Permit t/ p
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j BUILDING PERM
" CITY OF TIGARD PERMIT #: BUP2006 -00077
c_,lik SW DEVELOPMENT Blvd., O
SERVICES -639 -4171 DATE ISSUED: 2/2/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09710 SW WASHINGTON SQUARE RD F -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: DEMO
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: M 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: $ 17,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC CUSTOM COMMERCIAL BUILDERS INC
BY THE MACERICH COMPANY 688 SWEET LANE
9585 SW WASHINGTON SQUARE RD COTTAGE GROVE, OR 97424
TIGARD, OR 97223
Phone: Contact #: PRI 541 - 767 - 0605
FEES Reg #: LIC 151674
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/2/2006 $62.50
[TAX] 8% State Surcharl 2/2/2006 $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 questions to OUNC by
calling 503 - 246 -6699 or 1- 800 -33.. -2344.
/ / Permittee Signature: �/
Issued BY: /` / 1 ... �i �� ,�i 9 �� L 1 p_ie, ri J,_____
I
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.
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2 /01 /YWED 04:33 PM WESTERN CONST FAX No, P. 002
6o
Building Permi p p � lica GIVE FOR OFFICE I(1: l si :ONLY
Ci ty o of Tigard Jimmied Date/B : • a a oli � M
13125 Hall Blvd., Tigard, OR 97223 Plan 23 I 7x ' . r U 0 ow —00077
Phone: 503.639.4171 Fax EB 01 2I
503.598.1960 r .; ' I ' Permit:
Date/By:
Inspection Line' 503.639.4175 1 !! � �'I1;, DateRendy/By: I . See Attached Checklist for
Internet: www.ci.tigard.or,us CITY OF TI . = a Notified/Method: I._' Supplemental Information
BUILDING DIVISION (�
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ® Demolition Permit fees* are based on the value of the work performed.
❑ Addition/alteration/replacement 0 Other: Indicate value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION ~ work indicated on this application.
111 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Off Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9710 SW Washington Square Road New dwelling area: square fcet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: For Love 21 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUEEtED 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
DESCRIPTION OF WORK , work indicated on this application.
Demo in an existing space Valuation: $517,000.00
Existing building area: 2360 square feet
New building area: 2360 square feet
❑ PROPERTY OWNER ■:; TENANT Number of stories: 1
Name: Forever 21 /Accessory Type of construction:
Address: 2001 S. Alameda Street Occupancy groups:
City /State/ZIP: Los Angeles, CA 90058 Existing: M
Phone: (213)741 -5115 Fax: (213)741 -5111
New: M
® APPLICANT ® CONTACT PERSON .-
NOTICE
Business name: Western Design Group, Inc All contractors and subcontractors arc required to be
Contact name: Veleta Gee 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 J Fax: : (360) 699 -0511 . -
E -mail: vgee®westernconstruction.com
/� � &:ONTRACTO . - ,
^ Business name. L BUILDING PERMIT FEES*
Address: /; v. f30.r 6, c Pease refer to fee seheduf
Address:
CDC Gl ��',, � Q,�150(..., 9 ya t� Fees due upon application ll� A City /ZIP, Phone: ( I ax: ( ) /
' �/ Amount received 6
CCB lie.: /57b
/ ' Date received:
Authorized signature: ` .4.4nald / I permit application expires if a per s not obtained
within 180 days after it has been accept as complete -
Print name: Veleta r / I Date: 2/1/06 I • Pee methodology set by Tri- County Building Industry
iii r Service Board. V
f ei/ •
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: 13UP2006.0 )077
13125 SW Hall Blvd:, Tigard, OR 97223 DATE ISSUED: 217/2006
Phone: (503) 639 -4171 �I�h
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/512006 TIME: 7:10AM PAGE: 4
SITE ADDRESS: 09710 Sam WASHING ON SQUARE RI.) F - 1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: FOR LOVE 21
DESCRIPTION: DEMO'
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: CUSTOM COMMERCIAL BUILDERS INC PHONE #: 541 -707 -0605
Inspection Request Scheduled For: Date: 5/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final insaoection 029380 01 360 - 601 -8167 N
Corrections /Comments /Instructions:
Q UP200(0 do" l , l
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL /A CALL FOR INSPECTION ❑ ADDITI• AL FEES ASSESSED
kiFA
Inspector: / Date: �.I Phone #: (503) 718 - 2-L73