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Permit (67) CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2016-00281 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 11/03/2016 TIC rtiRC7 9 Parcel: 1S135BA00102 Jurisdiction: Tigard Site address: 10124 SW WASHINGTON SQUARE RD Project: Costa Vida Subdivision: OAKBURG Lot: 9 Project Description: TI for future tenant:Modifying dining and kitchen layout. Contractor: KUGEL CONSTRUCTION Owner: PPR SQUARE TOO LLC PO BOX 1271 PO BOX 847 CHEHALIS,WA 98532 CARLSBAD, CA 92018 PHONE: 360-740-4305 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VBPermit Fee-Additions,Alterations, 11/03/2016 $2,615.95 Occupancy Grp: A-2 Occupancy Load: 93 Demolition 12/o State Surcharge-Building 11/03/2016 $313.91 Dwelling Units: 0 Plan Review 10/06/2016 $1,700.37 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 11/03/2016 $357.00 Bedrooms: 0 Bathrooms: 0 Plan Review-Fire Life Safety 11/03/2016 $1,046.38 Value: $350,000 Info Process/Archiving-Lg$2.00(over 11/03/2016 $70.00 11x17) Info Process/Archiving-Sm$0.50(up to 11/03/2016 $1.00 Floor Areas: 11x17) Metro Const.Excise Tax 11/03/2016 $420.00 Total Area: 3159 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $6,524.61 Required: Required Items and Reports(Conditions) Fire Sprinkler: Yes 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. 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 87 or 800.332.2344. Issued By: ` Permittee Signature: Air a 1503.639.4175 by 7:00 a.m.for the next available inspection date. 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. • , City of Tigard !AI 111 COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Commercial - No Land Use Building Permit #: l k' d/C-- f Site Address: /0 /a / c) £' tfi v r'J saucy c,/6 Suite/Bldg#: Project Name: S i 1// (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: New Cost \)t(1b1 frSt1ttrAn-1 Ti OW ti:- 0(111/) Existing Business Activity: rf-zA k Proposed Business Activity: rte/ A Verify site address/suite# exists and active in permit system. .„,1K River Terrace Neighborhood: ❑ Yes No ,g Zoning: M U r .Permitted Use: S. Yes ❑ No ❑ Spec Space Confirm no land use required. .N" Business License: Exists: ❑ Yes , No,applicant notified to obtain business license Notes: • Approved by Planning: Date: �+/-lL' I I 0 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Building Permit Submittal Original Submittal Date: 9 /67 Site Plans: # Building Plans: # 33 Building Permit#: L building pe Bove. Workflow Routing: Plan ning g'"-Permit Coordinator Building Workflow Sign-off: if Sign-off for Planning(include notes from planning review) Route Application Documents: ding: original permit application,site plans,building plans,engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: _- Date: g/.,17/4 I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx A • 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 /A Tigard Trans SDC: ❑ Yes N/A Parks SDC: ❑ Yes /A OK to Issue Permit Approved by Permit Coordinator: Date: g/ v/i& I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx RECEIVED IE71 3l$ ��it ¢l€[ (il[ 1i11 k}lt[T�`��IIi �€;t-�(' .(tb CEIi illi Itll VIII till €1St �� SEP 2 6 2016 oREG© Transmittal CITY OF TIG slaty JHIIARCHITECTURgMetter BUILDING DIVI 221 West Tenth St.- Medford,OR 97501 (541)772-4372 Fax: (541)499-6329 www.oregonarchitecture.biz Owner ❑ Date September 22, 2016 Architect ❑ Job Name Proposed Restaurant Engineer ❑ Washington Square II -Suite A07 Consultant ❑ 10124 SW Washington Square Contractor ❑ Rd Tigard, Oregon 97223 Other Dan Nelson Community Development 503-718-2436 City of Tigard Permit Center 13125 SW Hall Blvd, Tigard, OR 97223 Enclosed are; Enclosed are (3)sets of 24x36 plans for a proposed new tenant is a Costa Vita restaurant, to be located at 10124 SW Washington Square Rd Suite A07 And the building application. If any additional information is needed contact Patrick via e-mail at patrick@oregonarchitectue.biz. Or I can be reached via telephone at the above number. Thank you. Signe.: (Mark McKechni-, AIA ) 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 10124 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Record Type: Commercial - Building Inspection Type: 285 Drywall nailing Result: PASS Comments: Firewall ok Violation Summary: Tel: 503.718.2439 Inspection Date: Record ID: B U P2016-00281 Inspector: Jeff Grove Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10124 SW WASHINGTON SQUARE RD, March 28, 2017 at 11 :03:16 TIGARD, OR, 97223 AM Record Type: Record ID: Commercial - Building BUP2016-00281 Inspection Type: Inspector: 299 Final inspection Chip Barnett Result: PASS - CofO Comments: Violation Summary: Inspector Contractor