Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 -00225
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
TIGARD Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9355 SW WASHINGTON SQUARE RD T19
Project: VERIZON WIRELESS Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: TI
Contractor: BNK CONSTRUCTION INC Owner: PPR WASHINGTON SQUARE LLC
45 82ND DR SUITE 53B 2235 FARADAY AVE STE #O
GLADSTONE, OR 97027 CARLSBAD, CA 92008
PHONE: 503 - 557 -0866 PHONE:
FAX: 503 - 557 -1085
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/14/2010 $1,287.15
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/14/2010 $154.46
Stories: 0 Height: 0 ft Plan Review 10/15/2010 $836.65
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 10/15/2010 $514.86
Value: $130,000 Metro Const. Excise Tax - Commercial 12/14/2010 $156.00
Use
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,949.12
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Yes Parapet:
Fire Alarm: Yes Protected Corridors:
Smoke Detectors: Yes 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 • • •- Ice 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. ENTION: Or- son law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952.:01 -0010 through OAR 2 -0. •0. You may obtain a copy of the rules or direct questions to OUNC by calling 501987 or 1.800.332.2344.
Is ed By: # �,� Permittee Signature: f %� •••°"--
Call 503.639.4175 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.
Building Permit Application
Commercial V FOR - OFFICE USE ONLY Phone: 503.639.4171 Fax: 503.598.1960 1 ;
Received
City of Tigard rj Date /By: 1 / L n Permit No.: f ' '
l
13125 SW Hall Blvd., Tigard, OR 972 � Plan Review
Other Permit:
L Date /By: I II :WIN l G��
TIGARD Inspection Line: 503.639.4175 V Date Ready /By: Juro: 0 See Page 2 for ■ Internet: www.tigard- or.gov � ,'S1G 1p Notified/Method: DOI 'U' - Supplemental Information
1 ( _ - ho Lva
1 ° TYPE O Wo` , 0 5',J1-- ,. REQUIRED DATA 1- AND°2- FAM1TY DWELLING 21
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
j Indicate the value (rounded to the nearest dollar) of all
�
�/ Additio Ite rati replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
- , ,- ` work indicated on this application.
r,. n CA TEGORY OF CONSTRUCTIO w . ,
Valuation: $
❑ 1- and 2- family dwelling liCom /industrial
El Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
J S I T E , INFOR , ` AN D LOCATI , Total number of floors:
Job site address: SW. VA/Asilli,i (ate goiv4 204 New dwelling area: square feet
CityiState /Z1P: 7 ! oQ Garage /carport area: square feet
Suite/bldg. /apt. no.: " Project name: VVRI Zonl W /2Mllrss Covered porch area: square feet
Cross street/directions to job site: JV,/ 63(,VNi R Deck area: square feet
fSW 2 IteD. Other structure area: square feet
Loc4YErV /Ai 144J' (.,/D,I SO U4 AC h' Y14‘4.. 4REQUIREDDATA: 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 G b ,ti 5 , work indicated on this application.
Valuation: $
/lee JAI!' 02 1410/1.34 !til 0}14 EICUM.16 7e�f.NA"1r Si / Ml /Gs CVO
Al � jn MI/4 Existing building area: / 8 square feet
^7 New building area: square feet
-'❑ `PROPERTY OWNER ' . TENANT„ Number of stories: 6 lJo ,
Name: ccre "44C4 (t!o ,z.o / w12An..ss) Type of construction: 1/-3 a 2//JKL19
Address: l fUo 56- 057.4 1Amy pis 4 3/_L Occupancy groups:
City /State /ZIP: Bwr(E`/VO' WA, Mpg Existing: f'4 a rAi
Phone: (4u ) 6 0j , f3 /j Fax: (445 )441- 81 New: J4exe4rrgn up
' t .❑ .AP_P,L1CANT, r " '� _ CONTAC�T� PERSON NOTICE `
Business name: Vegjec l W11Z.tf1.trS 5 Al; contractors and subcontractors are required to be
Contact name:ives g,„,„<4 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: /9000 SE 645n,Aftr NAY MS 3/ -1. jurisdiction in which work is being performed. If the -
City/State/ZIP: '•, applicant is exempt from licensing, the following reasons
Ci
BtSt t,�vvg 1 VIVA ?8 008 apply:
Phone: (4$ )w3 • sus Fax:: (47 5) 40 .8 17D
E -mail: Srefic, itz,464J Q Veriszol4 Ilt/Ia4STAstr. co,
`, : x CONTRACTOR ; , _ a ,
Business name: rinli / k_ t', or 594,114.e BUILDINGPERMIT -FEES*
Address: �j ,. , (Please fee schedule):..
�� O Z v. Structural plan review fee (or deposit):
City/State /ZIP: /% is [ K t D 4 q702-7
—
Phone: / Fax: FLS plan review fee (if applicable):
( ;z,3 ) 877..... 6 ( '56 - 5z 7 /e,a)
CCB lic.: Total fees due upon application: t �j' 1 1 . z 5" S I
//) � 7 h 6"5 fir""
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
� � within 180 days after it has been accepted as complete.
Print name: i Gve �° at / Date: lam%/ V // s * Fee methodology set by Tri-County Building Industry
r /�' / Service Board.
I: \Building\Pennits \BUP - COM PennitApp.doc 10/01/09 440 4613T(11/02/COM /WEB)
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