Permit p CITY OF TIGARD BUILDING PERMIT
s COMMUNITY DEVELOPMENT Permit#: BUP2013-00119
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2014
Parcel: 2S102BD02600
Jurisdiction: Tigard
Site address: 12925 SW PACIFIC HWY
Project: Verizon Wireless Subdivision: NORTH TIGARDVILLE ADDITION Lot: 37
Project Description: Replace(7)of(12)existing antennas on existing cell tower. Locations and tip heights will not change.
Contractor: M&A CONTRACTING INC Owner: KIM, PENNEY
1366 LEE ST SE 395 NW SILVERADO DR
SALEM,OR 97302 BEAVERTON, OR 97006
PHONE: 503-581-6125 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: OTR Type of Const: Other Permit Fee-Additions,Alterations, 06/25/2014 $225.80
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 06/25/2014 $27.10
Dwelling Units: 0 Plan Review 05/15/2013 $146.77
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 06/25/2014 $67.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-LRP 06/25/2014 $10.00
Value: $10,000 Info Process/Archiving-Sm$0.50(up to 06/25/2014 $21.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $498.17
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
952-001-00 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: , ea
z ,
// `� Permittee Signature: r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Building Permit Application
Commercial FOR OFFICE USE cll.N
City of Tigard RECEIVED 1 ;B� �� �� PermitNo.: u�� 3�00�
Irli
13125 SW Hall Blvd.,Tigard,OR 97223 5 Plan Review f q
Phone: 503.718.2439 Fax: 503.598.1960 MAY 1 5 2013 Date/By: om«Permit:
TIGARD Inspection Line: 503.639.4175 Date R s. B See 1'age 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: s /,3 Supplemental Information
DINC DIVISION / v'd
TYPE OF REQUIRED DATA:1-AND 2-FAMILY DWELLING .30
❑New construction ❑Demolition Permit fees'are based on the value of the work performed. k
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the 1
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwelling Valuation: $
®Commercial/industrial
❑Accessory building El Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12925 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
,..k`--
Suite/bldg./apt.no.: Project name:POR Tigard/99 Covered porch area: square feet
Cross street/directions to job site:Pacific Hwy and Walnut Street,behind Deck area square feet
commercial strip mall. This is an 80'wireless tower. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.:02600 Permit fees'are based on the value of the work performed.
Tax map/parcel no.:WCTM 2S102BD
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.
Replace 7 of the 12 existing antennas on the existing cell tower. Locations and Valuation: $10,000.00 "1-*'
tip heights w ill not change. Existing building area: square feet
New building area: square feet
® PROPERTY OWNER I ❑ TENANT Number of stories:
Name:Verizon Wireless Type of construction:
Address:5430 NE 122"Ave _ Occupancy groups:
City/State/ZIP:Portland,OR 97086 Existing:
Phone;(503)720-7295 Fax.( ) New: ��
0 APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* �\
Business name: Urban Wireless for Verizon Vs ire less (rlrwrntlh►tr3beat ailkJ \`
Structural plan review fee(or deposit):
Contact name:Shanin Prusla `.
FLS plan review fee(if applicable):
Address:10376 SE Sunburst Way
Total fees due upon application: A.
City/State/ZIP:Portland,OR 97086 .
Phone:(503)720-7295 Fax::( ) Amount received: )4.7 ',`i
E-mail:sbani�UrbanWirelessInc.com
PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* I
CONTRACTOR Comm- • and residential prescriptive in :•ation of
roof-top mo ' PhotoVoltaic Solar P- System.
Business name:Top 11/4-( OI— 4 -t'�.4!,,. 1 n�, l Submit two(2)set 4f roof plan ,- connection details
36,4 h—
and fire department ac s, : . • checklist.
the. Oregon
Address: SolarInstallation SL ciL�tode checklist.
City/State/ZIP: 3��,� 4_ g 7 a,2-- Permit fee odes pl. view $180.00
Phone: S4/--/( y5 7ax:( ) administrative :
�7� Stat• reharge(12%of permit fee): ► S21.60��
CCB lie.: '77/g // S ''
t Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is mot obtained
within 180 days after it has beer accepted as complete. ' -
Print name:Shanin Praia,Urban Wireless I Date:5/14/13 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\BuildinglPerinits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(l 1/02/COM/WEB)
• Building Division
Development Code Provision Review
F1 G A Et D Commercial Projects - No Associated Land Use Case
Building Permit No: u P .o13—C)O/ 1 cl ❑ Expedited Review
Project Name: \)GI`s I 7-01J
Site Address: 1 g9 a 5 6-w P4-c1 Ft c y , Suite/Bldg #:
Plans Routed:
Original Plan Submittal Date: 51t 5-4.5 Routed By:
1St Revision Submittal Date: Routed By:
2°`' Revision Submittal Date: Routed By:
To the Applicant:
Y If the proposed use is not permitted within the zone,please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718-2439.
If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact Ines awc - at (503) 71827 or 431MS @tigard-or.gov)
Proposal: replace 1 (..)-F--tne 12 ex►sh Anie-t as on an exAtti vn cGi I
-to►Ne'r, No chawj, tv, laccd,�l„ ►-a h.6--r1p �J
Zoning G
Permitted Use Yes PI No ❑
Land Use Required: Yes ❑ No Iiir
Notes:
T Approved ❑ Not Approved ❑ DCPR Not Required—No DCPR Fees Due
Date Routed to Building:
1:\CURPLN\Masters1Development Code Provision ReviekDCPR_COM_NoLandUse.doc Rev.01/16/13
Debbie Adamski
To: shanin @urbanwirelessinc.com
Subject: POR Tigard/99, Verizon Wireless, BUP2013-00119
Shanin,
The revised plans submitted on 3/15/14 for this project have been approved and are ready to be picked up. The balance
of the fees due are$351.40. We will need to have the contractor identified before we can issue the permit. Our office
hours for permit pick up are Monday through Thursday, from 8:00 am to 4:30 pm. Let me know if you have any
questions regarding this matter.
Debbie Adamski
Senior Permit Technician
City of Tigard I Community Development
13125 SW Hall Blvd.,Tigard, OR 97223
503-718-2450
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
12925 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2013-00119
Chip Barnett
Violation Summary:
Inspector Contractor