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Permit
, rrrerxuu..rra.0raau rir.sauare rrerrarresrxr. .xr. • ._.... _ ,,, nx r..rrra.+..lerrfaNMWY(MdIFMIHtMMMrMMtMlMxuiA49lUf/tNYlfMll#i.4111Hr. r... .. .r. st rc f r... r.r..sxt t s t.. ...,,r s r.r................ � q CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2021-00189 Date Issued: 1/20/2022 T I Ci A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DA16500 Jurisdiction: Tigard Site address: 17026 SW FRIENDLY LN Project: Verizon Subdivision: None Lot: None Project Description: Tower work:Relocate(3)Antennas,(9)RRHs.Install(5)Antennas,(1)OVP,(1)Hybrid cable.Modify antenna mount.Ground work:install(1)OVP. Contractor: QUALTEK WIRELESS LLC Owner: PORTLAND GENERAL ELECTRIC COMPANY 1150 FIRST AVE SUITE 600 121 SW SALMON ST KING OF PRUSSIA, PA 19406 PORTLAND, OR 97204 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, 08/16/2021 $453.95 Occupancy Grp: U Occupancy Load: 0 Demolition 12%State Surcharge-Building 08/16/2021 $54.47 Dwelling Units: 0 Plan Review 08/03/2021 $295.07 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 08/16/2021 $110.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 08/16/2021 $44.50 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 $957.99 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: / t Permittee Signature: ov-\ cop 1 i c Ct,cl( y-\ 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 M— 2 Commercial t b...k,„./F. , ', " ..t.,... FOR UITI('f: I SF O\I.1 City of Tigard JUL G 4 2021 Date/By. 6 .0'3/2 21 -(a PermitNo.: atil'202toa/sv a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie Date/B _ Related Permit _ Phone: 503-718-2439 Fax: 503-598-1960(;I?•Y OF I Ita�,�jD y: � ' TIGA.RD Inspection Line: 503-639-4175 BUILDING DIVISION Date Ready/By: lure See Page 2 for y Internet: www.tigard-or.gov No' , ethod: %/1 �1 Supplemental Information rI _ TYPE OF WORK REQUIRED e ATA:1=AND 2-FAMILY DWELLING ❑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 101 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 0 Commercial/industrial Valuation: $ 0 Accessory building 0 Multi-family Number of bedrooms: ❑Master builder ®Other: WitreleSs i i•(M Number of bathrooms: JOB SITE INFORMATION AND LOCATION J Total number of floors: Job site address: 17024 gm/ F7itnttt Li M L of ' New dwelling area: square feet City/State/ZIP: Veavve-.%►p pi ' 0 g.. '"7 067 Garage/carport area: square feet Suite/bldg./apt.#: Project name:t ,'= cog, V 1?ftZOIV$ng( Covered porch area: square feet Cross street/directions to job site: Deck area: square feet f 5 a h Shf lapyJ S Taii, Le 9 0 V\ 5 Other structure area: square feet ci,j eleia Li t-� �tC-NC f c ( l S CA 't (21.3 6-1- REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: ��0 u t- ALO R-B 231,0 I Lot#: Permit fees*are based on the value of the work performed. fax map/parcel#: ZS (ppA (p 500 Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor.overhead,and the profit for the DESCRIPTION OF WORK q� work indicated on this application.► See A-l-4-Actie4�- AS- 1 e t`ts+is_ Valuation: $ ZS, too. Oa 1 i r_1-c[ I K.c 4„ (t 0 77 Existing building area: square feet . C.1�77 .T New building area: square feet r 1 0 PROPERTY OWNER W TENANT Number of stories: Name: CA.0uJA1 0iLSv{it.Address: Type of construction: 5� ( e V..), .�-a 00 Occupancy groups: City/State/ZIP: 5e,46444.e. CU 14 6/8 10 c Existing: Phone:(lop) 2 S';—1 103 Fax:( ) New: 0 APPLICANT $ CONTACT PERSON BUILDING PERMIT FEES* (PleasBusiness name: G MA- f��;-yVr . S ' c. j L.L.G. viewere(orer ee schedule) Structural plan review fee(or deposit): 1)7 Contact name: PAx y ,,,,a, t "-s, FLS plan review fee(if applicable): Address: City/State/ZIP:'$ eNtsc (il)._ dot 001 Total fees due upon application: 3Cf it—Li Z11 Amount received: Phone: p(p) Fax: :( ) E-mail:6i r GM4.po �410A,`j(�X+�/t cel. (SOH PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* '"/1t 7 Commercial and residential prescriptive installation of CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System. e� w-Y<.\cS Submit two(2)sets of roof plan with connection details Business name: —Ow a\.)o.0c ` �' and fire department access,along with the 2010 Oregon Address: `\'ST) ('(S� 1A ) �k�) Solar Installation Specialty Code checklist. City/State/ZIP: \G.\v t.-y.) cA- \ NOW, t\ \ O(P Permit fee(includes plan review $180.00 and administrative fees): Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB Lie.: Total fee due upon application: $201.60 Authorized signat This permit application expires if a permit is not obtained ` within 180 days after it has been accepted as complete. Print name: C' A9^`Z 40, Date:7/A * 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) RECEIVED JUL 272021 PROJECT DESCRIPTION 9U�ING DIV SIO N 17026 SW Friendly Lane, Beaverton, OR 97007 Proposed modifications to existing Verizon installation PROJECT DESCRIPTION THE PURPOSE OF THIS PROJECT IS TO ENHANCE BROADBAND CONNECTIVITY AND CAPACITY TO THE EXISTING ELIGIBLE WIRELESS FACILITY. TOWER SCOPE OF WORK: • RELOCATE (3) ANTENNAS • RELOCATE (9) RRHs • INSTALL (5) ANTENNAS • INSTALL (1) OVP • INSTALL (1) HYBRID CABLE • MODIFY ANTENNA MOUNTS GROUND SCOPE OF WORK • INSTALL (1) OVP { ‘ ' if your requested information is not visible, pleas click here. RECEIVED Jill 2 7 21121 , erry OF-'TIGARD BUILDING DIVISION ,...,, ..,r., ,. Geographic Information Systems . , Navigation:Washington County m GIS a.-:....,, '.: Parcel Report 2S1060A16500 I General Information interactive maps 0 Parcel Report for Taxlot: 25106DA1650 map gallery contacts + other gis links frequently asked questions , : —'`"'i c.‘1,4 ‘„,ti'MONGRASS LN Property Search property/taxlot ,i,,, , ..,:,,,ir--V,41 SW SCHCiLLS FER'RY RC) ' " . , . ,„ ._........._ SW FRIENDLY Lla — 4-, tax maps — —,,,,,,„, ,.. i i„ .' I r:. 7'7-' 1,, ,'1°.10' Survey Search I 70 -f• .14 I f,'1 1 !,-•,4,.....14 ,1 Land Services . ,, 54 ' ,,„4„.,,I 7 436 t 73 70 , t Building Services I 741,`,I 73 41 f-'3 4, -,,,!I)'I ' iC' ,";'", ,,,,::,, 107r4- 1 7.4'..i..t,T.12 I ,-: '1:.';:: -1,-.,r', — S17,,,,1` ;, , „, , ,, , t It, ,r3t2 t,1. , 1.:IV!5.,NOV 4,Ii,E,),A,,,41....f.,,,,! S 1/3.41.1",2d0 ".1''''''' SW 13 IR DS DEI.'' ..;' c7 i3,247 tii. i'.'.,...-..1.7..i.,2 t 1i,,..i:941'...Lii141 I.,-4.,it,ra4 ' r,...,,,,..,... 1.332,, . 032.2 ." i ,f,'7 „ „ .., ,7 7,10 %11114 17,,,,tt,,, '13320 .0.,3,,,1P — '— '"',,, ,,,,,24.4 t,-,.,t,i ,0 ,:,5 i I....;',., 1.11V 1.3: „< ' . i r.7.1Ai t: RD t General Property information Map 8i.Taxlot ID#: 2S106DA16500 Real Property Account#: R482310 Site Address: 17026 SW FRIENDLY LN,BEAVERTON OR,97007 I City/State/Zip: Legal: Sub Reports: District Overlay Information Assessment 8 Taxation Information Scanned Tax Mau i permits IS Prov1k Ownership Information: Information Withheld-AllY2 Interactive Mapping: InterMap Other Resources: Unk to External Sites: Virtual Earth Viewer Googie Maps Street Viewer ©2000-2021 Washington County.All rights reserved.Links to external sites do not constitute endorsements by Washington County.By visiting this and other Washington County web pages,you expressly agree to be bound by the terms and conditions of the site.For questions regarding information privacy,liability,accessibility,and public records policies,please review the statements document. 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Need assistance with this page?email us I it ' ij it • . to Lonq. your requested information is not visible, pl` click here. 4.400 r 711110' IN — r Geographic Information Systems Navigation: Washington County» GIS » Reports: GeoSearch District Overlay 2S106DA16500 General Information Overlay Information 2S106DA16500 interactive maps __.__._.... __.._..__.._ ____ _ _.._ map gallery Jurisdiction: .flgr�i ii contacts City Zoning (updated 9/2016): R-25 (confirm with Tigard City Planning, department) other gis links WA1211 / 10/05/2011 / Completed annexation to a frequently asked questions Annexation Proposal/ Effective Date/ district/ Action/ File : http://library.oregonmetro.gov/annexation/WA1211.pdf ' Property Search Within Urban Growth Boundary Yes property/ taxlot Within Metro's Urban Service Area tax maps (*Updated July 31st each calendar No year): Survey Search In Urban Road Maintenance District Land Services (*Updated July 31st each calendar No Building Services year): In ESPD (*Updated July 31st each calendar year): Ground Water Resouce Area: COOPER MTN-BULL MTN Service District for Lighting Assessment Not in an Assessment Area. 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Plat: Property is not part of a subdivision CensusTract:_____.._._ _..._.__..._.._..,_,.,._......,_,_ ._ ._._._..__..._._.._ 031909 Census Block:W ..-. _ __.____.,..__ 2003 Census Blockgroup: 2 'Census Geoid: 410670319092003 Zipcode: 97140 Garbage Hauler: Waste Management of Oregon Garbage Dropbox: Waste Management of Oregon Thomas Brothers Guide: Page: 654 - Grid: F4 * The data layers used to derive items in the report are assembled from multiple sources. Report items flagged with an asterisk (*) are derived from the taxcode layer maintained by Washington County s Department of Assessment and Taxation Cartography Division. The taxcode layer is updated once a year on July 31st and may not reflect final/proposed annexations or boundary adjustments.All information should be verified with individual service districts. © 2000- 2021 Washington County. All rights reserved. Links to external sites do not constitute endorsements by Washington County. By visiting this and other Washington County web pages, you expressly agree to be bound by the terms and conditions of the site. For questions regarding information privacy, liability, accessibility, and public records policies, please review the statements document. This page maintained by Washington County Technology Services. Need assistance with this page? email us City of Tigard COMMUNITY DEVELOPMENT DEPARTMENT II I T 1 c n 1z D Building Permit Review — Commercial - No Land Use Building Permit #: BUP202/-o01g9 Site Address: 17026 SW Friendly Lane Suite/Bldg#: Project Name: Verizon Wireless (Name of commercial business occupying the space. If vacant,enter Spec Space.) Plannir JevieW . Proposal: Modify existing wireless communication facility Existing Business Activity: Wireless Communication Facility Proposed Business Activity: Wireless Communication Facility ® Verify site address/suite# exists and active in permit system. ❑x River Terrace Neighborhood: ® Yes E No ® Zoning: R-25 El Permitted Use: N Yes ❑ No E Spec Space ® Confirm no land use required. rii Business License: Exists: ❑ Yes ❑ No,applicant was provided a business license application Notes: Allowed per 18.450.030.A and C. Approved by Planning: AralliA oeitfrtek Date: 7/29/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved E Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved Buildir Permit-Submittal Original Submittal Date: 47/7OZJ Site Plans: # Building Plans: # 3 Building Permit#: [ 1E nter building permit# above. Workflow Routing: -Planning ❑ Permit Coordinator [Building Workflow Sign-off: a Sign-off for Planning(include notes from planning review) Route Application Documents: Ki'Building: original permit application, site plans,building plans, engineer and beam calculations a . ii st details,if applicable, etc. Notes: By Permit Technician: l/// Date: 1,6/03/262/ I:\Building\Forms\BldgPermitRvw COM_NoLandUse_111819.docx v - -. t Coorclioator.Review ❑ 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: 0 Yes 0 N/A Parks SDC: 0 Yes ❑ N/A ❑ OK to . s e Permit A • i roved by Permit Coordinator: Date: • I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx RECEIVED City of Tigard JUL 2 7 202i 11111 la COMMUNITY DEVELOPMENT DEPARTMENT CITY OF`i'IGARD 1:16 Collocation Supplemental Questionnaire BUILDING DIVISION SITE INFORMATION Collocating antenna is on: I Existing tower 0 Existing non-tower structure Address: I-?oU 5W fritnd(y LA06 City/State: Seavtrht-i, aR Zip: 11 o07 PROVIDER INFORMATION Name of provider: V'GVta✓. Wir tc) Has this provider previously served Tigard? $ Yes 0 No Contact name: 6ARy Abra.104 Phone: Lob-3449 - 4Z79 List other providers currently collocating on same tower or structure: A 14-7 t UW MO V\ Approved land use case number: 15..I P ZotE -• 001427Do'7.017-oo- isCrtr ntikck. �h CoAn , ) ANTENNA INFORMATION Existing: New: ' 1 Height of antennas: 0 ft.. Height of antennas: Q ft. Color of antennas: Fi / 6044 Color of antennas: Ackbgi Pttl te.( Color of equipment: 1 Pailotte4t Color of equipment: Piave/ i"aik+( Accommodating equipment: Accommodating equipment: Will new accessory equipment be installed? 0 Yes t No Location of new accessory equipment: ❑ Within previously approved fenced area O Within existing structure ❑ Other location: Will la pi-g be removed to accommodate the accessory equipment? ❑ 1'es it No 40041 A4,0^dataf44 5/2/ App s attire Print name ate SCV A+.htt t d CL i1's LA'SiljeicA Pole/structure owner's signature Print name Date sTAl i. t'sE O\I.A Zone: R 20 ufApproved 0 Not approved Received by: Pb.- Dater[2-C1 I 2*2J Reasons for denial: City ofTigard • 13125 Sly'Hall Blvd. • Tigard,Oregon 97223 • w'vwiigard-or.gov • 503-718-2421 • Paged ofl CROWN R OW N Crown Castle 0.144..0 CASTLE 1505 Westlake Avenue North Suite 800 Seattle,WA 98109 September 17, 2020 Re: Crown Castle—PNW Subject: Gary Abrahams—Authorized Consultant for Crown Castle Dear Reviewing Parties: This letter serves to notify you that Crown Castle has retained the services of Gary Abrahams, as approved agent to submit application for and obtain local jurisdiction approvals including but not limited to zoning and building permits. This includes applicable permitting for any and all customers seeking to install or modify their equipment on Crown Castle towers. Please feel free to contact me directly with any questions. Thank you for your expeditious processing of applications filed by Mr. Abrahams. Sincerely, Chris Listfjjeld Site Acquisition Project Manager—Seattle Chris.Listfjeld@crowncastle.com (206) 336-7403 The pathway,to possible. CrownCastie.com CrCROWN 1505 Westlake Ave N Phone: t206l 336-2863 Seattle,WA 98109 pax: CASTLE www.crowncastle.wm RECEIVED Via FEDEX to City of Tigard J U L 2 7 2021 Tigard,OR-application via mail CITY OF TIGARD BUILDING DIVISION July 19,2021 City of Tigard Community Development- Permit Services Attention:Tina Escalera 13125 SW Hall Blvd. Tigard,OR 97223 Phone:503-718-2439 RE: Eligible Facilities Request to modify equipment on a communications tower located at: • 17026 SW Friendly Lane,Beaverton,OR 97007 • Assessors Tax Parcel ID number: 2S1o6DA16500 • Real Property Account No.R482310 Jurisdiction:City of Tigard,OR Application for building permit Crown Site Number: 855864 Application ID: 540578 Crown Name: Scholls Ferry Beef Bend Carrier: Verizon Carrier site ID: 451206 Carrier site name: ORHI-BARROWS Crown Castle USA Inc.("Crown Castle")on behalf of Verizon is submitting the attached Eligible Facilities Request application for a building permit application to modify transmission equipment on a telecommunications tower located at 17026 SW Friendly Lane,Beaverton,OR 97007. Verizon proposes to modify this existing site as follows: Proposed Tower scope of work: • Relocate(3)antennas The Foundation for a Wireless World. CrownCastle.corn w t' A 1505 Westlake Ave N Phone: (206) 336-2863 #�,,,, y Seattle,WA 98109 Fax CASTLE www.crowncastle.com • Relocate(9)RRH's • Install(5)antennas • Install(1)OVP • Install(i)Hybrid cable • Modify antenna mounts Proposed Ground scope of work: • Install(i)OVP Submittal documents for this Building Permit application: • Cover letter(see this document) • One(1)copy of the City of Tigard Building Permit Application; • One(1)copy,Collocation Supplemental Questionnaire with attached Crown Castle authorization; • Three(3)copies,construction Drawings,by WT Group,dated 7/2/2021; • Three(3)copies of the Post Mod Antenna Mount Analysis Report and PMI Requirements by TES dated 5/20/21; • Three(3)copies of the Modification&Design drawings for Existing Antenna Mounts Existing Monopole Tower • by TES dated 6/4/2021; • Three(3)copies of the Structural Analysis Report by Black&Veatch,dated 3/30/2021; • Crown Castle Authorization to submit for permits,as tower and facility owner Section 6409 of the Middle Class Tax Relief and Job Creation Act of 2012,commonly known as the"Spectrum Act" (Pub.Law No.112-96,126 Stat 156),mandates that state and local governments"may not deny,and shall approve,any eligible facilities request for a modification of an existing wireless tower or base station that does not substantially change the physical dimensions of such tower or base station." Additionally,if"the reviewing State or local government determines that the application is incomplete"[they]"must provide written notice to the applicant within 3o days of receipt of the application,clearly and specifically delineating all missing documents or information." Under federal law, an Eligible Facilities Request is deemed granted with written notification in sixty(6o)days after an application is filed with a local jurisdiction,excluding tolling. Verizon is committed to working cooperatively with all jurisdictions around the country to secure expeditious approval of requests to modify existing personal wireless service facilities. If you should require more information regarding the Spectrum Act,please do not hesitate to contact me with your questions. Sincerely, Gary Abrahams for CCI The Foundation for a Wireless World. CrownCastle.com RECEIVED CROWN JUL 2 7 202' Crown Castle 1505 Westlake Avenue North %soCASTLE CITY OF IGARD Suite 800 BU1l.DING DIV!SION Seattle,WA 98109 September 17, 2020 Re: Crown Castle—PNW Subject: Gary Abrahams—Authorized Consultant for Crown Castle Dear Reviewing Parties: This letter serves to notify you that Crown Castle has retained the services of Gary Abrahams, as approved agent to submit application for and obtain local jurisdiction approvals including but not limited to zoning and building permits. This includes applicable permitting for any and all customers seeking to install or modify their equipment on Crown Castle towers. Please feel free to contact me directly with any questions. Thank you for your expeditious processing of applications filed by Mr. Abrahams. Sincerely, Chris Listf eld Site Acquisition Project Manager— Seattle Chris.Listfjjeldacrowncastle.com (206) 336-7403 Ali The pathway to possible. CrownCastle.com