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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00261 4 „,i,, DEVELOPMENT � Br S � ERV SERVICES DATE DATE ISSUED: 6/22/2005 PARCEL: 1 S135DA -01000 SITE ADDRESS: 08530 SW PFAFFLE ST ZONING: C -P SUBDIVISION: METZGER ACRE TRACTS LOT: 020 JURISDICTION: TIG Project Description: Modify cell tower. REISSUE: t FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: he FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : sf N: S: E: W: OCCUPANCY GRP: 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: $ 10,000.00 Owner: Contractor: SCHAEFFER, DONALD M LEGACY WIRELESS MUNCH, MICHAEL T 4252 SE INTERNATIONAL WY # F PO p BOX 82549 MILWAUKIE, OR 97222 PPhone ND, OR 97282 Phone: 503 - 656 -5300 FEES Reg #: LIC 150432 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 6/17/2005 $139.30 [BUPPLN] Pln Rv 6/17/2005 $90.55 [TAX] 8% State Surchari 6/17/2005 $11.14 . Total $240.99 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 -246 699 or 1-800- 332 - 344. Issued By: 6,sil Permittee Signature: 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. $'S 3o S cv l'S s-6- Building Permit Application ' " i�olz Ol i�icl: usi: ON�i,V City of Tigard RECEIVED i g Date/B° ( Permit No. / ._ i /... ��/ i 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re ' e Phone: 503.639.4171 Fax: 503.59$.19 i J A"- `'1 +.. I � ` Datr/B . L , � Other Permit: 1211417111M1_. ' Inspection Line: 503.639.4175 ,J 63; , � 20o5 'I Date R .. • - See Attac Checklist far Internet: www.ci.tigard.or.us Notified/Method: SupplementalInformeation CITY OF TIGARD BU ' LQ 'IYPE O'F'WO REQUIRED DATA: 1- AND 2-FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Addition/alteration/replacement ❑ Other: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling XCommerciaUndustrial Valuation: $ El 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: 3 SOJ 14FA F rLOE S New dwelling area: square feet City/State/ZIP: ! 11 cc A.4e,D 1 CX 9 7.2013 Garage/carport area: square feet Suite/bldg. /apt. no.: ' I Project name: )Q 7 l a , Covered porch area: square feet Cross street/directions to job site: T , .17-5 .S�‘..TM - r-o eX it - 470# Deck area: square feet 1 AeLOS -99 Ll/ . t' N k'6.t }t owro 5 (, Other structure area: square feet f P Lt cST. 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.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. Valuation: $ /(a, Q p 0 /�/9DiF►� ApI G'X 1 l.W /7►�4WN�i7 7OC.��eyii►vv�CA77a+/S McyU17- Existing building area: square feet TO rfert.AGC co ela 5-77n 4 Avv71 -morRS Wr 6 New M 1e rRS 'Los 'RI.E ,4+DDtt70,0 er e At ^/I 62(44 a/1,0,4,0; New building area: iv//4 square feet *TENANT Number of stories: /A Name: Day erg St Cjo ecA5r PL,1 t c._,Jr's Type of construction: re / Address: l 0,,f) , S(Ai - 6- ,D 5r Occupancy groups: City/State/ZIP: i -, J QA 9 7 33 Existing: Phone: (p) a.1 — I S 1 C. Fax: ( ) New: g. APPLICANT A CONTACT PERSON NOTICE Business name: -PQ I N Gts ek A SL e, . CONSULT 7N el,. SN C . All contractors and subcontractors are required to be Contact name: 'T�eP't ��� C: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: q E a L^ . ...e:AuQN S t D � 1 S r. a 65' jurisdiction in which work is being performed If the applicant is exempt from licensing, the following reasons City/ State/ZIP: pat TL A+� v ore 9 -7 apply: Phone: ( 5'3 ) 51 % co r I Fax: : 603) a4 7 2/ (9 8 E -mail: CONTRACTOR Business name: AISM / ( tI S( SLY/ /C4 • �I c_ BUILDING PERMIT FEES* Address: L../„A 5 L ( SC - - � it _ .Jm tf WA- Y Please refer to fee schedule City/State/ZIP: !L i v/,i. vK/ 9 ©R r - 7.2, a,� Phone: (503) , c, 3 ea f Fax: ( ) Fees due upon application Amount received CCB lie.: (c o 1,43ek Date received: Authorized signature: t This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: bie, , �' : 5 I Date: 6 f 7/ S • Fee methodology set by Tri -County Building Industry Service Board. i:U 3uitding \Permits\BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB) • CITY OF TIGARD BUILDING DI11SION PERMIT #: B6/112P2/2200005;00261 13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED: 6/22/2005 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 77 SITE ADDRESS: 08530 SW PFAFFLE ST CLASS OF WORK: SUBDIVISION: METZGER ACRE TRACTS LOT #: 020 TYPE OF USE: PROJECT NAME: CINGULAR WIRELESS DESCRIPTION: Modify cell tower. OWNER: SCHAEFFER, DONALD M, PHONE #: CONTRACTOR: LEGACY WIRELESS PHONE #: 503 - 656.5300 Inspection Request Scheduled For: Date: 11/9/2005 Pour Tim - : ! w LA Ci Code # Inspection Description Confirm # Contact # es -age 299 ' Final inspection 020664 -01 503-484-6872 Y : - Corrections /Comments /Instructions: �S 6 Gds 6 • I !i Fr SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES AS SED Inspector: 1 Date: �_ D� Phone #: (503) 718-