Permit CITY OF TIGARD BUILDING PERMIT
.1114
e • COMMUNITY DEVELOPMENT Permit #: BUP2010 00195
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9524 SW WASHINGTON SQUARE RD H08
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: H & M
Project Description: TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Permit Fee - Additions, Alterations, 10/21/2010 $5,557.95
CARLSBAD, CA 92008 Demolition
PHONE: Plan Review 08/19/2010 $3,612.67
Plan Review - Fire Life Safety 08/19/2010 $2,223.18
12% State Surcharge - Building 10/21/2010 $666.95
Contractor: Metro Const. Excise Tax - Commercial 10/21/2010 $1,080.00
HORIZON RETAIL CONSTRUCTION Use
1500 HORIZON DR
STURTEVANT, WI 53177
PHONE: 262- 638 -6000
FAX: 262 - 638 -6015
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 2 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $900,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $13,140.75
Required:, Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes 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 -0100. You may obta'rules or direct questions to OUNC b = `•.6699 or 1.800.332.2344.
Issued By: Permittee Signatu11'�+
t1 �' _
/Pr 1 3.638.4175 by 7:00 a.m. for an inspection that business • ay:
This permit ca • 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.
Building Permit Application
Commercial Ti
1 0
; 1
a City of Tigard l� O Received 8 /f ` � (I) 3 ^�
13125 SW Hall Blvd Permi No.: ki /1Zv� 1 v�
., Tigard, OR 97223_ Date/By: I l t'V�/ 001 q5 g ^®� Plan Review
Phone: 503.639.4171 Fax: 503.598. 4 � Date/By: ( ) Q � itl� Other Permit: � Q�] n �U "OWLS
T I G A K D Inspection Line: 503.639 \ /:\. A¢ �a 4Date Ready /B( ,/ luris: See Page 2 for
Internet: www.tigard- or.gov P�' _ • l�_v � Notife eth /..5 D Q Supplemental Information
./ TYPE OF WORK �� REQUIRE AT 1- AND 2- FAMILY DWELLING • ❑ New construction ❑ Demo* 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.
❑ 1- and 2- family dwelling ® Commercial /industrial
Valuation: $
❑ 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: 9524 SW Washington Square Rd. New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: H &M 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: I 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
DESCRIPTION OF WORK work indicated on this application.
T.I. - Tenant build -out of newly demised space. Work to include doors, Valuation: $$900,000.00
partitions, ceilings, lighting, fixtures, etc. MEP work. Existing building area: 19503 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 3
Name: Macerich Type of construction: IIB
Address: 401 Wilshire Blvd., #700 Occupancy groups:
City /State /ZIP: Santa Monica, CA 90401 Existing: M
g�
Phone: (310)394 -6000 Fax: ( ) New: M
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: Permit Resources All contractors and subcontractors are required to be
Contact name: Mary Ryan licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: P.O. Box 3749 jurisdiction in which work is being performed. If the
City /State /ZIP: Mission Viejo, CA 92690 applicant is exempt from licensing, the following reasons
apply:
Phone: (949) 582 -3735 Fax: : (949) 768-8436
E -mail: mary@permitresources.com
CONTRACTOR
Business name: T.B.D. l 1 BUILDING PERMIT FEES*
Address: `S � 1 1�U'< i 2J 0 f (please refer to fee schedule)
City /State /ZIP: silty - 1 Q IAdy. si CID; . S3 1'n Structural plan review fee (or deposit):
1 FLS plan review fee (if applicable):
Phone: (aCce� �($ .. (p I 1 1 Fax: ( ) ,Sa„ q
CCB lic.: , Total fees due upon application:
Amount received:
Authorized signature: �/ a _ This permit application expires if a permit is not obtained
�t within 180 days after it has been accepted as complete.
Print name: Mary Ryan Date: 8/18/10 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 10/01/09 440- 4613T(11/02 /COM/WEB)