Permit (48) CI CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2016-00037
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/02/2016
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9779 WASHINGTON SQUARE RD D11
Project: Champs-Landlord Work Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Demo/alteration of existing tenant space prior to TI
Contractor: WESTERN CONSTRUCTION SERVICES INC Owner: PPR WASHINGTON SQUARE LLC
2300 E 3RD LOOP SUITE 110 PO BOX 847
VANCOUVER,WA 98661 CARLSBAD, CA 92018
PHONE: 360-699-5317 PHONE:
FAX: 360-694-7818
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 02/02/2016 $487.01
Demolition
Occupancy Grp: Occupancy Load: 12%State Surcharge-Building 02/02/2016 $58.44
Dwelling Units: 0 Plan Review 02/02/2016 $316.56
Stories: 0 Height: 0 ft Plan Review-Fire Life Safety 02/02/2016 $194.80
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 02/02/2016 $0.50
Value: $28,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,057.31
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 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. ATTE Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi en e. se rule set in OAR
952-00 10 through 952- -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 3.232.1987 or 44.
Issu d By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe ti n date.
This permit card shall be kept in a conspicuous place on the job site until c pletion of the project.
Approved plans are required on the job site at the time of each ins tion.
Building Permit Applicath1AUr,�r�-1I
VEIP
Commercial LLtFOR OFFICE USE ONLV
City of Tigard FF13 2 t Received Permit No.: 37
13125 SW Hall Blvd.,Tigard,OR 97223 G C Plan Review /� �`�J
Phone: 503.718.2439 Fax: 53. 9�Q Date/B : Other Permit: Au�(p OC10,3
Inspection Line: 503.639.4175TAW Vf I`AAKlj Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov ?TM'Vf-,9a4L'.'FNotified/Method: I Supplemental Information
TYPE OF WORK REQUIRED DATA:l-AND 2-FAMILY DWELLING
❑New construction emolition 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.
Valuation: $
E31-and 2-family dwelling ommercial/industrial
Number of bedrooms:
ElAccessory building ElMulti-family
❑ Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: (/ J New dwelling area: square feet Vl �30
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross treet/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.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
IN DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: quare feet
New building area: square feet
ROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP:
Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT CONTACT PERSON BUILDING PERMIT FEES*
Business name: Pkase refer to fee schedule
`,. , Structural plan review fee(or deposit):
Contact name:
FLS plan review fee(if applicable):
Address:
City/State/ZIP: Total fees due upon application:
Phone:( Fax::( )
Amount received:
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photovoltaic Solar Panel System.
Business name: Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: /4AAml�r I Solar Installation Specialty Code checklist.
City/State/ZIP: Permit fee(includes plan review $180.00
and administrative fees):
Phone: Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: Total fee due upon application: $201.60
Authorized sign re: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pem-tits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
9 -� 7 E�
�-� ��o� �u��e�
�� � �
i �
c
���
���� � �
;� �►..ala-�� �-L Gv�-
�I �U/
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review — Commercial - No Land Use
Building Permit #: P,;�ol 7
Site Address: "7-7cl SVS v�asH►rc 1"on _)n� R�, Suite/Bldg#:
Project Name: JOp,c. 50GLc'e,
(Name of comm•rcial business occupying the space. If vacant,enter Spec Space.)
Planning Review
1
Proposal: i rater cif o L-4
Existing Business Activity: —0 Yi
Yverify
osed Business Activity: vQ a c4a l
Pro
site address suite# exists and active in permit system.
� P Y
er Terrace Neighborhood: ❑ Yes No
toning:
Mo G
� Use: Yes 13 No 13 Spec Space
6,Q Confirm no land use required.
Business License:
Exists: ❑ Yes No,applicant notified to obtain business license
Notes: I o
Approved by Planning: I ` ` , oL c o Date: Z Z I
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submitta41� //
Original Submittal Date: 5�
Site Plans: #
Building Plans: # �'j
Building Permit#: Enter building permit#above.
Workflow Routing. � Planning ermit r wilding
Workflow Sign-off. Q Sign-off for Planning(include notes from planning review)
Route Application Document1� uil�g; original permit application,site plans,building plans,engineer and
��///� beam calculations and trust details,if applicable,etc.
Notes: Liitg -4 !/c" �J
By Permit Technician: Cu—,�c�A l� Date:
1:\Building\Fonns\B1dgPermitRvw COM_NoL.andUse_070915.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved, NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\B1dgPernnitRvw_COM_NoLandUse_070915.doex