Permit CITY OF TIGARD BUILDING PERMIT
;� s l,,' COMMUNITY DEVELOP Permit #: BU P2010-00255
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9718 SW WASHINGTON SQUARE RD F05
Project: CATHY JEAN Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: TI
Contractor: HARDESTY + ASSOCIATES Owner: PPR WASHINGTON SQUARE LLC
500 EAST BALBOA BLVD 2235 FARADAY AVE STE #O
NEWPORT, CA 92661 CARLSBAD, CA 92008
PHONE: 949 - 723 -2230 PHONE:
FAX: 760 - 723 -2240
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 12/17/2010 $1,196.55
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 12/17/2010 $143.59
Stories: 1 Height: 28 ft Plan Review 11/17/2010 $777.76
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 11/17/2010 $478.62
Value: $115,000 Metro Const. Excise Tax - Commercial 12/17/2010 $138.00
Use
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $2,734.52
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 II other applicab 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 w is susp ded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cent —�. ose, rum 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 503.232.190 . 601 3 344.
Issued B/ ee Signature:
•
.639.4175 by 7:00 a.m. for the next available ins . . I. date.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of • . h inspection.
Building Permit Application
Commercial EIVED FOR OFFICE USE ONLY
Received ` �
City of Tigard C Re e iv / �' Permit No.: � d `��,
Da/B 13125 SW Hall Blvd., Tigard, OR 97223 n U�� Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �OV 1 ! Z Date /B : Other Permit:
TIGARD Inspection Line: 503.639.4175 � Date Ready :y: p' U �1u ® See Page 2 for
Internet: www.tigard - or.gov O'�. D Notified/Nlethod: l'/ "gib t i Z U Supplemental Information
%t CIIN 1 G D1 ISIpN C 5�Qo�4 • 1tLl kr w CAl E vrJl�,feit, „ 6 , M�C'!1s \
TYPE OF,W e .rte
�i , � � tg E UIREU � 1 ANDFAM DWE
�E
a
❑ New construction ® Demolition 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
1 work indicated on this application.
' � 1 � CATEGORY OF� CONSTRUCTION t z � pp
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building 111 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SI l INF, RM ATION A ND L Total number of floors:
Job site address: Washington Square,9718 S.W. Washington Square Road New dwelling area: square feet
City /State /ZIP: Tigard, OR 97233 Garage /carport area: square feet
Suite/bldg. /apt. no.: Space FOS Project name: Cathy Jean Shoes Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED 1)ATA COMMERCIAL USE CHECKLIST
Subdivision: 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
�„ r F I
DSCR
EIPTION OF WORK 4 work indicated on this application.
Demolition of existing tenant improvements Valuation: $$115,000.00
New tenant improvements including partitions, ceiling and lighting and new Existing building area: 1407 square feet ytpiv t)
finishes. New building area: square feet
�, � 'sp * f �
4 . 4 4PROPERT. OW)\ER?�, �`s ® TENANT Number of stories:
Name: Cathy Jean, Inc., Bud Jones Type of construction: 28 fully sprink
Address: 17221 Daimler Street Occupancy groups:
City /State /ZIP: Irvine, CA Existing: M
Phone: (949)225 -0600 Fax: ( )_ New: M
r ®.AP PLICANT s ®CONTA n<
, , .. , . a ..,. _ , . ,45 .,ate .., ,.. ,.F �.:m NOTICE=
Business name: Timothy G. Pleger, Architect All contractors and subcontractors are required to be
Contact name: Tim Pleger licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15640 N. 7 Street, Suite B9 jurisdiction in which work is being performed. If the
City /State /ZIP: Phoenix, AZ 85022 applicant is exempt from licensing, the following reasons
apply:
Phone: (602) 293 -3300 Fax: : (602) 293-3506
E -mail: tim @plegerhenry.com
fi AV R { CONTRACTORS ;
Business name: . f Q` G S_ c. acs c . _O , ,: yi •( BUILDING PERMIT F EES 7 ,
Address: c -> •-•a, pleas r fee s ,� 6,
S60 . Q� Structural plan review fee (or deposit):
City /State /ZIP: i,[ i, CA 'lam r_ 1
V v' / 4 � FLS plan review fee (if applicable):
Phone: ( ) Fax:( )
CCB lic.: q 7 a Total fees due upon application: # 1 254, l$ •
Amount received:
Authorized signatur : y This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Tim Pleger / I Date: 11 -16 -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)