Permit (34) CITY OF TIGARD BUILDING PERMIT
1: . COMMUNITY DEVELOPMENT Permit#: BUP2018-00133
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 05/15/2018
TIGARD9
Parcel: 1 S 135BB00300
Jurisdiction: Tigard
Site address: 10185 SW CASCADE AVE
Project: SigFox Subdivision: None Lot: None
Project Description: Installing(1)Omni antenna onto an existing cell tower, Installing H-frame for support cabinet onto an existing 3 FT
x 3 FT slab.
Contractor: MASTEC NETWORK SOLUTIONS LLC Owner: PORTLAND GENERAL ELECTRIC
1203 114TH AVE SE 121 SW SALMON ST.
BELLEVUE,WA 98004 PORTLAND, OR 97204
PHONE: 425-214-9727 PHONE: 503-708-4023
FAX: 503-210-1001
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: HAPermit Fee-Additions,Alterations, 05/15/2018 $301.85
Demolition
Occupancy Grp: U Occupancy Load: 0 12%State Surcharge-Building 05/15/2018 $36.22
Dwelling Units: 0 Plan Review 04/30/2018 $196.20
Stories: 0 Height: 0 ft DC Provision Review,COM TI-Ping 05/15/2018 $91.00
Bedrooms: 0 Bathrooms: 0 Info Process/Archiving-Sm$0.50(up to 05/15/2018 $27.50
Value: $15,000 11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $652.77
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 c s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m,for the next available inspectio d e.
This permit card shall be kept in a conspicuous place on the job site until co letion of t a project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
r,,,.-.. ;-. .:,'---,---31
Commercial 1 .. . 3 v'=' , ,µ
City of Tigard AP f v,-; -e,- 3
t i-t Received
v Date/By: . j� / Permit No. id il-te:�( /
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �`�/ 1J
: 1111 Phone: 503.718.2439 Fax: 503.598.1960 �- a t t Other Permit:
Date/By:
T[G A R D Inspection Line: 503.639.4175 CU,, ' j Date Ready/By: /J .rwis: El See Page 2 for
Internet: www.tigard-or.gov otified/Method: -,7 // . Supplemental Information
TYPE OF WORK REQUIIRED DATA:1-AND 2-FAMILY DULLING
❑New construction 0 DemolitionPermit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
ID1-and 2-family dwelling ®Commercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10185 SW Cascade Ave. New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:874140/Progress/SigFox Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CIILCKLIST
Subdivision: I Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.:R0273215 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.
Install(1)2'omni antenna onto an existing cell tower. Install an H-frame for Valuation: $15,000.00
support cabinet onto an existing 3'x 3'slab. Existing building area: square feet
New building area: square feet
>` PROPERTY OWNER 0 TENANT Number of stories:
Name:Portland General Electric Type of construction:
Address:121 SW Salmon St. Occupancy groups:
City/State/ZIP:Portland,OR97204 Existing:
Phone:(503)7084023- Fax:( ) New:
tea'APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES*
Business name:Crown Castle (Please/vier wfeeschedukl
Structural plan review fee(or deposit):
Contact name:Zach Phillips
FLS plan review fee(if applicable):
Address:5111 N.Bowdoin St.
City/State/ZIP:Portland,OR 97203 Total fees due upon application:
Phone:(503)7089200 Fax::( ) Amount received:
E-mail:zach.phillips.contractor@crowncastle.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business nam }. f * ) 11/ //Jam
, Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: /4)V3 //Li x3-- Pi17,Pt. J-:2 Solar Installation Specialty Code checklist.
City/State/ZIP: lfe� , q Permit fee(includes plan review $180.00
/
'�w4U and administrative fees
Phone:(t ).5 r'/.1ve — ��7 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: `tet-7 a) Total fee due upon application: $201.60
Authorized signature: gi"c__ ____ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Zach Phillips Date:4.30.18 * 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)
Building Division
Accessibility: Barrier Removal Improvement Plan
TIGARD
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: Total of all renovation,alteration or modification being done,
excluding painting and wallpapering. [1] $ 15,000
MULTIPLIER(25%barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
ELEMENTS: In choosing which accessible elements to provide under this section,priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains:and, $
(g) When possible,additional accessible elements such as storage and
alarms: $
TOTAL(shall equal line [2] of Valuation Computation): $
I:\Building\Pemuts\BUP-COM PemutApp.doc 03/03/2011
IN
s " Building Division
Plan Submittal Requirements
TI G A R D Commercial& Multi-Family-New,Additions or Alterations
1. SITE PLAN (fully dimensional,drawn to scale) labeled with:
A. ® map&tax lot# ® project name ® site address /1 suite number
® zoning ►/ applicant name ►1 phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Setbacks.
F. Parking,including disabled access.
G. Finished floor elevations.
2. EROSION CONTROL PLANS AND DETAILS.
3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of
plans required based on submittal type (no redlines or tape-ons accepted).
All details listed below shall be incorporated into the plans:
A. Scale (architectural or engineering only).
B. Foundation plan.
C. Floor plan(s).
D. Cross sections.
E. Reflective ceiling plan.
F. Seismic bracing detail for suspended ceiling.
G. Roof plan.
H. Exterior elevations.
I. Structural calculations,plans, details and specifications.
J. Accessibility barrier removal worksheet.
K. Deposit-based on valuation of project.
4. EXTRA SET OF THE FOLLOWING:
A. Two (2) copies of site plan to include vicinity map.
B. One (1) copy of erosion control plan with details.
C. Fire Department Building Survey, and full set of architecture drawings.
I:\Budding\Permits\BUP-COM PermitApp.doc 03/03/2011
IIIv Building Division
Plan Submittal Requirement Matrix
T I G A R D Commercial&Multi-Family-New,Additions or Alterations
Type of Submittal # of Plat
(Includes new,additions and alterations) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 3
(must include location of all accessible parking)
Plumbing(site utilities) 2
Building 3
Fire Protection System 3
Mechanical 2
Plumbing(building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,Washington
County, and Tualatin Valley Fire&Rescue),if applicable.
I:\Building\Permits\BUP-COM PermitApp.doc 03/03/2011
City of Tigard
q COMMUNITY DEVELOPMENT DEPARTMENT
1111111
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: jj 0 / T- 00/.0
Site Address: /0 jg5 S w CiCA�� 4V1- , Suite/Bldg#:
Project Name: s',\, Fo ®® ff
X �1�2 vJ/1 q CG��4C_c.7`r01-1
(Nana4 of commercial business occupying tie space. If vacant,enter Spec Space.)
Planning Review J /
Proposal:
C. // c r 4 S y j-d)( a /L2,9 `
' -.UIO ,')e U11C� /&.- C.71,-'1 /
Existing Business Activity:
Proposed Business Activity:
ifrVerify site address/suite# exists and active in permit system.
,dyer Terrace Neighborhood: ❑ Yes o
.,Zoning: AUG.
—Er-Permitted Use: l Yes ❑ No ❑ Spec Space
-0"—Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: � � Date: 4K4)///c
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: L/( j/71
Site Plans: #
Building Plans: ##
Building Permit#: Enter building permit#above.
Workflow Routing: Planning V>Permit Coordinator > Building
Workflow Sign-off: 'Sign-off for Planning(include notes from planning review)
Route Application Documents: L�iBuilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: /4‘.-(/,,? ate: ,c1///-
I:\BuildingForms\BldgPermitRvw_COM_NoLandUse 060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
0 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:
1/47QDC Fees Entered: Wash Co Trans Dev Tax:
0 Yes /A
Tigard Trans SDC:
0 Yes N/A
Parks SDC: 0 Yes N/A
(-- )K to Issue Permit
Al.-1-7-)ate:Approved by Permit Coordinator: �i� " `7/l(d/
1i
V)6 t/i,:CL--- Si /I
I:\Building\Fonns\B1dgPennitRvw_COM NoLandUse_070915.docx
APR C3 2013
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Collocation - Supplemental Questionnaire
PROPERTY ADDRESS FOR STAFF 1 sr o\i_1
10185 SW Cascade Ave. n &
Location of collocation: 6"L
Si Fox Zone:
Name of provider:
Sig
Fox
Phillips
Contact name: ❑ Not Approved il
Collocating antennas on: By: Date: �l 2tel I B
E] Existing tower
Reason not approved:
❑ Existing non-tower structure
Is this a new provider?
® Yes
❑ No
Other providers currently collocating on same tower or structure: I:\Community Development\land Use Applications\02_Forms and
Templates\land Use Applications\Future Forms Rev,12/14/2017
T-Mobile and Verizon
Indicate the previous approval:
BUP2015-00280
(SDR,MMD#)
ANTENNA INFORMATION
Existing: New:
Height of antenna(s): (sq. ft.) Height of antenna(s): 27.5" (sq. ft.)
Color of antennas : gray
Color of antenna(s):
Color of equipment: Color of equipment: I) rf
Accommodating equipment: Accommodating equipment:
(i.e.dishes) (i.e.dishes)
Will new accessory equipment be installed? fl Yes ❑ No
Location of new accessory equipment?
'n Within previously approved fenced area
❑ Within existing structure
❑ Other location:
(Please describe)
Will landscaping be removed to accommodate the accessory equipment? ❑ Yes EI No
If yes,describe here:
• pplic.nt's signature Print name Date
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of f 1