Permit tp CITY OF TIGARD BUILDING PERMIT
* COMMUNITY DEVELOPMENT Permit#: BUP2014-00022
Date Issued: 02/13/2014
T[G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 DD00800
Jurisdiction: Tigard
Site address: 14020 SW 72ND AVE
Project: T-Mobile Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Removing and replacing antennas with new antennas and RRU's
Contractor: HPS CONSTRUCTION INC Owner: I S PROPERTIES LP
598 BASELINE ATTN: UNITED RENTALS LEASE ADMIN
PO BOX 890 BY FISCHER&COMPANY URI
CORNELIUS, OR 97113 13455 NOEL RD,STE 1900
DALLAS,TX 75240
PHONE: 503-357-4217 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: DC Provision Review,COM TI-Ping 02/13/2014 $70.00
Occupancy Grp: U Occupancy Load: DC Provision Review,COM TI-LRP 02/13/2014 $10.00
Dwelling Units: 0 Permit Fee-Additions,Alterations, 02/13/2014 $377.90
Demolition
Stories: 0 Height: 0 ft 12%State Surcharge-Building 02/13/2014 $45.35
Bedrooms: 0 Bathrooms: 0 Plan Review 02/13/2014 $245.64
Value: $20,000 Info Process/Archiving-Sm$0.50(up to 02/13/2014 $12.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $761.39
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
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 d in acco •- ce with approved plans. This permit will expire if work is not started within 180 days of is --, • if work is suspended for more the 180
da . ATTENTION: • ,•on law reQuires you to follow the rules adopted by the Oregon Utility Note•-: ion Center. Those rules are set forth in OAR
9 2-001-0010 through OA' z .-1 01-0 • may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.100.332.2344.
I sued By: / /��/f Permittee Signature: , ( ' 101 1/Call 503.839.4175 by 7:00 a.m.for the next available inspection da l
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.
I
r
Building Permit Application
Commercial RECEIVED O1: (q I It I I •I ()\I 1
City of Tigard Date/B d / _ Permit No.: 4 t'00. _
• 13125 SW Hall Blvd.,Tigard,OR 9722AN 3 0 2014 Plan eviR i ' ' 4 ,/other 14 g Phone: 503.718.2439 Fax: 503.598.1960 Date/By: `r i� j (� 't
1 1(,n I.t) Inspection Line: 503.639.4175 Date Ready:y: tur;a: RI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Not /med od: � j Sappieme,et,aforma�a
BUILDING DIVISION' e o,� 0 -
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
New construction Permit fees°are based on the value of the work performed.
❑ El Perf
Indicate the value(rounded to the nearest dollar)of all
®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 ®Com Commercial/industrial
Valuation: $
❑Accessory building ID Multi-family Number of bedrooms:
❑Master builder ❑Other. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:14020 SW 72id Ave New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldgJapt.no.: Project name:P001316D 1-5 and Hwy 217 Covered porch area: square feet
Cross street/directions to job site:On 72*d Ave,just north of SW Bonita RI) 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.
Tax map/parcel no.: 2S101 DD00800 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.
Removing and replacing existing antennas with new antennas and RRUs. Valuation: $$20,000.00
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name:T-Mobile Towers Type of construction:
Address:12920 Occupancy groups:
City/State/ZIP:Dallas,TX 75240 Existing:
Phone:( )(972)980-7115 Fax:( ) New:
0 APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
eese refer Business name:T-Mobile Towers tbl�� )hea
Structural plan review fee(or deposit):
Contact name:Kara Campbell
FLS plan review fee(if applicable):
Address:8960 NE Alderwood Rd
City/State/ZIP:Portland,OR 97220 Total fees due upon application:
Phone:(503)547-7983 Fax::( ) Amount received: --.61----
E-mail:kan.ampbell @powderriverdev.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name:BPS Construction Inc. Submit two(2)sets o .41 f plan with connection details
and fire department acces , • ong with the 2010 Ore
Address:598 Baseline,PO Box 890 Solar Installation Specialty C, : Id;
City/State/ZIP:Cornelius,OR 97113 Permit fee(includes pl: •-- • $180.00•
and :ss I :I've fees):
Phone:(503)357-4217 I Fax:( ) State sure, • I (12%of permit fee): 1.60
CCB lic.:120253 2- N ((s Total fee due upon application: $201.60
Authorized signature: ta.A.ek Olvtilrika This permit application expires if a permit is not obtained
k_
I within 180 days after it has been accepted as complete.
