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Permit CITY OF TIGARD BUILDING PERMIT 11111 COMMUNITY DEVELOPMENT Permit#: BUP2021-00173 T 16 AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/19/2022 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9585 SW WASHINGTON SQUARE RD Project: T-Mobile Subdivision: None Lot: None Project Description: Modifying antenna equipment and ground structure. Contractor: MASTEC NETWORK SOLUTIONS LLC Owner: PPR WASHINGTON SQUARE LLC 1203 114TH AVE SE BY MACERICH RET BELLEVUE, WA 98004 PO BOX 4085 SANTA MONICA, CA 90411 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: VB Permit Fee-Additions,Alterations, 08/03/2021 $453.95 Occupancy Grp: U Occupancy Load: 0 Demolition 12%State Surcharge-Building 08/03/2021 $54.47 Dwelling Units: 0 Plan Review 07/15/2021 $295.07 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 08/03/2021 $110.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 08/03/2021 $75.00 Value: $25,000 11x17) Additional Plan Review 05/09/2022 $45.00 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $1,033.49 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 952-001-0090. You m obtain a copy. the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: rmittee Signature: C''/Gy���w1✓/ 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. Building,Permit Application -4/Z44/ Commercial RECEIVED City of Tigard Received e71if 202! • Permit No.: P2l,-OO 1 JUN 2 3 2021 Dankev 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review�w l �J Phone: 503-718-2439 Fax: 503-598-1960 Date/By: J Related Permit: I it A R D Inspection Line: 503-639-4175 CITY OF'I GARD Date Ready/By: C/1/2, LC Jaris: Ea See Page 2 for Internet: www.tigard-or.gov DIVISIONBUILDING Notified/Method:47 Supplemental Information (G-7`'14Ig- 69 TYPE OF WORK UIRED 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 p Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. i ❑ 1-and 2-family dwelling 0 Commercial/industrial Valuation: $ ❑Accessory building 0 Multi-family Number of bedrooms: ❑Master builder IQI Other: WIlp.f.Aefl5 Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 2:1 5 6 kAilith,hall-Folk) S-1. R.C. New dwelling area: square feet City/State/ZIP: "'f'j O(Z,0, O a 9121 Garage/carport area: square feet Suite/bldg./apt.#: Project name: cca. 5"1c/5-7 O/ 7 0 , Covered porch area: square feet Cross street/directions to job site: IL Deck area: square feet 5I/V 3 OMj l (I/Le ir•P OF Other structure area: square feet 6 LA) f N 111/"`_I"ct REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: Lot#: Permit fees*are based on the value of the work performed. Tax map/parcel#: 1 5 pie 0 000300 l r O Indicate the value(rounded to the nearest dollar)of all equipment,materials,labor,overhead,and the profit for the P'DESCRIPTION OWORK �1L.'Z3(o _ >4a work indicated on this application. ,!14OCI1 £ S W t. ✓r 4S kZSep Ce 7 Valuation: $ ®O t ilic 4'Z 4"A., e Q...(.4-,�. Existing building area: AYA square feet 1 New building area: lU/A square feet 0 PROPERTY OWNER 7CTENANT Number of stories: `A94-\ Name: Type of construction: c v W ette- Address: !5-0...r Ai ,A , leCia Occupancy groups: pc City/State/ZIP: /0 y Existing: p Phone:(yam)/)&J. 7403 Fa '7x:( ) New: 1 IV 0 APPLICANT lACONTACT PERSON BUILDING PERMIT FEES* (PlBusiness name: C A(,A- Al 0,,i o, ��' LL� ewe refer to fee schedule) Structural plan review fee(or deposit): Contact name: A / t �f `� FLS plan review fee(if applicable): Address: f d ,ox QO fj pr,], Total fees due upon application: City/State/ZIP: f [ 6 c.I 3003 � q Amount received: Phone:��) �{ 1/_�`� 1 Fax::( ) E-mail: ‘ / 6 (,4(4 xpe—f—(f'v+ -,5eArti Ces, Col PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof-top mounted Photo Voltaic Solar Panel System. Business name: - M AS-rE C Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: 12o /Y`71 Solar Installation Specialty Code checklist. City/State/ZIP: 1!f� `� ,f n) Permit fee(includes plan review $180.00 j� v `� and administrative fees): Phone:(y,L�" jam/ 1?JL _ IFax:( ) State surcharge(12%of permit fee): $21.60 CCB Lic.: lq/7Q Lill / .3 Total fee due upon application: $201.60 Authorized si _ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date:670.07Z1 * 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) ba,E — 6. ? 