Permit CITY OF TIGARD BUILDING PERMIT
1114
• COMMUNITY DEVELOPMENT Permit#: BUP2020-00195
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/3/2020
T I i;,4Ii D g Parcel: 2S101 DD00800
Jurisdiction: Tigard
Site address: 14020 SW 72ND AVE
Project: T-Mobile Subdivision: None Lot: None
Project Description: Adding(3)antennas,(1)junction box,and(1)hybrid cable on existing tower.Replacing(1)router;install(1)
junction box and(9)baseband modules w/in existing cabinet w/in existing compound
Contractor: MASTEC NETWORK SOLUTIONS LLC Owner: I S PROPERTIES LP
1203 114TH AVE SE BY FISCHER&COMPANY URI
BELLEVUE, WA 98004 GALLERIA NORTH TOWER II
13727 NOEL RD, STE 900
DALLAS,TX 75240
PHONE: 425-214-9727 PHONE:
FAX: 503-210-1001
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IA Permit Fee-Additions,Alterations, 10/06/2020 $301.85
Demolition
Occupancy Grp: U Occupancy Load: 0
12%State Surcharge-Building 10/06/2020 $36.22
Dwelling Units: 0 Plan Review 09/01/2020 $196.20
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 10/06/2020 $102.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 10/06/2020 $33.50
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 $669.77
Required: Required Items and Reports(Conditions)
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: \ ]_o\\3\ \osr t� Permittee Signature: OtirN Opp t t` `
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.
8(z4J2o .. g 1
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
Cityg of Tigard Date/B e/By:d 08 3/2 Pemur No.
020 8CIP2 i201V/96
Dat
13125 SW Hall Blvd.,Tigard,OR 97223 AUG 2 4 2020 Plan Review Q
Phone: 503-718-2439 Fax: 503-598-1960 Date/By: J' i�—'a0 ' Related Permit
I
n Line:
TIGARD Ea See Page 2 for
Internet: www tigard-or.gov 75CITY OF TIGARD Dallofifi dMellhud:eady/By: whyi r'C1 e�' S plement l Information
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.
El Addition/alteration/replacement ®Other: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling ®Conunerciallindustrial Valuation: $
❑Accessory building ❑Multi-family Number of bed ooms:
0 Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14020 SW 72nd Ave New dwelling area: square feet
City/State/ZIP: Tigard,OR 97224 Garage/carport area: square feet
Suite/bldg./apt.#: Project name: 824675 1-5&Hwy 217-T-Mobile Anchor Covered porch area: square feet
Cross street/directions to job site:From Portland Oregon head south on 1-5 Take exit 293 toward Haines St and
continue onto SW Dartmouth St.In 0.2 miles turn left onto SW 72nd Ave. Deck area: square feet
In 1.1 miles destination will be on the left. Enter the united rental compound. Go almost all the way to the back and its
on the left. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot#: Permit fees*are based on the value of the work performed.
(rounded
Indicate the value to the nearest dollar)of all
Tax map/parcel#: R0460003
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
T-Mobile proposes to installantennas,(1)junction box,and(1)hybridValuation: $ 15,000
p (3) cable on existing
Compound Area-
tower.T-Mobile also proposes to replace(1)router;and install(1)junction box and(9) Existing building area:364 square feet
baseband modules within existing cabinet within existing compound. New building area: N/A square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
N/A
Name: T-Mobile Type of construction: I IB
Address: 8960 Alderwood Rd. Occupancy groups:
City/State/ZIP: POrtland,OR 97220 Existing: Unmanned
Phone:( ) Fax:( )
New: No change
® APPLICANT- ® CONTACT PERSON BUILDING PERMIT FEES*
Business name: Crown Castle on behalf of T-Mobile (Please refer to lee schedule)
Structural plan review fee(or deposit): /7 e 2e'
Contact name: Sarah Baird
FLS plan review fee(if applicable):
Address: 1505 Westlake Ave N,Ste 800
City/State/ZIP: Total fees due upon application:
Seattle,WA 98109
Amount received:
Phone:( 206 )336-3204 Fax: :( )
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
sarah.baird@crowncastle.com
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: -R CW C �//1 , Submit two(2)sets of roof plan with connection details
r J7/Lg. {LvJ and fire department access,along with the 2010 Oregon
Address: /1 c 3 i'-'1iy f.721 Solar Installation Specialty Code checklist.
City/State/ZIP: Celle:Ul.� 1A / Petmit fee(includes plav review $180.00
I l0 0 7 and administrative fees):
Phone:(yam /yJ_ 9�i] Fax ( ) State surcharge(12%of permit fee): $21.60
CCB Lie.: 1 (7ler '
V i 7 Total fee due upon application: $201.60
Authorized signature Q�/24t — p This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Sarah Baird,Crown Castle,on behalf of T-Mobile Date: 8/18/2020 * Fee methodology set by Tri-County Building Industry
Service Board.
1:1Building\Permits\BUP_COM_PermitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB)
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
: .71 U' Accessibility: Barrier Removal Improvement Plan
Commercial & Multi-Family - Additions or Alterations
TIGARD 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_COMJ'ermitApp.doc Rev.03/05/2019
MilCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Plan Submittal Requirements
Commercial & Multi-Family - New, Additions or Alterations
TIGARD 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. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ 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:\Bullding\Permits\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 13125 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.
1:\Huilding\Permits\HUP_COM_PermitApp.doc Rev.03/05/2019
'PI • City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
,
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: Bap 202Q-QC/95
Site Address: 14020 SW 72nd Ave Suite/Bldg#:
Project Name: T-Mobile
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Install antennas and accessory equipment
Existing Business Activity: Wireless communication facility
Proposed Business Activity: Wireless communication facility
❑o Verify site address/suite# exists and active in permit s stem.
QRiver Terrace Neighborhood: ❑r Yes No
❑o Zoning: I-L
❑o Permitted Use: U Yes U No U Spec Space
ElConfirm no land use required.
❑r Business License: N/A
Exists: ❑ Yes 0 No, applicant was provided a business license application
Notes:
Approved by Planning: �._ 14.------ 71-0e.41...—"
Date: 8/25/20
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
...... m ': . iwr..,.. ...ram
Building Permit Submittal
Original Submittal Date: 48 2442d20
Site Plans: # .z
Building Plans: # 2-
Building Permit#: �n n' Et—Building
buildin permit# above. �y
Workflow Routing: L�'Planning Permit Coordinator Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: atuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: ,
Or By Permit Technician: _ - /,� Date: De3/2o
I:1Building\Forms\BIdgPermitRvw_COM NoLandUse_111819.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 Appli t:
Revision Notice 2: Date Sent to ' :. 'cant:
Revision Notice 3: Date Sen • Applicant:
❑ SDC Fees Entered: Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: 0 Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx
�R OW N 1505 Westlake Ave N, Phone: (206) 336-3204
�/�/ Seattle,WA 98109 Fax:
Lis) + CASTLE www•crowncastle.cum
September 23,2020
City of Tigard
Community Development
Attn: Eggie Maldonado
13125 SW Hall Blvd.
Tigard,OR 87223
SENT VIA ELECTRONIC MAIL TO: EDGARDOM@TIGARD-ORGOV
TIGARDBUILDINGPERMI TS@TIGARD-OR.GOV
**********NOTICE OF COMPLETE SECTION 6409 APPLICATION**********
RE: Request for Minor Modification to Existing Wireless Facility—Section 6409
11744 SW Pacific Hwy,Tigard,OR,97223
Crown Site Number:824338/Crown Site Name:Greenburg
Customer Site Number:POo1373B/Application Number:524390
Dear Eggie,
As you are aware,T-Mobile currently has pending before City of Tigard an application for 824338 Greenburg—T-Mobile
Anchor("Application")submitted as an eligible facilities request pursuant to Section 6409.1 Section 6409 is a federal law
governing the collocation, replacement, and removal of transmission equipment on existing wireless facilities. Under
Section 6409 and the applicable Federal Communications Commission regulations,' a state or local government must
approve an eligible facilities request(or find the request is not covered by the federal rules)within 6o days or the request
is deemed granted.
