Permit y 11 CITY OF TIGARD BUILDING PERMIT
a COMMUNITY DEVELOPMENT Permit #: BUP2012 -00268
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/15/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD Y05
Project: Doc Popcorn Kiosk Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Reassemble 12' x 12' prefabricated kiosk which includes one popcorn popper and 3 self contained sinks
Contractor: PARADIGM CONSTRUCTION LLC Owner: PPR WASHINGTON SQUARE LLC
10260 SW GREENBURG RD SUITE 400 PO BOX 847
PORTLAND, OR 97223 CARLSBAD, CA 92018
PHONE: 503 - 452 -6922 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIB Permit Fee - Additions, Alterations, 01/15/2013 $377.90
Demolition
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Building 01/15/2013 $45.35
Dwelling Units: 0 Plan Review 01/15/2013 $245.64
Stories: 1 Height: 0 ft Plan Review - Fire Life Safety 01/15/2013 $151.16
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm $0.50 (up to 01/15/2013 $5.00
Value: $20,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $825.05
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
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 l w. All work will
be do accordanc- . ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for ore the 180
day ATTENTION: Oregon aw - ..uires you to follow the rules adopted by the Oregon Utility Notification Center. Thos rules are -et f.rth in OAR
9 - 001 -0010 through OAR 95 . 1 1 -009b ' •u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1'.:7 or 1.800.3E2.2344
sued By: �/ �� Permittee Signa
• r •
\ / Call 503.639.4175 by 7:00 a.m. for the next available inspection date. I
This permit card shall be kept in a conspicuous place on the job site until completion of e ,jec I
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Commercial RECEIVED Received FOR OFFICE USE ONLY
1, • City of Tigard Date/B : • io /4, _ Pennit , .. _00c)& a
13125 SW Hall Blvd., Tigard, OR 97223 DEC 19 2 2 plan R ��
p _ �� Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Pplan Review
: m7
irigo
T I G A R D Inspection Line: 503.639 / p� Date Re. • VW J 0 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: 9' "./ s' a• (7 Supplemental Information
BUILDING DIVISION sPDkE iey
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
❑ Addition/alteration/replacement ® Other: Mall Kiosk equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
❑ Accessory building 12 Multi-family Number of bedrooms:
❑ Master builder ® Other: Mall Kiosk Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: Washington Sq. Mall, 9585 SW Washington Sq. Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Y05 I Project name: Doc Popcorn Covered porch area: square feet
Cross street/directions to job site: Washington Square Mall Deck area: square feet
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.
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.
Reassemble 12X12' prefabricated Kiosk, which includes one popcorn popper and 3 Valuation: $$20,000.00
Existing building area: square feet
self contained sinks
New building area: 144 square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: SteviePopsCo Type of construction: Stainless steel
Address: 1548 SE Tenino St Occupancy groups:
City/ State/ZIP: Portland OR 97202 Existing:
Phone: (503)422-0075 Fax: ( ) New:
® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: SteviePopsCo dba Doc Popcorn Structural plan review fee (or deposit):
Contact name: Greg Hicks FLS plan review fee (if applicable):
Address: 1548 SE Tenino St. Total fees due upon application:
City/ State/ZIP: Portland, OR 97202
Amount received:
Phone: (503 -) 422 -0075 Fax:: ( )
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
E - mail: greg.hicks@docpopcorn.com Commercial and residential prescriptive installation of
CONTIKCTOR roof -top mounted Photo Voltaic Solar Panel System.
� �� CTO \ Submit two (2) sets of roof plan with connection details
Business name: urns Co acting A u 1 l lo I`� Inc �•J and fire department access, along with the 2010 Oregon
Address: 2110 NE 5 m ve 'o � �acuN 2t t� .1-? .1-? q 0 0 Solar Installation Specialty Code checklist.
Permit fee (includes plan review
City/ State/ZIP: Was o al, WA 98671 % Q.TL ttN"t, 02. S 1 ?2. 5 and administrative fees): $180.00
Phone: (503) 80 220 -1.162 I Fax: ( State surcharge (12% of permit fee): $21.60
CCB lic.: 175406 l ito 4 Total fee due upon application: $201.60
Authorized signature: T This permit application expires if a permit is not obtained
g within 180 days after it has been accepted as complete.
I ,/ • Fee methodology set by Tri- County Building Industry
Print name: Greg Hicks I Date: 1). — I y__ ,____ I Servi Roam'