Permit a CITY OF TIGARD .4 - • ii. BUILDING PERMIT
III PERMIT #: BUP2007 - 00041
COMMUNITY DEVELOPMENT DATE ISSUED: 3/2/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136CC-02100
SITE ADDRESS: 11744 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: CLEARWIRE
Project Description: Collocation on existing monopole.
REISSUE: egg_ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ,At 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 LAKW WASHINGTON BLVD STE 1010 SE 11TH AVE
KIRKLAND, WA 98033 PORTLAND, OR 97214
Contact #: FAX 503 - 535 - 2620
Phone: 425 - 216 -7600 PRI 503 - 234 -9900
Reg #: LIC 203
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 1/25/2007 $152.95
[BUILD] Permit Fee 3/2/2007 $235.30
[TAX] 8% State Surcha 3/2/2007 $18.82
[FLS] FLS Pln 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: LQ,,,.4.1 Permittee Signature: /fV odtAil A at
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.
4
PP Comn( rcial Tenant Ii4reovenlenf /144)
Buildine Permit Application FOR OFFICE i •st ONI:l
� a 7 p
Int City of Tigard I �M p�! w / R lilzom Patin! r o.:. ; I . ,,,,,, , , A.,_ pii l a
.7 ° 13125 SW Ha Blvd., Tigard, OR 97223 Plan Vi
Phone: 503.639.4171 Fax: 503.598. 2 2 007 Date,B . / v► i ✓ 3-) - o Other Permit:
T i G n r u Inspection Line: 503.639.4175 Date Ready/By. � '� ® See Page 2 for
Internet: www.tigard-or.gov CbTY OF TIGARD NotiSediMethod � Sopple Information
BUILDING DIVISION
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
1SLAddition/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: 1 i 144 5 ) ?oz.1 1 G 14 W 1 New dwelling area: square feet
City/State/ZIP: 71 GCt.� t Or . cn 1:5 Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 I Project name: Covered porch area: square feet
Cross street/directions to job site: 56E D watch nv,,, c s \ r ee+11.1 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:15 i 3 (? C.GO 21 00 equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
• _tt� Valuation: •" s to o el
CAI l S,Te. Go - ►dcoal or, .. N om ca4eMvItt,b cola 1
1M1 o0. 1 �'1es 1 is I lbe v v, r,0 100 square feet
1.4 ao � d s n eyc _ o poles. Existing building area: 10
E v 9 o h vleAr3 Gonc . 1h GLibTtr c� C.Oirrpotl+
New building area: y 4 square feet
D PROPERTY OWNER I� IQTENANT% Number of stories: t z o a nO%,,O Q
m
Nae: {[�iC3. MA; % t) Lk) � tve e..%s )y ,)r) beam) Type of construction: -. ^
Address: RC)41 I RKX`.O�.s l 1%•1 Ir1 )I JD /0 E Sl']iTe. occupancy groups: LA
City/State/ZIP: KI rk\ o,yic `` W 1 W L 1 t) Existing:
Phone:4 a% (D - 1(p 00 I Fax: 0.125 2144 '`ICI 0 0 New:
APPLICANT s ELCONTACf PERSON NOTICE
Business name: 14, e o Y , v . e .• 1adop r,nGyii All contractors and subcontractors are required to be
Contact name: ' licensed with the Oregon Construction Contractors Board
0.r �.$ tR.v'1 S under ORS 701 and may be required to be licensed in the
Address: 5 2.45cD r'Jw De4 jurisdiction in which work is being performed. If the
City/State/Z[P :'Rkj• a , Q 1 1 Z•�7 3 9 applicant is exempt from licensing, the following reasons
c ' apply:
Phone�3) 3 14-1 - w9 65 Fax:: ( )
E-mail: V(,\ '5e s ® s p ► -' I T o he. • Go 1'+�,
1
CONTRACT •R
Business name: f p%AI D . I ! '� . BUILDING PERMIT FEES*
Address: 1 (P/aase "dc` to fee schedule)
Structural plan review fee (or deposit):
City/State/ZIP:
Phone: ( ) I Fax: ( )
FLS plan review fee (if applicable):
Total fees due upon application:
CCB lic.: •
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: te)r�s (Date: ` � tOi I • Fee methodology set by Tn-County Building Industry
Service Board.
I:\ Building \Permits\BUP- TI- PermitApp.doc 0323/06 440-4613T( I l 02/COM/WEB) /
, Os- • . 4
; i , ° Building Division
Plan Submittal Requirement Matrix
T I G A R 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 indude 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 #: BUP2007 -00041
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2007
Phone: (503) 639 -4171 ( i
Inspection Requests (24 Hrs.): (503) 639 -4175 . -' -� 1.L.
INSPECTION WORKSHEET FOR DATE: 5/11/2007 TIME: 7:01AM PAGE: 98
SITE ADDRESS: 11744 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CLEARWIRE
DESCRIPTION: Collocation on existing monopole.
OWNER: CLEARW1RE WIRELESS BROADBAND. PHONE #: 425-216-7600
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 - 234 -9900
Inspection Request Scheduled For: Date: 5/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 048096-01 503-8432053 N
Corrections /Comments /Instructions:
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If
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4 v it-/ 5/ ' Inspector: D ate: W �` / Phone #: (503) 718-