Permit I
4
CITY TIGARD BUILDING PERMIT
PE RMIT #: BUP2006 -00385
A ; DEVELOPMENT SERVICES DATE I 9/8/2006
G Y 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 11380 - 00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG
Project Description: Co location of equipment & antennas.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N 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: $ 19,700.00
Owner: Contractor:
CLEAN WATER SERVICES LEGACY WIRELESS
2550 SW HILLSBORO HWY 4252 SE INTERNATIONAL WY # F
HILLSBORO, OR 97123 -9379 MILWAUKIE, OR 97222
Phone: 503 - 681 -3600 Contact #: FAX 503 - 804 -9202
PM 503 - 656 -5300
Reg #: LIC 150432
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/8/2006 $235.30
[TAX] 8% State Surcha 9/8/2006 $18.82
[BUPPLN] Pln Rv 8/14/2006 $152.95
[FLS] FLS Pln Rv 8/14/2006 $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: ,J�a Permittee Signature: , mac,, ,
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.
J6(5 S w 5?'
Commercial Tenant Improvement
Building Permit Application Holz oFrlcE UsE oNLti
Ci}� of Ti and Received / `J g GVCIXA Date/B . 1 Q Permit No.: jl�ur f °`040
13125 SW Hall Blvd., Tigard, OR 97223
B Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/B . i �� ,� Other Permit:
TI G A R D
Inspection Line: 503.639.4175 Date Read See Page for
Internet: www.tigard - or.gov Notified/Method: Supplemental upplemental l Information
' t ;ri// ..� -. G: '
TYPE OF WORK C&J ' g IRED DATA: 1- AND 2- FAMILY ELLING
El New construction ❑ Demolition P. itfees* are based on the value of the work performed.
�+ Indicate the value (rounded to the nearest dollar) of all
Addition /alteration /replacement ❑Other: A " / u 1 ? equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION CI work indicated on this application.
,_,/ T - Valuation: s
❑ 1- and 2 -family dwelling per Commercial / - ` -1'U ' '
� lF . li Number of bedrooms:
0 Accessory building El Multi-family j hi.
❑ Master builder ❑ Other: - Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1b58 p ;1J S f= New dwelling area: square feet
City /State /ZIP: T((.t OR j n .4- Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: C., (C.Er ?may. _ k5 - i- 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: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map/parcel no.: 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.
14D1� �� i�G7� IPr�� 1-1T tJ'1Ct>, f„ rl� �.ti t5 Valuation: " / $
ir..4•4 C >F) Bul L l t 4 ( Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: ( , . ( ACT �tA.3 Type of construction: 3 +�
Address: 39 C5 r p ■ r -'/ I --s 7V-. s 1E 4- t 2,c, Occupancy groups: ti
City /State /ZIP: 5 tt v" O 1 3 c'a Existing:
Phone: (5,,-) ) 3 15 33 Fax: (50-9 3 tfg — `3`h New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: i Nkt t rp r , . g,... p evA ,e Lis All contractors and subcontractors are required to be
Contact name: �t.t� �p ���� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3c c4 4 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: e J 4- 0%(_ 5. Zt}b apply:
Phone: (col ) e.,8 ti - 5 06 7_ Fax: : (S 7 - �3r
E -mail: �[
CONTRACTOR
Business name: L__ l^pL `( BUILDING PERMIT FEES*
Address: f. G ...,�- ` ��. �� ,..%_ l N ` r � �
(Please refer to fee schedule)
��.1 2 Sl. d '`i.! Structural plan review fee (or deposit): 5 t
Y
City /State /ZIP: � ki 6 � y 0 1_, q '� ''� '
FLS plan review fee (if applicable): I
Phone: ( ) \ Fax: ( )
CCB lic.: j +✓ i : > - 15 O Total fees due upon application:
Amount received:
Authorized signature: t This permit application expires if a permit is not obtained
'''JA4:- within 180 days after it has been accepted as complete.
Print name: 1M l Date: et (4 -Ctx.> * Fee methodology set by Tri -County Building Industry
Service Board.
I:\Building\Permits\BUP -TI- PermitApp.doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
_ q Building Division
Plan Submittal Requirement Matrix
TI 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 .1 k
BUILDING DIVISION
PERMIT #: BuRyoutcloas
13125 SW Hall Blvd., Tigard, OR 97223 D ATE E ISSUED: c:ilar200€.;
Phone: (503) 639-4171 ArtomiiAll
Inspection Requests (24 Hrs.): (503) 639-4175 .09. - 1.E.
INSPECTION WORKSHEET FOR DATE: ILI W:M0"/ TIME: 7:06Am PAGE: 28
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CRICKET PDX
DESCRIPTION: Co-location of equipment & antennas
OWNER: CLEAN WATER SERVICES, PHONE #: 503-681-3600
CONTRACTOR: LEGACY WIRELESS PHONE #: 503-ff&5300
Inspection Request Scheduled For: Date: 111812007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 042227-01 281-650-3163 Y
Corrections/Comments/Instructions: -- 0 1 73 °2)5.-
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PASS El PARTIAL APPROVAL El CANCEL 0 NO ACCESS
FAIL . 0 CALL FOR INSPECTION El ADDITIONAL EES ASSESSED
OA 1 V P ! Z
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Inspector: Date: Phone #: (503) 718-