Permit A r + BUILDING PERMIT
CITY OF TIGARD PERMIT #: BUP2004 -00101
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Y� DEVELOPMENT SERVICES DATE ISSUED: 3/15/04
13125 SW Hall Blvd.. Tioard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10246 SW WASHINGTON SQUARE RD C -16 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 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: 3N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 19 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
Remarks: Tenant Improvement
Owner: Contractor:
BY THE MACERICH COMPANY MASTERMIND DEVELOPMENTS LLC
9585 SW WASHINGTON SQUARE RD DBA TOP DRAWER DEVELOPMENT
TIGARD, OR 97223 19360 SW 90TH COURT
TUALATIN, OR 97062
Phone:
Phone: 503 - 885 -8686
Reg #: LIC 133962
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pin Rv 3/11/04 $59.30 Electrical Permit Required
[BUILD] Permit Fee 3/15/04 $91.30 Sprinkler Permit Required
Plumbing Permit Required
[TAX] 8% State Surchari 3/15/04 $7.30 Framing Insp
[FLS] FLS Pin Rv 3/15/04 $36.52 Gyp Board Insp
Total Final Inspection
$194.42
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: -
Pe
ign at u ee �
Signature: P a� " 1
0 Call 639 -4175 by 7 p.m. for an inspection the next business day
IP IO2'f( 54' WA. See . RP .
jMSSL 4 JRta /4CAL -f
BuildTn2 Permit Application FOR OFFICE USE ONLY
Cl}� of Tigard Received q
City g Blvd., Tigard, RECEIVED Date/B : :0. 1. 1 1 Permit No ' 2 Y —oa /6 /
13125 SW Hall Plan Revie
/ fi r t
Phone: 503.639.4171 Fax: 503.598.1960 � \ B . "it Date/B Other Permit
Inspection Line: 503.639.4175 ^ 004 � / 1 Date Ready/By: saris ® See Attached Checklist for
Internet: www.ci.tigard.or.us MAR 11 L Notified/Method: Supplemental Information
CITY OF TIGARD
At III'�i Ai'� v i REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction [�l ❑ 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.
❑ 1- and 2- family dwelling '" m
lComercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
. , , . , • JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: L o 1K, 5 IAJ tAkt 8 , 6 ( 1 ,-_,,, New dwelling area: square feet
City/ State/ZIP: I j Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: o v y $, (� � �� Covered porch area: square feet
Cross street/directions to job site: r'VY,IC' - fp w - ?q £ f Deck area: square feet
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: $ ,S 000
° i - , Existing building area: 6,1 square feet
lie“) 4e“) / y 1 r • , \ 1 . I (mot af2--- New building area: square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name: Vta/rl,/ 1 Type of construction: a A
AA - 5t - � �yyy i p
Address: 1 Occupancy groups:
City/State/ZIP: OQ Or 9-70-act- Existing:
Phone: ( 503 ) <J t 0 -go 13 Fax: ( ) New:
- ' ❑• APPLICANT ' CONTACT PERSON NOTICE
Business name: �n P p1_A„3 Q. t)e\ - ,o p nn All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
I �.L, under ORS 701 and may be required to be licensed in the
Address: VI 3 O S 14. qb IA ( jurisdiction in which work is being performed. If the
City/ State/ZIP: 1 QJh'N 91 0 (409- applicant is exempt from licensing, the following reasons
1 apply:
Phone: & ) 38 S'8'f g' Fax :: (5 )3 ) qsS
E -mail: Y )„,(1 t i— ch 114.4,-1,..a0.),1 , nit
CONTRA OR
Business name: 4.41/44‘ BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City/ State/Z1P:
Fees due upon application
Phone: ( ) I Fax:( )
Amount received
CCB lic.: ' ?S 7
P Date received:
Authorized signatu-- This permit application expires if a permit is not obtained
% _i . ` � i within 180 days after it has been accepted as complete.
Print name: . _.∎ s � M�M s� • Fee methodology set by Tri-County Building Industry
Service Board.
i\ Building \Pemuts\BUP- PernutAppdoc 12/03 440- 4613T(II /02/COM/WEB)
•
Building Division
/ %mz�miIl Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal • # of Plans
Si,-)) S (Includes new, additions and alterations.) Required at
Submittal
(I- 1.
)( Demolition Permit 2
3 6/".5 (site plan required showing location and square
P1-5 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
Received Date Requested O AM PM BUP
Location b a 4 (o w A • ��Q - R �.J • Suite c—/* MEC
Contact Person m 0 J\.,�., Ph ( T7/ ) IP I - ti — 8 7 99 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: �/y� - SIT
Post & Beam �` /� ✓, ' / • ` /'�
Shear Anchors
Ext Sheath/Shear 1194 . 1.A.L0 •
Int Sheath/Shear
Framing
Insulation N b �\ „ 1
Drywall Nailing �Y
Firewall 4 0 15-2/]) ;,
Fire Sprinkler
Fire Alarm imV_\ ` �1 7�1 0 C — 0 0 \ T ie
Susp'd Ceiling -
Roof
Other: -
•-I
PART FAIL
4 d MBING
Po t & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan i
Other:
Final
PASS PART FAIL
MECHANICAL (..."))/. C:
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 El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA 5 /7 7
Approach/Sidewalk Inspector `i` Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL