Permit �
...
BUILDING PERMIT
C ITY OF T I G �4 R® PERMIT #: BUP2004 -00085
, � �i�I ' DEVELOPMENT Tigard, ) 639 -4171 DATE ISSUED: 4/6/04
SITEADDRESS: 09718 SW WASHINGTON SQUARE RD F -5 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 9 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: $ 150,000.00
Remarks: Commercial TI
Owner: Contractor:
PPR WASHINGTON SQUARE LLC SCHMIDT ELECTRIC INC
BY THE MACERICH COMPANY 2830 GRAND BLVD
9585 SW WASHINGTON SQ. RD. SPOKANE, WA 99203
PORTLAND, OR 97223
Phone:
Phone: 509 - 456 -2074
Reg #: LIC 149970
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 3/25/04 $939.30 Electrical Permit Required
[TAX] 8% State Surcharl 3/25/04 $75.14 Sprinkler Permit Required
Plumbing Permit Required
[BUPPLN] Pln Rv 3/25/04 $610.55 Framing Insp
[FLS] FLS Pln Rv 3/25/04 $375.72 Gyp Board Insp
Susp Ceilng Insp
Total
$2,000.71 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: f � /
� �'�N�
Perm ittee , )
Signature i I cry f�
Call 639 -41 7 p.m. for an inspection the next business day
18 Sw Wi4fi /14 7o, sad
Nu ✓o
B>s.ild ng Permit Applicatio FOR OFFICE USE ONLY
City of Tigard Date/B �i���� PetmitNo.• :, 1 e �� , , _OX !�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y I�It'
Date/B � �� .SC OtherPemut •
Inspection Line: 503.639.4175 �a� ` W Date ReadyBy. �r 10 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method• Supplemental Information
TYPE OF WORK REQUIRED DATA: 1 - AND 2- FAMILY DWELLING
❑ New construction El 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.
El 1- and 2- family dwelling E �.ommercial /industnal Valuation: $
El Accessory building El Multi-family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION / Total number of floors:
Job site address: ,...5 97 / S S. w. G•J,asG/,t fi.. "4". /41 New dwelling area: square feet
City/State/ZIP: .yo r74„/ (5. 9222-3 �s// Garage/carport area: square feet
Suite/bldg. /apt. no.: rS Project name: J 1/ti vo Covered porch area: square feet
Cross street/directions to job site: /,Ji4s4 ) &... k , 4 0 -,. e �4 1/ Deck area: square feet
b' 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.
-_ _/ Valuation: $
or
,p / A /A'S' i/,lciv+ /5 DO ° • �
Existing building area: z.5-ye square feet /
,/ New building area: z g 0 square feet
❑ PROPERTY OWNER It TENANT Number of stories:
Name: l.JN • pp Type of construction:
Address: Occupancy groups:
City/ State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
/'
Business name: i „j��l�T ,,Qye �,.. ,/ 4 All contractors and subcontractors are required to be
Contact name: " 544.0,649/ / L o oe 7vrs C kr? 'Edi1/0 �T under ORS with the and may be required to Contractors licensed Board
_
/ under ORS 701 and may be required to be licensed in the
Address: Z gz p s - 4 RI jurisdiction in which work is being performed. If the
City/State /ZIP: -�� Ll/A , 59 2O 3 apply
applicant is exempt from licensing, the following reasons
Phone: (5t9 Is 2 0) y Fax: : (5o7) i93, — 680p
E -mail: ,(,1-"(,(/0 -1. SCE, RA t 4 Tc o sAr T1l:I Clor.s . Co.N
CONTRACTOR
Business name: <4,1"0,4/7 ���oG T e.e. _ „7,�,L BUILDING PERMIT FEES*
Address: 55 2 _ S 40 vovee.,, 7 'eei
Please refer to fee schedule.
City/State/ZIP: 5,3/1',4.,,,,..a_ 1.4 992 23 Fees due upon application
Phone: 5o/) y s 6 Z 0 7 `f Fax: (SO' 'i 6251e,
Amount received
CCB lic.: / I/5)9 )19
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: 7 0 , 0 ,# t _ Date: 3 _ t 0 C/' * Fee methodology set by Tn - County Building Industry
/ Service Board.
i \ Building 'Permits\BUP- PermitApp doe 12/03 440- 4613T(1 I /02 /COM/WEB)
„,,
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Building Division
% % �; \ 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 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.
i:\Building\Forms \COM- PlanSubReq doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP; CUJ'5
Received Date Requested _ 1 AM PM BUP
Location 71 V t � r Suite ) - — MEC
Contact Person i Ph ( .5'47 79' - M
Contractor Ph ( ) SWR
/P6ar-a--- BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: .. SIT
Post & Beam l `7! - p/6
Shear Anchors C — /4
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall s -�L ' a. Cl ` cm./ Drywall Nailing � �y �' '
Firewall c t) . i _ a
Fire Sprinkler
Fire Alarm a O/ � d ccu
Susp'd Ceiling ` J
Roof VO J? }i LS 5 } Peit 4 ✓ j,p P
4 a � PART FAIL
ING
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 reinspection RE: - • El Unable to inspect — no access
Fire Supply Line / '
ADA 72/6 • Approach/Sidewalk Date Inspector _ i / ■■ Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL