Permit CITY OF TI GARD BUILDING PERMIT
P ERMIT #: BUP2004 -00568
-n> lk DEVELOPMENT SERVICES DATE ISSUED: 12/14/2004
" c' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD F -4 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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 45 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: $ 25,000.00
Remarks: TI, ceiling and walls.
Owner: Contractor:
WASHINGTON SQUARE LLC WESTERN CONSTRUCTION SERVICES
BY THE MACERICH COMPANY 4612 NE MINNEHAHA ST
9585 SW WASHINGTON SQUARE RD PO BOX 5768
TICAone R D, OR 97223 VANCOUVER, WA 98668
Phone: 360- 699 -5317
Reg #: MET 8 00 07 000 7 2765
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 12/6/2004 $283.30 Electrical Permit Required
[TAX] 8% State Surcharl 12/6/2004 $22.66
Sprinkler Permit Required
BUPPLN Pln Rv 1 2/6/2004 $184.15 Framing dsp
[BUPPLN] Gyp Board lnsp
[FLS] FLS Pln Rv 12/6/2004 $113.32 Susp Ceilng lnsp
Total $603.43 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.
�r
Issued By:
Permittee
Signature: `/ `, J /� ., - .
--,_ --___
Call 639 -4175 by 7 p.m. for an inspection the next business day
97/ cu.' W44 h 410'6ti a'r.�
, � L &di 1 • d Gucc / v
�s
Build n rCC Applfl �''y` t EI � i aR or IC U S1. ONLY
City of Tigard DDate/By ` �` 7 D Permit No 56 O
7 13125 SW Hall Blvd., Tigard, OR 97223 DEC 0 ( 200 Plan Review
,t i a
Phone: 503.639.4171 Fax: 503.598.1960 I ' Date/By Other Permit
Inspection Line: 503.639.4175 . I a Date Ready/By See Attached Checklist for
Internet: www.ci.tigard or us CITY OF TIGAR Notified/Method / 1a, Supplememtal Info
BUILDING DIVISION
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
V Addition/ tereplacement ❑ Other: equipment, materials. labor. overhead. and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling VI ustrial
Valuation: $
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 97i' / 50 v i r }I lyjknA) s QL ,L y kQE Rp Fit{ New dwelling area: square feet
City/State/ZIP: 1 w g p f ag C r) a•-3 -3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ! f ']2E F} L. rionfs (noose, Covered porch area: square feet
Cross street/directions to job site: I.) A5H rnl (7,-(-04 S Q A 1 6" eet 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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
eraz fide" 1, AkE�,1/41 eelc,ct�- Giza, 5f TI Led Valuation: $ a5 000
p��, ' P ET " - � t L► _f/ Existing building area: / 7 square feet
T bf'�'r�V VI New building area: i 7 0 p square feet
!if PROPERTY OWNER ❑ TENANT Number of stories:
Name: ir1/45 H..1) /e, l3 S Ck 1n a Re f1A deU.L - R & , I l? 071 Type of construction: S ,5
Address: Q5SS .5-4,J t,J,45m H i) b.7p it) So E '20, Occupancy groups: Y" l
City/State /ZIP: - L. ill D n 2 G 7 4) Existing:
Phone: (SD 3) (039- -KC,S Fax: (503 (odO _ 51 /a New:
DX-APPLICANT {a CONTACT PERSON . NOTICE
Business name: WAS Twill C0AJS7/OU SC12I i LC /,(t All contractors and subcontractors are required to be
Contact name: �Rrvt�� licensed with the Oregon Construction Contractors Board
�) . under ORS 701 and may be required to be licensed in the
Address: Lit 1 a N� g 14 t fV 4 C1.4 %ST•. jurisdiction in which work is being performed. If the
. ` applicant is exempt from licensing, the following reasons
City /State /ZIP: V X-4 1/ cola ✓ r 2 , iAlA o'&t, (v 1 apply:
Phone: (36,o) ( r 4 _ 1 , 1 Fax:: (3 o (9 4 lF - 7818
E -mail: p rnCp 5l lcc f70 Yt• G -iDvi&
CONTRACTOR
Business name: , A t iv L4 1 0-
BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City/ State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB lic.: ( 3 (7/87
//�� qq Date received:
Authorized signature: �
A. /1 This permit application expires if a permit is not obtained
J y ��Q,c within 180 days after it has been accepted as complete.
Print name: F ...Lei l4 ot-• U ft d Date: /y /6, loti * Fee methodology set by Tri-County Building Industry
Service Board.
CITY OF TIGARD 24 -Hour
BUILDING t, Inspection Line: (503) 639 -4175 a S _ c c'Cc ,
INSPEtTION'DIVISION Business Line: (503) 639 -4171
BUP (20 - 06 S"(07
Received Date Requested ( ( AM PM BUP
Location 97/9 &t9 S Q • (Q-p Suite r / MEC
Contact Person /g Ph (3c) !P O/ 7 �T PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Ren—e /l ZL LC
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
Susp'd Ceiling £ ��
Roof ��,7—
Other: - i- - -
•(,
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 be •re next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please cal or reinspec'•n RE: — _ ❑ nable to inspect — no access
Fire Supply Line �-
ADA D OAP Inspector / Ext
Approach/Sidewalk P •
Other:
Final DO NO REMOVE this inspection record from the Joh site. •
PASS PART FAIL
(A