Permit C A ITY OF TIGARD PERMIT #: BUP2004 -00606
- 1" DEVEL ACES 639 -4171 DATE ISSUED: 3/2/2005
SITE ADDRESS: 13680 SW PACIFIC HWY PARCEL: 2S102CC -01100
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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: 5N : 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: $ 60,000.00
Remarks: Installation of (3) antenna sectors on existing monopole, equipment cabinets & fence.
Owner: Contractor:
TIGARD LODGE #207 WESTOWER COMMUNICATIONS INC
PO BOX 230184 19500 SW CIPOLE RD
TIGARD, OR 97281 TUALATIN, OR 97062
Phone: 503 - 625 -4084
Phone:
FEES Reg #: LIC 140471
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 12/29/2004 $341.58
[BUILD] Permit Fee 3/2/2005 $525.50
[TAX] 8% State Surchari 3/2/2005 $42.04
Total $909.12
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: � - - -
all 639 -4175 by 7:00 p.m. for an inspection the next 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.
1,3 G k r - • ? c 4 ' G 14-w y
�}'h�tCh a $ r'ilnet►^.t •
Building Permit Applica E , ‘ ' ® FOR OFFICE USE ONLY
�/ Received / f
City of Tigard Date/B : , ; d t Permit No.: 0 2'i/-,. ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �'� N/05 -a/ Permit: y
� I Date/B :
Inspection Line: 503.639.4175
!DEC 2 8 . -. Y � J r.•I Date Ready/By: • la See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
CITY OF TIGARD j
TBURIONG DIVISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING
® New construction ❑ Demolition Permit fees* are based on the value of the work performed. 1
Indicate the value (rounded to the nearest dollar) of all J
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I- and 2- family dwelling ® Commercial /industrial Valuation: $
3 ❑ 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: 13680 SW Pacific Highway New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: PO63xc002A - Hwy 99 /Gaarde 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: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S102CC -01100 / R466604 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.
Installation of (3) antenna sectors on an existing 100' monopole and equipment cabinets Valuation: $$60,000.00
located at the base of monopole and enclosed by a 6' -0" high fence. Existing building area: /� s d square feet
New building area: 7 square feet
CO PROPERTY OWNER ❑ TENANT Number of stories:
Name: Tigard Lodge No. 207 Type of construction: sr/
0 1 Address: PO Box 230184 Occupancy groups: 11 a
City/State/ZIP: Portland, OR 97281 Existing: / J a
Phone: (503)625 -4094 Fax: ( ) New: v V o 2,
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: KDC Architects.Engineers, PC All contractors and subcontractors are required to be
Contact name: Eric Camp licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4720 200 St. SW, Suite 200 jurisdiction in which work is being performed. If the
City/ State/ZIP: Lynnwood, WA 98036 applicant is exempt from licensing, the following reasons
apply:
°hone: (425) 670 -8651 I Fax: : (425) 712-0846
I mail: holly.camp @kdcarchitects.com
CONTRACTOR
&iness name: To Be u
th Determined C ). 3, 1 O t.� .A., BUILDING PERMIT FEES*
Arens: _)6 ;5``" , Ci QQle- 2c)
1 Please refer to fee schedule.
t t
Ciate/ZJP: >.,� `- ` `T :� -� - 0,.70(02-
,(�[�� / Fees due upon application
- -1�' :'°= _ ax: F (5010 I OGv`3'o) :4 /0/Ca
CCB lic / 1/6 �l7 Amount received
` Date received:
Authorized.ignatu-' This permit application expires if a permit is not obtained
iliglr- within 180 days after it has been accepted as complete.
Print name:Eric mp ® I Date: 12/23/04 • Fee methodology set by Tri-County Building Industry
Service Board.
is]Building\Pen ms1BUP- PemtitApp.doc 12/03 440 4613T(11 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2004 -00606
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2005
Phone: (503) 639 -4171 � n��,i,a��ii � '•:.' I l
Inspection Requests (24 Hrs.): (503) 639 -4175 `'
INSPECTION WORKSHEET FOR DATE: 5140005 TIME: 7 :15AM PAGE: 61
SITE ADDRESS: 13680 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SPRINT
I
DESCRIPTION: Installation of (3) antenna sectors on existing monopole, equipment cabinets & fence.
OWNER: TIGARD LODGE #207, PHONE #: 503 -625 -4084
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 514/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006056 -01 971- 563.8834 N
Corrections /Comments /Instructions:
i (O_C f..............„ )
1°
• •A 11, r ____•- - c Ir C' ' - w.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Cf
Inspector: /\; / Date: Phone #: (503) 718-