Permit (132) CITY OF TIGARD BUILDING PERMIT
114-. - COMMUNITY DEVELOPMENT Permit#: BUP2017-00245
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 09/26/2017
TiC;AI<.fl 9
Parcel: 1S136AD06300
Jurisdiction: Tigard
Site address: 10955 SW 65TH AVE
Project: Verizon Wireless Subdivision: None Lot: None
Project Description: Removing(6)antennas and installing(9)new antennas.
Contractor: LEGACY WIRELESS SERVICES INC Owner: PORTLAND GENERAL ELECTRIC COMPAN
15580 SE FOR MOR CT 121 SW SALMON ST
CLACKAMAS, OR 97015 PORTLAND, OR 97204
PHONE: 503-656-5300 PHONE:
FAX: 503-656-5305
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: Permit Fee-Additions,Alterations, 09/26/2017 $225.80
Occupancy Grp: U Occupancy Load: Demolition
12%State Surcharge-Building 09/26/2017 $27.10
Dwelling Units: 0 Plan Review 09/06/2017 $146.77
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 09/26/2017 $91.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 09/26/2017 $18.50
Value: $10,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0 •
Mezzanine: 0
Total $509.17
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 applicab- law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 189,days of issuance • if work is suspended ' more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon U�'ity Notification 'enter. Those rules are s- fo in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUh(C by calling 50 32.19 7 or 1.800.332.2345(
Issued By: / AlAr Permittee Signature:
Call 503.639.4176 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.
I�
Building Permit Application 'PbY2. V 11 fk 1f2'd ,
CommerciaLI l "7 I OR 01 I-I( F I 'NI y:011.1
City of Tigard .� rvt :. ived p _ ` n /� } y /��
Date/By: / .11 7 Permit No.: /7 6 /✓'1OL 7-C.L Y/1-�_7
114 13125 SW Hall Blvd.,Tigard,OR 97223 p�u. i! I 3C
Phone: 503.718.2439 Fax: 503.598.1960 4' .' ) 9 1 other. Permit:
1 a 1l Date/By
i, Inspection Line: 503.639.4175 J Date • _ •• . P Hi See Page2 for
Internet: www.tigard or.gov ioti e /AO ,/41 Supplemental Information
TYPE OF WT4r11DING DIVISION REQUIRED DATA:I-AND 2-FAM LY 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 ®other: Wireless facility mod equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑1-and 2-family dwelling 0 Commercial/industrial Valuation $
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ®other: existing monopole Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 U9bb SW b5th Ave New dwelling area: square feet
City/State/ZIP: Tigard, OR 98223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: VZW POR VILLA RIDGE 4641.4 Covered porch area: square feet
Cross street/directions to job site: exit 294 trom 1-5 S,merge onto OR'9 W, „JJ,yrtcyj
Deck area: square feet
left on SW Coronado St, continue onto SW 64th Ave, project othercture area: square feet
1 on the lett
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: 1 S 136AD06300 R279549 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.
Remove 6 RRUs @ antennas on existing 94'monopole; add one Valuation: $ 10,000
mount reinforcement kit, add 9 KKUs(c�V antennas per plan Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER Dt TENANT Number of stories:
Name: Verizon Wireless Type of construction:
Address: 543U NE 122nd Ave
Occupancy groups:
City/State/ZIP: Portland, OR 97230
Existing:
Phone:( 50B 408 3464 Fax:( ) New:
[[APPLICANT Ey CONTACT PERSON BUILDING PERMIT FEES*
Business name: I nx Cnncrdtin (PJaa�refer mfee seh1uIe) 1
Y £I Structural plan review fee(or deposit):
Contact name: Aileen Zavales
Address: FLS plan review fee(if applicable):
17311 135th Ave N E A100, Total fees due upon application:
City/State/ZIP: Woodinville, WA 98072 146.77
Phone:( 200 972 1368 Fax::(425 )354 3277
Amount received:
E-mail: Azavales@lynxconsulting.org PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted Photo Voltaic Solar Panel System.
Business name: $ • z��f r . �/` fj ctS Sr'- G r Submit two(2)sets of roof plan with connection details
S and fire department access,along with the 2010 Oregon
Address: G>�f 10 i s� Solar Installation Specialty Code checklist.
City/State/ZIP: / / Permit fee(includes plan review $180.00
C f�0� �� �L��` 4c and administrative fees):
Phone:(3) G _57626 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: / CL„......._,.
