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Permit `111 CITY OF TIGARD BUILDING PERMIT ,f = COMMUNITY DEVELOPMENT Permit#: BUP2015-00238 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/02/2015 Parcel: 1S135BB00300 Jurisdiction: Tigard Site address: 10185 SW CASCADE AVE Project: Verizon Subdivision: OAKBURG Lot: 27 Project Description: Install(16)antennas with related equipment&accessories on an existing 116'monopole.12/10/2015: REPRINT permit to add(1)1'diameter microwave dish mounted to the tower;does not increase height of tower. Contractor: SUMMIT SOLUTIONS GROUP LLC Owner: PORTLAND GENERAL ELECTIC COMPANY PO BOX 1224 121 SW SALMON ST SISTERS, OR 97759 PORTLAND, OR 97204 PHONE: 541-549-6620 PHONE. FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT T Permit Fee-Additions,Alterations, 12/02/2015 $1,528.75 ype of Const: Demolition Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 12/02/2015 $183.45 Dwelling Units: C Plan Review 08/10/2015 $993.69 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 12/02/2015 $351.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 12/02/2015 $32.50 Value: $170,000 11x17) Metro Const. Excise Tax 12/02/2015 $204.00 Floor Areas: Total Area: 0 Accessory Structs 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $3,293.39 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 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: - Gy�,� Permittee Signature: -77 ` 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. yv 4 1 a 1 CITY OF TIGARD BUILDING PERMIT i g 't COMMUNITY DEVELOPMENT Permit#: BUP201500238 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/02/2015 T LARD Parcel: 1 S 135BB00300 Jurisdiction: Tigard Site address: 10185 SW CASCADE AVE Project: Verizon Subdivision: OAKBURG Lot: 27 Project Description: Install(16)antennas with related equipment&accessories on an existing 116'monopole. Contractor: SUMMIT SOLUTIONS GROUP LLC Owner: PORTLAND GENERAL ELECTIC COMPANY PO BOX 1224 121 SW SALMON ST SISTERS, OR 97759 PORTLAND, OR 97204 PHONE: 541-549-6620 PHONE: FAX: Specifics: FEES Description Date Amount Type of Use: COM Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 12/02/2015 $1,528.75 Demolition Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 12/02/2015 $183.45 Dwelling Units: 0 Plan Review 08/10/2015 $993.69 Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 12/02/2015 $351.00 Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 12/02/2015 $32.50 Value: $170,000 11x17) Metro Const. Excise Tax 12/02/2015 $204.00 Floor Areas: Total Area: 0 Accessory Struct: 0 Basement: 0 Carport: 0 Covered Porch: 0 Deck: 0 Garage: 0 Mezzanine: 0 Total $3,293.39 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 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: ------ •_ermitteeSignature: (� S— +Ailk 39.4175 by 7:00 a.m.for the next available inspection `•a '\- 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. wilding Permit ApplicatiNCFI%.EP Commercial FOR OFFICE: USE ONLY City of Tigard AUG 1 0 2015 Received �� Permit No.: 4 t 6 '642 'Date/By: o ' II OFTIGARD ii 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �I ` • Phone: 503.718.2439 Fax: 503. ry� l' t DateBy: ��' ,.`Z((``- Other Permit: ht00` . /9 T I G A R D Inspection Line: 503.639.4175 Date Ready/By: opt/s �,e� A ® See Page 2 for Internet: www.tigard-or.gov BUILDING D V1S!O Notified/Method: tV/r Supplemental Information IV NI 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:Colocation equipment,materials,labor,overhead,and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El1-and 2-family dwelling ElCommercial/industrial Valuation: $ ElAccessory building IDMulti-familyNumber of bedrooms: ElMaster builder ®Other:Cell Tower Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address:10185 SW Cascade Avenue New dwelling area: square feet City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet • Suite/bldg./apt.no.: Project name:POR CASCADE Covered porch area: square feet Cross street/directions to job site:SW Cascade Ave and SW Shady Lane. Deck area: square feet Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: l Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: IS1W35BB-00300 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. Verizon Wireless proposes to install(16)antennas and related equipment and Valuation: $170,000.00 accessories in an existing unmanned telecommunications facility on an existing Existing building area: square feet 116'monopole. New building area: square feet ® PROPERTY OWNER 0 TENANT Number of stories: Name:PGE,Main Contact:Jim Carver Type of construction: Address:2213 SW 153'd Drive Occupancy groups: City/State/ZIP:Beaverton,OR 97006 Existing: Phone:(503)464-8000 Fax:( ) New: 0 APPLICANT ® CONTACT PERSON .BUILDING PERMIT FEES* Business name:ACOM CONSULTING INC.(Applicant Agent for Verizon) (Please refer tofee schedule) Structural plan review fee(or deposit): $993.69 Contact name:Sarah Blanchard FLS plan review fee(if applicable): Address: 1125 SE Clatsop Street Total fees due upon application: $993.69 City/State/ZIP:Portland,OR 97202 Amount received: 993.69 Phone:(503)310-0544 I Fax: :( ) E-mail:sarah.blanchard@acomconsultinginc.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and resjdential prescriptive installatii of CONTRACTOR roof-top mounted Pho 'Voltaic Solar Panel em. Business name:TO BE DETERMINED 5 5 Submit two(2)sets of roo .Ian with co, ection details "hk`` "�`'``��` ,�""° and fire department access,a .':w'. the 2010 Oregon Address: O '-i)ok vut y Solar Installation Specialty Cod, a ecklist. City/State/ZIP: Permit fee(includes . .n revi• • SISTEZS , b2 g`l'1S°I and admil' rative fees): $180.00 Phone:(-31-k k. ) stmt._ 6(0 z o Fax:(jLl\ ) S4 -(oto 2.( State surcharge %of permit fee): $21.60 CCB lic.: 1/46 O b j 4„ 7/0 % �> r Tot. 'ee due upon application: $201.60 Authorized signature: t/ / This p emit application expires if a permit is not obtained [[[�� f within 180 days after it has been accepted as complete. Print name:Sarah Blanchard Date:7/27/15 * Fee methodology set by'fri-County Building Industry Service Board. I:\Building\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(1 l/02/COM/WEB) ,. City of Tigard IIa COI\'II\'IUNITY DEVELOPMENT DEPARTMENT r WARD Building Permit Review — Commercial - With Land Use Building Permit #: l'c711/ 5-00 -3?' Site Address: I b 1 BS W Ca.,/ CL OLA e.- N-,,c. Suite/Bldg#: Project Name: V e'te;2 c n (Name of commercial business occupying the space. If vacant,enter Spec Space.) Planning Review Proposal: J-hs-i-a-t( go GAlenn0-5 + r" ('t--led eb--:p.Y,e,a+-/access d �t e,5 t el Uow, av,ntd -I-c_(eco ,-,1,,4tCCS 6v.3 -ccsCAI (i+ty. Hulnoput C_ # -G Aur l-3 -e 1Verify •site address/suite# exists and active in permit system. `�� en [River Terrace Neighborhood: ❑ Yes N".-No 'Land Use Case #: tAvApaDis - boot ci Plans Match Approved Land Use: . ' 'Site Plan ❑ Landscape Plan ❑ Other: ❑ Urban Forestry Plan Elevation Plan .'Building Height: Maximum 1-Leight Actual Height ECis-(i n5 NIS)' Conditions Met: ❑ Prior to Submittal ❑ Prior to Permit Issuance Ni Ft Business License: Exists: Yes ❑ No, applicant notified to obtain business license Public Facilities Improvement (PFI) Permit: Required: ❑ Yes, applicant was notified )k No Applied For: ❑ Yes ❑ No, stop intake Notes: Approved by Planning: CIAp L,,P a , (16Z, — Date: e- 16 - 15 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: /o// < Site Plans: # 3 Building Plans: # '5 Building Permit#: _2–Enter building permit# above. Workflow Routing: ❑'Planning .-17gineering ermit Coordinator Tilding Workflow Sign-off: D–Sign-off for Planning(include notes from planning review) Route Application Documents: auilding: original permit application, site plans,building plans, engineer and beam calculations and trust details,if applicable, etc. Notes: By Permit Technician: C/ ___--1()-A.,,dza}al p,/,5,------ Date: I:\Building\Forms\BldgPennitRvw_COM_W ithL,andUsc_0709I 5.docx Engineering Review ❑ Slope at building pad: ,----„,„-.L ❑ PFI Permit#: ❑ Conditions "Met"prior to issuance of building permit ❑ Easements (encroachments) per engineering conditions of approval and plat (not typical on SDR/CUP) ❑ Water Quality/Quantity Facility: Assess Water Quality Fee in-lieu: ❑ Yes 4 No Assess Water Quantity Fee in-lieu: ❑ Yes Z No LIDA Facility on lot: ❑ Yes ® No ❑ NOT Approved by Engineering: Date Notes: • Approved by Engineering: kit u/L LA-9 Date: € Vic-- Revisions (after Building Submittal only) Reviewer Date Revision 1: ❑ Approved ❑ Not Approved Revision 2: ❑ Approved ❑ Not Approved Revision 3: ❑ Approved ❑ Not Approved 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: ❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A Tigard Trans SDC: ❑ Yes E N/A Parks SDC: ❑ Yes ❑ N/AK to Issue Permit p , ��«'� Approved by Permit Coordinator: k/� Date: I:\Building\Forms\BldgPennitRvw_COM_WithLandUse_0709I 5.docx