Permit (109) CITY OF TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT Permit#: BUP2017-00243
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2018
T t GAR f) g Parcel: 1S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 100
Project: Lincoln Center Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: Removing(6)antennas,and installing(6)antennas with ancillary equipment
Contractor: STEELHEAD COMMUNICATIONS INC Owner: LINCOLN CENTER LLC
28120 ST ROUTE 410 E SUITE A3 BY SHORENSTEIN PROPERTIES LLC
BUCKLEY,WA 98321 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360-829-1330 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM Permit Fee-Additions,Alterations, 10/09/2018 $377.90
Class of Work: ALT Type of Const: Demolition
Occupancy Grp: U Occupancy Load: 12%State Surcharge-Building 10/09/2018 $45.35
Dwelling Units: 0 Plan Review 08/30/2017 $245.64
Stories: 0 Height: 0 ft Info Process/Archiving-Sm$0.50(up to 10/09/2018 $17.50
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $20,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $686.39
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 Notificatio- --•er. Those rules are set forth in OAR
952-001-0010 through OA -001-0090. You '-k obtain a cop of the rules or direct questions to OUNC by ca'03. .1987 0 . .0.332.2344.=
Issued By: )1(‘/..� Permittee Signature: .
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.
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uilsizng Permit Application po 2 TT ‘QAU
Commercial I /E FOR OFFICE USE ONLY
City of Tigard Received
AUG 3 0 2017 Date/By: 0 3dr? I PermitNo.;�//�/���.rlt�L/�
III 13125 SW Hall Blvd.,Tigard,OR 97223 1(IK(� V (/
it
= Plan R
Phone: 503.718.2439 Fax: 503.598.!9 ) i., Date/ByOther Permit:
Inspection Line: 503.639.4175 (. 1 I"Y u l itfrkr t.,i c l
TIG-A R D Date Rea• ':y: Jur s: H See Page 2 for
Internet: www.tigard-or.gov BUILDING i- 1V1,gh t'q Notified/Met.od: 7,037,--`
� Supplemental Information
lb. ;,'t •d /AZ,—
TYPE OF WORK 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:Wireless equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
0 1-and 2-family dwelling Valuation: $
®Commercial/industrial
❑Accessory building ❑Multi-family Number of bedrooms:
0 Master builder ®Other:Wireless Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:10250 SW Greenburg Rd New dwelling area: square feet
City/State/ZIP:Portland,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:POR Tigard it Akd 11/ / Covered porch area: square feet
Cross street/directions to job site:From Hwy 217 Take Greenburg Rd Exit Deck area: square feet
Turn right on Greenburg Rd Other structure area: square feet
Site is on the Right Hand Side
REQUIRED DATA:COIYRCIAL:-USE CHECKLIST.
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OFWORK work indicated on this application.
Modification to existing wireless facility to include swamping out Rooftop Valuation: $20,000.00
Antennas and acilley equipment and adding 3 additional antennas. Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER v+ TENANT Number of stories:
Name:OR-Lincoln Tower LLC Type of construction: N/A
Address:1 SW Columbia Suite 300 Occupancy groups:
City/State/ZIP:Portland,OR 97258
Existing: U
Phone:( ) Fax:( )
New: U
® APPLICANT ',� CONTACT PERSON BUILDING PERMIT.FEES*
Business name:Centerline Solutions on Behalf of Verizon Wireless (Please refer to fee schedule)
Contact name:Kelly Lea
Structural plan review fee(or deposit):
Address:6623 NE 78th Court Suite B-1 FLS plan review fee(if applicable):
City/State/ZIP:Portland,OR 97218 Total fees due upon application:
Phone:(971)270-1930 X 5027 Fax::( ) Amount received:
4, E-mail:Klea@centerlinesolutions.com PHOTOVOLTAIC;SOLAR PANEL SYSTEM FEES*
CONTRACTS Commercial and residential prescriptive installation of
i. roof-top mounted PhotoVoltaic Solar Panel System.
Business name:To be provided at Pick-up , eC Submit two(2)sets of roof plan with connection details
p` » p S ���ev'c� Cu,� �SA% ` •V rand fire department access,along with the 2010 Oregon
Address: 4/�V S-j ti[1C- V\, � LA tQ 6, `'1(` 5�,'� j-. Solar Installation Specialty Code checklist. —
City/State/ZIP: ��\ \r„) }... G _. t� Permit fee(includes plan review $180.00
",-;),c\-, 1 0� and administrative fees)_
Phone:(S(S))Cgf 3'2(` ) Fax:(10),t aci— I a� State surcharge(12%of permit fee): $21.60
CCB lie.: /� Z � T / /
(Y�7 i5--
5 12 <f , i g Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: , t ; x " Date:4 241 I 0.-9. * Fee methodology set by Tri-County Building Industry
✓" Service Board.
I:\Building\Pennits\BUP-COM PermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
City of Tigard
d COMMUNITY DEVELOPMENT DEPARTMENT
■
T1caRD Building Permit Review — Commercial - No Land Use
Building Permit #: 61(f)/? ', 0,2 113
Site Address: W250 SA Greco lotAr M. Suite/Bldg#:
Project Name: PQ12, T
(Name of commer business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: PRIQ.& antote ots. 4 C `'w k mu',Km*.
Existing Business Activity: 0 f Ar
Proposed Business Activity: N/tc
Verify site address/suite#exists and active in permit system.
•EI River Terrace Neighborhood: ❑ Yes 72 No
.lg Zoning: MAI S�t
Permitted Use: e'�Yes ❑ No CI Spec Space
• Confirm no land use required.
▪ Business License:141k.
► Exists: ❑ Yes .' No,applicant notified to obtain business license
Notes: MCd1S Milt .140.13. otuso trir rAttugichwita-
Approved by Planning: ATIA 4Date: g 13t) I ii
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: VW/7
Site Plans: # 2
Building Plans: # ,2
Building Permit#: nter building permit#above.
Workflow Routing: Planning Permit Coordinator �U Building
Workflow Sign-off: ign-off for Planning(include notes from planning review)
Route Application Documents: f iilding: original permit application, site plans,building plans,engineer and
( beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: i --,,Z r- -' Date: 71047
I:\Building\Forms\BldgPernutRvw COM_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: CI Yes N/A
Parks SDC: ❑ Yes LI N/A
OK to Issue Permit
Approved by Permit Coordinator: Date: 9A/./ .."-----
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse_070915.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10250 SW GREENBURG RD 100, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Building BUP2017-00243
Inspection Type: Inspector:
299 Final inspection Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor