Permit CITY OF TIGARD BUILDING PERMIT
III
II
COMMUNITY DEVELOPMENT Permit#: BUP2O16-00029
T'(ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/10/2016
Parcel: 1 S135DA010OO
Jurisdiction: Tigard
Site address: 8530 PFAFFLE ST
Project: AT&T Subdivision: METZGER ACRE TRACTS Lot: 20
Project Description: Removing(3)antennas and installing(6)new antennas on existing cell tower.
Contractor: VELOCITEL INC Owner: DALTON, DAVID L
4004 KRUSE WAY PL, SUITE 220 8530 SW PFAFFLE RD
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
PHONE: 503-636-2500 PHONE:
FAX: 503-636-2501
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 02/10/2016 $453.95
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 02/10/2016 $54.47
Dwelling Units: 0 Plan Review 01/27/2016 $295.07
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 02/10/2016 $20.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $25,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $823.49
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 i - . .- - 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. • TENTION Ore9kon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-s.1-0010 through OAR 952-00 -.:90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I sued By: 4, Permittee Signature:
i
Call 503.639.4175 by 7:00 a.m.for the next available inspe ion 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
Commercialfo'' FOR OFFICE usE oNl ti
Iv iic.
Received
City of Tigard ry I}�b Date/By: I A/ f Permit No.: /,ri.Pa616 ,rrn_'1
I - " 13125 SW Hall Blvd.,Tigard,OR 97221 to 41 t-v Jj
�lJ"� 4 Uu��
10� Plan Review
Phone: 503.718.2439 Fax: 503.598. D Date/By: �.Other Permit:
C
TIGARD Inspection Line: 503.639.4175 Y� " 1(6 ti,"- .1,z DateReady/by: ,/yj�j Juris ® See Page 2for
Internet: www.tigard-or.gov �vV�iJ ,iNiS�1` Notified/Method-.,z/f gp 4244 Supplemental Information
[ .t VVI 11 ��ell- tf .EL
❑New construction Permit fees*are based on the value of the work performed.
❑Demolition
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
:_> 4 ', , . , work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ®Commercial/industrial
CIAccessory building El Multi-family Number of bedrooms:
❑Master builder ®Other:Wireless Number of bathrooms:
t ,1 ' s tl , ® Total number of floors:
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.: 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
Subdivision: 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,andthe profit ort e
r,. 11, , 11 work indicated on this application.
}
Existing cell tower-equipment modification. Remove(3)antennas and Valuation: $$25,000.00
instal(6)new antennas and ancillary equipment on tower. Existing building area: N/A square feet
No ground disturbance. New building area: 0 square feet
;; „ i .1; 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:( ) Fax:( ) New: Unoccupied
g , . _ _
Business name:FDH Velocitel,Inc.,for AT&T Mobility c
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
Amount received:
Phone:(503)421-2251 Fax::(503)636-2501
E-mail:michael.birndorf@fdhvelocitel.comW
e.. ® - : = Commercial and residential prescriptive installation of
.n „w4 ,. r k ., 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 lie.:200980 q.//41//'�
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/..,.
Date: 1-27-16 * 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)
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
BUP2016-00029
Chip Barnett
Violation Summary:
Inspector Contractor