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Case File TAX LOT 6200 I 58905 1 '05"E 175.00' I I TAX LOT 6300 PGE 3891 MAP 41 zz TIGA RD - NOR THEA S T co SITUATED IN SOUTHEAST - f� OU EA�T QUARTER OF THE NORTHEAST QUARTER CSF SECTION 36. TOWNSHIP 1 SOUTH. RANGE 1 WEST, W I WILLAMETTE MERIDIAN, WASHINGTON COUNTY. OREGON 2 M LEGEND _ d • v L I CHAIN LINK FENCE GRAVELED AREA Y�??S N I --•- BARB WIRE FENCE • HRS CONTROL Off' O .qE '�, o A OVERHEAD POWER UTILITY POLE EVERGREEN TREE y GUY ANCHOR EDGE BRUSH � MANHOLE O iso I 5 WATER METER PGE- OE :-oE . . E 34 795 MAP D11318 PGE -OE OE 0 o 7959 MAP D 1131 B : 0 G UL REGISTERED \ co PROFESSIONAL LAND SURVEYOR PGE /� / H R OREGON WES T POR TLA , / , S I NOV. 20,1970 J. H. GREENMAN SUBSTATION : 1 : : `°`:- _ _ `t. R K N •� 946 r u,1/ 2 I � -w� • 50 25 0 50 100FT 53 SCA LE.- " E. 1 - 50 z I � I J 3 � QUARTER CORNER H A N E R� ROSS & 3 1/2 " BRASS DISK H A T& T WIRELESS SERVICES -36 31 IN CONCRETE R SPORSEEN , INC • 15 S.E. 82ND DR!VE GLADSTONE, OR 97027 TEL. (503) 657-1384 FAX. (503) fi57-138 .• EDR _ _ DATE': SEPTEMBER 06, 2000 BY- No: 1 139 Project: 1139 - Aur - Tigard NE f-ile: d:\epdoto\ 11,3989_02\ 1139-02.d9n NOTICE: IF THE PRINT OR TYPE ON ANY -rl.�_Lil � � I11 , I11111JilI � I � I � I � ililili ; IiIIf-rj IT I I I-IT[T[T- .IT-I --111 i � � 1t � i int I � i � r� � ili iii I � I ill 1�7 .� I1 ili I� 1 "f r � 1 1 � f i ! t � .j.._ 1- ► f i I i i i i i i I i 1 1 1 I ( ( i i 11r i �r iii i iii IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 Z 3 � � I I 7 8 9 10 11 1� y IT IS DUE TO THE QUALITY OF THENo.36 -�-- -- — ORIGINAL DOCUMENT �~ 6 Z g Z L Z 9 Z 5 Z'•fi Z E Z Z Z T Z O Z s i 8 T LrT 9 i 4 i � I � I �' -�-� Y. � � ► � r Z x T I T 6 L 9 Illi 1111 llil 1111 1111 1111 1111 llil lil! IIIc 1111 �l�l !(II �1�� IIIL Illi 1111 111111« <�� ilil IIIc 1111 llillllll 1111 .1111 1111 llllllllllllil 1111 illl 1111 llil lll� 111111111 l�l� Ill. i Illllll. 11ill.11l ll 1� 1111��111 I MECHANICAL. General Notes 1 . Follow directions in `Installation Manual' NITROGEN '• Keyed Notes 50TTLE I. Install exhaust fan furnished by others. Provide 6" ductwork between fan and discharge above roof and between fan and fuel cell connection. Provide adapters at fan as required. Provide screened roof cap _ insect screen Seal roof weather ( tight. Provide 6"x4'' reducingfitting at locationspecified in `Installation Manual' for nal connection to fuelll (by others). 4X8 PLYWOOD ON WALL INVERTER AND \ ,LC�V1/ POI N I N r ' EQUIPMEN-7 --r FU El_ CEL I N l_, N E FX h AU __-- 4" DUCT THROUGH ROOF �\ • \ E UELO -------�, \ \ T ILT • • •.. flf+ n I FUEL CELL AT NERC - MECHANICAL_ /PGIE _ _ _ FILE NAME - --- 1'M• t•1,ANNF12 -_ DT5 PLANNER - - _— - -- ' DD-PAC-0 I new r- DATE V _ _ Joan Hosmer, 4G4-8I 5 _ I}�613_0102 OMWINGSCALE MWOm - � KEY CLIENT' _-_-- --- - I.C►CA1'TON -- -__—_ _ —��--------I pWC1 ror0and Gomer.l Woetrfo 114"= I `-O" Carol 5rowr; �! PACTRUST 3 of G ..,m, NOTICE: IF THE PRINT ORTYPE ON ANY T� ,-�I ( r ( rll ► I . III III III III II 1"� r III i�r II I r� IIS ili i � 1 IIS ll � tl < < il � fll III 111111T � � i ill IJTr _1 III-1-f-If -�.. � � r i r � 1111-1-1 C I I ' 1 I rT � ' I I I I I � ( � � � 1 < � � r � tt I I I II ► - IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 2 4 5 7 _ 8 _ 9 10 11 I 12 G IT IS DUE TO THE QUALITY OF THE V--- - - �-- � � Pi - - �� - -- No.36 ORIGINAL DOCUMENT F E— 6Z� 8Z LZ 9Z 5Z � Z —EZ ZZ TZ OZ sT 8I LT 9i fiT t ZT ii i ` 6 Illll.i�lf I�i� III il(� ��f� �(I� �fl� (�l� ��I� ilL� llu l��L I I(�►. .�II� �I �� I I I I 18 L 9 ll 1 1lllilll 1111(11111111.Illllllil�lllllllilllliaillll(IIIIIIIIillilllilllilllllll�llll � i 10955 SW 65`h Avenue REDMOND & ASSOCIATES Project No. 110.149.G Page No. 1 September 15, 2000 AT&T Wireless Services cao Mr. James Kramer Vision Development 4500 SW Kruse Way, Suite 370 Lake Oswego, Oregon 97035 Dear Mr. Kramer: Re: Geotechnical Investigation, Proposed Tigard NE Cellular Communications Tower Site, SW 64tH Avenue,Tigard (Multnomah County), Oregon INTRO DI:I CTIO Pi In accordance with the request of AT &T Wireless Services and that of Mr James Kramer of Vision Development,we have completed our Geotechnical Investigation for the above subject communications tower project. Our work was performed in general conformance with our formal proposal to Mr. James Kramer dated January 2, 1999. Verbal authorization of our services was provided by Mr. James Kramer on August 14, 2000. We understand that present plans are to construct a new communications tower and equipment shelter at the site. The tower reportedly will consist of an approximate 150-feet tall self-support, steel mono-pole tower structure while the equipment shelter is anticipated to be supported by a cast in-place concrete slab of about 12 by 28 feet in size. The scope of work for this investigation included the drilling of one (1) exploratory test boring at the proposed tower location on September 13, 2000 (see Site Vicinity Map, Figure No 1) The test boring was drilled utilizing trailer mounted, solid-flight, hollow-stem, auger and/or mud-rotary drilling equipment. The results of our investigation, including design and constniction recommendations for the project, are summarized within this report SCTE CONDITIONS The subject tower site is located to the west and/or north of SW 64th Avenue and adjacent to and just east of an existing substation site in Tigard (Multnomah County), Oregon (see Site Vicinity Map, Figure No, 1). The subject tower site is presently unimproved and consists of a recently graded and cleared area. Topographically, the subject she Is characterized as gently to moderately sloping terrain descending down to the south and is estimated at about Elevation 350 feet. Surface vegetation at the tower site is presently void due to the recent site clearing and grubing work. P.U. Box 301545 • Portland, OR 97294 • Phone: 760-1060 • Fax: 760-1372 4 Project No: 110.149.0 Page No.7 The subsurface soil conditions at the site consists of an upper unit of residual native soil deposits of upper Eocene age as well as an underlying unit of undifferentiated volcanic bedrock deposits of Miocene and Oligocene age. Specifically,the upper native soil materials were comprised of medium stiff to stiff, clayey, sandy sift to a depth of about 7.5 feet beneath existing site grades. These clayey, sandy sift subgrade soils are best characterized by relatively low to moderate strength and compressibility.These upper clayey, sandy sift soils were intum underiair by dense to very dense, moderately to slightly weathered and fractured basalt bedrock materials to the maximum depth explorad of about 15.0 feet beneath existing site grades.These moderately to slightly weathered and fractured bedrock materials are best characterized by relatively high strength and low compressibility. Grou,-id water was generally not encountered within the exploratory boring at the time of drilling and is riot expected to be a factor during construction. All soils were classified in accordance with the Unified Soil Classification System(USCS)which is outlined on Figure No. 3. CONCLUSIONS AND RECOMMENDATIONS Based on the results of our field exploration, the tower site was found to be generally underlain by native residual soil deposits cif upper Eocene age as well as volcanic bedrock materials of Miocene and Oligocene age. The native soil and/or bedrock materials were comprised of medium stiff to stiff,clayey, sandy sift to a depth of about 7.5 feet followed by dense to very dense, moderately to slightly weathered and fractured Basalt bedrock to the maximum depth explored of 15.0 feet beneath existing site grades. As noted above, ground water was not encountered at the time of our field exploration work and is not expected to be a factor during construction. In this regard, we are of the opinion that the site is suitable for the planned self- support steel mono-pole tower structure and equipment shelter provided that the following recommendations are incorporated into the design and construction of the pmject. In general, we are of the opinion that support of the steel mono-pole tower structure can best be provided by means of either a large concrete mat type foundation or an embedded spread footing and concrete pier system deriving bearing support on the underlying dense to very dense bedrock deposits. Howevar, due to the presence of the very dense bedrock deposits below a depth of about 7.5 feet beneath existing site grades, the use of a direct bury or drilled concrete pier foundation is generally not recommended at the site due to the anticipated extreme in very hard drilling and/or excavating conditions. In this regard, should It be desirable to use an embedded spread footing and concrete pier foundation system, additional uplift resisi:.oue for the tower structure could be developed through the use of soil cover(backfill) above the embedded spread footing element The following soil strength parameters may be used for foundation design purposes: Medium brown to reddish-brown, clayey, sandy SILT (ML); Allowable vertical bearing pressure 2.000 psi (above 2 0 feet) 3,000 psf (below 4 0 feet) Allowable lateral bearing pressure 200 psf/ft Soil unit weight (moist): 110 pcf Angle of internal friction (drained): 30 degrees Cohesion (undrained): 200 psf Coefficient of friction: 0.35 Passive earth pressure: 250 pc:f Adhesion of concrete to soil (ultimate): 750 psf REDMOND & ASSOCIATES i Project No.110.149.13 Page No.3 Gray-brown,moderately to slightly weathered Basalt bedrock(RK); Allowable vertical bearing pressure: 9,000 psf Aiowable lateral bearing pressure: 300 psftft Angle of Internal friction: 40 degrees Sol] unit weight(moist): 125 pcf Cohesion (undrained): 100 psf Coefficient of friction: 0.45 Passive earth pressure: 350 pcf Adhesion of concrete to soil (ultimate): 1,500 psf bearing pressures are intended Note: above and sustained livveelloadswand may be able lin increased by one-third for the total of d The of all loads loads including shorl-term wind or seismic loads. Founda Lona For conventional (lightly loaded) shallow foundations with no more than 12 to 18 inches of embedment, such as those required for an equipment shelter slap and/or pad,we recommend that an allowable contact bearing pressure on the order of 2,000 psf be used for design where foundations are supported below the existing topsoils by the underlying native, medium stiff to stiff, clayey, sandy silt subgrade soil materials. A coefficient of friction between the clayey, sandy sift subgrade soil and footing elements of 0.35 is recommended. Should it be desirable to to use an embedded spread footing and concrete pier system for support of the mono-pole tower stnidure, additional uplift resistance could be developed due to the weight of any soil cover/backfill used above the concrete footing element. Depending on the degree of compaction obtained in the soil cover, a moist unit weight ranging from about 100 to foo pg is backfill zone, we recommend thatwever, should ,thefoot ng backfill ment be co paled to located directly above the footing the requirements of structural fill Total and differential settlements of foundations, for both the tower and equipment shelter, designed and constructed in accordance with the above recommendations are expected to be less than 1-inch and 1/2-inch, respectively Site Preparation and Excavations Site preparation is anticipated to consist generally of the stripping and removal of the surficial topsoil materials which are believed to be about 1.0 feet of more in depth. Where structural fills are required, we recommend that structural fills be compacted to at least 92 percent of the ASTM 13-1557 test procedures. Additionally, the on-site clayey, sandy silt and/or highly weathered bedruck subgrade soil materials are generally considered suitable for useireuse as structural fill materials provided that they are free of rock fragments in excess of about 6 inches and at or very near to optimum moisture content at the time of compaction. In general,temporary excavations should remain fairly stable at near vertical inclinations to depths of about four(4) feet. Open excavations between the depth of four(4) feet and ten (10) feet should be bakait to inclinations of about '1/2 to 1 (horizontal to verticsf). However, where excavations exceed abort five (5)feet and where workers orke twill be inclinationrot within f the bottom of t 1 0 1 the excavation,we recommend a minimum temporary (horizontal to vertical). RF,DMQND & ASSOCIATES Project No. 110.149.G Page No.4 As an-aKemative,the excavation may be properly braced and/or shored to provide for worker safety. However,the braving and/or shoring of the excavation should be the responsibility of the excavation contractor. Additionally, at present levels,ground water is not expected to be encountered in open excavations which extend to depths of at least 6 feet or more. As such, dewatering of open excavations is not tpeled.encower very hard tationsc hi h extend below a depth of about�7.Q fent should be expected conditions on the Basalt bedrock deposits. CLOSURE The services performed by the Geotechnical Engineer for this project have been conducted with that level of care and skill ordinarily exercised by members of the profession currently practicing in this area under similar budget and time restraints. No warranty, either expressed or implied, is made. We will be pleased to provide such additional assistance or information as you may require in the balance of the design phase of this project and to a�J in construction control or solution of unforeseen conditions which may arise during the construction period. Sincerely, I N'r f'r N f Daniel M. Redmond, P.E. I • 9 9 President/Principal Geotechnical Engineer Z n UPIEAN Q Y ✓�/r t5. �9�� 0 M REV REDMOND & Asso(;iATES Job No.:0 1-03017 Page: 1 B cummun��.t�un. Date: 03/07/01 Coryontlun Prepared By:THW Customer: Bechtel Corporation Site: Tigard NE, OR PT87 100' Monopole designed for a basic wind speed of 90 mph + 1/2"ice, in accordance with ANSI/TIA/EIA 222-F Antenna loading per nage 1. Monopole Design Notes 1. All pole walls are in accordance with ASTM A572 grade 65, or equal. 2. Use (8)#18J x 7'-0" long anchor bolts with 3/8" thick template at top and bottom (3 nuts and 2 flatwashers at top, and 2 nuts at bottorn, per anchor bolt). NO WELDING. Anchor bolts material per ASTM A615 Grade 75. 3. The anchor bolt circle has a 41"diameter. 4. Base plate is 1.75"thick x 47"diameter, ASTM A633 grade E (Fy = 60 ksi). 5. Due to the 25% reduction in wind pressure, which is allowed by the 222-F standard when considering ice accumulation (section 2.3.16), the ice case does not control the design of any tower member or the foundations. `GT pFln-'C, NF ZrGON FXPfRATION DATE .3� �Z Information contained herein is the sole property of Sabre Communications Corporation, constitutes a trade secret as defined by Iowa Code Ch. 550 and shall not be reproduced, copied or used in whole or part for any purpose whatsoever without the prior written consent of Sabre Communications Corporation, 2101 Murray St - P O. Box 658 - Sioux City, IA 51102-0658 - Phone 712.258.6690 - Fax 712.258.8250 %x ENT Yelton DEAR�T/M /O�F Y, John A.Kitr , r1 haber,M.D.,Governor I �, d U Ll9 ] r « I 3040 -25th Streeet SE Salem, OR 97302-1125 r Phone: (503) 378-4880 i (800) 874-0102. Dec. 19, 2000 �`I�-. '..�..� PAX: (503) 373-1688 Dave Wand Senior RF Engineer AT&T Wireless Services 1600 Fourth Ave. Portland, OR 97201 Subject: Comments regarding.Proposed Tigard North- East Cell Site Aeronautics reference number 00-0559AT This proposed tower lies adjacent to the 1-5 corridor, South of Portland. Aircraft and helicopters regularly transit this route. Madical evacuation and rescue helicopters fly this route to reach accident victims, often in marginal weather conditions. If this tower is approved, it should be lighted with a dual fitted, steady burning, red Ld10 light mounted atop the structure in accordance with FAA AC 70/7460, Chapters 4,5 and 12. Thank Vou for your attention to this response. Sincerely, � J Thomas E. Highlan Aviation Planner CC City of Tigard Planning Department FROM MNB INC, 5032328023 (THU) 2. 8' 01 9:56/ST. 9:56/N0. 4861252518 F 2 HANER, ROSS & SP®RSEEN, INC. A ^ ENGINEERS CONSULTANTS SURVEYORS « 15 SE land Drive OMOC 509857.1384 roe M e:N1. $v/re 2111 Fax:S03.657.1367 C3103ione.O►opon 97027 trmWl:hr3enomhw{{t.mm MOMER Lease:Description p C 0 LTJ C j Tigard Northeast Stuion E E B 0 8 2001 I Tigard,OR B 1-case Description. A L easchalei,being. pporion Of 1110 Uuct of land in the norIJV=quarter of Section 36,Township I South, Range 1 West of the Willamette Meridian,Washington County,Gruen,conveyod by David N Weider and Elizabeth L.Welder,husband and wife,Grantor,to Potdand General Ela tric Co any,an Orcgon Corporation~Grantee,and recorded Septe nbcr 27, 1957 in Book 398, Page 264,Washington County Records,said Leasehold being more parttculxtly described as follows Commencing -,t the east one-q-vter comet of Section 36 and proceeding North 00 deV= 10 minutes 20 se cnnds Ew a distaecc of 377.60 feet along the,easletly boundary thercoC sr,-d esa5tcrly boundary also being thr..wed right-of-way of S.W. 65''Avenue,to a point;thenc(:leaving a right=glees said easterly boundary and proceeding North 89 degrees 49 minutes 40 sccands West a distance of 20.15 feet to a point,said pound being the most easterly corner of the L=sehold and the TRUE POINT OF BEGINNING, nonce,South 19 degrees 47 minutes 35 seconds West a distanix of 50.00 feet to a point; Thence North 70 degrees 12 minutes 25 seconds West a disance of 75.00 feet to a point; Thcnoe North 19 degrees '7 minu!es 35 seconds Fant a distarnoc of 50.00 thet to a point; Thcoex South 70 degrees 12 minutes 25 seconds East a distance of 75.00 feet to a point; iWd point being the TRUF POR4T OF BEGINNING of the lx Aold. Tlae ahove described Leasehold contaias 3750.00 square foes,moic or kis, Toget!ter With the right of ai;cLss, ingress and egress over,across and alo:tg said tract of land,including a utilities casement,to the above dcscnbod Lemsehold. OaR P/;t 1cgJff) NGCISTEREQ PRS'F ESIt I qA Al. f ,4 EYOR 0 A F C o N MOS. j0, 1•/R J. H. CKENUAN 946 Cxpint.sr owuc 3o • INON{T qI A' W�eTo ♦gEAT►/e NT • wVMiRi•A�VTQ rTiRR • NTOROCCECTAIC O{V{bOPMENT{ • 110�0{{q�rLw�rR • rNDVITOu, 4-Ts 84VOLOPNENT • INM6r•TION i RA1EM CONTYIOfv • PONT 6 NAN{ON Of V{lA•rrt NT• . u•n.... ,,.,.r......,• TO 4,#0 4►-.• Federal Aviation Administration AERONAUTICAL STUDY NORTHWEST MOUNTAIN REGION, ANM-520 No: 00-ANM-2377-OE 1601 LTND "AVENUE, S ,W. � RENTON, WA 98055-4056 ISSUED DATE: 01/18/01 a hj DA':%E WAND -- TIGARD NE SITE { k ,' AT&T WIRELESS SERVICES OF OR. INC. 1600 SW 4TH AVENUE ...--- PORTLAND, OR 97201-5596 ** D-STERM1,1ATION OF NO HAZARD TO AIR NAVIGATION ** The Federal Aviation Administration has completed an aeronautical study under the provisions of 49 U.S.C. , Section 44718 and, if applicable, Title 14 of the Code of Federal Regulations, part 77, concerning: Description: ANTENNA TOWER FREQ. 869 .04-891 .48 MHZ @ 100 WATTS ERP Location: METZGER OR Latitude : 45-26-29 .40 NAD 83 Longitude: 122-44-38 .30 Heights : 115 feet above ground level (AGL) 465 feet above mean sea level (AMSL) This aeronautical study revealed that the structure does not exceed obstruction standards and would not be a hazard to air navigation provided the following condition(s) , if any, is (are) met- : Based on this evaluation, marking and lighting are not necessary for aviation safety. However, if marking and/or lighting are accomplished on a voluntary basis, we recommend it be installed and maintained in accordance with FAA Advisory Circular 70/7460-1K. This determination expires on 07/18/02 unless : (a) extended, revised or teimiinated by the issuing office or (b) the construction is subject to the licensing authority of the Federal Communications Commission (FCC) and an application for a construction permit has been filed, as required by the FCC, within 6 months of the date of this determination. In such case the determination expires on the date prescribed by the FCC for comppletion of construction or on the date the FCC denies the application. MOTE : REQUEST FOR. EXTENSION OF THE EFFECTIVE PERIOD OF THIS DETERMINATION MUST BE POSTMARKED OR DELIVERED TO THIS OFFICE AT LEAST 15 DAYS PRIOR TO THE EXPIRATION DATE. This determination is based, in part, on the foregoing description which includes specific coordinates, heights, frequency(ies) and power. Any changes in coordinates, heights, frequency(les) or use of greater power will void this determination Any future construction or alteration, CITYOF T I G A R D ELECTRICAL PERMIT PERMIT#: ELC2001-00424 DEVELOPMENT SERVICES DATE ISSUED: 8/22/01 13125 SW Hall Blvd.,Tioard, OR 97223 (503) 639-4171 PARCEL: 1 S136AD 06300 SITE ADDRESS: 10955 SW 65TH AVE SUBDIVISION: PGE ZONING: C:-G BLOCK: LOT : JURISDICTION: TIG Proiect Description: Installation of(2)200 amp or less services and (14)branch circuits. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALIPANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS _ 0 - 200 amp: 2 W/SERVICE OR FEEDER: 14 PER INSPECTION:- 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVItW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: _ Reconnect only: SVC/FDR >=225 AMPS_ CLASS AREA/SPEC OCC: Owner: Contractor: fIORTLAND GENERAL ELECTRIC ALLIANCE ELECTRIC INC 121 SW SALMON ST 19590 SW 51 ST PORTLAND: OR 972.04 TUALATIN, OR 97062 Phone: Phone: 691-2222 Reg#: LIC 78713 ELE 3-310C SUP 2021S f FEES A Required Inspections )'pe By Date Amount Receipt— Ceiling Cover PIRMT CTR 8/22/01 $253.70 2720010000( Wall Cover Elect') Service 51'ICT CTR 8/22/01 $20.29 2720010000( Elect'I Final — Total � $273.99 -- T h.s Permit is issued subje,.t to the regulations conta ned in the Tigard Municipal Code State of OR. Specialty Codes and all other applicable laws All work will be done in acoortianc i with approved pl;ms This permit will expire if work is not stirwithin 180 days of issuance,or rf work is r,usoended for more than 180 dais ATTENTION Oregon law requires you to follow ruleS adopted-by th�Oregon Utility Notification Center Those rues are set forth in OAR 952-00'-0010 through OAF 952-001-0080 You may obt copies off,,;_Q rules or direct questions tb OUNC at(503) 2466699 or 1.900-332-2344 -- - � l Permit Signature: _ -Y -_— Iss d By: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ — DATE: CONTRACTOR INSTAL ATION ONLY SIGNATURE OF SUPR. ELEC'N: ■ )410C eye 'e DATE. — — LICENSE NO: do,;)11 Call 639-4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: Permit no.: city Of Tigard Project/appl.no.: Expire date: .22L& City u/7'igurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1 U I k 2 family dwelling or accessory 0 Commercial/industrial U Mulli-family U Tenant improvement U New construction U Addition/alteration/replacement U Other: _ U Partial 1 ' Job address: 10955 SW 65th Ave Bldg.no.: Sufic no.: ITax map/tax lot/account no.: Lot: Block_: _ Subdivision: BUP200100084 Project name. _ Description and location of work on premises: e W C e s 1 e I W 2 r Estimated date of complction/inspecticu )- ?n-0 f Job no: I're Mar Business name: Alliance Electric Description Qly. (ea) Total no.Insp Address: 1 n 5 U S l� 5 1St v New residential-singleor mulls-fandh per dwelling unit.Includes sonched garage City: Tualatin Slate:0 R zl!': 97-0--67— 5erviecinclurlcd: Phone: 7 Fax 19 5 0 6 E-mail: I000_ .y.tr( less — - 4 Each additional 500 sq.A.or portion thereof CCB no.: 79713 Elec.bus.lic,no: 3-310 C Limited energy,residential 2 City/metro Ilc.no.: Umited energy,non-residential 2 R-21 _(11 Each manufactured home or modular dwelling _Siapfire_o supervising ales rician(required) Date Service and/or feeder License Services or feeders-Installation, Sup.elect.name(print) ,)e r o w e B Wand 2 0 2 1 5 t201amps or relocation: or less 2 Name(print): to 400 amps 2 to 600 amps 2 Mailing address: to 1000 amps _ 2 City: Slate: ZIP: Over 1000 amps or volts 2 Phone: Fax: j E-mail: Reconnect only - I Owner installation:The installation is being made on property I own Temporary services orReders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: 200 amps or less 2 ORS 447,455,479,670,701. 201 amps to 400 amps -- — 2 Owner's sl nature: Date: 401 to 60fl amps 2 Branch circuits-nen,alteration, or extemion per panel: Name: _ A. Fee for branch circuits with purchase of t Address: service or feeder fee,each brancl,circuit ` - 2 City: Stale: ZIP: B. Fee for branch circuits without purchase - - of service or feeder fee,first branch circuli 2 Phone: I , d E-marl: - - - - -- Each additinnnl brooch circuit: R1 if 11111 RT Misc.(Service or feeder not Included): U Service over 225_ins c u w•u sal U I 14.111111-care facility Each pump or irritation circle 2 U Service over 320 amps-rating of I&2 U Hazardous location Fach sign or outline lighting 2 family dwellings U Building over 100)1 square feet fom or Signal circuits)or a limited energy panel, U Systern over 6W volts nominal mine residential units in one structure alteration,or extension* _ 2 — U Building over three stories U Feeders.400 amps or more "lkscri tion: U(kcupant load over 99 persons U Manufactured structures or RV pati Fitch additional Inspection over the allowable Many of the above: U F:gress/lightingpinn U Other: — Perinspection F—T 7T Submit sets of plans with any of the above. Investigation fee ILe above are not applicable to temporary construction service. Other --- Not all Jurisdictions ccept credit cards,please camote n)ud"ctton for me Information. Notice:This permit application Permit fee..................... U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ Credit card number: --._— -_.�_L within 180 days after it has been State surcharge(8%)....$ i Npres accepted as complete. TOTAI, ....................... --- t�irtie n'f cr�drr dawn on credit cant-- 1 Cardholder sigmture Arnmunt 441-1615(NUaICOMI Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below; TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Restricted Energy Fee......... ...... $75.00 Number of Ins ctions per permit allowed (FOR ALL SYS1 EMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq ft or less — $145 15 4 �_� Audio and Stereo Systems Each additional 500 sq.ft or portion thereof $33,40 1 Burglar Alarm Limited Energy —_— $7500 —_— Each Manufd Home or Modular ❑ Dwelling Service or Feeder — $90,90 --_ 2 Garage Door Opener' Services or Feeders Healing,\,entilation and Air Conditioning System' Installation,alte(ation,or relocation 200 amps or less $8U 302 201 amps to 400 amps $106.85— _ 2 Vacuum Systems" 401 amps to 600 amps $160.60 — — 2 I 601 amps to 1000 amps $240.60 A _ 2 Otfrer Over 1000 amps or volts $454.65 , 2 Reconnect only _ $6685— 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85 2 (SEE OAR 918-260-2.60) 201 amps to 400 amps _ $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. Audio and Stereo Systems Branch Circuits ❑ New,alteration or extension per panel Boller Controls a)The fee for branch circuits with purchase of service or Clock S js`ems feeder tee. E ach branch circuit $665 2 ❑ Dat-.Telecommunication Installation b)the fee for branch circuits without purchase of service ❑ or feeder fee. Fire AlarmInstallation First branch circuit _ $46.85 _ Each additional branch circuit — $665 HVAC Miscellaneous instrumentation ;Service_or feeder not included) Each pump or irrigation circle _ $53.40_ Each sign or outline lighting _ $53.40 ❑ Intercom and Paying Systems Signal circuil(s)or a limited energy panel,alteration or extension $75.00 _— _ Landscape Irrigation Control' Minor Labels(10) $125 00 _ Each additional Inspection over — Medical the allowable In any of the above Per inspection _—� $62.50 r. Nurse Calls Per hour $6250 In Plant _ ____ $7375 _�_ U Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other 8%State Surcharge $ _ _ — Number of Systems 25%Plan Review Fee No licenses are required Licenses are required for all other installations See"Plan Review"section on $ front of application _ ------ ------ — Total Balance Due S Fees: Enter total of above fees $____ EJTrust Account N — _ —� 8%State Surcharge Total Balance Due I wsts\fbrms\elc-fees.doc 10/09100 CITY OF T I GA R DELECTRICAL PERMIT PERMIT#: ELC2001-00463 DEVELOPMENT SERVICES DATE ISSUED: 9/18/01 13125 SW Hall Blvd., Tiqard, OR 97223 (503)639-4171 PARCEL: 1S136AD-06300 SITE ADDRESS: 10955 SW 65TH AVE SUBDIVISION: PGE ZONING: C-G BLOCK: LOT : JURISDICTION: TIG Proiect Description: Installation of(1) branch circuit for Nokia equipment. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 arno:� PUMP/IRRIGATION: EACH ADD'L 500SF: 2.01 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS — ADD'L INSPECTIONS_ 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION _ 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: PORTLAND GENERAL ELECTRIC K T ELECTRIC INC 121 SW SALMON ST P.O. BOX 7365 PORTLAND, OR 97204 BEND, OR 97701 Phone. Phone: 541-382-0882 Reg #: ELF_ 9-247C SUP 4784S LIC 145488 FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 9/18/01 $46.85 � 10010000( Wall Cover Elect'I Final 5PCT CTR 9/18/01 °;3.95 2720010000( Total $5C.80 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire 9 work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to 51 Permit Signature: Issued By:t � OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: --_ _ CONTRACTOR INSTALLATION ONLY -- SIGNATURE OF SUPR. E�yLEC'N: i ___ DATE:___ LICENSE NO: -)Ts —_.