Permit 4. ,
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00694
' ii^.II DEVELOPMENT SERVICES DATE ISSUED: 12/18/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 01107
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC -4
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: 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: $ 80,000.00
Remarks: TI - New food service counter.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC MARKET CONTRACTORS LTD
BY THE MACERICH COMPANY 10250 NE MARX ST
9585 SW WASHINGTON SQ. RD. PORTLAND, OR 97220
PORTLAND, OR 97223
Phone:
Phone: 255 -0977
Reg #: MET �
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require ,
[BUILD] Permit Fee 12/18/03 $634.90 Electrical Permit Required
[TAX] 8% State Surcharl 12/18/03 $50.79
Plumbing Permit Required
BUPPLN Pln Rv 12/18/03 $412.69 Framing Insp
[BUPPLN] . Gyp Board Insp
[FLS] FLS Pln Rv 12/18/03 $253.96 Susp Ceilng Insp
Total $1,352.34
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: at:a r
Pe rm ittee r
Si gnature: \ /l.� '
Call 639 -4175 by 7 p.m. for an inspection the next business day
12/08/2003 17:04 FAX 5035981960 CITY OF TIGARD lit1002
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./3111ding Permit Applicatio Received }()k OFFICE USE °NUN'
Building •
Datc/By: Perini t No.: •Vdt9.0 3 -ooef
city of Tigard Planning Approval Other
1 Re ew O Pemi ther it No.:
13125 SW Hall Blvd.
Tigard, Oregon 97223
- AO Date/Ey Permit No.:
Phone: 503 Fax: 503 Post Land Use
ItttenICt: www.ci.tigard.or.us ,44.-':-.7il Date/By: Case No.
Contact Juria.: i See Page 2 for —
24-hour Inspection Request: 503-639-4175 Name/Method: Supplemental Information
11. ' :.'..r ' ' I: . riTgfor..n . :11:::1;,; 1'1 : ..:' .'- l• "0 . ,.',' . .i • ..: ;.„ ,. ' ., - . , . 1 !: " - 1;!:j '- ' . ..:,...: ..•
D New construction Ili Demolition 1 ' : 1 : :;ir ' 1 PPP '. .. ;.:•:: ... ;'i
Ex Addition/alteration/replacement 0 Other:
: ‘ t.r! Ir'OR CON . . miltoN:•; ..• • - - '..•..i!ir$ Note: Permit fees* are based on the total value of the work performed. indicate
D 1 & 2-Family dwelling Conuriercial/Industiial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
0 Accessory Building ali Multi-Family
El Master Builder la Other: Valuation $ 1
;i' j.) :!' !' : , . • , i t . 'TION!.:.. ' '.!... 2 ' i No of bedrooms No of baths:____
Job site address: 93 >1), a I . , a- MO ii I: la . Cr of floors
cv' g area (sq. ft)
Suite #: EC_ 1 4 ' I BldJApt.# Garage/carport area (sq. ft)
Project Natne: Viej-ztj rrej2cts' Covered porch area (sq. ft•) .
Cross street/Directions to job site: Deck area (sq. ft.) •
. Other structure area (sq. ft.)
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Subdivision: - I Lot #: .
Tax map/parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate .
,-. ! ,,! . .,:aitsour fro w o r y v onic: : .!:, : ,4 .., ,... , .., the value (round w t t li n u t :ti niateri on :als, labor,
Tr. Pr i
Valuation $ .:,1 4
Existing building area (sq. ft.) ,alfir
New building area (sq. ft.) ,IFir
Number of stories /
::Illil:PROPERTY:OWNEp.. .,:;.,..,!...::-■;•.. r ` - . 'I .1':!.: f..:' ''' 7: ' ' •:.' 'i ' i Type of Construction
Name: iltike on J /), j2, P , ?pm- cw:
1' Occupancy group(s): Existing:
N
• Address: Wa 5"0 /per Av ve - S Z--
City/State/Zip: _S'cl ep..., 04
hone - V- 1 Fax
NOTICE: All contractors and subcontractors are required to be
.
P: 0 1 4S : 0ls -
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, licensed with the Oregon Construction Contractors Board under
h ' lliP ' :-. • '''' • . •-• : '''''-'.:•': ' r ' ' °NT 6 :,CT. PERS, °N ' :..' ''' 1 provisions of ORS 701 and may be requires! to be licenecd in thc
edl .,..
Business Name: ( I, j- C_, tr fo rt y) jurisdiction where work is being performed- If the applicant is exempt
Contact Name: .a-
5
• from licensing, the following reason applies:
Address: /c? 4/41:: 701,-y' _ 61-- City/State/Zip: City/State/Zip: Porl )on ne 9 20
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Phone:5 C)- ) K 7
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E-mail: 0 I t 5 .1) - I 14 ,,___,,, _ c fii.-5" . C o •(::::'...■'.; F `:. . .. ii:1:-':'!. rwa ' .-.1 .- • •--:. ,.'• .:•'',••
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Business Name: A 4-yke 1- Cv 1-r 10 r S' LTO Fees due upon application s_____
Address: i o)so 414::- Ae .e .
City/State/Zip: A r i ici A el OR 9 7 '2 P-0 Amount received_ S 1
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Phone: -57 7-- 6 7 /' Fax - 5 ) 7 2 7;4- Date received:
CCB Lic. #: .. Q IF -. I .. .
Authorized ‘
/1)2 0 Co Notice: This permit application expires if a permit is not obtained within
Signature: I. _ktil,,_„‘Mff = Date: 180 days after it has been accepted as complete.
,OSLL12/1a.1 *Fee methodology set by Tri-County Building Industry Service Board. .
(Please print name) ...
i:\Dsts\Permit Forms1131dgPemitApp.doe 01/03
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CITY OF TIGARD 24 -Hour /t . -`f - mob 9'a
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received /6 . to Date Requested 1 — U "t AM PM BUP
Location 9 3,3 WA - - Q'� Suite 3- X 9
Contact Person Ph ( ) /3 C PLM
Contractor
Ph ( ) SWR
BUILDING Tenant/Owner 4Wei. ELC
Footing ELC
Foundation Access:
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
P i MBING
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
•ke Dampers
ral PART FAIL
RICAL
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 reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / [/
/ /0 / Inspector r Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL