Permit , . .
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...„. A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00347
��; DEVELOPMENT SERVICES DATE ISSUED: 9/3/2004
' ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09650 SW WASHINGTON SQUARE RD G -15 PARCEL: 1S12600 -00300
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 46 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: $ 43,750.00
Remarks: TI
Owner: Contractor:
WASHINGTON SQUARE LLC HORIZON RETAIL CONSTRUCTION
BY THE MACERICH COMPANY 1458 HORIZON BLVD
9585 SW WASHINGTON SQUARE RD RACINE, WI 53406
TIg OR 97223
Phone: 262- 638 -6008
Reg #: LIC 98581
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 7/20/2004 $276.77 Electrical Permit Required
[FLS] FLS Pln Rv 7/20/2004 $170.32
Sprinkler Permit Required
BUILD Permit Fee 9/3/2004 $425.80 Framing Insp
[BUILD] Gyp Board Insp
[TAX] 8% State Surchari 9/3/2004 $34.06 Susp Ceilng Insp
Structural welding final rep
Total
$906.95 Final Inspection
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 questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: . )?:??,./4/44...-- 6
Permittee
Signature: , 7-], ai C G ��
Call / 639 -4175 by 7 p.m. for an inspection the next business day
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Buildin Permit Appli 1b - vt � FOR OFFICE USE ONLY
} P P ~ R eceived �f Q Kr � ��)) /
l ty Ig rd JUL k' ` boo Dat e/B y ! p� „(/�/ Permit No G ' # � d(/ 3y' 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan ev1e
Phone: 503.639.4171 Fax 503 598 1960 y� Date/By 8--y - / f� Other Permit
Inspection Line: 503.639.4175 CITY OF TIG6� ® .44-11. Date Ready/By inns 0 See Attached Checklist for
Internet: www.ci.tigard.or.us BUILDING DIVISION No ed/Metho � � T / Supplemental Information
-- ', , " ::TYPE OF WORK , •' " . REQUIRED DATA:•1 AND 2 - FAMILY DWELLING
' ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
is Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement ❑ Other T equipment, materials, labor, overhead, and the profit for the
" - , , „- t , work indicated on this application.
OF CONSTRUCTION
❑ 1 -and 2- family dwelling Commercial/industnal
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: ''1(Q(5O- Sw ) g ro S L New dwelling area: square feet
City/State/Z1P' , 'OK CI, 2 ` I Garage/carport area: square feet
Suite/bldg. /apt. no.: G - I S Project name: 'j V j )` .DL� �Z
_ Covered porch area: square feet
Cross street/directions to job site: 5 Efis 1,4_,m 1,4_,m ' i p („1 ) I SHC A -.) 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
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
- _ 'DESCRIPTIONS OF WORK . , work indicated on this application.
V aluation: $ 4 S
T�w.1Z ) �IpravcxY►e•� '' �E�1L srot2� ,1 0
kr ® ��i ` f ih52i L3 I NC TO'� � uols Existing building area:/ (,, S"'''' square feet
I r - New building area: 0 square feet
1- rF.
RO1 ERTY ,OWNER ' . ❑ TENANT' ":, T Number of stones. I
_ '
Name: 1✓1AG I(4 CO Type of construction:=6
C Address: .' \ x i Ls ,,. 1 , 1 ,, L , 1 Occupancy groups: rn
City/State/Z1P: 0,07 M31‘11CA CI. 9 oy o 7 -211 . Existing:
•
Phone: (.51 0)39r.{ •Low xZ„(d Fax: (3( p) 695 New:
V ` •
APPLICANT ` . ,- _ - ❑ CONTACT PERSON. NOTICE
Iv Business name: _ • (: I . ; h..it_is •Ley)) ni.11 contractors and subcontractors are required to be
I Contact name: H e I em, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed In the
Address:5 G .\44 1:-.) 05co _ jurisdiction in which work is being performed. If the
W City/State /ZIP: Q ) R j j D , o p % (�"� q applicant is exempt from licensing, the following reasons
Phone: 50) 3I ii . 3 5 l Fax:: ( ) / apply: £ 1 6. 17
I E -mail:
CONTRACTOR',;
' ' - - / Z D
: 3 -
Yy t7
N Business name: -�--I-69 L24:9 r V _ ..." • ,, -'- _ I^� ; BU R .DING P ERMIT FEES * "
r A Address: i C-- I- 0 /'��1/�� Please refer to fee schedule..
V t City/State/ZIP: .- C(, � La I Fees due upon application
W Phone: (A/ t - teepee) Fax: ( )
Amount received
CCB lie.:
Date received:
Authorized signature: ` - This permit application expires if a permit is not obtained
��/� w within 180 days after it has been accepted as complete.
Print name: C 1.4 Ag_i -.FS \ x) ii, N, Date: * Fee methodology set by Tri -County Building Industry
Service Board
1 \Building\Perrruts \BUP- PermiApp doc 12/03 440- 4613T(11 /02/COM/WEB)
•
•
Building Division
Azowl# Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City 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 3 **
Mechanical 2 `°
Plumbing (building fixtures) . 2
- -." •
Electrical •• r 2
•
Plan review is dependent upon submittal of a completed application and gabs: '
After plan review aptiroval, 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.
i:\Buildmg \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING , , Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Li e: (503) 639 -4171 MST
r 6121\--AM BUP L" — � s
Received /' Date Requested � \ PM BUP
Location Suite t MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
PART FAIL ► / '+ Y;ok
RING �J
Post & Beam °•
Under Slab
Rough -In
Water Service
Sanitary_Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In •
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for rei pection RE: I Unable to inspect — no access
Fire Supply Line
ADA W;
Approach/Sidewalk Date Inspector , Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL