Permit CITY OF TIGARD BUILDING PERMIT
: COMMUNITY DEVELOPMENT Permit#: BUP2020-00184
Date Issued: 10/13/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114AA00300
Jurisdiction: Tigard
Site address: 16295 SW 85TH AVE
Project: AT&T Cell Tower Subdivision: None Lot: None
Project Description: Remove and replace(6)antennas,remove(3)antennas,remove(12)TMAs,remove and replace(6)RRHs,add
(6)new RRHs.Add a mounting support kits to existing mounts.
Contractor: LEGACY WIRELESS SERVICES INC Owner: WH SHIPMAN LIMITED
15580 SE FOR MOR CT BY NORRIS& STEVENS INC
CLACKAMAS, OR 97015 900 SW 5TH AVE STE 1700
PORTLAND, OR 97204
PHONE: 503-656-5300 PHONE:
FAX: 503-656-5305
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 09/28/2020 $301.85
Class of Work: ALT Type of Const: IIIA Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 09/28/2020 $36.22
Dwelling Units: 0 Plan Review 08/20/2020 $196.20
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 09/28/2020 $102.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 09/28/2020 $61.50
Value: $15,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $697.77
Required: Required Items and Reports(Conditions)
1 Special Inspection(see plans)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 the 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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature:
O—'1' '•-, Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
*
BuildingPermit Application SEC " D
Commercial
AUG 4 202014 Rece ved
City of Tigard DareBv. 9.202o PermitNo.�P2020—Z/81
• 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF T?GARD Plan Review
Phone: 503-718-2439 Fax: 503.598-1 ILDINCI DIVISION Date/By: 8 '3j ....„.„......4.
Related Permit:
I I GAR D Inspection Line: 503-639-4175 Date Ready/By: Jura: Ia See Page 2 for
Internet: www.tigard-or.gov Notifted/Method: 7/ 'j��'/ N Supplemental Informadon
� y�*
f"—mae 1-e.%//Co-14=re
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
0 New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
G.Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling [21•Commercial/industrial Valuation: S
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder Other: unmanned cell tower Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16295 SW 85th Ave New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: PR52 Durham- 3C/4C/5C/FN Covered porch area: square feet
Cross street/directions to job site: Nil-
! e/ ev. Deck area: square feet
SW Durham Rd. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
Tax map/parcel#: 2S114A00300 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.
Remove and replace(6)antennas,Remove(3)antennas,remove(12)TMAs,remove Valuation: S 15,000.00
and replace(6)RRHs,Add(6)new RRHs.Add a mounting support kit to existing Existing building area: square feet
mounts. New building area: square feet
—
0 PROPERTY OWNER ® TENANT Number of stories:
Name: AT&T Mobility Type of construction:
Address: 19801 SW 72nd Ave.,Suite 200 Occupancy groups:
City/State/ZIP: Tualatin,OR 97062 Existing:
Phone:( ) Fax:( ) New:
IIAPPLICANT Itg CONTACT PERSON BUILDING PERMIT FEES*
Business name: Smartlink Group (P +derrofee sekeduh)
Structural plan review fee(or deposit): l9(i. 2 2
Contact name: Courtnee Gomez
FLS plan review fee(if applicable):
Address: 11410 NE 122nd Way
City/State/ZIP: Kirkland,WA 98034 Total fees due upon application:
Amount received:
Phone:( 914 527-4157 Fax: :( )
courtnee. tiiny�rou corn PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
omez@smar
E-mail: g kg P
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: T D �1t405 Submit two(2)sets of roof plan with connection details
LQ and fire department access,along with the 2010 Oregon
Address: itzSo y/L 4 C- Solar Installation Specialty Code checklist.
