as complete. Print nazi Dat. • Fee methodolo set Tri -C ount Buildin Indu Service Board iA/luild ngWembt uBUP- PamitAPP.doe 12/03 440-4617T(11 /O2/COAUWEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: W6 -- _ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 �� 5-045 35. Requests (24 Hrs.): (503) 639 -4175 ..4— INSPECTION WORKSHEET FOR DATE: ( 1 7 ( ' cs — TIME: PAGE: SITE ADDRESS: -i S8s Su.) ( , CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: £ (1i&Sr K1ci — OWNER: PHONE #: TED CONTRACTOR: PHONE #: &V? 34_ Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 247 C Corrections /Comments / Instructions: &Ee k 12 ( ,-.,„ p\Frer- Ped PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 Phone #: (503) 718-