Permit I . CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00028
COMMUNITY DEVELOPMENT DATE ISSUED: 3/2/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S101 DD - 00800
SITE ADDRESS: 14020 SW 72ND AVE ZONING: I -L
SUBDIVISION: " LOT: JURISDICTION: TIG
PROJECT: CLEARWIRE
Project Description: Co- location of (4) antenae on existing tower. Equipment of new concrete pad.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK 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:
CLEARWIRE WIRELESS BROADBAND OREGON ELECTRIC GROUP
5808 LAKE WASHINTON BLVD. NE 1010 SE 11TH AVE
SUITE 300 PORTLAND, OR 97214
KIRKLAND, WA 98033
Contact #: FAX 503 - 535 - 2620
Phone: PRI 503- 234 -9900
Reg #: LIC 203
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 1/23/2007 $152.95
[BUILD] Permit Fee 3/2/2007 $235.30
[TAX] 8% State Surcha 3/2/2007 $18.82
[FLS] FLS Pin Rv 3/2/2007 $94.12
Total $501.19
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 these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: tJ ' •
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.
=,5(A) 7 e.
Comme cial Tenant
Buildine Permit Application FuR ovFIc:1: l'SE (.)NL.l
City of Tigard CEIVED / of 11��.h7�i> •. �° , �/ -i 7- �•
.�
• 13125 SW HaII Blvd, Tigard, Plan Review
Phone: 503.639.4171 Fax: 503.598.1 Dig . A. ;1 Other Permit:
r �, �'. D Inspection Line: 503.639.4175 JA N 2 3 2007 Date Ready/By: �" See Page 2 for
Internet: www.tigard-or.gov Notifed/Me hod: Supple Information
CITY TIGARD
pp�
TYP E'�OF 1VOII DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Addition /alterationh lacement 0 Indicate the value (rounded to the nearest dollar) of all
eP equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling 19 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: 14tao g)1 ,ZN° JveT New dwelling area: square feet
City/State/ZIP: P o • OR_ 912.2-q Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: �>`. 0 itL e +�-1O4 S ON Deck area: square feet
S 14 e 1Lf '- I Other structure area: square feet
REQUIRED DATA COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map/parcel no.: 25 1 O i DD Qu5 00 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.
ELL.. ss r*. C;O l cr-4, 10%, - 1 v1s +o-I 1 4 cu river+ ►QS [i.%.,j Valuation: S 20 0 OQ
Existing building area: Loa square feet
rig tAintt,Y t. /J ..c clti e.-1(.14 I r newprt ok .. •
r y u% vv.e..A- 0,, W hG poi)
New building area: square feet
O PROPERTY OWNER ISLSENANT Number of stories: t0N 11 OQOIt
Name: C leeyr •tee % w U I>. kt;:y S �12A OJ` 1 hO Type of construction: Z.
Address :5%0 �r,�4e. WOrS ` na �I L.Vd . n)E Sul 7{ 1) Occupancy groups: t.&
City/StaterzlP: . k1G►)na) LOA. how5 Existing:
Phone: 6125 2. f(g .1 G 00 I Fax: c Z l l9 - 1 e w New:
APPLICANT ISL CONTACT PERSON NOTICE
Business name: qp uX e R% r)...ve lDpw,ea,t All contractors and subcontractors are required to be
, ` licensed with the Oregon Construction Contractors Board
Contact name:
�� Q $ W1�e' S under ORS 701 and may be required to be licensed in the
Address:5 56 sw i) 24 jurisdiction in which work is being performed. If the
City/StaterLIP: Po b 0,., . Q c1 apply:
is exempt from licensing the following reasons
apply:
Phone: 8 ) 31 -341205 l Fax:: ( )
E -mail: 01 L 5 eA ® 5p t r.r Olrne . 't C,c11-*-,
_ CONTRACTOR •
Business name: " " 1 D 03-1sI q BUILDING PERMIT FEES* "
Address: may (Please rrle,m fee srbamk)
City/State/ZIP: Structural plan review fee (or deposit): /6;2 • %S
Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application: p�—
Authorized signature: � w
Amount received: � i�� • / �
This permit application eipires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: ,...... ( 5 1 �N I Date: 1 Z-3 O� 1 • Fee methodology set by Tri- County Building Industry
Service Board
I:\ Building \Permits\BtJP- TI- PennitApp.doc 03/23/06 440-4613T(11/02/COM/WEB)
N 0 Qa..d, .Ltt-d pi.e.k �1 t . t C j I el( 01
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IP ili o ' Building Division
Plan Submittal Requirement Matrix
T I G A 1z D Commercial & Multi- Family - New, Additions or Alterations
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2 •
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building • 1*
Fire Protection System 2 **
Mechanical 2
•
Plumbing (building fixtures) ' 2
Electrical . - 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
I:\ Building \Permits \BUP- 71- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00028
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2007
Phone: (503) 639 -4171 At
11g
I
i
nspection Requests (24 Hrs.): (503) 639 -4175 .�'!+� °'f L.
INSPECTION WORKSHEET FOR DATE: 5/29/2007 TIME: 7:02AM PAGE: 63
SITE ADDRESS: 14020 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: Co- location of (4) antenae on existing tower. Equipment of new concrete pad.
OWNER: CLEARWIRE WIRELESS BROADBAND. PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-234-9900
Inspection Request Scheduled For: Date: 5/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 049116.01 503-849-2053 N
Correcti ns /Comments /Instructions: /0
R = Al...0 V C p (gyp- (__ , CKPASS PAR ' L APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL IYI ' A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 6 Z V Phone #: (503) 718- Z�7