Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: BUP2010 00120
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Subdivision: LINCOLN TOWER Lot: 0
Project: Lincoln Tower
Project Description: Installing wireless transmission facility on roof consisting of (8) antennas.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee - Additions, Alterations, 10/08/2010 $377.90
CALIFORNIA ST 49TH FL Demolition
PHONE: Plan Review 06/08/2010 $245.64
Plan Review - Fire Life Safety 06/08/2010 $151.16
12% State Surcharge - Building 10/08/2010 $45.35
Contractor:
RF SPECIALTIES LTD
PMB 319 25 NW 23RD PL STE 6
PORTLAND, OR 97216
PHONE: 503 - 515 -8176
FAX:
Specifics:
Type of Use: COM
Class of Work: ALT
Dwelling Units: 0
Stories: 12 Height: 0 ft
Bedrooms: 0 Bathrooms: 0
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $820.05
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permi • - • = • - b'ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do• = in accordance with = • •roved pia. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da -. ATTENTION: Oregon law -q ' -s you follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 through OAR 952- • 1 -0100. Y• ay obtain a copy of the rules or direct questions to OUNC by calling 503.246 9
I - ued By: / 0 di d Permittee Signature:
Calt 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 ,y V v� ' ��1�� FOR OFFICE: US[: (.)\'L1
City of Tigard C Received ��
vv Permit No.: V
II ° 13125 SW Hall Blvd., Tigard, OR 9722 r L� \ Plan Revie ►y, Ill Phone: 503.639.4171 Fax: 503.598.1 �\ �� DateB : /O /af� 10 OtherPennit: - - /-- { •
T i ` ii D Inspection Line: 503.639.4175 ,� \`' P� Qate Ready /: y: Juris: El See Page 2 for
Internet: www.tigard- or.gov ® ; � G t ,C J � otified/Method: 7 1 10 6 - � C, �. , Supplemental Information
TYPE OF WORK (.„1.• O l � � 4lV �� REQUIRED DATA: - AND 2- F AMILY 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 ® Commercial /industrial
Valuation: S
❑ 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: 10260 SW Greenburg Road New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: On roof of Lincoln Center, Deck area: square feet
Cross street is Oak. Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLLST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: I S135A6 03400 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.
Install wireless transmission facility on roof of building consisting of 3 panel Valuation: Au i�
antennas, 5 microwave antennas, and 6 DAP units flush mounted on mechanical Existing building area: NA square feet
penthouse on roof. Install one radio cabinet on the interior wall of penthouse New building area: NA square feet
❑ PROPERTY OWNER I ® TENANT Number of stories: 12
Name: Clearwire LLC/Michael Bacon Type of construction: IIB
Address: 4400 Carillon Point Occupancy groups:
City /State /ZIP: Kirkland, WA 98033 Existing: S -2
Phone: (503)975 -9394 Fax: ( ) New: S-2
❑ APPLICANT ® CONTACT PERSON NOTICE
Business name: Powder River Development Services, LLC All contractors and subcontractors are required to be
Contact name: Dan Dutton licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13220 SE Multnomah Court jurisdiction in which work is being performed. If the
City /State /ZIP: Happy Valley, OR 97086 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 756 -3888 Fax::( )
E -mail: duttondan @comcast.net
CONTRACTOR
Business name: INFPWRidolizeRmiiiiii. /Q.($P£Ci A Cre_s AlD BUILDING PERMIT FEES*
Address: f i 6 5/ p.rj t ow „' 3 A. §_rl (" (Please refer to fee schedule)
Structural plan review fee (or deposit): 0 2't5, (v`(
City/State /ZIP: p z OR. j 7 21 eo
FLS plan review fee (if applicable):
°
Phone: (5f)5 ) 55 / 6 -i 7., Fax: ( )
Total fees due upon applicatio q b ^
CCB lic.: / 16 ' a fi )
3 ���, /��! Z Amount received 94 rF1.)
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Daniel L. Du on Date: 6-7 -10 ' Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits \BUP -COM PermitApp.doc 10 /01/09 440- 4613T(11/02 /COM/WEB)