Permit 71 v CITY OF TIGARD
• BUILDING PERMIT
COMMUNITY DEVELOPMENT 00196
DATE ISSUED: 6 18 2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113 B 0 - 00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG
PROJECT: CLEARWIRE US LLC
Project Description: Add (6) antennas, (6) microwave dishes and (1) equipment cabinet on rooftop.
REISSUE: ClK FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALIT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: 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:
CLEAN WATER SERVICES OREGON ELECTRIC GROUP
2550 SW HILLSBORO HWY 1010 SE 11TH AVE
HILLSBORO, OR 97123 PORTLAND, OR 97214
Phone: 503 681 -3600 Contact #: FAX 503 - 535 -2620
PRI 503 - 234 -9900
Reg #: LIC 203
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUPPLN] Pln Rv 4/5/2007 $152.95
[BUILD] Permit Fee 6/18/2007 $235.30
[TAX] 8% State Surcha 6/18/2007 $18.82
Total $407.07
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 -0 -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 B 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 1 4M - - D6i O 7 Ce)
Commercial Tenant Improvement FOR OFFICE USE ONLY
R Received / �
City of Tigard a�C w j► DateB : AVM= Permit �(�( — 760 19
= R .1 13125 SW Hall Blvd., Tigard, OR 97 3 Plan Revie A
Phone: 503.639.4171 Fax: 503.598.196A p Date/B : ,♦ ���
Other Permit:
TIGARD
Inspection Line: 503.639.4175 ` — �oo I 7 Date Ready/By: 0 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD ,. tif• d/Metho. A p AVM Supple., ntalInformation d
M
TYPE OF WORK 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
' QAddition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling Commercial /industrial Valuation: $
111 Accessory building ❑ Multi- family Number of bedrooms:
111 Master builder ['Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: • TM ► It. New dwelling area: square feet
_ . r :,
City /State /ZIP: , ' O • 2.4- Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: SEA 1"1 f:LTI oN)S . i e a r 1' ). 1111 Deck area: square feet
V 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.: . a.,5 I ) 8 Q(4 �a Indicate the value (rounded to the nearest dollar) of all
Q equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 2 --o 0 00
Mil • _ _ • ear. •� • • YY1 1'0 • , i
d I 51,e.5 t ( E Q.ii p Co..�I'.-I G� nv. ! } t'1 e 1130 Existing building area: ` ( o square feet
1 ST I h �/°�1y h�l New building area: ,l square feet
❑ PROPERTY OWNER ' TENANT Number of stories: 3
IllEraMMEINIM I- s ;Pro . VA , Type of construction:
Address: 1 0 . • ` a t ¥ „,.. Ip i . . NE • • Occupancy groups:
City/State/ZIP: k \, . g$033 Existing:
Phone: (Ai Z • 2 4:1 "1(0oo Fax: (1 4 2 -9 21 (I — 19 New:
'e. APPLICANT &CONTACT PERSON NOTICE
Business name: wdel> "11v e,Y1)e\R e � Op - + All contractors and subcontractors are required to be
Contact nam 1�,a.Y.�e, 5 `'Iers licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 'D Q5G14 ..R.1 jurisdiction in which work is being performed. If the
�
City/State /ZIP: t . (lilt.). nZ 11Z35 applicant is exempt from licensing, the following reasons
I apply:
Phone: 63) N4 . 3.9435 Fax:: ( )
E- mail: 01 t i SSe.S Q •Jp Y1iQ1'!e . C,Ot"+1
CON TRACTOR
Business name: 0 b > ,a BUILDING PERMIT FEES*
Address:
' • ase re et to ee schedule
Structural plan review fee (or deposit): 6 f
City /State /ZIP: r
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application: r
N 1 /� Amount received: /5 9
Authorized signature J1 This permit application expires if a permit is not obtained lil within 180 days after it has been accepted as complete.
Print name: C \. I Ws Date: LI fr 0 7 * Fee methodology set by Tri- County Building Industry
I Service Board.
I: \ Building \Permits\BUP- TI- PermitApp.doc 12/27/06 440- 4613T(I1 /02 /COM/WEB)
• 1
,
1 Building Division
Plan Submittal Requirement Matrix
T I GARD 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 -TI- PermitApp.doc 03/23/06
CITY OF TIGARD _ , •
BUILDING DIVISION PERMIT #: BUP2001 -00196
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/18/2007
Phone: (503) 639- 4171l�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ,er�Ni�
INSPECTION WORKSHEET FOR DATE: 8/28/2007 TIME: 7:00AM PAGE: 62
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE US LLC
DESCRIPTION: Add (6) antennas, (6) microwave dishes and (1) equipment cabinet on rooftop.
OWNER: CLEAN WATER SERVICES, PHONE #: 503 6813600
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503- 234-9900
Inspection Request Scheduled For: Date: 8/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me - = : e Hi,
1 riv<
299 Final inspection 054712 -01 503 - 209.3520
Corrections /Comments /Instructions: ' 'o
(ti
Ni PASS •A"TIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: IS 67 Phone #: (503) 718- (4 6'
CITY OF TIGARD . . .
BUILDING DIVISION PERMIT #: BUP2007 -00196
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/10/2007
Phone: (503) 639 -4171 *84 t ,, y ph� hf��� l � 'ti\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7.03AM PAGE: 86
SITE ADDRESS: 16580 SW 05TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: GLEARWRE US LLC
DESCRIPTION: Add (6) antennas, (6) microwave dishes and (1) equipment cabinet on rooftop.
OWNER: CLEAN WATER SERVICES, PHONE #: 503 -681 -3600
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503.2349900
Inspection Request Scheduled For: Date: 6/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- • -
235 Shear walls/anchors 050708 -01 503-849-3617 OF G e.
Corrections /Comments /Instructions: 1'
gti i NC & Vi�:r i fri -■.
: � C - •- _ ��
p e:Q ., : 5 A S S ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F A IL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Z hone #: (503) 718 - Z 69:y
i