Permit , ,, ,,
4;0 + 'n ITY OF TIGAR B UILDING PERMIT
PERMIT #: BUP2004 -00088
I DEVELOPMENT SERVICES DATE ISSUED: 3/5/04
- II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09644 SW WASHINGTON SQUARE RD G -13 PARCEL: 1S12600-00300
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: �< FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: PE1fl FIRST:- sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: B 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: 4SDOO 01
Remarks: Interior demo work to prepare for TI.
I
Owner: Contractor:
PPR WASHINGTON SQUARE LLC DIAMOND SPECIALTY & MFG INC
BY THE MACERICH COMPANY 22825 NW DOGWOOD ST
9585 SW WASHINGTON SQ. RD. HILLSBORO, OR 97124
PORTLAND, OR 97223
Phone:
Phone: 640 -4699
Reg #: LIC 70339
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
•
[BUILD] Permit Fee 3/5/04 $62.50
[TAX] 8% State Surchart 3/5/04 $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 yo • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -010 throe: OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin: (503) 246 -6699 • 1- 800 - 332 -2344.
Issue By: 1 / i � 4 _� / �� • / -
Pe rm ittee �-
Signature: �. � } i, /.
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Application r-olz orrlcl: USE ONLY
City of Tigard Received y. � ? rn
Peut No ,' .2- C./ ii ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503 598.1960 /411, iry I ' Date/By: Other Permit
Inspection Line: 503.639.4175 ' I �„ Date Ready/By funs B See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING r " i'•
❑ 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.
❑ 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: 9644 SW Washington Square Rd., Space #G13 New dwelling area: square feet
City/State /ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Brighton Collectibles Covered porch area: square feet
Cross street/directions to job site: In Washington Square Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST '•
Subdivision: 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.
Demo work for tenant improvement Valuation: $$5,000.00
Existing building area: 1,252 square feet
New building area: 1,252 square feet
❑ PROPERTY OWNER ® TENANT Number of stories:
Name: Brighton Collectibles Type of construction: VN
Address: 14022 Nelson Avenue Occupancy groups:
City/State /ZIP: City of Industy, CA 97146 Existing: M
Phone: (888)595 -3532 Fax: (626)968 -9718
New: M
N APPLICANT ❑ CONTACT PERSON NOTICE •
Business name: Western Construction Services, Inc. All contractors and subcontractors are required to be
Contact name: Pam Deegan licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4612 NE Minnehaha Street jurisdiction in which work is being performed. If the
City/State/ZIP: Vancouver, WA 98661 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 699 -5317 I Fax: : (360) 694-7818
E -mail: pam@westernconstruction.com
' CONTRACTOR
Business name: Diamond Specialty
BUILDING PERMIT FEES*
Address: 22825 NW Dogwood St
Please refer to fee schedule.
City/State/ZIP: Hillsboro, OR 97124 -6567
Fees due upon application
Phone: (503) 640-4699 Fax: ( )
Amount received
CCB lic.: 70339
Date received:
Authorized signature: �� /1-111P- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Pamela A. Deegan Date: 3/5/04 * Fee methodology set by Tri-County Building Industry
Service Board