-- Call 639-4175 by 7:00pm for an inspection the next business day �zc CX, Electrical Permit Application Date receiv /t)i Permit no.: , –Co City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Hlvd.Tif,ard,OR 97221 Date issued: By:J,6 1 Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file aro.: Payment type: Land use approval: U 1 &2 family dwelling or accessory m Commercial/industrial U Multi-fa)nily LJ't'cnam jrrlpnrvement U New construction U Addition/alteration/replacement U Other. -- _ U I'ailial FORM 1 [Jobaddress: jt� f 01 nJ �– Itld . tiuitr n TaK map/tax lot/account no.: ---- Lot: Black: Subdivision: Project name:AT i T ,(s T' Description and location of work on premises:/ n —�Lr�c� L�raw�� X'(- _Cl Ii,Iimateddateofcnmplrlion/inspr-coon: -- 1 1 Job no: 4, -' / --- Fee May BUSineSSname: �7' ECF_G+KaL .l>✓�• Description Qt . (ea.) Total no.insp New mkienlial-single or multi-family per Address: 770. Abn' VG✓� doellingimil.lncludesattachedgo,age. City: f) State:OeC ZIP: y 77e8 Service included: Phoned.jg j dGw I Fax. 1 E-mail: _1000 sq.ft.or les -_-- 4 — Each additional /�S' SW sy.ft.or portion thercol CCB no.: Elec.bus.lic.no: .Z 47 Limitedencrgy,residential 2 City/rpetr.o lic.no.: Hiniled energy,non-residential 2 _a/ Each manufactured home or modular dwelling ,ignature of supervising electrician(requited) — Date Service and/or feeder — 2 Sup,elect.name(print): ,-/I)/ 7-HemPS—A License no:+1Wj, S krvtceonorelon-InsUllelion, alteration or relocation: 200 amps or less 2 Name(print): 201 amps to 4(x)amps - 2 -- — 401 amps to 6(x)amps 2 Mailing Address: _ 601 amps to 1000 amps 2 City: State: ZIP: Over Itx10 amps or volts _ — _— 2 Phone: Fax: E-mail: Reconnect only -- I Owner installation:The installation is being made on property I own Temporaryservices orfeeden which is not intended for sale,Irtsr,rent,or exchange according to installation,alteration,orrelocalion: ' 20011 ORS 447,455,479,670,701. 2amps or less — _ amps l0 400 amps - � _ 2 Owner's signature: _ - Date: 401 tr,6tx)nm s 2 T Branch circuits-nerv,alteration, or extension per panel: Name: — A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 -_. City: State: 7IP: B. Fee fur branch circuits without purchase �., 4 --- of service or feeder fee,first branch circuit: q 2 PhonC: Fax• F; ttlail: Each additional branch circuit: Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous locatlon Each sign or outline lighting 2 family dwellings U Building over 10,(0 squire feet touror Signal circuit(s)or a limited energy panel, U System over 6(x)volts nominal more residential units in one stricture alteration,or extension* U Building over three stories U Feeders,4n0 amps or more vlkscri tion:— — •Occupant load over 99 persons U Manufactured structures or RV park Exch additional Inspection over the allowable In any of the above: U EgressAightingplan U ether ------_ --_—-- Perinspection --- Submit __ sets of plant with any of the above. Investigation fee 1 Ire above are not applicable to temporary contraction service. Other —� Not att jurisdictions accept credit rants,please call)urisdictinn fur uean in6umauon Notice:This permit application Permit fee................... $ U Visa U MasterCard expires if a permit is not obtained Plan review(at _— %) $ _ Credit card number _�_ L within 180 days after it h&,;been State surcharge(8%)....$ Naar of raaldnu s�iown on c it cHypires accepted as complete. TOTAL. .......................$ rdhart1�— _ S cardholder sl�rlatore Amount 440-4615(fimc m) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee.......................................... .......... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less _ $145.15 —_—_ 4 E] Audio and Stereo Systems Each additional 500 sq.ft or 1 ❑ portion thereof _ $33.40 _ Burglar Alarm Limited Energy $75.00 _ Each Manufd Home or Modular 2 ❑ Garage Door Opener" Dwelling Service or Feeder $90.90 ❑ Heating,Ventilation and Air Conditioning System' Services or Feeders Installation,alteration,or relocation $80 30 2 200 amps or less — 2 ElVacuumSystems' 201 amps to 400 amps _ $106.85 401 amps to 600 amp- $160 50 2 l� Other $240 60 --- 601 amps to 1000 amps _ 2 Ove,1000 amps or volts _ $45465 Reconnect only $66.85 — 2 -- TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders Fee for each system.......................................................... $75.00 Installation,alteration,or relocation $66.85 2 (SEE OAR 918-260-260) 200 amps or less ---- 201 amps to 400 amps _ $100.30— 2 401 amps to 600 amps _ $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems sue"b"above. Branch Circuits ❑ Boiler Controls New,alteration or extension per panel a)1 he fee for branch circuits ❑ Clock Systems with purchase of service or feeder lee. ❑ Each branch circuli _ $665 2 Data Telecommunication Installation b)The fee''or branch circuits ❑ without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $4685 - ❑ HVAC Each additional branch circuit $6.65 _ Miscellaneous � Instrumentabon (Service or feeder not included) Each pump or irrigation circle $53 40 _--- ❑ Intercom and Paging Systems Each sign or outline lichbng _ $5340 Signal circuit(s)or a limited energy L� Landscape Irrigation Control' panel,alteration or extension $7500 Minor Labels(10) $125.00 — ❑ L— Medical Each additional inspection over the allowable in any of the above $62.50 ❑ Nurse Calls Per inspection Per hour $6250 ❑ . outdoor Landscape Lighting' In Plan! $7375 Fees: ❑ Protective Signaling Enter Intal of above fees $ __— F] Other_ -------- e%State Surcharge $ — —_ . Number of Systems 25%Plan Review Fee $ ' No licenses are required Licenses are required for all other installations See"Plan Review"section on _--- front of application --- Fees: Total Balance Due $ Enter total of above fees $� QTrust Account S_ _ ._._.._ 8%State Surcharge $— ---- Total Balance Due :-- i kisls\rnrmsvrlc-fees.doc 10/09/00 CITY OF TIGABD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ Date (Requested �(� AM PM BLD Location 1 C _r _rs- 7�t-r. - _ Suite _ MEC Contact Persvrr _ Ph (C! PLM Contractor Ph cry- /d -•/3r�1 SWR BUILDING Tenant/Owner t C�r � ELC � Retaining Wall ELR Footing Access. Foundation C,��,�/ FPS - Ftg Drain SGN Crawl Drain Inspection Notes, --- Slab — G � �'`�� SIT Post& Beam Ext Sheath/Shear Int Sheath/Shear - Framing Insulation -- Drywall Nailing Firewall - Fire Sprinkler _------- _Fire Alarm Susp'd Ceiling Roof Misc F inal - -PASS PART FAIL _--- PLUMBING Post& Beam ---- - ------- — - -- --- Under Slab Top Out ----- -------- ---- -- - __ — -- Water Service Sanitary Sewer ----__-- Rain Drair- Final - __-- --- -- - -----_ ..-_— PASS PART FAIL ------- -- - -- -- - -- -----_----- - MECHANICAL Post&Beam -- --- - ----� - -_--- Rough In Gas Line ---------- _------- -- Smoke Dampers Final -- ---- -- -------- ---- --- PASS PART FAIL ELECTRICAL -- ------- ---_— Service Rough In ----- .---._.--- - ---- -- -_.-.__ UG/Slab Low Voltage - --- -_---- -- ----- Fire-AI@rm ---------------- - ----- -- - PASS ART FAIL -_-- ---------------_-_ - - ---.-, _____._____ Backfill/Grading -- Sanitary Sewer Storm Drain ( ) Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( )Please call for reinspection RE: __---- ( )Unahle to inspect-no access ADA Approach/Sidewalk Date Inspector V` Z r�'' -, f Ext Other U �— 'G,�--,�`--. --- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF T11'GARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -� BUP _ Date Requested (`' /l' AM PM — BLD Lo_ Location Suite MEC —_ �l' �-5 .S (/, - Contact Person _ Ph PLM _— Contractor 1 <: ; _�c��LG� Ph C�' _` Z 1_ Z SWR �. 7 /L L/ [BUILDING Tenant/Owner _ - ELC , Retaining Wall ELR Footing Access: y/ /�ff v� ��h T' CiG FPS Foundation r/ ` Ftg Drain SGN Crawl Drain Inspection Notes: �drrt 6;�4�-ypcy), 1� =rCcff i`S Po =brF jj �►sldf r� ra.� `� �. SIT Post&Beam _ Ext SheathiShear �Q Int Sheath/Shear c/ .S /pcwf c! /,^5/Wf r Cff- - Framing 'T— Insulation r-/� Drywall Nailing _-- ��(-. -- -- --- Firewall Fire Sprinkler ---- --- --�-— -- -- Fire Alarm Susp'd Ceiling ,< ` Roof Misc.------ - --aL�� Ti��q�_�_ T^- �/ _ Final -_ PASS PART FAIL - ---- - -- - !- —� PLUMBING Post& Beam Under Slab — Top Out Water Service -- Sanitary Sewer Rain Drains ` ��1.2�I- 182'1 Final PASS PART FAIL - MECHANICAL Post& Beam Rough In , { 11= �irX--� ✓� c L�L_ 1�=u1-r= Gas Line `-� Smoke Dampers t _ Final 1.11 PASS PART FAIL — ELECTRICAL -- Service - Rough In - UG/Slab ---- - ------ -- - — Low Voltage Fire Alarm A3 PART AI Backfill/Grading Sanitary Sewer --_required before next inspection Pay at City Hall, 13125 SW Ball Blvd Storm Drain )Reinspection fee of$ Catch Basin I )Please call for reinspection RE:— -__-._- _ I ) Unable to inspect-no access Fire Supply Line ADA i Approach/Sidewalk I?etB � �_Inspector-,L- Other Ext -�. -TT ✓ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour lospection Line: 639-4175 Business Line: 639-4171 --- — L3ur --__ --- Date Requested AM PM BI-D Location LJ (� �ite _ MEC --- Contact Person Ph /_ x- PLM Contractor Ph SWR BUILDING Tenant/Owner C� .[t{��-�-��-� ELC Retaining Wall ELR _- Footing Access: Foundation FPS Fig Brain SGN Crawl Drain Inspection Notes: - - - Slab ----- --- - -- ---- SIT _-- Post&Beam Ext Sheath/Shear - _ _- Int Sheath/Shear Framing Insulation Drywall Nailing _--- Firewall Fire Sprinkler _- 's Fire Alarm - c•,usp'd Ceiling �-••--- Root Misc Final J PASS PART FAIL ------ -- - ---- PLUMBING Post&Beam ------ -l------- -- ----- --. Under Slab A _---_-._-- Top Out -------- --- — Water Service ---- --- - -- —__-. Sanitary Sewer Rain Drains Final — PASS PART FAIL MECHANICAL Post& Beam --- - - - ----- ---------- ---------- Reugh In Gas Line --- - - ,.-. ____---------- Smoke Dampers Final --. ._ - ----- -- --- --- _-- -- FAIL LECTRICAY 4jough in a UG/Slab _--__ - ----- - ----- --- Low Voltage Fire Alarm --- -- - -- - - -- -- F' -- , PASS ART FAIL -- - s --- ---- -------- —---- Backfill/Grading -- ---- -- _---- --- -- Sanitary Sewer Storm Drain ( Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ Please call for reinspection RE. [ Unable to inspect-no access Fire Supply Line --- ADA Approach/Sidewalk Date Inspector J�L PCEXtOther -- __ i -- � 'h��.�— _ Final PASS— PART FAIL 00 NOT REMOVE this inspection record from the job site. r i CITYOF T I GA R D BUILDING PERMIT PERMIT#: BUP2001-00084 DEVELOPMENT SERVICES DATE ISSUED: 4/6/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136AD-06300 SITE ADDRESS: 10955 SW 65TH AVE SUBDIVISION: PGE ZONING: C-G BLOCK: LOT: JURISDICTION: TIG I REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: 950 sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 3N sf N• S: E:� W: OCCUPANCY GRP: U2 TOTAL AREA: 95000 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: 15 ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: _ REQG_S_ETBACKS _ REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 65,000.00 Remarks: 120' monopole with prefabricated equipment shelter, mechanical application to be submitted at a later date Owner: Contractor: MALIBU PACIFIC 735 NE JACKSON SCHOOL ROAD HILLSBORO, OR 97124 Phone: Phone: 693-9797 Reg#: LIC 059045 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Mechanical Permit Require PLCK CTR 3/1/01 $359.35 27200100000 Electrical Permit Required Foot/Found !nsp FIRE CTR 3/1/01 $221.14 272.00100000 Reinforced concrete final rr 5PCT CTR 4/6/01 $44.23 27200100000 Structural welding final rept CDCB CTR 4/6/01 $125.00 27200100000 High strength bolts final rer (additional fees not listed here) Structural observ, final repsMisc. Inspection Total $1,427. Final Inspection 57 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 than 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 952-001-1987. You may obtain a copy of these rules or direct questions to OI)NC by calling (503) 246-1987. Pe rm ltee / Signature: Issued B y: � � � -------- Call 639-4175 by 7 p.m. for an inspection 'the next business day Bwlding�'er. jl�L�piic�a�tio� Datereceived: 3 Permit no.:Q{ City of Tigard Projeel/appi.no.: _ Expiredate: Address: 13125 SW Hall Blvd,Tigan,OR 97223 1; Receipt no.: Cit�oj""ligan! Mone: (503)639-4171 Vatcissued: Y• Fax- (503) 598-1960 Case file no.: Payment type• Com J Q'� l&2 family:Simple plex: Land use approval: � - ' U I &2 family dwelling or accessory Commercial/industrial ❑Multi-family U New construction U Demolition ❑Additiort/alteration/replacement ❑Tenant:atprovement O Fire sprinkler/alarm U Other. _- 1 v, �f-h- suilc no.: lab address: _oil, Lot: Block; Subdivision: Tax map/tax lot/account no.: I� Project came: 1 �,c intirm tut lcua)um f ark on premises/special conditirins• r -- �` - - t lil"t pit AN T Name: i E—f Mailing address: s L- 1&2 family dwelling: City. I I i)- State:OR Z1P: Valuation of work........................................ $ - Phone: Fax: E-mail: No.of bedrooms/baths................................. -- Owner's representative: 1 r _ Total number of floors...................•............. Ptwne: I'ax: G mail: New dwelling area(sq.ft.) ............... Uarage/carport area(sq.ft.)....... ................. - _ Yvl�. Rob I rasa)-L r -f T Q Covered porch area(sq.ft) ......................... - Name Deck area(sq.ft.) ....................... Mtriling address: -- rJ Outer structure arca(sq.ft.)....................... . _ City: � titatc: zl u`�D3_ -------_.� f, nt� Com merciaUindustrial!multi-tausily: Phone: (p I ;tr (035 ISIS - ,,. $t� j�v Valuationof work.......••.......................•.... MKIIIJ Existing bldg.arca(sq.ft.) .......................... Business nary T�_ New bldg.area(sq.ft.) '�SCt St, T Address: Number of stories........ .............................. City: _ State: 7.1P: _ Type of construction.................................... Phone: Fat. E-mail - -- occupancy I;,►u,(s): Existing: CCB no.: _ _ —.--- - New: Citylrnctro iic,no.: Notice:All Conti actors and subcontractors are required to he licensed with the Oregon Construction Contractors Board under A provisions of ORS 701 and may be required to he licensed in the —-- mason where work is being performed.If dee applicant is Address: Cobh .9-f-_ _ exempt from licensing,the following applies: Cit } stall: 7.IP: S? __ — -- —— — Contact c� rsott: Plan no.: Phone: ,-Z I I Fax: Gmai I- •ontact peron: Fees due upon application ......•......•......•.....$ Name:_ nf'_ — Address 9 — V Date received: - �� p / mount received ...................•..................... City: V _ State: : _ �9z, R-rna�l: Please refer to fee schedule, Phone: x Fax: ^ —�. .__._ _— Na�Ij fudcdietton�ar-I credit card%,p1eYe call lwlldkllan fa"It"fnfurmntlon I hereby certify I have read and examined this application and the l]Viss C]htndrrcara attached checklist.All provisions of Incas and ordinances governing this Credit cud number _. _--. _——_. —.