The 6o-day time frame for review,or"shot clock,"is only tolled only if a state or local government determines that the
application is incomplete and provides written notice in accordance with the FCC regulations within 3o days of the start
of the shot clock.3
With respect to the Application,our records show that the shot clock started on August 21,2020.It has been more than
thirty days since the start of the shot clock and we have received no notice of incompleteness that tolls the shot clock under
the federal rules.As a result,the application is now complete for purposes of Section 6409.
1 Middle Class Tax Relief and Job Creation Act of 2012,Pub.L.No.112-96, §6409(2012)(codified at 47 U.S.C.§
1455).
2 Acceleration of Broadband Deployment by Improving Wireless Facility Siting Policies,29 FCC Red.12865
(2014)(codified at 47 CFR§1.6100);and Implementation of State&Local Governments'Obligation to Approve
Certain Wireless Facility Modification Requests Under Section 6409(a)of the Spectrum Act of 2012,WT Docket
No.19-25o(June 1o,2020).
3 47 CFR§i.61oo(c)(3).
The Foundation for a Wireless World.
CrownCastle.c0m
5
ke
CROWN
150ttle,W 98109 N, Phone: (206) 336-3204
Seattle,WA 98109 Fax:
VAWI CASTLE "° `°m
As noted previously,the Application is a request for approval to collocate,replace or remove transmission equipment on
an existing tower or base station,which does not substantially change the physical dimensions of that tower base station.
As such,it is an eligible facilities request that as state or local government"may not deny and shall approve"under federal
law.4
Accordingly,it is our expectation that the application will be approved on or before the shot clock deadline of October 27,
2020.Otherwise,the application will be deemed granted.
Our goal is to work with you to obtain approvals earlier than the deadline.If you have questions,please feel free to contact
me to discuss. We look forward to working with you on this important project, which will improve wireless
telecommunication services in your community using collocation on existing infrastructure.
Regards,
Sarah Baird
Site Acquisition Specialist
Crown Castle
Agent for Applicant
sarah.baird @crowncastle.com
(206)336-3204
4 See 47 U.S.C.§1455(a);47 CFR 1.6100.
The Foundation for a Wireless World.
CrownCastle.com
City of Tigard
IIm COMMUNITY DEVELOPMENT DEPARTMENT
.'7
TIG .RD Collocation Supplemental Questionnaire
SITE INFORMATION
Collocating antenna is on: ® Existing tower 0 Existing non-tower structure
Address: 14020 SW 72nd Ave City/State: Tigard,OR Zip: 97224
PROVIDER INFORMATION
Name of provider: T-Mobile Has this provider previously served Tigard? 0 Yes ❑ No
Contact name: Sarah Baird,Crown Castle Phone: 206-336-3204
List other providers currently collocating on same tower or structure: None
Approved land use case number:
ANTENNA INFORMATION
Existing: New:
Height of antennas: too ft. Height of antennas: too ft.
Color of antennas: Paint to match Color of antennas: Paint to match
Color of equipment: Paint to match Color of equipment: Paint to match
Accommodating equipment: N/A Accommodating equipment: N/A
Will new accessory equipment be installed? ®Yes ❑ No
Location of new accessory equipment:
® Within previously approved fenced area
® Within existing structure 1
0 Other location:
Will landscaping be removed to accommodate the accessory equipment? 0 Yes ® No
Ifyes, describe here:
44.-CraQ Sarah Baird,Crown Castle,on behalf of T-Mobile 8/18/2020
Applicant's st ture Print name Date
9a,cpQ Sarah Baird,Crown Castle 8/18/2020
Pole/structu owner's?e signature. Print name Date
STAFF USE ONLY , n
Zone: 1•"a� 'A Approved ❑ Not approved Received by: Date: S -Z-r J-o
Reasons for denial:
City ofTigard • 13125 SW Hall Blvd. • 'Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 1