Permit CITY OF TIGARD BUILDING PERMIT
- "R COMMUNITY DEVELOPMENT Permit #: BUP2011 -00066
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/26/2011
TIGARD Parcel: 25101 DD00101
Jurisdiction: Tigard
Site address: 6975 SW SANDBURG ST 100
Project: AT & T Subdivision: Lot: 0
Project Description: Replacing (3) antennas on existing rooftop.
Contractor: LEGACY WIRELESS SERVICES INC Owner: WESTON INVESTMENT CO LLC
15580 SE FOR MOR CT 2154 NE BROADWAY, STE 200
CLACKAMAS, OR 97015 PORTLAND, OR 97232
PHONE: 503 - 656 -5300 PHONE:
FAX: 503 - 656 -5305
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 08/26/2011 $453.95
Class of Work: ALT Demolition
Dwelling Units: 0 Plan Review 03/31/2011 $295.07
Stories: 0 Height: 35 ft 12% State Surcharge - Building 08/26/2011 $54.47
Bedrooms: 0 Bathrooms: 0 Info Process /Archiving - Sm Sheet (up to 08/26/2011 $19.00
Value: $25,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $822.49
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 the 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 -0090. You may obtain a cop of_thejules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: I
1 .c .. • .4175 by 7:00 a.m. for the next available inspa ion date.
This permit card s all be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
, ing Permit Application . , •
C o mm e r cia l F OR OFFICE USE ONLY
City of Tigard Received
13125 g Fr,,..\\(,,: \ Date /BY t ( Permit No.: j i. • G
IN - n City 5 SW Hall Blvd., Tigard, OR 97223 �., fJ Plan Review .=
' Phone: 503.718.2439 Fax: 503.598.196 �t,�* o' 7 / Date /By: .. ) ►` Other Permit:
Inspection Line: 503.639.4175 �+, 11 Date Read /B .tuns: See Pa e 2 for
TIGARD p \'0 �\, Y y // r / g
Internet: www.tigard -orgov ■`' ∎ = S.4 Notified/Method: f f /0 i p Supplemental Information
., � e c ,,�
TYPE OF> WOR Y p RE JIRED DATA 1 AND S FAMILYrDWELLING
❑ New construction ❑ Dem�i•tion�O o� Permit fees* are based on the value of the work performed.
. d Indicate the value (rounded to the nearest dollar) of all
EkAddition /alteration/replacement ❑ kV equipment, materials, labor, overhead, and the profit for the
CATEGORYF CONSTRUCTION ,
work indicated on this application.
❑ 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Anil p Ih (�(� Number of bathrooms:
J OB SITE` INFORMATION . AND LOCATION Total number of floors:
Job site address: C ) S S 1../ CA, h.(4 t•t V p ki New dwelling area: square feet
City /State /ZIP: .i Ci t, VN Olt q-7-/:/,' % Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: r k g5 Tic kv A Covered porch area: square feet
Cross street/directions to job site: 7 7 la , Deck area: square feet
Other structure area: square feet
REQUIRED DATA COMMERCIAL -USE CIiECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2-S101 D I] 0 0 l v I Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
;,` v 1 ED cRIPTION OF WORK. ` work indicated on this application. �r�)
R lD 1� L 1 0t, 0- (b1 rl J' .F. x t'S T • 1�) hla I- �7 Valuation: $ Z ( 0 v V
/A ' ` ttl(t}'�- Existing building area: square feet
Ti
New building area: square feet
PROPERTY OWNER l. TENANT Number of stories:
Name: AT (eT A /1 n t?►' Type of construction:
Address: R T C 6,&11,1 i , 4/1. I Air 2,A i A Occupancy groups:
City /State /ZIP: 12 1, r : 0,4 / 4 - 0110S Z Existing:
Phone: ( ) Fax: ( ) New:
1 ❑ j APPLIC 1t - >. . . ._.... F .:,, (/�, CO TACT PERS
NN- v
. � � BUILDING PERMIT FEES* � `
,.:z.,, o (Pieose -refer to fee hedi i t . ,i<
sc jiu„ . ,
P TS (o b .c ,,1Lb - Tg r )
Business name: �/ Structural plan review fee (or deposit):
Contact name:: 11 Z� ` N „L t L t S FLS plan review fee (if applicable):
Address: 10 01 SE: lv" 4 Al S 4'e L /�
J �f Total fees due upon application:
City/State /ZIP: Pa Ir G1 . t � O VL '1 7 Z I 1
Amount received:
Phone: (
C ^ (� Cl 501 ) 7O 1 0 Fax: : (�b) )Z32. 0 -1t "1 ,
E-mail: . l � ` PHOTOVOLTAIC S OLAR. SYSTEM.F
4!x a ,'m Comm cial and residential prescriptive installation .
Y
" � ` ` s � GONTRACT � y � , � r roof -top nted Photovoltaic Solar Panel S . -
� ...... �' , , .,. . z. ��U.. y.. _ . . ,tea , �. .. ,.�. ...y,;,� , . .._ . �i�f ...,, zn ✓ r�,.,,•, � -.- ,.
Business name: I +� Submit two (2 of roof plan with co •ction details
l +� e.lL�j' wt � c ... /I a� and fire department acc- - Ion: - • the 2010 Oregon
Address: / 5 ∎M S'O tnr in Or Solar Installation Special - "6,; hecklist.
Permit fee '' des plan revi
City/State /ZIP: Gi et 7 0 (5
` d administrative fees):
i
Phone: (5j3 ) (' .- Ufl Fax: (Sp3) 6,5---6 —5105--- St. urcharge (12% of permit fee): $21.60
/'1,:9
CCB lic.: J ' S ( -)d,.. -)d,.. ' ' 7(fp5-
Total fee due upon application: $201.60
Authorized signat�urre: H, /- . This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: z 4 pi,;( 91 S Date: (i>0 1 * Fee methodology set by Tri County Building Industry
f Service Board.
I: \Building \Permits \BUP -COM PermitApp.doc 02/24/2011 . 440- 4613T(11/02 /COM/WEB)