Print name.Kara Campbell Date: U4613T 13011 J * Fee methodology set by Tri-County Building Industry
Service Board.
'dinglPermitslBUP-COM PermitApp.doc 0284/2011 440�613T(1l/02JCOM/WEB)
Building Permit Number: Zu Roo (4(-D6
1101 ' Building Permit Review is
Commercial Project —No Associated Land Use '1, • : EI Y,f
ED
rlc;nRRD
IAN 3 0 2014
Site Address: I'-1020 $A) 7Znci I\ve,, CITY�OFTIGARD
❑Verify site address is valid. BUILDING p1VIgI(1Rl
Project Name : T— M010-11€
Planning Review
Proposal: reel Q tie, ex15 '1 tlf ar -ennA s wi+h AvAl
,onin :
Mr/Permitted Use Yes 0/lo ❑ Spec Space
Land Use Required ❑ Yes Of No
Notes: rxo 1 r1Greasti in vvi- ; No expo.r6Oft f:tIT 9r"Oulr,d 't Q.Vel
eau;e&Wn _
Approved by: Vit./, ��/ // ♦ � Date: ( (30( t q
Revisions (after Building Submittal only) Reviewer Date
Revision 1 Approved ❑ Not Approved ❑
Revision 2 Approved ❑ Not Approved ❑
Revision 3 Approved ❑ Not Approved ❑
Building Permit Submittal /
Original Plan Submittal: Date: 1t 3priq ByCLth
Site Plans: # a
Building Plans: # a
Create Case Record#: ['Enter case#above for Building Permit Number.
Workflow Routing: 0--Planning ❑ Engineering ❑ Permit Coordinator Building
Workflow Sign-off: Fe Sign-off for Planning staff,including notes from planning review(page 1)
Route Application Documents:`A ] Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
ll� original plan review routing form.
❑ Building: original permit application,site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Reviewed B� C LC__,(/�Q.Le Date: /4/PY
Notes:
1:\BuildingWorms\BIdgPermitRvw_COM_NoLandUse_123013.docx
6,u06020/V oada9-
1101 et
COLLOCATION RECEIVED
Supplemental Questionnaire
T I G A R D City of Tigard, 13125 SW Hall Blvd.,Tigard, OR 97223 JAN 3 0 2014
Phone: 503.718.2421 Fax: 503.598.1960
CITY OF TIGARD
IF YOU ARE APPLYING FOR A PERMIT TO COLLOCATE ANTERIANG DIVISION
PLEASE COMPLETE THE INFORMATION BELOW.
Name of Provider: Mg 101 i.e.
Property Address/Location of Collocation: 140,D,() SUJ -,2_.._ -+ 4C V
Zone: 3....- - L
Collocating antennas on: NI Existing tower ❑ Existing non-tower structure
Is this a new provider? ❑ Yes [] No
Ifyes, list other providers currently collocating on same tower or structure,if any:
?lea St twtc-t 0-4-• T wto h it. Ina-s e i S-tT Kc) Cu c a Ct.►-va_ a rte. -toms s app 0cats'►
If no, indicate the previous roval(SDR,MAID or BUP# : C Pg6-O \. C& vi,Cvd` f'Cart
f p �p � � u l
Height of antenna(s): loo ft. 4, `
Color of antenna(s) and accommodating equipment (i.e. dishes):
O6NCuA
Color of existing tower or structure: Ot-v-fl
Will new accessory equipment be installed? Yes ❑ No
Ifyes,please answer the following:
Location of accessory equipment: IS, Within fenced area previously approved
❑ Within existing structure
❑ Other location (Please describe below.)
SrA.a,(,l CO VP rnov k{e d it -e t) g Cj Lath---f-
Will landscaping be removed to accommodate the accessory equipment?
❑ Yes (Please describe below.) Nj No
l i %IR Applicant's Signature: \.tri ' 0
Name Printed: ) 6--4"(A- CU 0'4 ( Phone: t' 2 ) r j -0-l vc b
hj. •K s pe .t. ❑ Do not issue permit. Refer to planner.
b#6401.v. ( 130114
Planning Staff Signature Date
I:\CURPLN\Masters\C ollocateAntennas.doc
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14020 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Building
299 Final inspection
2014-03-03 00:00:00
BUP2014-00022
PASS - No C of O
Violation Summary:
Inspector Contractor