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Permit
a CITY OF TI GARD,- BUILDING PERMIT 1 1 11 : PERMIT #: BUP2007 -00040 COMMUNITY DEVELOPMENT DATE ISSUED: 3/2/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 102CC -01100 SITE ADDRESS: 13680 SW PACIFIC HWY ZONING: C - G SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: CLEARWIRE Project Description: Collocation on existing monopole. REISSUE: 5'- FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK:r 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 LAKE WASHINGTON BLVD NE S 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] Pin 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 Pin 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: 4,j, Permittee Signature: CY\ CL42_40 _,t,( 4-...----- 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. ConintiiirTenant enWeQen'/ I / G 7 - CVQQ / Buildine Permit Application I.oR orrlcl_: ( o. : .y dElla City of Tigard Ai i / a5 07 PennitNo.:.1 !�„7 ,,• 6 :� 13125 SW Hall Blvd, ti 33� �! =�1 Plan Review s " Phone: 503.639.4171 F 0 .5 98.1960 Date/13 . 3 -/ - 0 Other Permit: T I G A R D Inspection Line: 503.639.417 Date Re: • /B ® See Page 2 for Internet: ww Notified/Method: EM Information stotretill :7013i al u . 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 ISI Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. CI 1- and 2- family dwelling Commercial /industrial Valuation: S CI 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: 5(98r S %I R A New dwelling area: square feet City /State/ZIP:�C�tw 0 VS en Z$ I r Garage/carport area: square feet Suite/bldg /apt. no.: I Project name: Covered porch area: square feet Cross street/directions to job site: 5 e► D I . l7NS coo 5 t-i EL, r Deck area: square feet • I 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.: Z.S 1 0 ZC•C.O I I O 0 equipment, materials, labor, overhead, and the profit for the Co DESCRIPTION OF WORK work indicated on this application. , e..L.L. 5 i o n c • loc ON - 1 ' 1 .00 4- 1 ANTENNAS OA Valuation: ) 2. rni canLo1w e C) I sl- 4E.. TO 1 sr. 1 DO yY onopal c, . Existing building area: 2-00 square feet L4 1 p . QY1 1,1 e.13 tOv1C . ?ma to ki.jell Gi t sk - . c.g»" poovs building area: q 9 square feet ❑ PROPERTY OWNER I Q TENANT Number of stories:' 00 v %Ohe pail Nam e,Legfrztu5 1 RR. Li►RE>I.ttss l�J Rect bcerti Type of construction:. g Address:5 to Ts \NI66 -11 levl �L.\�I7 QU E. S l�l Te s o cupancy groups: City/State/ZIP: R.& d , W $03) Existing: Phone: f4 Z1 ZI Co • 7 (ODD Fax!( 25) V 4 -1400 New: $ APPLICANT 13 CONTACT PERSON NOTICE Business l name: iy v rip D e j . op a r i All contractors and subcontractors are required to be Contact name: oslr.ls5 � � 5 licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the A ddress : SW De_3►saAa RIZt. jurisdiction in which work is being performed. if the City/State/ZIP: �QTZ+�. © �9 applicant is exempt from licensing, the following reasons e 1 1 ` 1 apply: Phone: GC& 31 44 •3gib 5 Fax:: ( ) E-mail: VursE.S 0 SPIT Vont . cove% CONTRACTOR �— i _ ! _ _ - BUILDING PERMIT FEES* Business name: � : 1 _ . lx .._L_ " Address: 1 (Pktase refer tofee s:hedale) Structural plan review fee (or deposit): schedule), y5 City /State/ZIP: Phone: ( ) I Fax: ( ) FLS plan review fee (if applicable): Total fees due upon application: CCB lic.: • _ Amount received:41/6 a• 9C Authorized signature: 1./ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name cA - 1,0. i ey%S I Date: 1/2. 5 7 • Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\BlJP- TI- PermitApp.doc 0323/06 440-4613T(11/02/COM/WEB) AI 0 vvi#vt .�c�q„..t..c,, k d t r6324-0 - - - 49( Di I 0 ° 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 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. 1: \ Building \Permits \BUP -TI- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION . PERMIT #: BUP2007 -00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 312/2007 Phone: (503) 639- 4171ti Inspection Requests (24 Hrs.): (503) 639 -4175 ' I.. INSPECTION WORKSHEET FOR DATE: 4/18/2007 TIME: 7:00AM PAGE: 58 SITE ADDRESS: 13680 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CLEARWIRE DESCRIPTION: Collocation on existing monopole. OWNER: CLEARWRE WIRELESS BROADBAND, PHONE #: 425-216-7600 CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 Inspection Request Scheduled For: Date: 4/18/2007 Pour Time: Code # Inspection Description Confirm # Contact # - 299 Final inspection 046675 -01 503 - 849-2053 0 Corrections/Comments/Instructions: rr• aroi/PA r • 4 v �a1PP a ..\- Lotto - o L s ►.i :t P n Ai --- / Tr ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL C*O ACCESS .EAIL 0�i CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED Inspector: _ (, i-W V ■ Date: V 8 d Phone #: (503) 718- , P CITY OF TIGARD - `. BUILDING DIVISION . PERMIT #: BUP2007 -00040 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2007 Phone: (503) 639 -4171 14 a i ;l�l Inspection Requests (24 Hrs.): (503) 639 -4175 ... ' __.. INSPECTION WORKSHEET FOR DATE: 8/31/2007 TIME: 7:00AM PAGE: 40 SITE ADDRESS: 13680 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: GLEAM/ORE DESCRIPTION: Collocation on existing monopole. OWNER: CLEARWIRE WIRELESS BROADBAND, PHONE #: 425 - 216 -7600 CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 - 2349900 Inspection Request Scheduled For: Date: 8/31/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 054959.01 503-209-3520 N Corrections /Comments /Instructions: r f J /1 ://:/jr r` 0-pAgg ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ` ' 1 ---- Date: o‘f 6 1 Phone #: (503) 71 S- 2--'‘,Z4