Permit I.- �' BUILDING PERMIT
C ITY OF TIGARD PERMIT #: BUP2006 -00055
_.1l1i�� DEVELOPMENT SERVICES DATE ISSUED: 1/30/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D -11 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Racking
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: 2N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 88 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: $ 5,000.00
Owner: Contractor:
WASHINGTON SQUARE LLC JAMES J DERLETH
BY THE MACERICH COMPANY 2547 ST CHARLES WAY
9585 SW WASHINGTON SQUARE RD MEDFORD, OR 97504
TIGARD, OR 97223
Phone: 503 - 639 -8865 Contact #: FAX 541 - 774 -9812
PRI 541 - 840 -2680
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FEES Reg #: LIC 149693
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/30/2006 $91.30
[TAX] 8% State Surcharl 1/30/2006 $7.30
[BUPPLN] Pin Rv 1/19/2006 $59.35
[FLS] FLS Pin Rv 1/19/2006 $36.52
Total $194.47
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:. .A.clo OJ Permittee Signature: _, �� _ _ , oft,
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
i
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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■
Building Permit A A ,vE II roll OFFICE OF ()M.\
of Tigard L Received nffinin permit No.- '�� 1
13125 SW Hall Blvd., Tigard, OR 97223 � ' Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 I . � I ,'t '''''k . A -zt. f Date/B , 401 Other Permit: Inspection Line: 503.639.4175 - � _ r ' I Date Ready c y: " . ®upplemental See Att ached Checldist Information for
CITY OF
Internet: www.ci.tigard.or.us TI Notified/Method S
BUILDING DI t SIGN
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING •
❑ New construction ❑ 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 b r• mmercial /industrial Valuation: S
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
i
Job site address: 97 'j/1/ 144 / /4/&, ,A7 New dwelling area: square feet
City /State/ZIP: 77fi Dii 9 777--" Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet \CA
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST .
Subdivision: i 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.
/e,4-U< /,,./ 0 1.---,_.,,-.-7,2-- 1.---,_.,,-.-7,2-- Valuation: $ 6 4 60
Existing building area: square feet
New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories:
Name: 7 7 /'77 , ' 1 Y L 0 ,"7P7 Y / y Type of construction: a g
Address: Occupancy groups: �'/� �P'
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ONTACT PERSON NOTICE
Business name: (jz / �.//7 /7" , df'7 All contractors and subcontractors are required to be
Contact name: /�j' // - 7 7 ,--.S/ licensed with the Oregon Construction Contractors Board
, � / under ORS 701 and may be required to be licensed in the
Address:
7S ' fr 60/A? jurisdiction in which work is being performed. If the
Q ,' applicant is exempt from licensing, the following reasons
City / State/ZIP: Q L /v D /`, 9 7 / apply:
Phone: ( ) ,ZS—Z_ - 5( Fax:: ( ) Z / - 2_7 0
E -mail: 7-////O/'/7 ( J �" 7 i�� 7/ 1
CONTRACTOR
Business name: L l
7 m Y 'S � � 2 e 1 I � T n G • BUILDING PERMIT FEES*
Address: L., $ /- Ch oV' / W4 l I
City / State/ZIP: /)7) y , re y ` j 7 S o y Please refer 10 ee schedule.
(sy( ) d Fees due upon application
Phone:
ye, - . c 41 )7 Li �y
CCB lic.: ` s Amount received
�l j �-�- Date received:
I T Authorized signatur 1 ' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
G
Print name: /,l� �ONT4O/ I • . te: • Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Pennits\BUP- 11- PetmitApp doc I2/03 440- 4613T(I1/02/COM/WEB)
` ' • 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.
.Building Pennits\BUP -11-Pe mi App.doc 12/03 410-4613T(11/02/COM/W®)
CITY OF. TIGARD
BUILDING DIVISION PERMIT #: BUP2006 00015
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1130/2006
Phone: (503) 639 -4171 t'1 I�I
Inspection Requests (24 Hrs.): (503) 639 -4175 .,�.� `__..
INSPECTION WORKSHEET FOR DATE: 2/812006 TIME: 7 :01AM PAGE: 42
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE BOMBAY COMPANY
DESCRIPTION: Racking
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 - 83865
CONTRACTOR: JAMES J DERLETH PHONE #: 511 - 840.2680
Inspection Request Scheduled For: Date: 2/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 026472 -01 626.890.7351) N
Corrections /Comments /Instructions:
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❑ PA ❑ PARTIAL APPROVAL ❑CANCEL 111 NO ACCESS
FAIL
El CALL FOR INSPECTION
El ADDITIONAL FEES ASSESSED
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Inspector: Date: U v Phone #: (503) 718 -Z ,PA1Q
CITY -OF TIGARD
BUILDING DIVISION PERMIT #: BUP200Ei 000 i6
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/30/2006
Phone: (503) 639 -4171 .t'14 h
Inspection Requests (24 Hrs.): (503) 639 -4175 _' ' e I ..
INSPECTION WORKSHEET FOR DATE: 2/9/2006 TIME: 7:04AM PAGE: 55
SITE ADDRESS: 09779 SW WASHINGTON SQUARE RD D-11 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE BOMBAY COMPANY
DESCRIPTION: Racking
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -88G5
CONTRACTOR: JAMES J DERLETH PHONE #: 541- 840 -26t30
Inspection Request Scheduled For: Date: 2/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 026562 -01 626- 890 -7358 N
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: ' Date: 9 v Phone #: (503) 718 -