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Permit CITY OF TIGARD BUILDING PERMIT 1 COMMUNITY DEVELOPMENT I Permit#: BUP2021-00170 LP Date Issued: 8/12/2021 T I t.1 A t;r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135BB00300 Jurisdiction: Tigard Site address: 10185 SW CASCADE AVE Project: Verizon Wireless Subdivision: None Lot: None Project Description: Modify antennas on existing pole' 'EPRINT with new dontractor information. Contractor: TOOL TECH LLC Owner: LAMAR ADVERTISING OF EUGENE 2085 HWY 99 PO BOX 66338 COTTAGE GROVE, OR 97424 BATON ROUGE, LA 70896 PHONE: 541-521-1479 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/29/2021 $453.95 Occupancy Grp: U Occupancy Load: 0 Demolition 12%State Surcharge-Building 07/29/2021 $54.47 Dwelling Units: 0 Plan Review 07/14/2021 $295.07 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 07/29/2021 $110.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 07/29/2021 $110.00 Value: $25,000 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,023.49 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 952-001-009900.r 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: Permiftee Signature: '�sP2 c C' t�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. Building Permit Application Commercial ' ` ..`ta Foa OFFICE USE ONLY City of Tigard Received ._ g Received � 1,4 Permit No.: 1 _ O1' 14 a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503-718-2439 Fax: 503-598-1960 Date/B : Related Permit: t 1 ti n R t) Inspection Line: 503-639-4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.ttgard-or.gov Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING 0 New construction 0 Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all 121 Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. 0 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ IDAccessory building ❑Multi-family Number of bedrooms: ❑Master builder [Other: Wireless Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 10185 SW Beaverton Tigard Hwy New dwelling area: square feet City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet Suite/bldg./apt.#: Project name: 874140/Verizon Mod Covered porch area: square feet Cross street/directions to job site: Site is accessed off of SW Cascade Ave off of Deck area: square feet 210, take the south side of SW Cascade Ave and site is on the (r). 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#: 1 S135 BB00300; R273215 + R273206 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. (See attached) Valuation: $ 25,000 Existing building area: N/A square feet New building area:N/A square feet 0 PROPERTY OWNER l 'TENANT Number of stories: N/A Name: Crown Castle for Verizon Type of construction: N/A Address: 1505 Westlake Ave N #800 Occupancy groups:N/A City/State/ZIP: Seattle, WA 98109 Existing:N/A Phone:(206) 233-7403 Fax:( ) New: N/A 0 APPLICANT lZ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: Grown Castle Structural plan review fee(or deposit): Contact name: Betty May FLS plan review fee(if applicable): Address: 2055 S. Stearman Dr. Total fees due upon application: City/State/ZIP: Chandler, AZ 85286 Amount received: Phone:(602) 845-1715 Fax::( ) PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E-mail: Betty.may@crowncastle.com Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. Business name: Tool Tech LLC Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 2085 Hwy 99 S Solar Installation Specialty Code checklist. City/State/ZIP: CottagePermit fee(includes plan review j Grove , OR 97424 $18000 and administrative fees): . Phone:(541 ) 521-1479 Fax:( ) t,E. State surcharge(12%of permit fee): $21.60 �I CCB Lic.: 175901 V1/),3 Total fee due upon application: $201.60 ;z Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ;{ Print name: 50 �Zy Date:5/17/2022 * Fee methodology set by Tri-County Building Industry li (v//f' Service Board. , E{} I:\Building\Permits\B _COM_PermitApp.dot. Rev.04/21/2014 440-4613T(11/02/COM/WEB) 3yy(t �t133 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 1,1 Accessibility: Barrier Removal Improvement Plan g Commercial & Multi-Family - Additions or Alterations _l l 6^R l) 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): $ 1:\Building\Permits\BUP_COM PermitApp.doc Rev.03/05/2019 ill CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2021-00170 Date Issued: 8/12/2021 T f G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135B600300 Jurisdiction: Tigard Site address: 10185 SW CASCADE AVE Project: Verizon Wireless Subdivision: None Lot: None Project Description: Modify antennas on existing pole Contractor: QUALTEK WIRELESS LLC Owner: LAMAR ADVERTISING OF EUGENE 1150 FIRST AVE SUITE 600 PO BOX 66338 KING OF PRUSSIA, PA 19406 BATON ROUGE, LA 70896 PHONE: 484-804-4500 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: VB Permit Fee-Additions,Alterations, 07/29/2021 $453.95 Occupancy Grp: U Occupancy Load: 0 Demolition 12%State Surcharge-Building 07/29/2021 $54.47 Dwelling Units: 0 Plan Review 07/14/2021 $295.07 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 07/29/2021 $110.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 07/29/2021 $110.00 Value: $25,000 11x17) Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,023.49 Required: Required Items and Reports(Conditions) Fire Sprinkler: Parapet: 1 Special Inspection(see plans) 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: Hollyvary De,ve .e Permittee Signature: OvvAppUco.tIn p Call 503.639.4175 by 7:00 a.m.for the next available inspection date. t'Y 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. Building Permit Application -1 i z Commercial RECEIVED h)R OFFICE I SI.OS1.1 City of Tigard dp Received --t \ NV R�(�2ol\ o "lb JUL 0 ?DV Date/Bv: + �3 z1 Permit No. 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503-718-2439 Fax: 503-598-I Date/Bt- 7��'�� Related Permit: Inspection Line: 503-639-4175 ITY OF TIGARD Date Ready/By: a ® See Page 2 for "`,AItI) www.tigard-or.gov BUILDING DIVISION No' edImethod:7� / I' r SupplementalInformation ,11 Internet: www.ti rd-or. ov TYPE OF WORK REQUIRE P',A . :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 ®Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. dwellingValuation: $ ❑ I-and2-fami]Y 0 Commercial/industrial ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder 1111 Other: Likhreite,C75 Number of bathrooms: 4.A� r �N� Total number of floors: JOBt� SITE INFORMA N A ON Job site address: I O 1 C'rj S w l New dwelling area: square feet City/State/ZIP: --LT,p-(LO 1 0(2, R 1 U,) Garage/carport area: square feet Suite/bldg./apt.#: Project name:'27 1 t'}t a0/Ywiz 04.00 Covered porch area: square feet Cross street/directions to job site: S t'r'e `--s k_c4654. OFF ,OF Deck area: square feet rj't4 f.ASC(eOC /cVQ. C OF 2(0, -1-C l-e- ,.. tom '.spO-� Other structure area: square feet 4'.14P Q{r S%KJ U/6CIAOL Ave. l'*M) StlE 6 0f't1-he- () REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot#: Permit fees*are based on the value of the work performed. Tax map/parcel#: 1 S 1351313 003 e 0) R t-7321)+ 22773 10( 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. S rt L Valuation: S 2.. / O0C) M` Existing building area: p, square feet New building area: Ai A square feet 0 PROPERTY OWNER I TENANT Number of stories: f I., Name: C, ciu,;;A, c 4,e! trQitri7.01 1 , Type of construction: NIA Address: I 5" L $f fV'IJG tJ. -Q)0 0 Occupancy groups: N A City/State/ZIP: 4'V ll, -[e I 0 Q Existing: Al f Phone:(ZED' ) 233---7 t•f o3 Fax:( ) New: //A` 0 APPLICANT h CONTACT PERSON BUILDING PERMIT FEES* Business name: 6f&l). 4ewlii4.. . 5orinCeS La. — Meese refer tales srbedule) - Structural plan review fee(or deposit): Contact name: ,P,y.." �y FLS plan review fee(if applicable): Address: L 6 DS '?.©Q0 City/State/ZIP: ` f C L) I A I 6 O 01 / Total fees due upon application: Phone:Qp(2)34q.. 1-0_-7 1 Fax::( ) Amount received: E-mail: C9P�Y(a 4. istia Ne4-t ce-1, �Q�VtGQc` Gott PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted PhotoVoltaic Solar Panel System. Business name: --F-1319' Submit two(2)sets of roof plan with connection details �\ and fire department access,along with the 2010 Oregon Address: \,'�C> c.c}k INA, - ..(D Ob Solar Installation Specialty Code checklist. ty `: - 0 e �� f _ Permit fee(includes plan review City/State/ZIP: rlrt tY5 ,Nr 17'® and administrative fees): $180.00 Phone:( ) tut:( ) State surcharge(12%ofpermit fee): $21.60 CCB Lie.: 21 U C VI Total fee due upon application: $201.60 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. L rint name: t t°-d'Y9 yji(��(yYe� Date:6,/ 44 * Fee methodology set by Tri-County Building Industry Service Board. ig\Permits\BUP_COM_PennitApp.doc Rev.04/21/2014 440-4613T(11/02/COM/WEB) City of Tigard IIICOMMUNITY DEVELOPMENT DEPARTMENT C TIGARD Building Permit Review — Commercial - No Land Use Building Permit #: aU92c-21---co 1710 Site Address: 10185 SW Cascade Ave Suite/Bldg#: Project Name: Verizon (Name of commercial business occupying the space. If vacant,enter Spec Space.) Plauuiuk 1>teviety Proposal: Modify anntenas on existing pole. Existing Business Activity: Wireless Facility Proposed Business Activity: Wireless Facility RI Verify site address/suite # exists and active in permit system. iN River Terrace Neighborhood: ❑ Yes n No C Zoning: MUG KI Permitted Use: ® Yes D No ❑ Spec Space iE Confirm no land use required. a Business License: Exists: 0 Yes ❑ No,applicant was provided a business license application Notes: No land use per 18.450.030.A, Approved by Planning: ATUA Get"" """" Date: 7/7/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved 0 Not Approved Revision 2: 0 Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Buildir>ro Permit Submittal Original Submittal Date: "I\ 1`Z 1 Site Plans: # 3 Building Plans: # 3 Building Permit#: lEi Enter building permit#above. Workflow Routing: L Planning 'B--Ikrtttit Coordinator l uilding Workflow Sign-off: 0 Sign-off for Planning(include notes from planning review) Route Application Documents: la/Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable,etc. Notes: By Permit Technician: 'l \CA1\ we ,,Q, Date: 1V)'74 C1Building\Forms\BldgPermitRvw COM_NoLandUse_111819.docx t Coordinator Review D Conditio . ` et"prior to issuance of building permit ❑ Approved,NO : ased: Notes: Revisions (after Building Submittal only) Revision Notice 1: Date Sent to Applicant: Revision Notice 2: Date Sent to Appli Revision Notice 3: Date Sent to - .. cant: ❑ SDC Fees Entered: W. o Trans Dev Tax: ❑ Yes ❑ N igard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A 7 OK to • u e Permit • roved by Permit Coordinator: Date: 1:\B ui Iding\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx r City of Tigard 1111 m , " COMMUNITY DEVELOPMENT DEPARTMENT -116ARD Collocation Supplemental Questionnaire e741(to/514o5 1 SITE INFORMATION Collocating antenna is on: ® �xisti�n J w ❑ Existing non-tower structure Address: 10 085 IA-) City/State: T G✓z-O i 0 a- Zip: R 7 Z23 -f l?‘a rr o l-E-i/g h w .,� PROVIDER INFORMATION J Name of provider: Hasthis �provider previously served Tigard? 4 Yes 0 No Col "-�Contact name: Abx a'w4 ew ` ft C i Phone: 2.36-3`f`i `L4Z-1, List other providers currently collocating on same tower or structure: T Mo 6' le- Approved land use case number: ANTENNA INFORMATION Existing: New: Height of antennas: S ft. Height of antennas: -7c ft. Color of antennas: C ( S Cot 02 Color of antennas: FaC.holizAi Shy GB I - f Color of equipment: &`-ktogi Col0g Color of equipment: V.0 C.t/latine- Accommodating equipment: Accommodating equipment: N 0 C.64-7- Fac irl c-to1- Will new accessory equipment be installed? 0 Yes ® No Location of new accessory equipment: 0 Within previously approved fenced area 0 Within existing structure 0 Other location: Will landscaping be removed to accommodate the accessory equipment? 0 Yes 6 No fy :, des, he here:Applicant' signature Print / 4'Date Pole/structure owner's signature Print n:.me Date STAFF USE ONLY Zone: ❑ Approved ❑ Not approved Received by: Date: Reasons for denial: GVf44d nnay'`UYiNO}%Y Nance r.-"iGM'M1:n' .. u`mi8 lMrdr' _.•r'•"" —.T um ggp�F - City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of1