Permit CITY OF TIGARD BUILDING PERMIT
i B. COMMUNITY DEVELOPMENT Permit#: BUP2014-00219
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2014
Parcel: 2S102BD02600
Jurisdiction: Tigard
Site address: 12965 SW PACIFIC HWY
Project: AT&T Subdivision: NORTH TIGARDVILLE ADDITION Lot: 37
Project Description: Antennae replacement with new associated equipment added to existing AT&T wireless facility.
Contractor: VELOCITEL INC Owner: KIM, PENNEY
2415 CAMPUS DR SUITE 200 395 NW SILVERADO DR
IRVINE, CA 92612 BEAVERTON, OR 97006
PHONE: 503-349-2149 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT T Permit Fee-Additions,Alterations, 10/02/2014 $301.85
ype of Const: Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 10/02/2014 $36.22
Dwelling Units: 0 Plan Review 09/18/2014 $196.20
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 10/02/2014 $25.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $15,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $559.27
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 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ Permittee Signature:
K"—503.: -.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 ApplicatidlJ.CEI%TED
Commercial FOR OFFICE USE ONLI
City of Tigard p p Received ♦47471 117 Permit No.:
• 13125,SW Hall Blvd.,Tigard,OR 9423 1 8 2014 Date/B . `i u i �•�'� 4
8 Plan •
Review. -1 i a
Phone: 503.718.2439 Fax: 5044911 960 Date/13 : `WI;11 Other Permit:
T I G A R D Inspection Line: 503.639.4175 y OF TIGARD D81e Ready Juris: 61 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: ® �j Supplemental Information
TYPE OF WORK RE UIRED 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
0 Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1-and 2-family dwelling ®Commercial/industrial Valuation: SN/A
El 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: 12965 SW Pacific HWY New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:N/A Project name:AT&T PL77 2C Covered porch area: square feet
Cross street/directions to job site:SW Frewing St Deck area: square feet
See Title Sheet on site plans for detailed driving directions. Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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.
Antennae replacement with new associated equipment added to existing AT&T Valuation: $15,000.00
wireless facility. Existing building area: 220 square feet
New building area: 0 square feet
0 PROPERTY OWNER I I TENANT Number of stories: 1
Name:New Cingular Wireless PCS,LLC(AT&T Mobility) Type of construction: IIB
Address:4004 Kruse Way PL.,STE 220 Occupancy groups:
City/State/ZIP:Lake Oswego,OR 97035 Existing: S-2
Phone:(503)636-2500 Fax:(N/A) New: S-2
❑ APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Ryka Consulting t7'leaserefer w fee schedule)
Structural plan review fee(or deposit):
Contact name:George Pierce
FLS plan review fee(if applicable):
Address:918 S.Horton St.,STE 1002
City/State/ZIP:Seattle,WA 98134
Total fees due upon application:
Phone:(206)523-1941 Fax::(206)260-7930
Amount received: 1(94- >C7
E-mail:gpierce @rykaconsulting.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business namt 1/41-041 at..c— Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: (01:11f eevci. P #"LZo Solar Installation Specialty Code checklist.
City/State/ZIP: 14: a%vao t 0 i't- 411 v Sl Permit fee(includes plan review $180.00
Phone:(CS ) )`{ 4-11 K 4i I Fax and administrative fees):
( ) State surcharge(12%of permit fee): $21.60
CCB lie.: 2€501q J "cifl j
Total fee due upon application: $201.60
I Authorized signature: _ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:George Pierce I Date:10/12/14 ' Fee methodology set by Tri-County Building Industry
- Service Board.
1:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-46131(11/02/COM/WEB)
•
City of Tigard
■
COMMUNITY DEVELOPMENT DEPARTMENT
TI CJ n R D Building Permit Review — Commercial - No Land Use
Building Permit #: [ �•�,� 9
__r{� �,lR,
Site Address: 12965 � .Pat&iTic H . Suite/Bldg#:
Project Name: Kre:f
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
'�
Proposal: replace a n+P n v' A.rr o'1hev e ,
Existing Business Activity: wireless co'nmuniactions
Proposed Business Activity: zoJ
Verify site address/suite#exists and active in permit system.