3 /V i. DESCRIPTION OF WORK CROWN CASTLE FOR T-MOBILE (BU 879570) 9585 SW Washington Square Road, Tigard, OR 97223 PROJECT DESCRIPTION THE PURPOSE OF THIS PROJECt IS TO ENHANCE BROADBAND CONNECTIVITY AND CAPACITY TO THE EXISTING ELIGIBLE WIRELESS FACILITY. TOWER SCOPE OF WORK: •REMOVE(E)CANISTER •REMOVE(3)COMMSCOPE-DHHTT65B-3XR ANTENNAS •REMOVE(3)SAMSUNG POWER JUNCTION CYLINDER •REMOVE (3)SAMSUNG FIBER JUNCTION CYLINDER •REMOVE (3)RRH-C2A WIEXT FILTERS •REMOVE (3)RRH-B8 RRUS •REMOVE(3)RRH-P4 RRUS a REMOVE(3)SAMSUNG TELECOMM-HYBRID CABLES • INSTALL(3)COMMSCOPE-FINV-65B-R3-VI ANTENNAS • INSTAL ,82"VENTILATED CANISTER a INSTALL(3)NOKIA-AEHC ANTENNAS •INSTALL(3)NOKL.A.-AHFIGRRUS • INSTALL(3)NOKIA-AHLOA RRUS • INSTALL(2)COMMSCOPE-HCS 2.0 PENDANTS INSTA (2) 125 HCS 2.0 HYBRID CABLES(1-1/2") GROUND SCOPE OF WORK: JUNCTION BOXES ' •REMOVE MMBS • INSTALL(2)AMIA,(1) •REMOVE I3BU FSMF,(2)ASIB,(2)ARK. •REMOVE TELCC)CAB (3)ABIA(4)ARIL(3)ABK: •REMOVE PPC •INSTALL (1)VOLTAGE •INSTALL DELTA MINI BOOSTER POWERPLUS WITH CAMLOCK W/2 AMPLIFIER RAYCAP • INSTALL(1)DELTA HPL3 •INSTALL(1)EXTRA CABINET AMPLIFIER •INSTALL(2)LED LIGHTS •INSTALL(1) CSR IXRE V2 INSTALL(I)DELTA LB3 TRANSPORT SYSTEM BATTERY CABINET • INSTALL POWER/TELCO •TNSTAIL(2) HCS 2.0 CONDUITS It your requested information is not visible, pleas;: click here. t ,°air,' Geographic Information Systems tc 1 , oN Navigation:Washington County-..GIS s Reports:Parcel Report 151260009300 I General Information interactive maps xiot: 151260000300 14 ParcelReport for Ta map gallery .., SW t Art:rri' - h" ,Fi ., /I i. contacts + ;i, SIN CAft t-5 HOME i- ✓ other gis links iVI NIGi1R1.^cti if. is frequently asked questions _ .i .'� '. t r ., W Property Search r Nr iiiirh property J taxlot 4- `' rr' tax maps " ,; I r ,',.i.... ;4 L ShF�dt s. ..Et i hV;:KMAN yt, ^ dr e� Survey Search °a :,.v 1v„rtf, lil, Sty :yAfr,,hi. ' S' t i. n AY PS. rrr, ,l Land Services y5t' I, iSrn%if,.^t err tier `l d Building Services r 9yWWPPt an EL t' a` - fli }...,.- I d . ,,z,it n t y v ic. Fs y d,-c' ; iv rw . -{ wr . Ji t to Jr u General Property Information Map&Taxlot ID#: 1S1260000300 Real Property Account#: 1R236596 R236587 Site Address: 9302 SW WASHINGTON SQUARE RD.TIGARD OR,97223 City/State/Zip: ....._.—,._.r.,.-....._..,.._...--.._-----e._. ........_.—...__.._..._.-.—_..._.n..__ Legal: -... _..—_. Sub Reports: District Ovgr_Ip_y Information Assessment 5 Taxation Information Scanned Tax Maps permits&Projects Ownership Information: Information Withheld-why? Interactive Mapping: interMay Other Resources: Link to External Sites: Virtual Earth Viewer Google Maps Street Viewer m 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 1111111 q COMMUNITY DEVELOPMENT DEPARTMENT TIGARD Building Permit Review — Commercial - N o Land Use Building Permit #: P202.1-60 (7-3 Site Address: 9585 SW Washington Square Rd Suite/Bldg#: Project Name: T-Mobile (Name of commercial business occupying the space. If vacant,enter Spec Space.) P1w .tp rR Review Proposal: Modification to antennas on existing pole and accessory equipment. Existing Business Activity: Wireless facility Proposed Business Activity: Wireless facility K7 Verify site address/suite # exists and active in permit system. J River Terrace Neighborhood: ❑ Yes g7 No E Zoning: MUC ® Permitted Use: ® Yes ❑ No ❑ Spec Space ;A Confirm no land use required. IV Business License: Exists: ❑ Yes ❑ No,applicant was provided a business license application Notes: No land use per 18.450.030.A. and C. Approved by Planning: ATM /AMP& Date: 7/7/2021 Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved .8uildir-Permit Submittal Original Submittal Date: 0V.2p.o2./ Site Plans: # Building Plans: # 3 Building Permit#: M—Enter building permit# above. Workflow Routing: [-Planning ❑ Permit Coordinator G7-Building Workflow Sign-off: ®'Sign-off for Planning(include notes from planning review) Route Application Documents: g—Building: original permit application,site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: Date: 4 7/1{/2 1:\Building\Forms\BldgPermitRvw_COM_NoLandUse_111819.docx t Coordinator 1 eviety ❑ 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 - Tigard Trans SDC: ❑ Yes ❑ N/A Parks SDC: ❑ Yes ❑ N/A ❑ OK to •. u e Permit . .roved by Permit Coordinator: Date: 1:\Building\Forms\BldgPermitRvw COM NoLandUse_111819.docx FOR OFFICE USE ONLY—SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 11111 Transmittal Letter T l ;1\R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: Brandon Taggert DATE RECEIVEDD: DEPT: BUILDING DIVISION RECEIVED FROM: Zach Phillips APR 2 8 202Z COMPANY: Crown Castle(on behalf of T-Mobile) CITY OF TIGARD 3UILDING DIVISIONp. PHONE: 503.708.9200 By:• EMAIL: zach.phillips©crowncastle.com RE: 9585 SW Washington Square Rd. 1,1 2i)?i-o'vi 7 (Site Address) (Permit Number) 879570/532628/WA.SQUARE/TMo (R2201064/1S-1-2600-00300-001) (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 2 Additional set(s) of plans. Revisions: Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. 2 Engineer's calculations. Other(explain): REMARKS: Revising permit to remove the antenna shroud modifications. The existing shroud will be used, per the revised drawings and structural calculations. FOR OFFICE USE ONLY Rou to Permit Technician: Date:' A.,Z Initials: Fees Due: Yet . No Fee Description: Amount e: Special Instructions: Reprint Permit (per PE): ❑ Yes E No ❑ Done Applicant Notified: LDate: ��7L 2--- Initials: I:\Building\Forms\Transmittal Letter-Revisions_073120.doc , . RECEIVED JUN 2 3 2021 CITY OF ItGARD City of Tigard 3UILDING nivi — S!ON s COMMUNITY DEVELOPMENT DEPARTMENT i s Collocation Supplemental Questionnaire uuua.rzr...m,-zzjgganzn.ayS—,,,..v.,..a,affin..1r.4.-,4„.Z7:.-117.1:2VIX,, t.....L....,t,...1W1a,krair..,..C2,:.•.,....V.1.1: .04,,,s,,,....,,v.1.:2 1:13' .,' - -analIMIIIIIIIIMIIIIIIIIIIIIIIIM e7C(SIO SITE INFORMATION Collocating antenna is on: IX Existing tower 0 Existing non-tower structure Address: 9585 SW Washington SO RD City/State: Tigard, OR Zip: 97223 PROVIDER INFORMATION Name of provider: T-MObile Has this provider previously served Tigard? al Yes 0 No Gary Abrahams 206-349-4279 Contact name: Phone: List other providers currently collocating on same tower or structure: AT&T, Sprint Approved land use case number: MM02000-00016 g 0 Fizele.t.... 002 1 ANTENNAINFORMATION Existing: New: 84 79,84 Height of antennas: f t. Height of antennas: ft. Painted Color of antennas: FactoryColor of antennas: Factory Painted sky color Factory Painted Factory Painted Color of equipment: Color of equipment: Accommodating equipment; Accommodating equipment: Will new accessory equipment be installed? lia Yes 0 No Location of new accessory equipment: lit] Within previously approved fenced area 0 Within existing structure CI Other location: Will la scaping be removed to accommodate the accessory equipment? El Yes 5t3 No If es;betr: .-.--7.--- Applicant' ignature Print name Date See Attached C6 fA-- bt<)t-lea qiiiiii) Pole/structure owner's signature Print name Date Zone: OW, 71 Approved 0 Not approved Received by: /1. - Date: 1 1 I 24 14 Reasons for denial: City ofTigard • 1-315 SW Hall Blvd. • Tigard,Oregon 97223 • www.tiga7d-or.gov • 503-718-2421 • Page lot! 1 W — : CROWN Crown Castle 1505 Westlake Avenue North cT CASTLE 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, 61_4- 1 Chris Listfjeld Site Acquisition Project Manager—Seattle Chris.Listfjeld(a7crowncastle.com (206) 336-7403 1 he p.it fits a} to ifroh,,tbie CrownCastle.corn RECEIVED CCROWN JUN 2 3 2021 Crown Castle ,�,,, CITY OF TIGARD, CASTLE1505 Westlake Avenue North Suite 800 BUILDING DIVISION 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, Ft-- Chris Listfjeld Site Acquisition Project Manager—Seattle Chris.Listfjeld@crowncastle.com (206) 336-7403 The pathway to possible. CrownCastle.com FROM: Gary Abrahams GMA NETWORK SERVICES LLC 590 — 1ST AVENUE SOUTH, SUITE 705 SEATTLE, WA 98104 PHONE: 206-349-4279 EMAIL: GARY@GMANETWORKSERVICES.COM TO: City of Tigard Community Development — Permit Services Attention: Eggie 13125 SW Hall Blvd. Tigard, OR 97223 Phone: 503- 718-2439