' - ►1 Permit fee(includes plan review
!j
City/State/ZIP: lt e Li/ Lt j/ !/ 97Q I and administrative fees): $180.00
Phone:(�)6, .�3�U Fax:( ) State surcharge(12%of permit fee): $21.60
CCB Lic.: �J�),' Total fee due upon application: $201.60
Authorized signature: J V \ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:
Courtnee Gomez Date: 7/29/2020 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
1-1-G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
REQUIREMENT: OREGON REVISED STATUTE (ORS)447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five percent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering: [1] $
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Permits\BUP_COM PermitApp.doc Rev.03/05/2019
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. " Plan Submittal Requirements
Commercial & Multi ?amily - New, Additions or Alterations
T[GAIZD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov.
1. SITE PLAN (3) copies - fully dimensional,drawn to scale and labeled with:
A. 0 map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name 0 phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the"Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans,details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit-based on valuation of project.
I:\Building\Pemtits\BUP_COM_PermitApp.doc Rev.03/05/2019
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
" Plan Submittal Requirements Matrix
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 1312_5 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439• www.tigard-or.gov
Type of Submittal # of Plans
(Includes new,additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan is required showing location and square footage
of all buildings to be demolished,erosion control plan and
tree protection,if applicable)
Site Work 3
(must include location of all accessible parking)
Plumbing(site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing(building fixtures) 2
Electrical 2
Solar Photovoltaic 2
(Requires check list for prescriptive installation. If not
prescriptive installation,engineering is required.)
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),if applicable.
I:\Budding\Permits\BUP_COM PermitApp.doc Rev.03/05/2019
City of Tigard
IICOMMUNITY DEVET OPMENT DEPARTMENT
T l c n R n Building Permit Review — Commercial - No Land Use
Building Permit #: /3UP-20Z0- eo/84
Site Address: 16295 SW 85th Ave Suite/Bldg#:
Project Name: AT&T
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Remove/replace antennas and equipment
Existing Business Activity: Wireless communication facility
Proposed Business Activity: Wireless communication facility
0 Verify site address/suite#exists and active in permit s stem.
❑o River Terrace Neighborhood: ❑ Yes LI No
Q Zoning: I-P
❑o Permitted Use: L"I Yes U No U Spec Space
❑✓ Confirm no land use required.
❑' Business License:
Exists: ❑r Yes ❑ No, applicant was provided a business license application
Notes:
Approved by Planning: �� :�jz Date: 8/5/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: OO"04--2620
Site Plans: # c3
Building Plans: # 3
Building Permit#: Enter buildin ermit# above.
Workflow Routing: 9-Planning U Permit Coordinator IR-Building
Workflow Sign-off: Qn'�S,ign-off for Planning(include notes from planning review)
Route Application Documents: L� Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
ByPermit Technician:
% - Zd e rt ec mcian: =�i�j,/� Date: i 20
I:\B ui l ding\Forms1B ldgPermitRvw_COM_NoLandUse_I 1 1819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date n to Applicant:
Revision Notice 3: Date en 0, ' ..licant:
❑ SDC Fees Entered: s Co Frans Dev 0 Yes ❑ N/A
\\.ia Tra ❑ Yes ❑ N/A
P C: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved b mit Coordinator: Date:
I:1Building\Forms\BldgPermitRvw_COM_NoLandUse_l 11819.docx
Branden Taggart
From: Branden Taggart
Sent: Friday, September 25, 2020 6:37 PM
To: 'Courtnee Gomez'
Subject: AT&T Antenna Replacement Permit: BUP2020-00184 - 16295 SW 85th Ave.
Attachments: Invoice.pdf
Hi Courtnee,
The AT&T antenna replacement permit, located at 16295 SW 85th Avenue, is ready to issue now. The balance due is$-
501.57, and I have attached an invoice above for you to reference. The permit fees can be paid online through our
website: https://aca.accela.com/tigard/Default.asPx. From there, click on the Building tab, enter the permit number
(BUP2020-00184) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and I will place this permit in the conference room, adjacent to the outer Permit
Center lobby,for pickup between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on
Fridays.
Thank you,
Brander Taggart
711 w City of Tigard
p Senior Permit Technician
Community Development
13125 SW Halt Blvd
Tigard, OR 97223
(503)718-2449
brandent@ttgard-or.gov
1