Permit 7 a CITY BUILDING PERMIT
4 PERMIT #: BUP2008 -00220
COMMUNITY DEVELOPMENT DATE ISSUED: 7/28/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136AD -06300
SITE ADDRESS: 10955 SW 65TH AVE ZONING: C -
SUBDIVISION: PGE LOT: JURISDICTION: TIG
PROJECT: PGE ANTENNAS
Project Description: Installing new antennas on existing monopole and new equipment cabinet on the ground.
REISSUE: _(L FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: feel FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: NONE sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 20,000.00
Owner: Contractor:
PORTLAND GENERAL ELECTRIC M & A CONTRACTING INC
COMPANY 1366 LEE ST SE
121 SW SALMON ST SALEM, OR 97302
PORTLAND, OR 97204
Phone: Contact #: PRI 503 - 581 - 6125
Reg #: LIC 177866
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/26/2008 $191.20
[BUPPLN] Pin Rv 6/26/2008 $124.28
[TAX] 12% State Surch 6/26/2008 $22.94
Total $338.42
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of thes- es or dire l uest • • to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss ed By: / /. j2 �, Permittee Signature: , - , '�%—
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application Commercial FOR OFFICE USE ONLY Recei City of Tigard G � DatelB / y� - P ermit No.:
— rQ
° 13125 SW Hall Blvd., Tigard, OR 9 cm
q �
Plan Review
2: \\ Phone: 503.639.4171 Fax: 503.598. 960 \` D A go a te/By: /`1q — lo V Other Permit:
T I G A R D Inspection Line: 503.639.4175 J `Gr` _ ` Rea dy!$ y: H See Page 2 for
Internet: www.tigard- or.gov 0 � O Notified/Meth / T Supplemental Information
TYPE OF WO v� �O� �� REQUIRED DATA: 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling 10 Commercial/industrial Valuation: $
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 0 I Ss Sc.,) 4,514, ,4 . New dwelling area: square feet
City/ State/ZIP: Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: ZS + o ei Or Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.: / Si 31 DI) 6 3 0 0 equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
.1%)/ r/4U- Mau) Aletr6.it�ltl,4S M. Eicar/N Valuation: $ 2 O pOO Do
MaytvP4lC Au D 4 mew ektAv,t�..,�` d l6, ',le-1- Existing building area: square feet
o N ' i a. 4 y.}) New building area: # square feet
®, PROPERTY OWNER ❑ TENANT Number of stories:
Name: P4 E Type of construction:
Address: r 2.‘ S CO Sou tt, N Occupancy groups:
City/State/ZIP: POpr L.A -iuD 602 Existing:
Phone: ( ) Fax: ( )
New:
APPLICANT isr CONTACT PERSON NOTICE
Business name: .f4 (IQ.t K S LLB All contractors and subcontractors are required to be
Contact name: i <ev ( 14,„mr. /1/4, licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: j N j) t 2.l S r - jurisdiction in which work is being performed. If the
City/State /ZIP: Q (��.N OQ q 7 Ill applicant is exempt from licensing, the following reasons
apply:
Phone: (5 ) 4 4 p R • 023 4- ( Fax : (S03) 4.4q -of i 9
E -mail: 'GJ '1 a G 4.OI. GD
J J CONTRACTOR
Business name: M 4- 4 (JJ — & / l� BUILDING PERMIT FEES* / _ .
Address: I a _ k .. . r ... 6,_f_ (Please
plan review refer to fee schedule) ' /
2
Structural pliew fee (or deposit): /�L�
City / State/ZIP: lD
Sal , . o 97'509-
//� w fee (if applicable): -
Phone: ( 5 j 561 - i d 1 Fax: ( )
Total fees due upon application: '3 3 . Lid-
CCB lic.: /77 .g is 6
Authorized signature: Amount received: %',
This permit application expires if a permit is not obtained
Print name: /�� � / � (/Jfj � r/ A/ Date: 6 N within 180 days after it has been accepted as complete.
cv t t -Z 7 * Fee methodology set by Tri- County Building Industry