,, , (2 .2,/1
c--/A0
fee due upon application: $201.60
Authorized signatuThio permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Ai les Date:8-31-2017 * Fee methodology set by Tri-County Building Industry
Service Board.
I:tBuilding\Permits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) *based on 10,000 valuation, by B.Taggart
w
City of Tigard
C " COMMUNITY DEVELOPMENT DEPARTMENT
lig
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: ,6 i 7(;o?tt5'
Site Address: /0__755 45-‘11-) (,5 .l Suite/Bldg#:
Project Name: l.Cit; 14AJ l_Vi-c tj5
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review I
Proposal: ,%e r^ wi -
i u11 r-CJ h�l�1 'f
Existing Business Activity: (t)/;:e /1c 07 ,VM . 4i J
Prop d Business Activity: / // //
Verify site address/suite# exists and active in permit syst )
'l o''ver Terrace Neighborhood: ❑ Yes 4J No
II oning:
4rmitted Use: Yes ❑ No ❑ Spec Space
nfirm no land use required.7Business License:
Exists: Yes ❑ No,applicant notified to obtain business license
Notes: /1j ---,7..4?-4,46-17.4' 71--
p > 0,:s. /J7 vC
CI
Approved by Planning: i Date: C1/91/ -
Revisions
1/9 / -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: '1/5/ %7
Site Plans: # 9
Building Plans: # 3
Building Permit#: [ —er building permit#above.
Workflow Routing: 11:1.Pfa ming Brmit Coordinator -i ding
Workflow Sign-off: Itk<n-off for Planning(include notes from planning review)
Route Application Documents: CSI--f uil`ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes:
...xrnir2..._-By Permit Technician: Date:
--->
�7/ 7
I:\Building\Forms\BidgPermitRvwCOM NoLandUse 060116.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:
DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes N/A
Parks SDC: ❑ Yes N/A
(L' OK to Issue Permit /�
Approved by Permit Coordinator: Date: "/ 1
-?----
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_070915.docx
I
L( LYNX
August 31, 2017 ` r k
Branden Taggart, Permit Technician `� - ` 94 1(jr
City of Tigard ~ rt
Community Development Department ' '
13125 SW Hall Blvd. 4,5
Tigard, OR 98223
RE: Request for Building Permit—Verizon Wireless, "POR Villa Ridge" at 10955 SW 65th Ave
Dear Mr.Taggart:
On behalf of Verizon Wireless, Lynx Consulting is submitting to the City of Tigard a building permit
application for minor modifications proposed at this existing, 94' monopole (within a fenced, gated
and leased compound) located at 10955 SW 65th Avenue in Tigard.
The scope of work is removing six RRU units (at antennas); adding one mount reinforcement kit and
replacing with nine new RRUs at antennas, per plan.The value of this work is estimated as$10,000
and you kindly estimated our plan review fee as$146.77.
Enclosed are the following items:
Building Permit Application and checklist
Three sets of signed/stamped construction plans (11 x 17)
Two sets of the signed structural analysis/report
Two copies of Cover Sheet only, showing vicinity map
Two copies of the Site Plan (sheet C-3)
Check for$146.77
We have left the contractor as"TBD"; a general contractor will be selected prior to building permit
issuance.
If you have any questions or need additional information please let me know; I can be reached at
206-972-1368 and my email is Azavales@Ivnxconsulting.org. Thank you for your consideration.
Sincerely,
Aileen Zavales
Lynx Consulting, Inc.
1 1 P a g e 17311 135th Avenue NE,Suite A-100,Woodinville,WA 98072
Aileen Zavales
From: Julie Drinkwater <JulieD@tigard-or.gov>
Sent: Wednesday, September 20, 2017 10:04 AM
To: Aileen Zavales
Cc: #Building Permit Technicians
Subject: BUP2017-00245, 10955 SW 65TH,Verizon Wireless
Good morning Aileen
The permit for Verizon Wireless is ready to be issued.The balance due is$362.4.
I also wanted to mention that we will need to have the contractor information before we can issue the permit.
You can pay this fee online at https://aca.accela.com/tigard/ by searching for the permit number, or you can
pay in person, Monday-Thursday, 8:00 am to 4:30 pm. We are closed on Fridays.
Thank you
01/{-
Julie
Drinkwater I J �/"(A.6
Permit Technician Assistant
Cit) of Tigard i Building Department
13125 SW Hall Blvd „cr. .
Tigard, OR 97223
503-718-2804
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails arc retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10955 SW 65TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Building BUP2017-00245
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor