Permit • I,..
4 6,, CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00608
, DEVELOPMENT SERVICES DATE ISSUED: 10/9/03
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10104 SW WASHINGTON SQUARE RD A -2A PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
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: 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: $ 1,500.00
Remarks: Demolition of partition in front display area.
Owner: Contractor:
PPR SQUARE TOO LLC LAVIER ENTERPRISES
BY MACERICH COMPANY 321 SE ALDER
ATTN: JANET FISHER, ASSET MGMT PORTLAND, OR 97214
SANTA MONICA, CA 90407
Phone:
Phone: 503 - 234 -8532
Reg #: LIC 75591
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 10/9/03 $62.50
[TAX] 8% State Tax 10/9/03 $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 (51 • _ • • 99 or 1- 800 - 332 -2344. •
Iss ed By: i / � I (l / /L•/ A
Perm' ee
Signature: , ,l.i., M
\ .
Cal 639 -4175 by 7 p.m. for an inspection the next business day
jp • .
Building Permit Application Received FOR OFFICE USE ONLY
Building
Date/By /P 9 00 Permit No.. � ai °o06‘18°'
City of Tigard
ly Planning App oval Other
13125 SW Hall Blvd. 0.0 f:.%)
Date /By: Permit No.:
Plan Review Other
Tigard, Oregon 97223 Date /By Permit No J 4l �
7
Phone: 503 -639 -4171 Fax: 3 -5 _ -}�I60 ;"Dill °I Date/By Post-Review
Case Noe
Internet: www.ct.tigard.or.0 b' p ^ =*i - --� el See Page 2 for
24 -hour Inspection Request: �`��6�fG OS�O� Contact Juris.: Name /Method. Supplemental Information
TYPE OF WORK REQUIRED DATA:
El New construction El Demolition I & 2 FAMILY DWELLING
El Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed indicate
El I & 2- Family dwelling El Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, matenals, labor,
overhead and profit for the work indicated on this application.
El Accessory Building El Multi- Family
❑ Master Builder El Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No of baths:
Job site address: /� 16 8(/ Ula 1,�,n Total number of floors
S S iv It New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: "R 0. (4. S tA,0,rI S 100-e Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, matenals, labor,
overhead and profit for the work indicated on this application 41 N
.0ew.p F,rtv) :19 ViQ 11 , 60
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories.
❑ PROPERTY OWNER ❑ TENANT _ Type of construction g'
Name: p 4 to, q -hi . aQ . //60 Occupancy group(s): Existing: /1
New: (y
Address:
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
BUILDING PERMIT FEES*
E-mail: Please refer to fee schedule.
CONTRACTOR
Business Name: I. a v I elt. CA . ir' C S
Q Fees due upon application $
Address: 3 Se. 4idt.a.
City /State /Zip: Pc,r4, per- q 7 21 y Amount received $
Phone: , r3 N . %S 3. Fax: So 3 • a3'R •$41 ai Date received:
CCBLic. #: 7559/ /oS
Authorized / Notice: This permit application expires if a permit is not obtained %Rhin
Signature: Date /0/q/03 180 days after it has been accepted as complete.
/ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i. \Dsts\Permit Forms\BldgPernitApp.doc 01/03
i �� Plan Submittal Requirement Matrix
al 0. � Commercial & Multi- Family
City of Tigard New, Additions or Alterations
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(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 \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received Date eque ted )1 ii ` �� AM PM BUP
Location 1i /0V S //fa /a • U . �C 'Y Suite 4- .'34 MEC
Contact Person Ph PLM
Contractor h ( ) SWR
:01 � Tenant/Owner 6 ELC
Footing
Foundation ELC
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 J
Susp'd Ceilin //,
Roof
O
in
PART FAIL
• I MBING
Post & Beam )...,(
Under Slab
Rough -In
Water Service (IP 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 0 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 (i /� n
FDA l (,/lit V [ a c
Approach/Sidewalk D at e Inspector — Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) • • 4175
INSPECTION DIVISION Business Line: (50 • •• 17 MST
• • ar, 3 —006 oe
0 1°
Received ? / 3 L Z 1 Date R s ed AM PM BUP
Location u) 4.94 - 5 Suit A- • - MEC
Contact Person GGU L c.Q . pi ) 3 Z - b c/ - 5 2 PLM
Contractor t" �• R
BUILDING Tenant/Owner r6 a-c-k_ f3 iVt.z-r-f S -t rr (A Z ) ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam � ' ' + -� e � imiummfft
Shear Anchors 1 v 0
-
Ext Sheath/Shear jA/1
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
itmdla •
S 'ART FAIL
P =1NG
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA k Vo c2
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
J