Permit •
C � BUILDING PERMIT
ITY OF PERMIT #: BUP2006 -00105
l ; DEVELOPMENT SERVICES DATE ISSUED: 2/21/2006
�,� I ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09625 SW WASHINGTON SQUARE RD FC -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Walk -in cooler /freezer, 1 piece unit.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: . � 000, oc)
Owner: Contractor:
WASHINGTON SQUARE LLC WOODBURN CONSTRUCTION CO
BY THE MACERICH COMPANY PO BOX 129
9585 SW WASHINGTON SQUARE RD WOODBURN, OR 97071
TIGARD, OR 97223
Phone: Contact #: PRI 503- 981 -8821
FAX 503 - 981 -9504
FEES Reg #: LIC 238
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/21/2006 $62.50
[TAX] 8% State Surchar! 2/21/2006 $5.00
Total $67.50
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 than 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 obtain a copy of these rules or direct • estions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued Permittee Signature: s,�i� weir
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.
Building =.
Permit ,�.1u -, �.i!_ FoR(>FfIch:um.:ONix
City of Tigard Received
— `o� i ( �L Pemat No . 4 ■d O " d
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
A-, . , Phone: 503.639.4171 Fax: 503.598Q6Q 21 Zpp ir,� .}, �l i'DateB Other Pemlit
Inspection Line: 503.639.4175 Cu -1 Date Ready/By. ® See Attached Checklist for
Internet: www.tigard- or.gov Notified/Method. Fign Supplemental Information
CITY OF TWA'
1300
Vli>P REQUIRED DATA: T- AND 2- FAMILY DWELLING
❑ 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling `B Commercial /industrial Valuation: S
❑ 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: 9926 WE iziyi 'Uk .. New dwelling area: square feet
City /State/ZIP: f-t► fi r\ . (3y Garage /carport area: square feet
Suite/bldg. /apt. no.: a. ( Project name: S A '71,1/ . 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.
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 / I work indicated on this application.
J 7 � .. _.� , 1"C ua �k1 Jt , Z� ( _ _ 1, I t ourT Valuation: S
� �Vlf:�.� SJL� Existing building area: square feet
New building area: square feet
❑ PROPERTY. OWNER I ❑ TENANT Number of stories:
Name: _ Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE , .
Business name. Oryl` 7 y7 All contractors and subcontractors are required to be
Contact name: &4, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: v )C / 2 jurisdiction in which work is being performed. If the
City /State /ZIP: {r 2 A , applicant is exempt from licensing, the following reasons
( apply:
Phone: ) K / Fax: . ( � ) y� , j / - V -
E -mail: `��
CONTRACTOR
1
Business name
BUILDING PERMIT FEES*
Address:
• Please refer to fee schedule.
City/State/ZIP
Fees due upon application
Phone:( ) I Fax:( )
Amount received
CCB lic.:
Date 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 ` –Ls%-� Date' • Fee methodology set by Tri -County Building Industry
s � Service Board.
I\ Bwldmg\Pamns\BUP- T1- Pam Mop doc 12/30/05 440 -4613T(11 /02/COM/WEB)
Building Division
" J l ( Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
CO of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 2* *
Mechanical 2
Plumbing (building fixtures) 2
Electrical 2 '
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over- the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
1:\ Building \Pamirs \BUP- 11- PamitApp doc 12/30/05 440- 613T(1 I /07JCOM/WEB)
CITY OF TIGARD ° -A
BUILDING DIVISION { PERMIT #: p" �0/ 05 - 13125 SW Hall Blvd., Tigard, OR 97223 , ''
DATE ISSUED:
Phone: (503) 639 -4171 A 1(j
to i - r''
Inspection Requests (24 Hrs.): (503) 639 -4175 1 " 1 ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS:CI (0 7 1../ail- i// - i CLASS OF WORK:
SUBDIVISION: LOT #: /� / / TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE # �� 7 Z
CONTRACTOR: I - G PHONE #:
Inspection Request Scheduled For: Date: q — 3 — Co Pour Time:
Code # Inspection Description Confirm # Contact # Message
799 G;
Corrections /Comor is /Instructions: 0,-
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1n � /
Inspector: �► L/� � ' Date: Li ( 1( (p Phone #: (503) 718- ) IA