Permit .i .
t.' ;` C ITY O TIGARD BUILDING PERMIT
ip
' ° - COMMUNITY DEVELOPMENT Permit #: BUP2009-00215
T I GA;j D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 01/15/2010
Parcel: 151250000300
Jurisdiction: TIGARD
Site address: 9595 SW WASHINGTON SQUARE DR B12
Subdivision: Lot: 0
Project: True Religion Blue Jeans
Project Description: Rack storage.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Permit Fee - Additions, Alterations, 12/08/2009 $180.17
CARLSBAD, CA 92008 Demolition
PHONE: 12% State Surcharge - Building 12/08/2009 $21.62
Plan Review 12/08/2009 $117.11
Plan Review - Fire Life Safety 12/08/2009 $72.07
Contractor:
HORIZON RETAIL CONSTRUCTION
1458 HORIZON BLVD
RACINE, WI 53406
PHONE: 262- 638 -6008
FAX: 262- 638 -6015
Specifics:
Type of Use: COM
Class of Work: NEW
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $6,500
Floor Areas:
Total Area:
Accessory Struct•
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $390.97
Required: Required Items and Reports (Conditions)
1 BUP Bolts in Concrete
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Manual Pull Stations: Yes
Accessible Parking:
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 0
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fo h in AR
952- 001 -00 0 throw OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 5 3. 6.6699 1.80 .332.23
UsiuN Issued By: a1 C- Permittee Signature:
J 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.
B Permit Applicati
E � i '4 ,,,1 k t , <
F; ' I ()R ()I I IC I. Util ON 1 V,v
p City of Tigard DEC 0 . 8
Commercial X0 09 V Received A D /1 / Permit 9 �t /
a ay Date/By: / d 7 U " or
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie : ,
]` /� Other Permit
Ph one: 5 03 . 639 . 4 1 71 F ax: 503.5 6 ®F T ' G Date/By: ( i ! Iv 1 C 1 l
I c Ica l y Inspection Line: 503.639.4175 B U�� D` At ^ A RD Date Ready : •. Juris !a See Page 2 for
Internet: www.tigard or.gov G DI V ISION Notif d/Method: //7 47r , / S p lementalInformation
TYPE OF WORK <QUIRED t AT:.: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are b..; - • 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.
dwelling Valuation: $
❑ I- and 2-family g ❑Commercial /industrial
❑ 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: g 1h Stu GUQ,��L, c( kr o
>';/ New dwelling area: square feet
City /State /ZIP: 740 0 v 61 0 e l-7 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: l
% vu e _ / i byc Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 1 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.
Td � �u i
J .G/ 4G2 Valuation: $1�5�O
� / _ J Existing building area: square feet
(� Q V--(f �� New buildin g area: square feet
9
❑ PROPERTY OWNER ❑ TENANT • Number of stories:
Name: PPP Wa cs1,-G; I to S &t LL,_ Type Type of construction:
Address: 3 S / ,- y � `7�t° Occupancy groups:
City /State /ZIP: ClajL S ha / Q c O)� Existing:
Phone: ( ) / Fax: ( ) New:
❑. APPLICANT ❑ CONTACT PERSON . NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail:
CONTRACTOR
4) Business name: /-(�yv i � a12 I0. + ^/ I rl, � B UILDING PERMIT FEES*
� Address: / / (Please refer to fee schedule) � � Structural plan review fee (or deposit):
City /State /ZIP: 6- 1 , 1��' 3 L c.l� p
Phone: ) fi, _ / 00, Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: �'� Total fees due upon application:
9 Amount received: C1 .
Authorized signat� ,.f,' This permit application expires if a permit is not obtained
Q within 180 days after it has been accepted as complete.
/Q �
Print name: (/l (a.v k �c 4 11 . Date: /, _3 _ Q ( * Fee methodology set by Tri -County Building Industry
Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11 /02 /COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
T1G`ARD;
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
L: \Building \Permits \BUP -COM PermitApp.doc 06/25/08
i S CITY OF TIGARD FEE AND PAYMENT HISTORY . 4.,
la
E , 13125 SW Hall Blvd., Tigard OR 97223
- 503.639.4171
TIGARD
BUP2009 -00215 - 9595 SW WASHINGTON SQUARE DR B12, TIGARD, OR 97223
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due
Permit Fee - Additions, Alterations, 2300000 -43104 $180.17 $180.17 $180.17 12/8/09 Check 176201 $0.00
Demolition
12% State Surcharge - Building 1003100 -24001 $21.62 $21.62 $21.62 12/8/09 Check 176201 $0.00
Plan Review 2300000 -43106 $117.11 $117.11 $117.11 12/8/09 Check 176201 $0.00
Plan Review - Fire Life Safety 2300000 -43108 $72.07 $72.07 $72.07 12/8/09 Check 176201 $0.00
Totals for Fees $390.97 $390.97 $390.97 $0.00
Receipt # Payment Method Check # Pavor: Receipt Date Receipt Amount
176201 Check 186558 Horizon Retail 12/08/2009 $390.97
Construction Inc
Total Payments: $390.97
Balance Due: $0.00