Permit •
CITY OF TIGARD PERMIT
PERMIT #: BUP2005 -00374
DEVELOPMENT SERVICES DATE ISSUED: 8/15/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DD -00101
SITE ADDRESS: 06975 SW SANDBURG ST ZONING: C -P
SUBDIVISION: TIME SQUARE LOT: JURISDICTION: TIG
Project Description: Remove (4) existing antennas & replace w/3 new antennas, utilizing existing mounts, add (1) cabinet
inside existing equip.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N : sf N: S: E: W:
OCCUPANCY GRP: UNK 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:
AMERICAN PROPERTY MANAGEMENT LEGACY WIRELESS
2154 NE BROADWAY 4252 SE INTERNATIONAL WY # F
PORTLAND, OR 97232 • MILWAUKIE, OR 97222 •
Phone: 503 - 284 -2147
Phone: 503 - 656 -5300
FEES Reg #: LIC 150432
Description Date • Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/4/2005 $139.30
[TAX] 8% State Surchari 8/4/2005 $11.14
[BUPPLN] Pln Rv 8/4/2005 $90.55
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 99 0 1- 800 - 332 -2344.
Issued By 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.
•
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S' 10 ■
Building Permit AnnIie'a�tio ``-- w 40
; FOR OFFICE USE ON I,V
City of Tigard ,y 2 05 ReCC1V ''
`J Date/B . 1 Permit No ' "' i5J3 C 7 c/
13125 SW Hall Blvd., Tigard, OR 97223 Plan R
Phone: 503.639.4171 Fax: 503.598.1960 e/,/ '�/*/rk , .j -` I '� Dat dBe `rte, ;
i wir mil 0 5 Other Permit:
Inspection Line: 503.639.4175 V Y O ' TICAH : ' L'. Date Rem►'! //]] s �- , 0 See Attached Checklist for
Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method i - G/ Supplemental Information
- 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 .
s i Addition /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: $ /4
❑ 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: (O ?-7_,s- sl2 Sara b vri Rd New dwelling area: square feet
City /State/ZIP: 7' are ', erR. 9 s, Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: 77'S � / Covered porch area: square feet
Cross street /directions to job site: FR awl s,GU. .to, San d bu 1 ,&!'j Deck area: square feet
yr) c .,.�d. ert Sari d bL,VrJ 4/1)04 /14 dear a iC/. Other structure area: square feet
/ REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees' are based on the value of the work performed.
71 (o `i
Tax map /parcel no.: 7 In o val g3 - v "blu 1 . /'t 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.
Valuation: 5 /D CVO
Aemom- 'l extsniu myrEitimiS i replace Lul3 new c utfenns.
(3 pe(/ Se -Ern - - 3 s ..m72 s) u fr /l' 2,Nl ex, s mater /910v,t�rs, /9.O/7 Existing building area: square feet
/ 0 M/3 CAS/ g /NS/O6 ,FXt5i7,46 krjurpol n. .5/1s/ls2, New building area: square feet
• - PROPERTY OWNER . 0 'TENANT .' . - Number of stories:
Name: e„ la E•11--el A , ems7 — Type of construction:
Address: 0 11 S SelAi. 4 ►-0Q ei...4 , strc rL ZOQ Occupancy groups:
City /State/ZIP: perrris+-,,00 t De. 7 2 is Existing:
Phone: (3--o) ) 2 8 rf a'Z / Fax: ( 5713 2 B. l.s'8 3 - New:
'- APPLICANT ❑ CONTACT_ PERSON NOTICE
Business name: L.0 cer-f / PR r rice E I4 o jft - All contractors and subcontractors are required to be
Contact name: Cti�t s /zc/ (�� licensed with the Oregon Construction Contractors Board Ael under ORS 701 and may be required to be licensed in the
Address: q $2-8 £ 6 oft , s, 6 . Su /r_ z/O jurisdiction in which work is being performed. If the
City / State/ZIP: p applicant is exempt from licensing, the following reasons
d7t-71. A, a , C3R _ �l 3 z / p) apply:
Phone: (c7)3 ) L/ 22, 5 / I Fax:: (.573 ) ). V 93-•0 Z
E -mail: j c 5 raA/ @ J e- S r ct�s c o GI AirS . C evil
.CONTRACTOR '
Business name: e 5 eL c WI Re `E-ts , Tt t.c` . BUILDING PERMIT FEES"
Address: NZ,S .. . 1'N - 1e v vl .i-srv' GU Ay Please refer to fee schedule.
City /State/ZIP: p n A-ti!b tom. 9 777_2_ /
Phone: (s--67 ) I Fax: Bog, 9 y Fees due upon application
Amount received
CCB Iic.: / SO Lf 3 2...
Date received:
Authorized signature: I 1
0 (1 1 This permit application expires if a permit is not obtained
I within 180 days after it has been accepted as complete.
Print name: .J Ci, n s n 'l 6(Z (4c1 I Date: 68. d 3 • QS • Fee methodology set by Tri -County Building Industry
I Service Board.
i:\ Building \Permits\BUP- TI- PermitApp.doe 12/03 440.4613T(11/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00374
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1+6/2005
Phone: (503) 639 -41714 41,x, I
Inspection Requests (24 Hrs.): (503) 639 -4175 ; -' `'I L.
INSPECTION WORKSHEET FOR DATE: 10 /21/2005 TIME: 7:08AM PAGE: 104
SITE ADDRESS: 06975 SW SANDBURG ST CLASS OF WORK:
SUBDIVISION: TIME SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CINGULAR WIRELESS
DESCRIPTION: Remove (4) existing antennas & replace w/3 new antennas, utilizing existing mounts, add (1) cabinet
inside existing equip.
OWNER: AMERICAN PROPERTY MANAGEMENT, PHONE #: 503-284-2147
CONTRACTOR: LEGACY WIRELESS PHONE #: 503-656-5300
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message L.0d S-
299 Final inspection V 018938 -01 971 - 998-2503 Y G r /�,,
""
Corrections/Comments/Instructions:
(1:
XPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /
Phone #: (503) 718-