V,_,/iZoning: C-G
LN ermitted Use: IlYes ❑ No ❑ Spec Space
Lid Confirm no land use required.
Notes: (p I ncr 1r) ck c in visual i mpa c ) Or expaY)S1or
ark- a tbunti it iP�
Approved by Planning: —n m 1.e},T y x ih Date: q I I6I ty
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 Submittal Date: 9/'g/7
Site Plans: # 3
Building Plans: #
Building Permit#: ter building�pe #above.
Workflow Routing: Planning 0"--Permit Coordinatoruilding
Workflow Sign-off: E, S1gn-off for Planning(include notes from planning review)
Route Application Documents: building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: t ! ,/, / Date:
1:lBuilding\Forms\BldgPermitRvw_COM_NoLandUse_071514.docx
Permit Coordinator Review
❑ Conditions Met-Prior to Issuance of Building Permit
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ OK to Issue Permit
Approved by Permit Coordinator: / , Date: 49//� ��
I:\Building\F orms Bl dgPerm itRvw_COM_No L an d U se_071514.docx
RECEIVED
SEP 18 2014
CITY OF TIGARD
BUILDING DIVISION
Memo
To: City of Tigard
From: George Pierce
Date: September 16, 2014
Re: Building Permit Submittal Package — PL77
To whom it may concern:
• Enclosed please find the Building Permit submittal package for the above mentioned AT&T
Wireless site. Please acknowledge receipt of this package by signing below and fax to 206-
260-7930 or email to qpierce@rykaconsulting.com.
Received by City of Tigard
`°
Signs ure: 0-4-MiLdzin1 l
Date Received: 9/44 f.fr
Ryka Consulting 1 918 S. Horton Street Suite 1002 Seattle, WA 98134
From: Debbie Adamski
To: Steve Griffiths:#CD Pop
Cc: #BUildinp Permit Technicians
Subject: •I . r- - ion Project in the City Of Tigard
Date: Monday,June 9,2014 1:19:34
First,would . •-: - n e Planning Department please respond to Steve's questions in regards to
the planning department side of his project? Thanks.
Steve—
Below are the answers to the building related questions you had.
Here are the permit fees for a cell tower modification with a project value of$15,000. ` � 41(1:1 )1
Permit fee $301.85 (1,' 1
Plan rev fee $196.20 r
State surcharge $ 36.22
Dev Code Review 80. 0 X
Archive fee, $2.00 per page for<11 x 17& $.50 per page for>11 x 17
The plan review fee would be required at submittal,with the rest due at issuance. For submittal we
would require a commercial building permit application,(2)sets of plans and (2)sets of engineering,
if applicable. Our current plan review time has been running about 2 weeks.
Let me know if you have any additional questions.
Debbie Adamski
Senior Permit Technician
City of Tigard I Community Development
13125 SW Hall Blvd.,Tigard,OR 97223
503-718-2450
From: Steve Griffiths [mailto:SGriffiths @rykaconsulting.com]
Sent: Monday, June 09, 2014 12:21 PM
To: Debbie Adamski
Subject: RE: AT&T Minor Antenna Modification Project in the City Of Tigard
Hello,
I am working with AT&T, on a minor modification project to increase their telephone capacity, by
either adding or swapping antennas on an existing Wireless Facility located in the City Of Tigard.The
antenna addition/swap will not increase the height of the tower or cause any ground disturbance.
Will there be any Land Use permits required for this scope of work? Or will the Planning Department
review the plans for compliance and consistency with the development code and previous approvals
in conjunction with the building permit?
Can you tell me how much the intake fee and plan review fees will be based on a project valuation of
$15,000.00 and what forms you require and how many copies? Finally,can you tell me how long
the review process typically takes?
Thank you in advance for your help!
Please let me know if you need any additional information.
Stephen Griffiths
F.k i ` _ . i, , ,
206.523.1941 Office
206.260.7930 Fax
918 South Horton Street Suite 1002, Seattle, WA 98134
www.rykaconsulting.corrl
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If
requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public
Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative
Rules"City General Records Retention Schedule."
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
12965 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2014-00219
Jeff Grove
Violation Summary:
Inspector Contractor