Permit (39) CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2017-00090
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2017
T[t�; fd'j_ g Parcel: 1S136CCO2100
Jurisdiction: Tigard
Site address: 11746 SW PACIFIC HWY
Project: T-Mobile Subdivision: None Lot: None
Project Description: Replace/relocate antennas,remove/add radio units&some equipment in existing cabinets in fenced area.
Contractor: EXCEL CONSTRUCTION INC Owner: GRUNBAUM FAMILY TRUST
35858 N HONEYMAN RD BY GRUNBAUM, HANS H AND MARILYN K,
SCAPPOOSE, OR 97056 21390 SW EDY RD
SHERWOOD, OR 97140
PHONE: 503-944-9817 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 05/01/2017 $347.48
Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 05/01/2017 $41.70
Dwelling Units: 0 Plan Review 04/10/2017 $225.86
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 05/01/2017 $90.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 05/01/2017 $22.50
Value: $17,500 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $727.54
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: c ,
p
/A
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.
BAilding Permit Application
Commercial REGE!VED FOR OFFICIE USE ONLV
6. City of Tigard Received U
g Date/By: / Io 7 I / Permit No.: 10,:26/ 7-ddd�D
13125 SW Hall Blvd.,Tigard,OR 97 Plan Re.'
' z Phone; 503.718.2439 Fax: 503.598rT96f1� 1. 0 2017 t)ate/By it Other Permit:
Inspection Line: 503.639.4175 Date Read Jens:
T I G A R D GARB y ,y: SI See Pagel for
Internet: www.tigard-or.gov CITY OF TI No ified/Method: �pt Sill //i% Supplemental Information
TY1 D�W�RK'DIVISION01 (0 drh e" -//r,/ C1�"i t
REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling ®Commercial/industrial Valuation: $
0 Accessory building ❑Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:-14344 1 11746 SW Pacific Hwy New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:P-A reen 7—/Y.-C.)11/1C.- Covered porch area: square feet
Cross street/directions to job site:Located behind Dutch Brothers Coffee Deck area: square feet
Adjacent to Costco Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.:2100 Permit fees*are based on the value of the work performed.
Tax map/parcel no.:1S136CCO2100 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.
Replace two antennas; relocate two antennas;add two antennas Valuation: $$17,500.00
remove one remote radio unit(RRU);add five RRUs;add eight diplexers; Existing building area: 1,525 square feet
add and replace modules inside existing equipment cabinets located on ground. New building area: square feet
0 PROPERTY OWNER ® TENANT Number of stories:
Name:Crown Castle Type of construction:
Address:8547 1546 Ave NE Occupancy groups:
City/State/ZIP:Redmond,WA 98052 Existing:
Phone:(480)735-6953 Fax:( ) New:
® APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
Business name:T-Mobile West LLC (Please refer to fee schedule)
Structural plan review fee(or deposit):
Contact name:Chris Forsberg
FLS plan review fee(if applicable):
Address:8960 NE Alderwood Rd
Total fees due upon application:
City/State/ZIP:Portland,OR 97220
Phone:(503)860-2587 Fax::( ) Amount received: �� b'
E-mail:chris.forsberg@craigwirelessconsulting.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR _ roof-top mounted Pho • shale Solar Panel System.
Business names � � � "_ -- Submit two(2)sets of root an with connection details
"f"A: and fire department access,al. g with th .! r•regon
Address: 5 r' [' - Ai
,� 4 Solar Installation Specialty co': • -c list.
City/State/ZIP: �Q! �y_ Permit fee(incl • an rev'--w
y ;SC-� 6/�J�� l:>J� q 7ClCy+ r $180.00
. • ministrative fees):
Phone:(j3 ) e14 y 787Fax:( ) State sure
7 : (12%of permit fee): $21.60
CCB lie.: 1 Lr Total fee due upon application: $201.60
Authorized signattue: .�'�"�1 . ' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Chris Forsberg Date:4/10/2017 * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Pernits\BUP-COM PennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
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ty f
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COMMUNITY
Tigard DEVELOPMENT DEPARTMENT
!NJ:.
R D
Building 1 eri t Review — Commercial - No Land. Use
` )AP,(o�/7-00.0 r0
Building Permit #: �'
Site Address: //9" Oft) A, ...),,4 /-4,1,Suite/Bldg#:
Project Name: 77_ M >ie
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: iiee ho ni ,
7,
/-71q2c, A 16 tfll l'A / ..grici 7-7e,-)196-('
,:j , rip re e .a-r4PJ
Existing Business Activity: f )//+e/es (? ,i. c;A
Pro sed Business Activity: /7 // //
Verify site address/suite#exists and active in permit sys m.
Verify
Iver Terrace Neighborhood: CI Yes No
oning: C-
/ Use: Yes Ci
❑ Spec Space
firm no land use quired.
Business Licens .
on .
Exists: Yes / El No,applicant notified to obtain business license
Notes: �' 1 1) 0�1 /il j/is' 7k2-( //Ztx%r—
Approved by Planning: c___ � ��
_.._, _____S ' Date: �//0/���
Revisions (after Building Submittal only) Reviewer
Date
Revision 1:
❑ Approved CI Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved El Not Approved
Building Permit Submittal
Original Submittal Date: y/6/ ' 7
Site Plans: # 5
Building Plans: # 'j5
Building Permit#: Enter building permit#above.
Workflow Routing: Er-Planning Permit Coordinator 5I'Buildin
Workflow Sign-off: Tdg
'Sign-off for Planning(include notes from planning review)
Route Application Documents: E'Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
By Permit Technician. Date:
//1 /7
I:\Building\Forms\BldgPemutRvw COM_NoLandUse 060116.docx
r .
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:
C Fees Entered: Wash Co Trans Dev Tax: CI Yes / " /A
Tigard Trans SDC:
CI N/A
Parks SDC: ❑ Yes /A
OK to Issue Permit '/
(Approved by Permit Coordinator: Date: o� /0'
I:\Buildmg\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11746 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2017-00090
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor