Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2000 -00394
j� DEVELOPMENT SERVICES DATE ISSUED: 11/30/00
- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE. ADDRESS: 09751 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
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: 0.00 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 15,000.00
Remarks: Commercial TI
Owner: Contractor:
PPR WASHINGTON SQUARE LLC D L. WILSON CONSTRUCTION CO
P.O.BOX 21545 3007 NE 181ST
SEATTLE, WA 98111 PORTLAND, OR 97230
Phone: Phone: 666 -3600
Reg #: LIC 00110530
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PLCK CTR 9/20/00 $138.31 27200000000 Sprinkler Permit Required
FIRE CTR 9/20/00 $85.11 27200000000 Framing Insp
Final Inspection
. PRMT CTR 11/30/00 $212.78 27200000000
5PCT CTR 11/30/00 $17.02 27200000000
Total $453.22
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Pennitee // /
Signature: T
Issued By: z .��� F •
Call 639 -4175 by 7 p.m. for an inspection the next business day
TIGARD Commercial Building Permit Application Plan Check
13 HALL BLVD. Tenant Improvement Recd By
p Date Recd ,67e �o
i IGA , OR 97223 Date to P.E. 9 9C e,
503) 6394171 Date to DST
Print or Type Permit# /a Pdi,o4o-610,57
Related SWR # "
Incomplete or illegible applications will not be accepted Called eibifi>t AP
Name of pevelopment/Project Existing Building [Jf New Building ❑
Job %Jw;s w., S.,,, WA . 5i.
A Address Street Address Suite Building
gi41 -5 514. WASti. S f4. Data
Bldg # City /State Zip Existing Use of Building or Property:
'f, v i r or- 1122 3 .,1.0 I vP..5 ca
Na e
Property CIA,. shit" P Proposed Use of Building or Property:
Owner Mailing Address Suite r et
I01-09 X 7 5 Viv :5io» 5t No. Of Stories:
Ci /S to Zip Phone
' (1 4 1,4, 04 91 u& 251-190 Sq. Ft. Of Project:
Occupant Nam
i . 5:113141 Occupancy Class(es)
Name I
Contractor 12. 1.-. 'Vikk... Type(s) of Construction
X Prior to permit Mailing Address Suite
7 ‘• issuance, a copy 30 1f ST Will this project hav a Fire Suppression System?
of all licenses 0 � ' Yes [ No ❑
are required if City /St to Zip Phone Americans with Disabilities Act (ADA)
expired in C.O.T. �p p I /2"o lv(1�- 3G�
database 1
or , �F- Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
(10* k 1 Project $ 16 000
�j - Valuation
Architect N � -✓a^'� 4 A k5ak / rci.t Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
(ol2-t '7W 14 .100
?Col to Zip Ph ne I hereby acknowledge that I have read this application, that the information
Col i Olt Trill Z41100 given is correct, that I am the owner or authorized agent of the owner, and
l / that plans submitted are in compliance with Oregon State Laws.
Engineer a A550C.c S
M 1. Sig r o ner /Agent Date t tf Maili Address Suite ��
Q( Conta son Name I / Phone
City /State Zip N i d G l AS 7. V c� W -1(00
244 .249 0
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition O Map/TL# Land Use:
)(Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 Notes:
Description of work:
0( TIF:
Note: Site Work Permit Application must precede or accompany Building
Permit Application
e fAi'e n/ s' /,? ", 3
I: \COMNEWTI.DOC (DST) 5/98 ! L , 4 0,5 /
COMMERCIAL PLAN SUBMITTAL
t REQUIREMENT MATRIX
Plan tRevie■ids dependent tipon of ig a COMPLETED
aPplidation. For submittal, the application must 'pontain the
signature of the supervising electrician before pla*review..ttyili:ibe;:OidUcted.
After . plan review apprial Plans Examiner will contact the applicant to request
additional plan sets for distribution purPoses. (Copy for Contractor City. .
Washington eountyjualatinValley Fire„& Re •iE •
. „. ••
• Total # of
TYPE OF SUBMITTAL Hans KEY:
• . S(ibmitted
S (Private) 1 S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P = Plumbing
P (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) 2 New = New Building -
E (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
..1:
. . :
*BAIA & F..(Alt) .
*4:: ENO 3
*alk. tili& Rik EA E,,(Al.t) 3
NOTES:
1 !Shaded . areaS4piidtiOtOALT 4:1);tryiitto4poty,•;:-: ':'• • •
1:Ndsts\forms\matrxcom.doc 10/30/98