— work will lx complied with,whether s cilled herr in or no /,��I _ — Lifelle Authorized si Hit[, _ ale.: ifj -____ Nomr d cudholder a%%hown an credli card $ Print name: rJ_ ^ —� ludhnlci-er ti�nalurc Amount J t1�[ — Notice:I his permit application expires if a pertnil is not obtained within 190 days after it hit,,been accepted im complete. 4404613 t60KOMl Bui•lding r 1i licatio>I i 1 P Datereccived: t✓ I'emllt no..&( 22)e)r--a City of Tigard Noject/appl.no.: Expiredate: Cuy o f 7 i�.n t Address: 13125 SW Ball Blvd,Tigan,OR 97223 Date issued: By: Receipt no.: 1'tlone: (503)639-4171 Fax: (503) 598-1960 Case file no.: Payment type: 000 Z 2. W family•Simple Complex: Land use approval: U I &2 family dwelling or accessory Commercial/industrial U Multi-family U New construction C]Demolition U Addition/alteration/replucement O'I'cnant burn„vr.mertl U Fire sprinkler/alarm U Other. _-- 1 1 1 y''• Vqe j�_ JSuite n.,.: Job address a Tax map/tax ladaccoun� 1 no.: W?G'A b Lot: Block: Subdivision: ProDcct name: �,l 'nti,m nd IOCe[lon ork on premiseVspecial rens cprs Y - - 1 1 Name: _ �L- I al 2 fancily dwelling: Mailing address: 2- ' Slate: City: t e 1 LR Valuation of work.................................. ZIP: No.of bedrooms/baths..................... I'hone: Fax: E mai . • l: Total number of floors................................. _ Owner's representative: Phone: Fax G mail: New dwelling area(sq.ft.) ..................gun ....... -- Garage/carport area(sq.ft.)................. Covered porch area(sq.ft) ......................... _ -- N_ame M-e %101 QY 5Y_ l i 1 rug Q Deck area(sq. ft.) Mailing ndd_ress: a=_k,,..,._ Z'irate: J Olhcr structure ... ............ City: l �-_- - Q Commercial/indtulrial/multi-family: Phone: ),ax, la3Valuation of work. 5' IS/S F• mat ....................................... $ aS 0 0� - 1 _ r Existing bldg.area(sq.ft.) .......................... _ Business name: 1 l New bldg.area(sy.ft.).......... Address:-T Number of stori E C.^I f'v t C�V✓ !vl O --- City: She' - LlP' Type of constty Vie e d e d - L e JL }- Phone: T� F'ax; E=mail Occupancy grin W/ o�i /F u.r/o W's_-- City/metro lie,no.: Notice:All con 2 G/a / to he licensed with th rd under ” provisions of OI G v ted in the � Name: M /%�G �--` jurisdiction whe cant is Address: LDVLh e�1 !- ~_ exempt from tic Cit : State: ZIP: —----- -- --- --- _Contact person — Plan na: -- - _-- — -- - Phone: 2_ l 1` X: F-mai : Contact pet.on: Fees due upon application ...........................$_ Name: L� - I -�" _ Date received: _ Address: 5--_--- .-- State: �. ZQ��_ Amount received ......................................... — City; V Plem refer to fee schedule. Phone: t'ax: F.-mail: - ___ ----- �.'�Q-- hereby certify 1 have road and examined this application and the, L(_!redit allklietion•ccepl rtMfl C. td�,pIN1e cull Judutktinn to 7pKpiles U MasterCard attached checklist All provisions of laws and ordin inces governing this number -_— -- — -- -work will be complied with.whether s cified here in or nod,,/ OWale: ,�� / ne of ciriiMilder u mown oa ere ed Authorized si atur _ - -- - r tednulu,e Amount Print name: _ 4.10 A611 I6=K'UM 1 T Notice: his permit application expiresif a pemdt is not obtained within 160 days after It har been accepted a9 complete. /L'L•'tCb April 5, 2001 CY OF iTnIGARD Carlson Testing OREGON 3430 SW Hunziker Tigard, Oregon 97223 PERMIT NO: BUP#2001-00084 OWNER: AT and T PROJECT ADDRESS: 10955 SW 65"' Tigard, OR. PROJECT DESCRIPTION: Tower and Equipment Shed TYPES OF SPECIAL INSPECI'ION,: As setout on the enclosed form 'Hie ovaier has notified us that he/she will retain your services to pertorrrl Special Inspections in accordance with the provisions of the State Building Code, permit. documents and special inspection requirements. The owner or the owner's agent must also confirm with you that they have authorized you to do the special inspection work. As the regulatory agency, the City requires that you do the following: 1. Submit copies of all inspection reports promptly to the building division, Architect, enginf;er, and the contractor. 2. Maintain one copy of each field report at the job site. 3. Submit a final report at the completion of each category of work that you Inspect. (See UBC Appendix Chapter 13 for soils special inspection final report requirements.) If you fail to comply with the above requirements, there may be cause for the City to revoke your authority as special inspector for this job. Should you have any questions, please call me at (503)639-4171 X 392. Sincerely, 6 Rv ert . I oskin, ("IT,C3O Senior flan, Examiner + 13125 SW Nall Blvd., Tlgafd, OR 97223 (503)639-4171 TDD (503)684-2772 ----- CITY OF TIGARD 24-Hour ; BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST ® a40oi610 Received ----- Date Date Requ9sted_ /3 j/0 t_AM_ _ PM BUP Location __ _ Suite_. MEC Contact Person - ----------- NS / Ph ( 6.3) 2EJ-::: PLM --- — Contractor ........ Ph SWR DIN Tenant/Owner –C--Sd/� �7t�/'�-►�� ) ELC - Footing Foundation Access: ^^�� ELG Ftg Drain o�� l `� G R+�111..� ELR - - ----- Crawl Drain ��s..-a-{ Dom/ • �'/ ~ Slab Inspection Notes: SIT Post& Beam Shear Anchors 7 - Ext Sheath/Shear Int Sheath/Shear Framing - ---- -_-_ _- Insulation Drywall Nailing - ----- - --- Firewall Fire Sprinkler - -- -- --- Fire Alarm Susp'd Ceiling - ------ - Root Other: _ anal ASS PART-- FAIL PLUMBING - ---- �l Post& Beam Under Slab _ Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain -- Shower Pan Other: ---- Final PASS_PART FAIL_ MECHANICAL Post& Beam Rough-In -------_. Gas Line Smoke Dampers -- - --- - — Final PASS PART FAIL - ELECTRICAL Service Rough-ln UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd _PASS PART _FAIL SITE _— _ J Please call for reinspection RE. ____ Unable to inspectno access Fire Supply Line ADA - r Approach/Sidewalk Date- _l �� Z- Inspector Ve -� Other. Final DO NOT REMOVE this Inspectlon record from the job site. PASS PART FAIL SEE 35MM ROLL #21 FOIZ OVERSIZED DOC UMEI�TT CITE( OF TIGARD MECHANICAL PERMIT — DEVELOPMENT SERVICES DATPERMIT#: MEC2.002-00394 DATEISSUED: 9/6/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136AD 06300 SITE ADDRESS: 10955 SW 65TH AVE ZONING: C-G SUBDIVISION: PGE JURISDICTION: TIG BLOCK: LOT: _ CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TvPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: BOILERS/COMPRESSORS _ HOODS: FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: -- 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Inline exhaust fan venting for future appliance (fuel cell) FEES Owner: PORTLAND GENERAL_ ELECTRIC Type By - Date J Amount Receipt_ COMPANY PRMT CTR 9/6/02 $72.50 272002000C 121 SW SALMON ST 5PCT CTR 9/6102 $5.80 272002000C PORTLAND, OR 97204 — Total $78.30 Phone: Contractor: PORTLAND MECHANICAL CONTRACTOR 6521 SE CROSSWHITE WAY PORTLAND,OR 97206 REO3UIRED INSPECTIONS Mechanical Insp Phone:503-788-5510 Final Inspection Reg#:LIC 151807 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or directquestions to UNQJhy calling (r,n'-17dC-Q1 RQ � Issue By: r Lam,/ Permittee Signature: ,` --- Call (503) 639-4175 by x:00 P.M. for inspections needed he next business day Mechanical Permit Application "Dateeived:9 "'I' Permit no.:Al& City of Tigard Project/appl.