Permit CITY OF TIGARD BUILDING PERMIT
_ COMMUNITY DEVELOPMENT Permit#: BUP2015-00156
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2015
Parcel: 1 S135DA01000
Jurisdiction: Tigard
Site address: 8530 SW PFAFFLE ST
Project: AT&T Subdivision: METZGER ACRE TRACTS Lot: 20
Project Description: Replacing(3)antennas,and installing a new horizontal frame reinforcement on the existing platform.
Contractor: VELOCITEL INC Owner: DALTON, DAVID L
2415 CAMPUS DR SUITE 200 8530 SW PFAFFLE RD
IRVINE, CA 92612 TIGARD, OR 97223
PHONE: 503-349-2149 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 06/02/2015 $453.95
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 06/02/2015 $54.47
Dwelling Units: 0 Plan Review 06/02/2015 $295.07
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 06/09/2015 $75.00
Bedrooms: 0 Bathrooms: 0 DC Provision Review,COM TI-LRP 06/09/2015 $11.00
Value: $25,000 Info Process/Archiving-Sm$0.50(up to 06/09/2015 $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 $909.49
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 c••y of the ru- - direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 5 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 ONLY
eived
I% - - City of Tigard C r E4v _ Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 GV Plan Revie '�'� �. r •• Y ! ,a
~ '.r• I/�� Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/ : =ar t ��.�
TI GARD Inspection Line: 503.639.4175 1t 1n, 2 20 Date Ready : �� Suns ® See Page 2 for
Internet: www.tigard-or.gov JU 1` Notified/Method: � O /> �V/q Supplemental Information
�;, of a `P1/4143 iV/ie-x ���""GLL�
TYPE OF WORK U"D�Nd` pI- 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 ®Commercial/industrial
Valuation: $
El Accessory building El Multi-family Number of bedrooms:
❑Master builder ®Other:Wireless Number of bathrooms:
B SITE'" R Total number of floors:
JOB SITE INFORMATION AND LOCATION
r
Job site address:8530 SW Pfaffle Street New dwelling area: square feet
City/State/ZIP:Tigard OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: l Project name:AT&T-PR72 Covered porch area: square feet
Cross street/directions to job site:See page T-1 of plans. Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: f Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1S135DA01000 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF Wi;: work indicated on this application.
Existing cell tower. Remove(3)antennas and replace with Valuation: $$25,000.00
with(3)new antennas. Install new horizontal frame reinforcement on existing Existing building area: N/A square feet
antenna platform. No ground disturbance. New building area: 0 square feet
® PROPERTY OWNER Number of stories: 1
Name:Donald Schaefer&Michael Munch Type of construction: IIB
Address:18655 NE Chehalem Drive Occupancy groups:
City/State/ZIP:Newberg,OR 97132
Existing: Unoccupied
Phone:( ) I Fax:( ) New: Unoccupied
' ® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:FDH Velocitel,Inc.,for AT&T Mobility (Please rejerto fee schedule)
Structural plan review fee(or deposit):
Contact name:Michael Birndorf
FLS plan review fee(if applicable):
Address:4004 Kruse Way Place,Suite 220
Total fees due upon application:
City/State/ZIP:Lake Oswego,OR 97035
Phone:(503)421-2251 Fax::(503)636-2501 Amount received:
E-mail:michael.birndorf@fdhvelocitel.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name:Velocitel,Inc.,Jay Telford Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:4004 Kruse Way Place,Suite 220 Solar Installation Specialty Code checklist.
City/State/ZIP:Lake Oswego,OR 97035 Permit fee(includes plan review $180.00
and administrative fees):
Phone:(503)636-2500 Fax:(503)636-2501
State surcharge(12%of permit fee): $21.60
CCB lic.:200980 Total fee due upon application: $201.60
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Michael Birndorf Date:6-02-15 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
SY
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
I IGAKI ) Building Permit Review — Commercial - No Land Use
Building Permit #: 5i ,O c atJ J'-c
Site Address: S5l.10 SW sP-VaCrVie Sf . Suite/Bldg#:
Project Name:
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: cep\ace, exl \►nl wireless communi CC `'lof mark,,
Existing Business Activity: Wl fe1P,55 comrninniCaCVInC TI 6ti-Ke `i
Proposed Business Activity: same
g/Verify site address/suite#exists and active in permit sys m.
kg/River Terrace Plan District ❑ Yes No
12 Zoning: c- P
!Cif/Permitted Use: dYes ❑ No Cl Spec Space
Ai Confirm no land use required.
Business License/
Exists: Ml Yes ❑ No,applicant notified to obtain business license
Notes: (10 \II SUM\ ch a n c 3, OlnQ no mod l-�I c * o n� a+ C� ov \e e,i
Approved by Planning: �1 m ( Date: 6 12-I ` S
Revisions (after Building Submittal only) Reviewer Date
Revision 1: Cl Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: 6/05---
Site Plans: # /UM-
Building Plans: a__
Building Permit#: building permit#above.
[
Workflow Routing: ' farming ❑ Permit Coordinator g
Workflow Sign-off: D-3'ign off for Planning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: - _ _ Date: 6/V i;"
AI AP
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse 03 1015.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
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:
M%K to Issue Permit
Approved by Permit Coordinator: Date:
"/6 �y�
1:\Building\Forms\BldgPermitRvw_COM_NoLandUse 031015.docx
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
8530 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Building
299 Final inspection
PASS - No C of O
BUP2015-00156
Chip Barnett
Violation Summary:
Inspector Contractor