Permit CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2014-00058
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/10/2014
Parcel: 25102AD03450
Jurisdiction: Tigard
Site address: 8777 SW BURNHAM ST
Project: Sprint Subdivision: TIGARD HIGHWAY TRACTS Lot: 22
Project Description: Installation of(3)panel antennas on existing cell tower.
Contractor: SABRE COMMUNICATIONS CORPORATION Owner: TIGARD, CITY OF
2101 MURRAY ST 13125 SW HALL BLVD
SIOUX CITY, IA 51101 TIGARD, OR 97223
PHONE: 712-258-6690 PHONE: 503-639-4171
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Permit Fee-Additions,Alterations, 04/10/2014 $377.90
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 04/10/2014 $45.35
Dwelling Units: 0 Plan Review 03/12/2014 $245.64
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 04/10/2014 $70.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-LRP 04/10/2014 $10.00
Value: $20,000 Info Process/Archiving-Sm$0.50(up to 04/10/2014 $20.00
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $768.89
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 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 the 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 952-001-0090. You may obtain a copy of the rules• - • • • NC by callin• 503.232.1987 or 1.800.332.2344.
•
Issued By: _ -.� •ermittee Signature: _
Call 50 • .y 7:00 a.m.for the next available inspection dat .
This permit card shall be kept in a conspicuous place on the job site until completi• of the project.
Approved plans are required on the job site at the time of each inspection.
Buildin Permit A lication
Commercial CEIVED I ,,i, ,,i , i, I t H ,,, I
City of Tigard RDateBecewed, jff�!�! Permit No.: `c4- M0/4{zx5''
13125 SW Hall Blvd.,Tigard,OR 94 \R 1 1 2014 Plan Review� I )`�
8 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: / / Other Permit:
i i nisi Inspection Line: 503.639.4175 Date Ready/By: / iuris: 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: /��iy �• Supplemental Information
BUILDING DIVISION ram„D Q
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
®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 ®Commercia�ndustrial
' Valuation: $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
r6777JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:AP-SW Burnham New dwelling area: square feet
City/State/ZIP:Tigard,Oregon 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:879526P003XC047 Sprint Covered porch area: square feet
Cross street/directions to job site:SW Hall and Burnham St 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.:APN-2S102AD03401 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 three panel antennas on an existing telecommunications facility Valuation: $820,000.00
Three antennas were removed in a project in 2012/13 Existing building area: n/a square feet
New building area: n/a square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 80'
Name:City of Tigard and Tigard Water District Type of construction: IIB
Address:131125 SW Hall Blvd Occupancy groups:
City/State/ZIP:Tigard,OR 97223 Existing: unmanned
Phone:( ) Fax:( ) New:
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Crown Castle USA (Please refatoteruAedorlr)
Structural plan review fee(or deposit):
Contact name:Sandra Walden -
FLS plan review fee(if applicable):
Address:1500 SW Park Ave#324
Total fees due upon application:
City/State/ZIP:Portland,ORegon 97201
Phone:(503)709-0820 Fax::( ) Amount received:
E-mail:s andra.walden.contractor@crowncastle.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of l7--
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System. r
Business names' &- cs �-C G Lwi �-.r Submit two(2)sets of roof plan with connection details
y'`M a''`tl and fire department access,along with the 2010 Oregon
Address: ?It// 1)-1 C.* c / Solar Installation Specialty Code checklist.
City/State/ZIP: / ' Permit fee(includes plan review
(7/� ��n'tiX c/� j � (��)V, and administrative fees): $180.00
Phone: G v Fax: State surcharge(12%of permit fee): $21.60
CCB lic.: it/ ]� Total fee due upon application: $201.60
Authorized signature: i64,.,a This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Sandra Walden Date:3/6/14 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46137(1 l/02/COM/WEB)
RECEIVED
N
III
COLLOCATION MAR 11 2014
_ Supplemental Questionnaire CITYOFTIGARD
T I G A RD GI).of"Tigard! 13125 SU'Hall Bird.,Tigard,OR 97223 BUILDING DIVISION
Phore: 503.718.2421 Fax: 503.598.1960
IF YOU ARE APPLYING FOR .A PERMIT TO COLLOCATE ANTENNAS,
PLEASE COMPLETE THE INFORMATION BELOW.
Name of Provider: Sprint LP
Property Address/Location of Collocation: 8777 SW Burnham,Tigard, Oregon 97223
Zone: CBD
Collocating antennas on: ® Existing tower ❑ Existing non-tower structure
Is this a new provider? ❑ Yes ® No
I/j es, list other providers currently collocating on same tower or stmt./gm if any:
If no, indicate the previous approval(SDR,MAID or BUP#): ( L. r' Yi- - C.C r 114.f"./E• 03`;`,
Height of antenna(s): 100 ft. .I5`r. 'mac a -e c,s:5 _'cc. 1 ' n 4-u,rec ...).c. ...
Color of antenna(s) and accommodating equipment(i.e. dishes):
Grey, pole and antenna
Color of existing tower or structure: steel grey (not painted)
Will new accessory equipment be installed? ® Yes ❑ No
If yes,please annver the following:
Location of accessory equipment Within fenced area previously approved
❑ Within existing structure
❑ Other location (Please describe below.)
Replacing 3 antenna that were removed in 2012. No expanded lease area or increase in height of
tower.
Will landscaping be removed to accommodate the accessory equipment?
❑ Yes (Please describe below.) ® No
Applicant's Signature: ,r.2`4:F `, Date: 1/6/14
Name Printed: ' S ndra Walden Phone: 503-709-0820
6,:'c`-c.t L'eq-.it.c-. (. ,1 I dre. OZ I -c- '_
FOR OFFICE USE ONIX
V] OK to issue permit. ❑ Do not issue permit. Refer to planner.
A- CA A.Cw' I - a 1 - l 4 _
Planning Staff Signature Date _1
1
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8777 SW BURNHAM ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2014-00058
Chip Barnett
Violation Summary:
Inspector Contractor