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard,OR 97223 i City nJTigard Date issued: By�/ Receipt no.: Phone: (503) 639-4171 Fax: (503 598-1960 � Case file no.: Payment type: �j U 1 200 2 -C�Off'lI Land use approval: Building permit no.: i TYPE OF-PERMIT U I &2 family dwelling,of accessory 0 Commercial/industrial U Multi-family ❑'1'r_nant improvement U New construction U Addition/alteration/replacement U Other: — --_ __---- - ----- 1 Job address:Ufa$o - o .JEt3r(1Z`� Indicate equipment quantities in boxes below. Indicate the dollar Bldg,no.: Suite no.: value of all mechanical materials.equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: Subdivision: *See checklist for important application information and Project name: ( jurisdiction's fee schedule for residential permit Ice. i it county: ZIP: t T. j ` 1 t t t Descrip'on��location ork on premises: Fee(ea.) Total Est.dale of completion/inspection: i ll,LtrJ �J'/IRUS7 �A� Ikwrriplion _ fr>. Itec.only Ites.enily Tenant improvement or change of use: ha Air hanndling unit CfM i__ Is existing space heated or conditioned?0 Yes U No Air conditioning(site plan require ) Is existing space insulated?0 Yes U No I A"srnt4nnfirt!xii;lingliVACsystcmMECHANICAL 1 o-IIerFEompressors State boiler permit no.: Business name: a HP Tons BTU/H Address: ,-_�\g� 3� 'tr smo c amper. uct smoke detectors City: Slate ZIP:g'Z 0 cat pump(site plan required) ed) Phone: oo fax: 4-�'3�E-mail: ncl I rep ductwork/cc vent �t liner ❑Yes Q No CCB no.: nsta replac re ocate eaters-suspend suspended, City/metro lic.no.: — wall,or floor mounted Name(please print): I en(I'•tr a iancc other t an furnace on: lNTACt PERSON of goal Absorption units ^_ I1TUAI Name: __-- Chillers-__—__ till - Com ressors—, ___ III, Address: nv ronmenla ex oust an vent at on: City: State: ZIP: Applianccvent Phone: I i F mail: )ryerex gust _ oodsiypel/ k lcTict azina(-- hood fire suppression system _ Name: Exhaust fan with single duct(bath fans) _ Mailing address: ;x gusts sterna art from earn or AC -_- ue piping an sl ut on(up to outlets) City: State: Z(P: Type: --LPG ,—. NO3 Oil Phone: it ;1t E-mail: PucT-ii in eac 1 a itiona7over 4 outlets rocesspiping(sc tematicrequire ) — Number of outlets Name: )TtTlrste+fi appliance or egrTment:J Address: Decorative lirepl_tce City: State: ZIP: nsert-type - -- ood stovelpe et stove Phone: Fax: E-mail t)t er. Applicant's signature: Date: —7- 1 ter: _-- Name (printY Not all jurisdiction%accept ctedit cards•please call jurisdiction kx more information. Notice:This permit application Permit fee.....................$ — Minimum fee................$ _ U visa U MasterCard expires if a permit is not obtained Credit Cord nornber: -- —_—•- -. -- �L� Plan review(at _ %) $ _ within 180 days after it has been , AMR+ y' State surcharge(8%)....$ ——}�onre or cs o r u shown on credit c $ accepted its complete. TOTAL .......................$ Cardholder signature Amount 4404617(60 MM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: _ Description: Price Total _51.00 io$5,000 00-- Minimum fee$72.50 Table 1A Mechanical Code Qty(Ea) Amt 55,001.00-to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional$100.00 or Including ducts&vents 14.00 fraction thereof,to and Including 2) Furnace 100,000 BTU+ ____ $10,000.00. Includingducts&vents 17.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace - $1.54 for each additional$100.00 or Including vent 14.00 fraction thereof,to and Including 4) Suspended heater,wall heater $25,000.00. or floor mounted heater $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereof,to and including 6) Repair units $50,000.00, 12 15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond fraction thereof. footnotes below. Comp •• Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit to 100K BTU _ 14.00 8%State Surcharge $ 8)3.15 HP;absorb unit 100k to 500k BTU - 25.60 25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb Required for ALL commercial permits only unit.5.1 mil BTU 35.00 TOTAL COMMERCIAL PERMIT FEE: 10)30-50 HP;absorb unit 1.1.75 mil BTU 52.20 ------- --- -- 11)>50HP;absorb unit>1.75 mil BTU 1 87.20 ASSUMEDA! V .UATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM -------- --- - - 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description: Qt (Es) Amount _ 17 20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents Fum ce>100,000 BTU including 1,170 10.0015)Vrint fan connected to a single duct ducts i vents _ Floor furnace Includingvent 955 8.8016)Ventilation system not Inr,;uded In Suspended healer,wall heater or 955 appliance este 10.00 floor mounted heater Vent not Included In appliance 445 17)Hood served by mechaniccil exhaust permit _ 10.00 Repair units 805 18)Domestic incinerators <3 hp;absorb 1!rdt, 955 _ _ 17.40 to 100k BTU 19)Commercial or Industrial type incinerator 3.15 hp;absorb.unit, 1,700 69.95 _ 101k to 500k BTU 20)Other units,including wood stoves 15-30 hp;absorb.unit,501k to 1 2,310 10.00 mll.BTU 21)Gas piping one to four outlets 30-50 tip;absorb.unit, 3,400 _ 5.40 ,- 1-1.75 mil.BTU 22)More than 4-per outlet(each) >50 hp;absorb.unit, 5,725 1.00 21.75 mil,BTU Minimum Permit Fee$72.50 SUBTOTAL: $ Air handling unit to 10,000 din _ 656 _ --- e -Air handling unit 210,000 cfm � 18%State Surcharge� g a Non-portable evaporate cooler 656 Vent fan connected to ao single duct - 446 TOTAL RESIDENTIAL PERMIT FEE: $ Vent system not Included In 656 a Ilance ernlit - H_o_od served by mechanical exhaust 656 other Inenec Ions and Foes: Domestic Incinerator 1 170 1 Inspections outside of normal business hours(minimum charge-two hours) $62 50 per hour. Commercial or industrial Incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum charge-half hour) Other unit,including wood stoves, 656 $e2 50 pet hour hiserts etc. 3 Additk.nal plan review required by changes,additions or revisions to plans(minimum Gas piping 1-4 outlets 380 charge-one-half hour)$e2 50 per hour Each additional outlet 83 --! °9tate Contractor Boller Certification requl•ed for units 200k BTU. TOTAL COMMERCIAL a "Residential t/C requlrks site plan showing placement of unit. VALUATION_ All New Comm~_-Ial Buildings require 2 sets of plans. is\dsts\forms\mech-fees.doc 02/11/02 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 I�.JC- � G BUP _ ---- Received — Datej39RWsted AM.. _ PM BLIP Location .___ ��aZ"�L� 'L Suite .~ MEC Contact Persons Ph(---) �D J 5 �� PLM Contractor —_ _ ___— h(G_ _) SWR — BUILDING Tenant/Owner _ y _—_ ELC Footing --- ELC Foundation ACCeSS: Fig Drain ELR --_-__ Crawl Drain --- Slab Inspection Notes: SII Post R Beam -- ---- -- _ Shear Anchors -^ Ext Sheath/Shear Int SheathiShear Framing ------- - Insulation Drywall Nailing - -- --- -- ------- ----- -- - -- -- - Firewall Fire Sprinkler - --R Fire Alarm Susp'd Ceiling -- -"- - --- --` Roof Other: --.. ----- - ---- -- _ _ - ____. - Final PAS,,. PART FAIL PLUMBING Post&Beam Under Slab ----- —_ ------ -- -- — -- - --- - -- Rough-in q_'7z Water Service - ------------ - -- -- Sanitary Sewer Rain Drains - ------ -- -- Catch Basin/Manhole Storm Drain - --- --- -_ - _.- Shower Pan Other. - -_ ------- -- -- .. ---- Final' F'6 T FAIL - CH ANICA - - - - - — Rough-In - Gas line Smoke Dampers - --- ------ WAS PART FAIL --- ------- . CTRICAL _ Service Rough-In - UG/Slab - - Low Voltage Fire Alarm Final Reinspection fee of$ Pa inspection.re uired before next Y at Cit Hall, 13125 SW Hall Blvd. PASS PART FAIL [-] ----- 4 Y ---_ SITE -- [ 1 Please call for reinspection RF _ _ __—__—__.__.. Unable to inspect-no access --- ------ -- Fire Supply line ADA /` // Approach/Sidewalk Dab -- CY�f `�,1 `� �� Inspoctor -� -____ -- - Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL SEE 35MM ROLL # 21. FOR. OVERSIZED DOCUMENT